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To become a Pre-Approved client, we will have to know some very basic, yet personal information. Please make sure to complete all sections of the form. We will process your request and contact you promptly. Your social security number is not being requested at this time. Pre-Approval will be based on income, job time, and debits. A credit report will NOT be pulled at this time. We look forward to speaking with you soon. If you have any questions or concerns about sending information over the net, please feel free to E-mail us at:

Response-O-Matic Form

The Home Source Quick App.

(* are required to be filled in to process)

*Loan Purpose:     *Type of Property:
*Loan Amount:    *Property Value:  
*Occupancy Type:   *Down Payment or Equity:
*Contact Me By:   *What is the best time to be reached?

Applicant(s) Information



(If used)
*Name Name
Street Address Street Address
City City
*State State
Zip/Postal Code Zip/Postal Code
Work Phone Work Phone
Home Phone Home Phone
*E-mail E-mail

Employment Information

Borrower Co-Borrower
Employer Name Employer Name
City City
State State
*Monthly Wages$ Monthly Wages$
Bonuses or Other Income Bonuses or Other Income

Credit Assessment

It is important that you answer these questions as accurate as possible for me to help you!
*Combined Monthly Debts $: (List only installment or revolving debts, do not include rent, cable, util, phone etc.)

*Credit History: Excellent   Good   Fair   Poor   Not Sure

*The number of 30 day + lates on any debts in the past two years: 0 to 3  4 to 10  More than 10
*Any foreclosures by you or a co-borrower? None Yes, in the past 2 yrs Yes, over 2 yrs.
*Have you or a co-borrower declared some form of bankruptcy?
Within the past 2 years:      Yes    No    Within the past 3-7 years:  Yes   No
*Current Debt Collects?       Yes    No
Do you have any questions to ask myself or anything that you would like me to know about concerning your credit, work situation etc?  (Please type in the box below)
How did you hear about us?  

Thank you, your business means a lot!!!

Copyright The Home Source 1999