Prequalification Mortgage Paper – Fill Out and Use This PDF

Under PERSONAL DATA, enter the Borrower's Name, Birthdate, Social Security # and Home Phone#, mark Married, Unmarried, Separated or Divorced, and enter Years of School and Cell Phone#.

Enter the Co-Borrower's Name, Birthdate, Social Security # and Home Phone#, mark Married, Unmarried, Separated or Divorced, and enter Years of School and Cell Phone#.

Enter the Ages of Children living with you and the Number of persons in proposed household.

Enter your Present Address, City, St, Zip, Lived here how long and Monthly Payment $, and enter Mailing if different with its City, St and Zip.

Enter the Prior Address (If less than two years at present address), How long at prior address? and its City, St and Zip.

What best describes your present housing (check one): Single family house that I rent, Mobile home on my land, Apartment that I rent, Live with Family, Mobile home on someone elses land or Other.

For Single family house that I own, mark On permanent foundation? with Yes or No.

For Other, write the Describe line.

Under Employment Borrower and under Employment Co-Borrower, enter the Employer, Position, Address, Phone, City, St, Zip, How long employed here, Hourly Rate, Hours Per Week or Salary.

For Previous employment (if on current job less than 2 years) and Previous employment for Co-Borrower (if on current job less than 2 years), enter the Employer, Position, Address, Phone, City, St, Zip, How long employed here, Hourly Rate, Hours Per Week or Salary.

List all other household income (Alimony, child support, disability and etc.): list who receives the income and the source, with the Name, Source and Monthly Amount.

Under Borrower and Co-Borrower, mark Yes or No: Are either of you U.S. Veterans or Reservists? Are there any outstanding judgments or collections against you? Have you had property foreclosed upon or repossessed? Have you owned a home during the last three years? Do you operate a business from your home?

Mark Yes or No for Have you been declared Bankrupt within the past 7 years? If yes, enter the date of discharge.

Mark Yes or No for Do you have to pay Alimony, Child Support or Separate Maintenance? If yes, enter the amount paid per month $.

Under Assets, enter the Name of Bank or Credit Union with its Current Balance, the 401(K) Value $, IRA Value $, Value of Stocks and Bonds $, and Auto: Make, Year and Value $.

Under Monthly Debt Payments, enter who each is Paid to with its Monthly Payment $ and Balance $, and include payroll deducted loans and student loans, even if the payment is deferred.

Under BORROWER SIGNATURE AUTHORIZATION, Part 1 - General Information, enter the Borrower and, if there is a Co-Borrower, the Co-Borrower; the Lender Name and Address is VHDA, 601 S. Belvidere Street, Richmond, VA 23220.

Under Part II - Borrower Authorization, you authorize the Lender to verify your past and present employment earning records, bank acounts, stock holdings and any other asset balances that are needed to process your mortagage loan application, and to order a consumer credit report and verify other credit information, including past and present mortgage and landlord references.

A copy of this form will also serve as authorization; the information the Lender obtains is only to be used in the processing of your application for a mortgage loan.

Under CONSENT FOR DISCLOSURE OF PERSONAL INFORMATION, you consent to the disclosure by the Virginia Housing Development Authority (VHDA), acting on its own behalf and any of its employees, contractors, agents and representatives to ______ of all personal information, including information which may be covered or protected by federal or state law, about you which they may now or hereafter have relating to your application for a loan for the financing of the residence located at ______. This consent is given voluntarily and for your benefit.

This consent: Does include medical records and information, or Does not include medical records and information.

VHDA is not obligated by this consent to make any disclosure of such personal information and shall not be liable for the completeness or correctness of any personal information so disclosed; this consent shall remain in effect until the receipt by VHDA of written notice that this consent has been revoked.

Enter the Date in This consent is executed this day of, 20, then sign as Borrower and, if there is a Co-Borrower, as Co-Borrower.

A photo-copy or facsimile of this consent shall have the same force and effect as the original.