Pre - Approval

Borrower Information

Co-borrower information

First Name:*

First Name:

Last Name: *

Last Name:

Social Security:*

Social Security:

Date Of Birth:*

Date Of Birth:

E-Mail Address:

Home Phone:*

Home Phone:

Cell Phone:

Employment History:

Current Employer:

Work Number:

Address:

Employer Address:

City:

Employer City:

State:

Employer State:

Zip:

Employer Zip:

Employment Dates:

Do you recieve:

1099
W2

Do you recieve:

1099
W2

Job Title:

Gross Monthly Income

Other Income (specify)

Current Address:*

Current Address:

City:*

City:

State: *

State:

Zip:

Rent Amount:

Dates Lived:

Banking Information:

Reserves:

Checking/Savings:

Retirement/401K:

Gross Monthly Income:*

Other:

Child Support:

No
Paying
Receiving

Child Support:

No
Paying
Receiving

Ammount $:

What area are you interested in?

County:

City:

State:

I/we, as applicant(s) certify that all information provided above is true, accurate and complete to the best of my/our knowledge and is being provided for the purpose of obtaining credit. I/we, as applicant(s), authorize LongTide Homes, Ltd. To request a credit report and furnish a copy of this report and all other credit information to any and all lenders that LongTide Homes, Ltd. Deems appropriate and to release any of my/our credit-related or income-related information to such lenders.

If you have spoken to a sales consultant please type their name in the box.

AGREE
DISAGREE

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