On-Line Loan Pre-Qualification

On-Line Loan Pre-Qualification
Welcome to the Bell Capital Online prequalification page. If you are interested in applying for a mortgage with us, you may fill out the form below. This does not bind you or oblige you to use Bell Capital as your mortgage broker; it simply allows us to gain preliminary information about you to expedite the approval process. Once your prequalification is processed, you will be contacted by a Bell Capital counselor.If you would like to prequalify with us, but would rather not do so over the Internet, you may contact us, and we will gladly continue the process in person or over the phone.

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Last Name
First Name
Borrower's Current Address
City, State, Zip
Address of Property to be Financed
City, State, Zip
Current Home Phone #
Work Phone #	Ext.
Your Email address:
Have you applied for a mortgage within the past 90 days?	Yes No

 Please fill out the appropriate section below for either a purchase or for a refinance.

If this loan is for a purchase, please fill out the following section:

Has a contract been signed?	Yes No
Expected closing date
New construction?	Yes No
Number of units
Purchase price:
Down payment:
First time homebuyer?	Yes No
Real Estate Agent/Builder
Agent/Builder Phone
Agent/Builder FAX

If this loan is for a refinance, please fill out the following section:

Loan amount requested:
Amount currently owed:
Approximate value of home:
Current interest rate:
Current loan term:
When did your loan start?
Number of units