Mortgage Prequalification Application
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Mortgage Information
Please Select One   Purchase Refinance
If Refinance, Cash Out?   Yes No
Term Requested   Thirty year Twenty year
    Fifteen year Ten year
Primary Account Owner
*Name (First M. Last):
*Date of Birth (mm/dd/yyyy):
*Social Security Number:
*Driver's License Number:   State
*E-mail:
 
*Current Address:
*City, State Zip: ,
*Current Home Phone Number:
 
*Current Employer:
*Current Job Title:
*Time at Present Employer:
*Current Work Address:
*City, State Zip: ,
*Current Work Phone Number:
Co-Borrower
Name (First M. Last):
Date of Birth (mm/dd/yyyy):
Social Security Number:
Driver's License Number:   State
E-mail:
 
Current Address:
City, State Zip: ,
Current Home Phone Number:
 
Current Employer:
Current Job Title:
Time at Present Employer:
Current Work Address:
City, State Zip: ,
Current Work Phone Number:
Other Information
To further assist in pre-qualification, please provide the following Other information (Please do not use commas or dollar signs in any answer):
Value/Sales Price of Property 
*Loan Amount needed 
Borrower
Gross Income  (Borrower)
Total Revolving Debt (i.e. - credit cards) per month
Total Installment Debt (i.e. - personal or auto loans) per month
Co-Borrower
Gross Income 
Total Revolving Debt (i.e. - credit cards) per month
Total Installment Debt (i.e. - personal or auto loans) per month
This prequalification application is for information purposes only and is not an application for a mortgage loan. You may obtain a mortgage loan application at any of our branch locations, by calling 781-878-5252 or contacting us by secure email.
By clicking submit you are authorizing South Coastal bank to access a tri merge credit report in conjunction with your application for a Mortgage Pre Approval.
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