FORM 1

   
    Prior to filling your information, please identify your Realtor, Loan Officer, friend, or   Note: This website is hosted by Valueweb and  
    source such as advertising via flyer or yellow page   equiped with Secure Socket Layer (SSL) option.  
    Applicant Information:   Therefore this website has all the advantages of  
    Name ( first, middle, Last )     secure encryption.  
    Date of birth ( month, day, year )      
    Social Security Number  ( eg: 000-00-0001 )       
    *1-Marital Status       *1-Note: if divorced, provide full copy including all  
    What is your current living status own  or rent       pages of a divorced decree during application  
    If own - what is your total monthly Mortgage Payment ($)       
    If rent - what is your monthly rent ($)       
    Name of apartment/ management      
    *2-Home Tel (eg:713-773-0990)  Cell ph.      *2-Note: For security & safety purpose - our credit dept.  
    Current Street address     will call the applicant prior to credit checking.  
    City   State    Zipcode        
    if stay less than 2 years at current address, please disclose former address:      
    Former  Street address          
    City    State    Zipcode        
    Applicant Employment Information:      
    Are you employed self-employed retired with source of income      
    Gross income before taxes  $ per hrwkmthyr      
    Current Employer or Business      
    Telephone number ,e.g 281-679-8868      
    Title/position    Years on Job        
    if work less than 2 years at current job, please disclose former employer info:      
    Name of Former Employer        
    Telephone number ,e.g 281-679-8868      
    Title    Years on Job        
    Applicant monthly Liabilities Information:      
    Total monthly Car payment $      
    Total monthly Credits Cards  (approximately)  $       
    Other expenses (approximately)  $      
    Applicant Asset Information:      
    Assets: Bank Name        
    Total amount of Balance of all accounts $        
    401K, IRA or other Assets - Specify Type      
    Total value of assets in $      
         
 
  By submitting  this  form, I/we  authorized  Texas  Wholesale Mortgage, Inc. and/ or
     
    its assign  to obtain my/our  credit  report and/or  additional individual information  to      
    determine credit worthiness. The  information  that is obtained is strictly confidential.      
    An electronic submission of this authorization may be deemed to be equivalent of the      
    original. This pre-qualification  is  not a Loan Application. Your  loan  application  will      
    begin  upon receipt  of complete   signed  " Uniform  Residentail  Loan  Application "      
 
  and submission of all related documentation - confer with your Loan Officer.
      
         
    Notes/remarks/ special instructions - please specify below:      

    

    

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