Loan Application

Please fill out this pre-qualification form. By providing this form to us, you're giving us much of the information we need to begin the pre-qualification process. Once you've submitted this information, Mortgage Trust Group will contact you within 24 business hours.

Note: Fields in bold are required.

Contact Info	Borrower	Co-Borrower
First Name:
Last Name:
Address:

City:
State:
Zip Code:
E-Mail:
Daytime Phone:
Night Phone
Fax:

Employment	Borrower	Co-Borrower
Self Employed?:	Yes No	Yes No
Employer:
Employer Phone:
Years at this job?:

Gross Income	Borrower	Co-Borrower
Monthly Wages:
Commission/Bonus:
Other Income:

Monthly Payments	Borrower	Co-Borrower
Installment Loans:
Credit Cards:
Other Obligations:

Mortgage Information
Mortgage Type:	Purchase Refinance
Purchase Price:
Down Payment:
Loan Amount: