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Home Loan Prequalification Form
Leave me blank for Home Loan Prequalification.
*
Required
Borrower Information
Member Name
*
Borrower
Date of Birth
*
Borrower
Home Phone
*
Borrower
Cell Phone
*
Borrower
Email
*
Borrower
Current Address
*
Borrower
City
*
Borrower Address
State
*
Borrower Address
AL
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AR
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DE
DC
FL
GA
HI
ID
IL
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IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip
*
Borrower Address
Own or Rent?
*
Borrower
Own
Rent
Length of Residence
*
Borrower
Employer
*
Borrower
Full- or Part-Time?
*
Borrower
Full-Time
Part-Time
Employer Address
*
Borrower
City
*
Borrower Employer Address
State
*
Borrower Employer Address
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip
*
Borrower Employer Address
Employer Phone
*
Borrower
Gross Monthly Income
*
Borrower
Length of Employment
*
Borrower
Years
Months
Co-Borrower Information
Member Name
Co-Borrower
Date of Birth
Co-Borrower
Home Phone
Co-Borrower
Cell Phone
Co-Borrower
Email
Co-Borrower
Current Address
Co-Borrower
City
Co-Borrower Address
State
Co-Borrower Address
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip
Co-Borrower Address
Own or Rent?
Co-Borrower
Own
Rent
Length of Residence
Co-Borrower
Employer
Co-Borrower
Full- or Part-Time?
Co-Borrower
Full-Time
Part-Time
Employer Address
Co-Borrower
City
Co-Borrower Employer Address
State
Co-Borrower Employer Address
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip
Co-Borrower Employer Address
Employer Phone
Co-Borrower
Gross Monthly Income
Co-Borrower
Length of Employment
Co-Borrower
Years
Months
Relationship to Borrower
Co-Borrower
Loan Reason
Reason for Loan
*
Purchase
Refinance
Loan Amount Requested
*
Downpayment
*
I/we certify that everything I/we have stated in this application is correct. By submitting this form I/we authorize Premier Community Credit Union to check my/our employment and credit history. A consumer credit report may be requested in connection with this application and with any renewals, updates or extensions of any new credit.
Submit Prequalification
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