FORM 2

   
    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 $      
         
    Co-Applicant Information:      
     Name ( first, middle, Last )        
    Date of Birth ( month, day, year )      
    Social Security Number  ( eg: 000-00-0001 )       
    *1A-Marital Status        *1A-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 ($)       
    If rent - what is your monthly rent ($)       
    *2A-Home Phone (eg:713-773-0990)  Cell ph.      *2A-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:      
    Co-Applicant Employment Information:      
    Are you employed self-employed retired with source of income      
    Gross income before taxes  $ per hourweekmonthyear      
    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        
    Co-Applicant monthly Liabilities Information:      
    Total monthly Car payment $      
    Total monthly Credits Cards  (approximately)  $       
    Other expenses (approximately)  $      
    Co-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:      

    

    

  Equal Housing Lender. All Rights  Reserved by texaswholesalemortgage.com 2004-2009