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Income
Borrower
Co-Borrower
Gross Monthly Income
Monthly Take Home Pay
Unemployment Income
Child Support / Alimony
Disability Income
Other Income
Rental Income
Total Monthly Combined Income - Use Take Home Pay, not Gross Monthly Income for Total Income
Mortgage Information
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Type of Property
Owner Occupied
Investment Property
Estimated Value
cyberhomes
Lender
Balance
Payment
1st Mortgage
2nd Mortgage
3rd Mortgage
Property Taxes - Annual expense if not included in mortgage payment
Any liens, including personal liens recorded against the borrower, co-borrower or property?
Yes
No
If "Yes", please explain
Monthly Expenses
Monthly Expense
Balance Owed
Rent, if applicable
Auto Payment #1
Auto Payment #2
Auto / Gas Expense
Credit Cards (minimum payments)
Health Insurance
Child Care / Support / Alimony
Food expending money
Utilities, Phone, Water and Services
Other
Type:
Other
Type:
Total Monthly Expenses
Assets
Value
Amount Owed
Auto # 1
Auto # 2
Savings / Checking
CD / Money Market
Stock / Bonds
Rental Property # 1
Rental Property # 2
Rental Property # 3
Cause Of Hardship
Choose the most applicable
Divorce / Separation
Income Loss / Involuntary
Unmanageable Increases In Monthly Payment
Involuntary Job Transfer
Family Crisis
Illness / Injury / Disability
Explanation
Your Contact Information
Your Contact Preference
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Email
Phone
Regular Mail
How did you find us?
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Attorney Referral
Credit Counselor
In My Email
Internet Search
Lender Referral
Mail From Us
Newspaper
Other
Personal Referral
Realtor Referral
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Your Email Address
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First Name
MI
Last Name
Property Address
City
State
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Maine
Maryland
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Michigan
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Nevada
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New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
County
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Zip Code
Phone
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ext
Type:
Other Phone
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ext
Type:
Preferred Agent
On submitting my application for short sale prequalification, I agree with the following
(Each option must be checked prior to submitting):
I am aware that this is a prequalification only. My Lender may ultimately decline my request for a discounted payoff.
I am aware that this prequalification will be based on information provided by me, and that a short sale is not my only option.
I have been advised to consult with an attorney and or tax professional regarding the submission of a short sale request.
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