Request Information and Buyer Pre-Qualification

 

 

 

                                                    

    

                                                                    Contact Information

 

 

 

                                          Borrower                                                      Co-Borrower               

        Name:                                                   

        Address:                                                

        Phone:                                                   

        Email:                                                   

        Type of Home:                        Ranch Expandable Cape Finished Cape Colonial Vacation Manufactured_Single_Section Manufactured_Sectional                

        Location of Home:                                   

                                                                                Buyer Qualification

        Where do you work?                                        

        How long in this position?                             

        Total Monthly Gross

        Income $:                                                              

        (or Weekly Gross x 4.3)

        Monthly Expenses (Total for Borrower and Co-Borrower)

        Car Loan #1  $:              

        Car Loan #2  $:                

        Child Support  $:           

        School Loan  $:              

        Credit Card #1  $:         

        Credit Card #2  $:         

        Credit Card #3  $:         

        Credit Card #4  $:         

        Other  $:                       

        Other Information

        Downpayment  $:                 Source: 

        Any credit problems?    

        Bankruptcy:        Yes No   If yes, how long ago?  

        Reposessions?:  Yes No   If yes, how long ago?  

        Credit Score:            Go here for your free credit report

        Comments / Information Requested:    

Disclaimer:  Country Lane Homes does not directly provide money for homes.  The

homes are financed through banks and lending institutions.  Country Lane Homes does not make

any credit decisions for these banks and lending institutions.  

 The purpose of this form is to help us better assist you in obtaining financing for your home.