<br> <br> <br> The Mortgage Network-Loan Pre Qualifcation Form

Purchase Loan Contact Form

  • Use this form to express interest in purchasing a new home (not refinancing an existing home).
  • Please complete this form and a loan officer will contact you within 3 hours
  • If you are interested in refinancing an existing loan, please use the refinance form.
  • Please fill in as much information as possible for better, faster service.
  • Call us at: 1-877-237-1777

Contact Information

 Street address
 City, State, Zip
 Phone
 Fax
 Email

Current Status

I have signed a sales agreement. My closing date is
I am currently looking for a house and would like to get pre-approved for a loan.
I am interested only in prequalification at this point.
I am not in the market right now but will be interested in a loan some time in the future.

Purchase Information

My price range: to
Down payment (% or amount):
Location purchase (City, State):

Financial Information

My credit history is:
   Excellent (no lates in last 12 months)
   OK (Just a few dings)
   Bad

Income - Monthly:
Other debt - Monthly:

Comments