1991 Spruce Hills Drive, Bettendorf, Iowa 52722        Phone: (563) 355-7500 or (888)816-2758

 

Please complete the form below to apply for home loan pre-qualification. Your information will be kept confidential by Cherry Creek Mortgage Company in accordance with our Privacy Policy. This form is secured using SSL (Secure Socket Layer) Technology. The padlock icon in the lower right corner of your browser should be displayed "locked" (closed) indicating your data is being transmitted securely. If you have any problems with this form or questions regarding pre-qualification, please e-mail cmattan@ccmclending.com, who will be glad to help you or you can call any of the phone numbers listed above to speak with a mortgage consultant.

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Your preferred Cherry Creek Mortgage Company Loan Officer is:   
How did you hear about Cherry Creek Mortgage Company?:   
BORROWER
First Name:
 

Last Name:
 

 Social Security Number:
 
Home Phone Number:
 		 Date of Birth (MM/DD/YY):
 
Married
Separated
Unmarried (includes single, divorced or widowed)		 Dependants (not listed by Co-Borrower):
Number:   Ages:
Present Address:
Street Address
Apt./Suite/Floor
City/State/ZIP
 		Do You: Own? or Rent?

Number of Years:                        

Name of Employer:
    
Self-Employed? 

Street Address of Employer:

City/State/ZIP:

Employed how many years?                        

Monthly income: 
Position/Title/ Type of Business:
 Business Phone:

Notice: Alimony, child support, or separate maintenance income need not be revealed.
Other Income (monthly amt.): Describe Other Income:
 
CO-BORROWER
First Name:

Last Name:

 Social Security Number:
Home Phone Number:
 Date of Birth (MM/DD/YY):
Married
Separated
Unmarried (includes single, divorced or widowed)		 Dependants (not listed by Borrower):
Number:   Ages:
Present Address:
Street Address
Apt./Suite/Floor
City/State/ZIP		 Do You: Own? or Rent?

Number of Years:

Name of Employer:
   
Self-Employed?

Street Address of Employer:

City/State/ZIP:

 Employed how many years?

Monthly income:
Position/Title/Type of Business:
 Business Phone:
Notice: Alimony, child support, or separate maintenance income need not be revealed.
Other Income (monthly amt.):
 Describe Other Income:
List Checking and Savings Accounts (Borrower and Co-Borrower)
 Name of Bank/S&L/Credit Union:

 Address:
 Account Number:
Amount:
 
 Name of Bank/S&L/Credit Union:

 Address:
 Account Number:
Amount:
 Name of Bank/S&L/Credit Union:

 Address:
 Account Number:
Amount:
Other Available funds
(such as gifts):
401(k)/Retirement Total Vested Interest
GENERAL INFORMATION
What range of home would you like to purchase? from:  
to:
How much money would you like to spend out of your personal resources for your home?
What is the maximum monthly house payment you would like to have?
Are you currently working with a realtor?  Yes  No
May we contact about your qualifications? Yes  No
Realtor's Name:
 Realty Company:
May we obtain a credit report for the purpose of assisting you in this transaction? Yes  No
Where is it best to contact you? Home
Work
Other (please specify):
What time of day is best to contact you?
May we send you e-mail at home or work?
  Yes  No		 E-mail address:
DECLARATIONS:   Borrower
Have you been declared bankrupt within the past seven years?  Yes  No 
Have you had property foreclosed upon or given title or deed in lieu thereof in the past seven years? Yes  No
Are you presently delinquent or in default on any Federal debt or any other loan, mortgage, financial obligation bond,  or loan guarantee? Yes  No
Continuation:
If you answered "Yes" to any of the previous three questions, please use the field to the right for further description. If not applicable, please type 'N/A'.
Are you a United States Citizen? Yes  No
Are you a Permanent Resident Alien? Yes  No
Do you intend to occupy the property as your primary residence? 

If yes, please answer the following three questions:

 Yes  No
Have you had an ownership interest in a property in the last three years? Yes  No
What type of property did you own? principal residence (PR)
second home (SH)
investment property (IP)
How did you hold the title to the home? solely by yourself (S)
jointly with your spouse (SP)
jointly with another person (O)
DECLARATIONS:  Co-Borrower
Have you been declared bankrupt within the past seven years?  Yes  No
Have you had property foreclosed upon or given title or deed in lieu thereof in the past seven years? Yes  No
Are you presently delinquent or in default on any Federal debt or any other loan, mortgage, financial obligation bond,  or loan guarantee? Yes  No
Continuation:
If you answered "Yes" to any of the previous three questions, please use the field to the right for further description. If not applicable, please type 'N/A'.
Are you a United States Citizen? Yes  No
Are you a Permanent Resident Alien? Yes  No
Do you intend to occupy the property as your primary residence? 

If yes, please answer the following three questions:

 Yes  No
Have you had an ownership interest in a property in the last three years? Yes  No
What type of property did you own? principal residence (PR)
second home (SH)
investment property (IP)
How did you hold the title to the home? solely by yourself (S)
jointly with your spouse (SP)
jointly with another person (O)
Information for Government Monitoring
The following information is requested by the Federal Government for certain types of loans  related to a 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. The law provides that a Lender may neither discriminate on the basis of this information, nor on whether you wish to furnish it. However, if you choose to furnish it, under Federal regulations this Lender is required to note race and sex on the basis of visual observation or surname. If you do not wish to furnish the information below, please check the box below. (Lender must review the material to assure that the disclosures satisfy all requirements to which the Lender is subject under applicable state law for the particular type of loan applied for.)
Borrower

I do not wish to furnish this information.
Ethnicity: Hispanic or Latino
Not Hispanic or Latino
Race/National Origin: American Indian or Alaska Native
Pacific Islander or Native Hawaiian
Black or African-American
Asian
White
Sex:  Female or Male
Co-Borrower

I do not wish to furnish this information.
Ethnicity: Hispanic or Latino
Not Hispanic or Latino
Race/National Origin: American Indian or Alaska Native
Pacific Islander or Native Hawaiian
Black or African-American
Asian
White
Sex: Female or Male

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