Pre-qualification Worksheet

Borrower Information
First Name	M. Last Name	Social Security Number
Home Phone	Work Phone	Email address
Present Address	City                      State       Zip	Years at address: Birthday
Employer	Employer Address	City                      State       Zip
Position	Gross Monthly Income $	Yrs on job: Yrs in line of work
Marital Status	What is the maximum monthly payment you can afford?	How much can you apply toward down payment or closing cost?
Referred by:	Referral Contact Number:	Subject Address
Co-Borrower Information
First Name	M. Last Name	Social Security Number
Home Phone	Work Phone	Email address
Address	City                      State       Zip	Years at address: Birthday
Employer	Employer Address	City                      State       Zip
Position	Gross Monthly Income $	Yrs on job: Yrs in line of work

In an attempt to determine my/our credit worthiness, I/we hereby authorize Instant Home Remedy an affiliate of Mortgage First Real Estate Services to obtain a copy of my/our credit report. I/we understand that an inquiry will appear on my credit report.

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Borrower Date Co-Borrower Date

Please return signed agreement to Kevin via fax at 713-863-8606. Or contact 281-772-1786.