Fillable YES! I/We would like to apply for Down (Albany High School)

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YES! I/We would like to apply for Down (Albany High School)

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FIRST MORTGAGE PRE-QUALIFICATION
Please fill out this application form completely, sign and date it, and review the checklist of required documents to ensure your
application packet is complete as possible.
□ YES! I/We would like to apply for Down Payment and/or Closing Cost Assistance
SUBJECT PROPERTY ADDRESS:
CUSTOMER INFORMATION
Borrower Name:
Co-Borrower Name:
Social Security Number:
Social Security Number:
Date of Birth:
Date of Birth:
Address (Street):
Address (Street):
(City, Zip):
(City, Zip):
Marital Status: Married Single Other:
Marital Status:
Married Single
Other:
Home Phone: Cell:
Home Phone: Cell:
Email:
Email:
Are you a citizen of the United States? YES NO
Are you a citizen of the United States? YES NO
Do you currently: Rent Own Other:
Do you currently: Rent Own Other:
How long at your current address?
How long at your current address?
If less than 2 years, prior address:
If less than 2 years, prior address:
Current rent payment (if applicable): $
Current rent payment (if applicable): $
EMPLOYMENT INFORMATION – Provide three (3) current paystubs.
Name of Employer:
Name of Employer:
No. of Years:
Self Employed? YES NO
No. of Years:
Self Employed? YES NO
Employer Address:
Employer Address:
Position:
Position:
Annual Income:
Annual Income:
If you’ve worked here less than 2 years, name of prior
employer:
If you’ve worked here less than 2 years, name of prior
employer:
Years with prior employer:
Years with prior employer:
HOUSEHOLD INFORMATION
Please list ALL persons currently living in your household (attach separate sheet of paper if needed)
Estimate annual income if necessary. Please indicate if any household members are full-time students.
Date of Birth
Annual Income
Source of Income
BORROWER ASSETS* - One current bank statement
CO-BORROWER ASSETS* - One current bank statement
Name & Address of Bank or Credit Union
Cash or Market
Value
Name & Address of Bank or Credit Union
Cash or Market
Value
$
$
$
$
538 Erie Blvd. W. Ste. 100, Syracuse, NY 13204 • www.homehq.org • (800) 724-4330 | (315) 474-1939 • fax: (315) 474-0637
FIRST MORTGAGE PRE-QUALIFICATION
INFORMATION FOR GOVERNMENT MONITORING PURPOSES
The following information is requested by the Federal Government for certain types of loans related to a dwelling in order
to monitor the lender’s compliance with equal credit opportunity, fair housing and home mortgage disclosure laws. You
are not required to furnish this information, but are encouraged to do so. The law provides that a Lender may not
discriminate either on the basis of this information, or on whether you choose to furnish it. If you furnish the information,
please provide both ethnicity and race. For race, you may check more than one designation. If you do not furnish
ethnicity, race, or sex, under Federal regulations, this lender is required to note the information on the basis of visual
observation and surname if you have made this application in person. If you do not wish to furnish this information, please
check the box below. (Lender must review the above material to assure that the disclosures satisfy all requirements to
which the lender is subject under applicable state law for the particular type of loan applied for.)
BORROWER
I do not wish to furnish this information
CO BORROWER I do not wish to furnish this information
Ethnicity:
Hispanic or Latino Not Hispanic or Latino
Ethnicity:
Hispanic or Latino Not Hispanic or Latino
Race:
American Indian, Alaskan Native Asian
American Black or African American White
Native Hawaiian or other Pacific Islander  Other
Race:
American Indian, Alaskan Native Asian
American Black or African American White
Native Hawaiian or other Pacific Islander Other
Gender:
Male Female
Gender:
Male Female
SIGNATURES
I authorize Home HeadQuarters, Inc. (HHQ) to obtain credit reports in connection with this application and any loan or
account established, as well as any update, renewal, extension, review or collection thereof. HHQ will use the credit
report to confirm my residency address, review existing credit obligations, payment history, and determine whether my
income is eligible to support a loan payment. Upon my request, HHQ will provide me with the name and address of the
Consumer Reporting Agency contacted to supply the report. I understand that credit inquiries have the potential to
