PRE-QUALIFICATION WORKSHEET Network Funding Mortgage Fast Track Qualifier On-line Form NOTE* You must enter an email address and agree to the conditions at the bottom of the form. Loan and Property Information Type of Loan: Purchase Refinance Construction Home Equity Sales Price/Value: Loan amount requested: Borrower Information Borrower's Name (incl. Jr or Sr.): Social Security #: Complete Home Ph: Email: Age: Yrs School: Status - Select One Married Separated Single Divorced Widowed Present Home Address: City: State: Zip: Property Status Own Property Rent this Property House / Rent Payment: $ /mo. Borrower Employment Information Name of Employer: Address of Employer: City: State: Zip: Years at this job: Years in profession: Position/Title: Bus Phone w/ Area Code: - C0-Borrower Information C0-Borrower's Name (incl. Jr or Sr.): Social Security No.: Complete Home Ph: Age: Yrs School: Status - Select One Married Separated Single Divorced Widowed House / Rent Payment: $ /mo. Present Home Address: City: State: Zip: Property Status Own Property Rent this Property CO-Borrower Employment Information Name of Employer: Address of Employer: City: State: Zip: Year at this job: Year in profession: Position/Title: Bus Phone w/ Area Code: - Monthly Income Gross Monthly Income    Borrower    CO-Borrower Base Income $ $ Overtime/Commisions $ $ Rental Income $ $ Other Income $ $ Source of Down Payment / Closing Cost Source    Amount Sale of Current Home $ Savings/Checking Accounts $ Gift/Other Sources $ Down Payment Planned $ Assets Checking and Savings Accounts Bank Name & Acct. Balance $ Bank Name & Acct. Balance $ Stock and Other Assets Bank Name & Acct. Balance $ Bank Name & Acct. Balance $ Retirment, 401K, emply. savings: $ Real Estate Assets: $ Liabilities Loans Owed    Payment    Balance Mortgage (if applicable) $ $ Creditor: $ $ Creditor: $ $ Creditor: $ $ Child Support/alimony owed $ $ Buy selecting the radio button at the end of this statement,I certify that the above information is true and correct. I authorize Network Funding Mortgage to obtain a credit report in order to make a preliminary determination of a mortgage loan application. I understand that a full loan application and credit report must be completed at a later date. Click if you agree: Preferred Method of Contact: E-Mail Phone Mail Additional Comments: Texas Specialists!! All Loans Not Available in All Areas To request further information, please e-mail: Jfox@Amcap1.com