Borrower #2 Name:_________________________ SSN:_______________ Age:_____

Current Address:________________________________________________ Zip:_____

Own or rent?_____ # of years there:_____ # of Dependents:_______

#1 Present Employer:_________________________________ # of Years on the Job:____

Yearly Base Pay: $__________ Overtime: $__________ Other Pay: $___________

#2 Present Employer:_________________________________ # of Years on the Job:____

Yearly Base Pay: $__________ Overtime: $__________ Other Pay: $___________

Amount of Cash You Have Available for Down Payment & Closing Costs: $____________

Circle the Source of this Cash: Savings, Gift from Family, Retirement/IRA, Relo Package

Monthly Child Support You Pay: $_________ Child Support Your Receive: $_________

Are You in Default on a Student Loan? _____ Have You Had a Bankruptcy? _______

List of debts, loans, credit cards:

Lender's Name: ------ Monthly Minimum Payment: ------ Approx. Remaining Balance:

__________________ _______________________ ________________________

__________________ _______________________ ________________________

__________________ _______________________ ________________________

__________________ _______________________ ________________________

I/we, the undersigned, authorize Allied Home Mortgage to run a credit check for the purpose of pre-qualifying for a mortgage.

Signatures: #1________________________ #2_____________________________Date:________

If this pre-qualification is approved, do you wish to be mailed a full application?_________

Which type of loan? VA_____ FHA_____ Conventional______ Not Decided______

Are there special circumstances or requirements I should know before I run the numbers? _________

How should we contact you? Telephone: _______________________(home) _____________________________(work)

e-mail:___________________ or at the above postal address:______