Welcome to the
Nebraska Mortgage Company
When experience and integrity matter...
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Questions?
402-488-2222
866-421-7889
Express Pre-Qualification Form
Step1. Tell us about you.
(
*
indicates required fields)
Borrower Information
What is the Borrowers Name?
First
*
Middle
Last
*
What is the Borrowers Address?
Street
City
State
*
Zip
What is your Social Security number and Age?
SSN#
Date Of Birth:
What are your telephone numbers?
Home
*
Work
Co-Borrower Information (If any)
What is the Co-Borrowers Name?
First
Middle
Last
What is the Co-Borrowers Address?
Street
City
State
Zip
What is your Social Security number and Age?
SSN#
Date Of Birth:
What are your telephone numbers?
Home
Work
Step2. Tell us about your employment.
Borrower
Self Employed?
Employer:
Length (Yrs/Mths):
/
Monthly Income:
$
Other:
$
Co-Borrower
Self Employed?
Employer:
Length (Yrs/Mths):
/
Monthly Income:
$
Other
$
Step3. Tell us about your assets/liabilities.
Borrower
Assets:
Checking:
$
Savings:
$
CD's/Stocks/Bonds
$
401K's/IRA's
$
Co-Borrower
Assets:
Checking:
$
Savings:
$
CD's/Stocks/Bonds
$
401K's/IRA's
$
Combined Monthly Liabilities
Type
Monthly Payment
Unpaid Balance
Credit Cards:
$
$
Auto Loans:
$
$
Other Loans:
$
$
Child Support:
$
Step4. Tell us about your situation.
What is the property address?
Street:
City:
State:
Zip:
Number of units:
Occupancy type:
Estate Held:
Property Value:
$
What is the type of mortgage loan?
What is the purpose of this loan?
If you selected "Refinance", what is the purpose?
If you selected "Other", please explain.
Additional Camments:
*
I/We (borrower[s] named herein) understand that this form is for pre-qualification
only and is not an application.
Authorization to check credit verification
YES
NO
By selecting "YES" to this radio button, I/WE hereby authorize Affinity Mortgage to order a consumer credit report to verify credit and other information pertaining to pre-qualification. The information that Rome Financial obtains is only to be used for mortgage pre-qualification purposes.
Email Address:
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