Ocala Florida Mortgage -- Fleming Mortgage Services


	Cala Hills Professional Park 2123 SW 20th Place, Suite 102 • Ocala, Florida 34474 Phone: (352) 237-5168 • E-mail: info@flemingmortgage.com

On This Website:

Prequalify for Your Loan Online

NOTE: This is not a loan application and is used for
prequalification purposes only.

This form uses SSL encryption for your security. However, you may also pre-qualify by fax. Download our Prequalification Form and Fax to (352) 237-7091. (Get Adobe Acrobat Reader)

Use the form to begin the process of applying for your loan.
When we have received this information, we will contact you
to discuss the best loan options for your situation.

Borrower:		Co-Borrower:
Name:		Name:
Date of Birth:		Date of Birth:
SS#:		SS#:
Address:		Address:

City:		City:
State:	Zip:	State:	Zip:
E-mail:		Email:
Own Rent No. Yrs.		Own Rent No. Yrs.
Rent Paid by: Cash Check		Rent Paid by: Cash Check
Home Phone:		Home Phone:
Cell Phone:		Cell Phone:
Married Unmarried (includes single, divorced, widowed) Separated

Employment Information:

Self Employed:		Self Employed:
Position / Title & Type of Business:		Position / Title & Type of Business:

Years on this job:		Years on this job:
Years in this profession:		Years in this profession:
Name & Address of Employer:		Name & Address of Employer:



Work Phone:		Work Phone:
Gross Monthly Income: $		Gross Monthly Income: $
Other Income: $		Other Income: $
Source of other income:		Source of other income:

Asset Information:

Name of Bank:
Address of Bank:
Account Number:	Balance:	$

Name of Bank:
Address of Bank:
Account Number:	Balance:	$

Name of Bank:
Address of Bank:
Account Number:	Balance:	$

Stocks & Bonds (Company Name, Account Number & Description):
Item #1:
Item #2:
Item #3:
Item #4:

Real Estate Owned:

Property Address:	Present Market Value	Mortgage Amount	Gross Rental Income	Mortgage Payments	Type of Property
	$	$	$	$
	$	$	$	$
	$	$	$	$

Automobiles Owned:

Make:	Year:	Value:	$
Make:	Year:	Value:	$
Make:	Year:	Value:	$

Subject Property Information:

Address:
City:
State: Zip:
Amount of Mortgage Applied For: $
No. of Months Applied For:
Choose on of the following from each row:
Purchase	Refinance	Construction
Primary Residence	Secondary Residence	Investment Property

Refinance Information:

Year Home Was Acquired:

Purpose of Refinance: Rate / Term Cash Out Debt Consolidation

Personal / Financial Information Release Authorization:

I / We hereby authorize the release of any personal and / or financial
information requested by Fleming Mortgage Services as specified below:

Employment and Income Verification
Checking and Savings Deposit Verification
Mortgage Loan Balances and Payment History
Consumer Credit Balances and Payment History
Any other pertinent personal or financial information

Additional Questions or Comments:

Fleming Mortgage Services
Cala Hills Professional Park
2123 SW 20th Place, Suite 102
Ocala, Florida 34474

Phone: (352) 237-5168
Toll Free: 1-877-237-5948
Fax: (352) 237-7091
E-mail: info@flemingmortgage.com