Miami Beach Mortgages are our specialty

Pre-Qualification Application

Borrower's Name
Street Address
City
State
Zip Code
Email
Home Phone	Example 305-535-2230
Work Phone		Ext.
Employer
Social Security Number	Example 427-65-9861

Co-Borrower's Name
Street Address
City
State
Zip Code
Home Phone	Example 305-535-2230
Work Phone		Ext.
Employer
Social Security Number	Example 427-65-9861

Do you currently RENT or OWN (check one)

RENT or

OWN

How long have you lived at current residence?

Borrower's gross annual income?
Co-Borrower's gross annual income?

AVAILABLE CASH

Checking Account
Savings Account
401K/Savings Plan
Gift
Other Assets
Total Assets

MONTHLY PAYMENTS

Mortgage/Rent
Car Payment
Personal Loan
Credit Card 1
Credit Card 2
Credit Card 3
Other Payments
Total Debt

ADDITIONAL COMMENTS

Authorization

In sending this email, I (We) understand to complete my Home Ownership Analysis, information about me may be obtained from a credit reporting service, and that all information provided is strictly confidential.

Halpern & Associates Mortgage Corporation, Inc.

1680 Michigan Ave #1001

Miami Beach, Florida 33139

Telephone 305.535.2230

Facsimile 305.535.2231

Email raymodia@halpernassociates.com