Prequal Application

Borrower Information

• First Name
  OK First Name is required
• Middle Initial
  Optional OK Middle Initial is required
• Last Name
  OK Last Name is required
• Residential Address (Not a P.O. Box)
  OK Residential Address (Not a P.O. Box) is required
• City
  OK City is required
• State AK - AlaskaAL - AlabamaAR - ArkansasAZ - ArizonaCA - CaliforniaCO - ColoradoCT - ConnecticutDC - District of ColumbiaDE - DelawareFL - FloridaGA - GeorgiaHI - HawaiiIA - IowaID - IdahoIL - IllinoisIN - IndianaKS - KansasKY - KentuckyLA - LouisianaMA - MassachusettsMD - MarylandME - MaineMI - MichiganMN - MinnesotaMO - MissouriMS - MississippiMT - MontanaNC - North CarolinaND - North DakotaNE - NebraskaNH - New HampshireNJ - New JerseyNM - New MexicoNV - NevadaNY - New YorkOH - OhioOK - OklahomaOR - OregonPA - PennsylvaniaRI - Rhode IslandSC - South CarolinaSD - South DakotaTN - TennesseeTX - TexasUT - UtahVA - VirginiaVT - VermontWA - WashingtonWI - WisconsinWV - West VirginiaWY - Wyoming
  OK State is required
• Zip
  OK Zip is required
• Phone Number
  OK Phone Number is required
• E-mail
  OK E-mail is required

• Preferred Method of Contact

  • Phone
  • Email
  OK Preferred Method of Contact is required
• Social Security Number
  OK Social Security Number is required

• Date of Birth

  JanFebMarAprMayJunJulAugSepOctNovDec 12345678910111213141516171819202122232425262728293031 20242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915191419131912191119101909190819071906190519041903190219011900
  OK Date of Birth is required
• Employer
  OK Employer is required
• Work Phone
  Optional OK Work Phone is required
• Years on Job
  OK Years on Job is required
• Gross Monthly Income
  OK Gross Monthly Income is required
• Number of Dependents
  Optional OK Number of Dependents is required
• Total Monthly Installment Debt
  Optional OK Total Monthly Installment Debt is required
• Estimated Annual Property Taxes
  Optional OK Estimated Annual Property Taxes is required

• Are you a Veteran?

  • No
  • Yes
  Optional OK Are you a Veteran? is required

• Are you a First Time Home Buyer?

  • No
  • Yes
  Optional OK Are you a First Time Home Buyer? is required

• Do you Own or Rent?

  • Own
  • Rent
  OK Do you Own or Rent? is required
• No. of Yrs at Current Residence:
  OK No. of Yrs at Current Residence: is required
• If less than one year, previous address:
  Optional OK If less than one year, previous address: is required
• Money for Downpayment?
  OK Money for Downpayment? is required
• Referral Source?
  Optional OK Referral Source? is required
• Purpose of Loan
  Optional OK Purpose of Loan is required

The following information is requested by the federal government for certain types of loans related to dwelling. In order to monitor the lender's compliance with equal credit opportunity, fair housing. and home mortgage disclosure laws. You are not required to furnish this information. but are encouraged to do so. You may select one or more designations for "Race". The law provides that a lender may not discriminate on the basis of this information, or on whether you choose to furnish it. However, if you choose not to furnish the information and you have made this prequalification in person, under federal regulations the lender is required to note ethnicity, race, and sex on the basis of visual observation or surname. If you do not wish to furnish the information, please check below.

• Ethnicity

  • Hispanic or Latino
  • Non Hispanic or Latino
  Optional OK Ethnicity is required

• Race

  • American Indian or Alaska Native
  • Asian
  • Black of African American
  • Native Hawaiian or other Pacific Islander
  • White
  Optional OK Race is required

• Sex

  • Male
  • Female
  Optional OK Sex is required
• • There will be a Co-Borrower
  Optional OK There will be a Co-Borrower is required

Co-Borrower Information

• Name
  OK Name is required
• Home Phone
  OK Home Phone is required
• E-Mail
  OK E-Mail is required
• Social Security Number
  OK Social Security Number is required

• Date of Birth

  JanFebMarAprMayJunJulAugSepOctNovDec 12345678910111213141516171819202122232425262728293031 20242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915191419131912191119101909190819071906190519041903190219011900
  OK Date of Birth is required
• Employer
  Optional OK Employer is required
• Work Phone
  Optional OK Work Phone is required
• Years on Job
  Optional OK Years on Job is required
• Gross Monthly Income
  Optional OK Gross Monthly Income is required
• Number of Dependents
  Optional OK Number of Dependents is required
• Total Monthly Installment Debt
  Optional OK Total Monthly Installment Debt is required

The following information is requested by the federal government for certain types of loans related to dwelling. In order to monitor the lender's compliance with equal credit opportunity, fair housing. and home mortgage disclosure laws. You are not required to furnish this information. but are encouraged to do so. You may select one or more designations for "Race". The law provides that a lender may not discriminate on the basis of this information, or on whether you choose to furnish it. However, if you choose not to furnish the information and you have made this prequalification in person, under federal regulations the lender is required to note ethnicity, race, and sex on the basis of visual observation or surname. If you do not wish to furnish the information, please check below.

• Ethnicity

  • Hispanic or Latino
  • Non Hispanic or Latino
  Optional OK Ethnicity is required

• Race

  • American Indian or Alaska Native
  • Asian
  • Black of African American
  • Native Hawaiian or other Pacific Islander
  • White
  Optional OK Race is required

• Sex

  • Male
  • Female
  Optional OK Sex is required

• How did you hear about us? EmployerFriendInternetNewspaper AdPromotional MailerRadio AdRelativeSearch EngineTV AdOther
  OK How did you hear about us? is required
• Comments
  Optional OK Comments is required
• Security Code
  OK Security Code is required

Carthage Federal Savings and Loan reserves the right to use the above information to obtain verifications of identity and background before opening any accounts. We may also access information about you from a consumer reporting agency, such as a copy of your credit report, before opening any account. By submitting this form, I/we grant full permission to do so.