impact my credit score.
I also authorize HHQ to verify any information contained in this application with other parties and to report its transactions
with me. I authorize HHQ, the lender, to share information I have provided on this application and any other information
relevant to my home improvement service with any of the Program partners.
I certify that all statements made in this application are true and are made for the purpose of purchasing a home and
(possibly) requesting home improvement services.
Home HeadQuarters, Inc., its agents and/or assignees, reserves the right to inspect any and all work associated with a
home improvement loan or grant or any other HHQ financial product or service.
This application in no way guarantees or implies funding and/or service through Home HeadQuarters, Inc., its agents
and/or assignees.
Signature of Borrower
Date
Signature of Co-Borrower
Date
Please provide photo identification and proof of household income along with this application. Once there is an accepted
purchase offer, additional documentation will be required for full mortgage approval.
REQUIRED SUPPORTING DOCUMENTS
Other: _________________
Other: _________________
538 Erie Blvd. W. Ste. 100, Syracuse, NY 13204 • www.homehq.org • (800) 724-4330 | (315) 474-1939 • fax: (315) 474-0637
FIRST MORTGAGE PRE-QUALIFICATION
CERTIFICATION
BOR
ROW
ER
’S
C
ERTIF
ICAT
ION
A
ND
AUT
HO
R
IZ
ATIO
N
The undersigned certify the following:
1.
I/We have applied for a mortgage loan from Home HeadQuarters, Inc. (“Lender”)
In applying for the loan, I/We completed a loan application containing various information on the purpose
of the loan, the amount and source of the down payment, employment and income information, and asset
and liabilities. I/We certify that all of the information is true and compete. I/We made no misrepresentations
in the loan application or other documents, nor did I/We omit any pertinent information.
2.
I/We understand and agree that Lender reserves the right to change the mortgage loan review process
to a full documentation program. This may include verifying the information provided on the application
with the employer and/or Financial institution.
3.
I/We fully understand that it is a Federal crime punishable by fine or imprisonment, or both, to knowingly
make any false statements when applying for this mortgage, as applicable under the provision of Title 18,
United States Code, Section 1014.
AUTHORIZATION TO RELEASE INFORMATION
To Whom It May Concern:
1.
I/We have applied for a mortgage loan from Lender. As part of the application process, Lender and the
mortgage guaranty insurer (if any) may verify information contained in my/our loan application and in
other documents required in connection with the loan, either before the loan is closed or as part of its
quality control program.
2.
I/We authorize you to provide to Lender and to any investor to whom Lender may sell my mortgage,
and to the mortgage guaranty insurer (if any), any and all information and documentation that they
request. Such information includes, but is not limited to; employment history and income; bank, money
market; and similar account balances; credit history; and copes of income tax returns.
3.
Lender or any investor that purchases the mortgage or the mortgage guaranty insurer (if any) may
address this authorization to any party named in the loan application.
4.
A copy of this authorization may be accepted as an original.
5.
Your prompt reply to Lender, the investor that purchased the mortgage or the mortgage guaranty
insurer (if any) is appreciated.
6.
Mortgage guaranty insurer (if any).
AUTHORIZATION TO PULL CREDIT AUTHORIZATION
By signing below, I /we hereby authorization Home HeadQuarters, Inc. to obtain a consumer credit report
through a credit reporting company chosen by Home HeadQuarters, Inc.
I/We understand and agree that Home HeadQuarters, Inc. intends to use this consumer credit report for the
purposes of evaluating my/our financial readiness to buy/refinance a home.
Borrower Signature
Print Name
Date
Co-Borrower Signature
Print Name
Date
538 Erie Blvd. W. Ste. 100, Syracuse, NY 13204 • www.homehq.org • (800) 724-4330 | (315) 474-1939 • fax: (315) 474-0637
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YES IWe would like to apply for Down (Albany High School)

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Completed 16 July 2021

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