NMLS #2365

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Regent Financial Group

Please fill out our Pre-Qualification form below.
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Purchase or Refinance
How is the property currently used?
Borrower Information

We will gather some basic information about you and your mortgage needs to help find you the best available options there are.


Contact information
Current Address
Living Details
Birth Date
Social Security Number
Monthly Income

Now lets answer some questions about income.
Notice: Alimony, Child Support or Separate Maintenance income need not be revealed if the borrower or co-borrower does not choose to have it considered for repaying this loan.


Gross Monthly Income $
Additional Monthly Income $
Do you have any additional income?
Additional Income
Additional Monthly Income $
Employment Section
Employed

Please add your employment information below.


Self Employed
Assets
Checking $
Savings $
Retirement Funds $
Other $
Additional Real Estate Owned
Additional Real Estate Owned
Additional Details (Marital Status)
Do you pay child support or alimony?
How Much Per Month $
Are You a Veteran?
How Many Dependents?
First Time Home Buyer?
Co-Borrower

Are you applying with a co-borrower?

No
Are you married to the Co-borrower?
Co-borrower Detail
Co-borrower Detail
Co-borrower address the same as borrower?
Co-borrower Address
Birth Date
Living Details
Social Security Number
Monthly Income

Now lets answer some questions about income.
Notice: Alimony, Child Support or Separate Maintenance income need not be revealed if the borrower or co-borrower does not choose to have it considered for repaying this loan.

Gross Monthly Income $
Additional Monthly Income $
Do you have any additional income?
Additional Income
Additional Monthly Income $
Employment Section
Employed
Self Employed
Assets
Checking $
Savings $
Retirement Funds $
Other $
Additional Real Estate Owned
Additional Real Estate Owned
Additional Details (Marital Status)
Do you pay child support or alimony?
How Much Per Month $
Are You a Veteran?
Yes
No
How did you hear about us?
Additional Fields
Authorization
I agree to PreApp LLC Terms of Service and Privacy Policy. I also agree to Regent Financial Group eDisclosure and eSignature Credit Authorization agreements. I authorize by my Electronic Signature below, for Regent Financial Group to obtain a credit report.

Regent Financial Group
MLO - Bradley Dexter
NMLS #78146
PreApp 1003
1910 S 72nd Street, suite 103
Omaha, Nebraska 68124
Business Phone: 402-8845634
Cell Phone: 4025255008
Fax: 4028845638
www.regentfinancial.com
Email: braddexter@regentfinancial.com


PreApp 1003