Mortgage Pre-qualification Form

BBorrower #1

Full Name

Phone

Street Address

City

State

ZIP

Employer

Years Employed

Employer Street

City

State

ZIP

Employer Phone

CBBorrower #2 (Co-Borrower)

Full Name

Phone

Street Address

City

State

ZIP

Employer

Years Employed

Employer Street

City

State

ZIP

Employer Phone

Income Information — (B) Borrower — (CB) Co-Borrower

Monthly Gross Income (B)

$

Additional Income (B)

$

Monthly Gross Income (CB)

$

Additional Income (CB)

$

Monthly Obligations

#	Liabilities Credit Cards, Loans, Mortgages, Etc.	Monthly Payment	Unpaid Balance
1	Debtor description	$	$
2	Debtor description	$	$
3	Debtor description	$	$
4	Debtor description	$	$
5	Debtor description	$	$
6	Debtor description	$	$
7	Debtor description	$	$
Total Monthly Obligations		$

Credit Score (B) - Borrower

Credit Score (CB) - Co-Borrower

Authorization

I understand this is a worksheet for my personal use. First Federal Bank will rely on verified incomes and credit servicing obligations to make all credit determinations. I authorize First Federal Bank SSB to access and pull a current credit report from all major credit bureaus.

Thank You