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VA Pre-Qualification Form

Please complete the following form:

Are you buying or refinancing?
Location of home?
What is your credit rating?
How soon do you need to close?
New home value?
First Name:
Last Name:
Current Address:
City
State
Zip Code
Day Phone Number
Evening Phone Number
Email Address
Are you eligible for a VA loan?	Yes No
PRIVACY ACT NOTICE: This information is to be used by the agency collecting it or its assignees in determining whether you qualify as a prospective mortgagor under its program. It will not be disclosed outside the agency except as required and permitted by law. You do not have to provide this information, but if you do not your application for approval as a prospective mortgagor or borrower may be delayed or rejected. The information requested in this form is authorized by Title 38, USC, Chapter 37 (if VA); by 12 USC, Section 1701 et. seq. (if HUD/FHA); by 42 USC, Section 1452b (if HUD/CPD); and Title 42 USC, 1471 et. seq., or 7 USC, 1921 et. seq. (if USDA/FmHA). BORROWER'S AUTHORIZATION: By submitting this form you hereby authorize our lending Partners Loan Services to verify your past and present employment earnings records, bank accounts, stock holdings, and any other asset balances that are needed to process your mortgage loan application. You further authorize our lending Partners Loan Services to order a consumer credit report and verify other credit information, including past and present mortgage and landlord references. It is understood that this authorization is being transmitted electronically. A copy of this electronic transmission will also serve as authorization. The information the our lending Partners Loan Services obtains is only to be used in the processing of your application for a mortgage loan.