Coast360 Pre-qualification Questionnaire First Name: Last Name: Cell Phone Number: Home Phone Number: Email Address: Please choose the type of occupancy and type of property. Type of occupancy : Select... Owner occupied Investment Property type: Select... Single-family dwelling Condominium Townhome Multi-family (1-4 units) Land Please list all monthly Income (e.g. employment, length of service, gross monthly earnings, etc.). If no other sources of income indicate “0” if none). Employer: Length of service: Gross monthly earnings: Alimony: Child Support: VA Compensation: Social Security: Other source of income: Please list all debt obligations, make sure to include outstanding balances and monthly payments. Please provide an estimate of how much you have in verifiable liquid assets (e.g. savings and checking accounts, to include retirement or investment accounts as well). If no other verifiable liquid assets indicate “0” if none). Savings: Checking: Retirement: Investment: Other: If you are purchasing a home - Please provide the purchase price. Please also provide the source of your down payment and closing costs. Purchase price: Source of your down payment and closing costs: If you are refinancing a home - Please specify how much you want to borrow and your intent, with estimates where applicable (e.g. $140k to pay off 1st mortgage, $100k to consolidate loans, $15k cash back for improvements and $10k to cover closing costs). How much do you want to borrow? Intent with estimates: If you are constructing a home - Do you own the property free and clear? How much are you estimating construction costs to be? Do you own the property free and clear? Yes No Est. construction costs: Is there a monthly payment you would like to stay within? $ Please note below any specific questions you may have about the mortgage transaction you are contemplating. Before clicking Submit, please ensure that all your information is correct. Please tick this box before submitting your pre-qualification: Security Code Go to main navigation