NMLS #179785

Thank you for contacting
Region Mortgage
Please fill out our Pre-Qualification form below.
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Purpose of this loan?


Property type?





How will the property be used?




Mixed-Use: If you will occupy the property, will you set aside space within the property to operate your own business? (e.g., daycare facility, medical office, beauty/barber shop)

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

Notice: An email has been sent to with the subject " Toolbox Link". If you are unable finish the pre-qualification form now, you can use that link to complete it later. The pre-qualification form should only take a few minutes to complete.

Living Details

Birth Date

Social Security Number

Employment Section




Employed

Please add your employment information below.

Do not include bonuses, overtime, or commission, this will be added later.

Self Employed

Any Additional Monthly Income?


Assets

+ add additional assets

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?


Add Co-borrower?

Are you applying with another borrower or a co-borrower?


Are you married to the Co-borrower?


Co-borrower Details

Co-borrower address the same as borrower?


Co-borrower Address

Living Details

How long has the co-borrower lived at the current address?

Birth Date

Social Security Number

Employment Section




Employed

Please add your employment information below.

Do not include bonuses, overtime, or commission, this will be added later.

Self Employed

Any Additional Monthly Income?


Any assets not already listed by the borrower?


Additional Real Estate Owned

Does the co-borrower have any real estate owned not already listed by the borrower.


Additional Real Estate Owned

Does co-borrower pay child support or alimony?


How Much Per Month

Co-borrower a Veteran?


How Many Dependents?

First Time Home Buyer?


Notice: Upon submission of your prequal form, each co-borrower added will receive an email with the subject "FIRST_NAME LAST_NAME Toolbox Link" (if not found check spam folder). Co-Borrowers can use the toolbox link to complete their portion of the prequal form OR you can complete their portion by following the next steps. Please DO NOT have the co-borrowers fill out a new prequal form.

Each co-borrower will have to sign their own credit authorization from their own toolbox. If the email is not found in the inbox, please check the spam folder.

Are you married to a co-borrower?


Are you married to a co-borrower?

How did you hear about us?

Authorization

agree to PreApp LLC Terms of Service and Privacy Policy. also agree to Region Mortgage eDisclosure and eSignature Credit Authorization agreements. I authorize by my Electronic Signature below, for Region Mortgage to obtain a credit report.

Thanks

Thanks


Region Mortgage
MLO - Ed Stojancevich
NMLS #368666

9111 Broadway Suite H
Merrillville, IN
Business Phone: (866) 773-4466
Cell Phone: (219) 973-6644
Fax: (219) 400-5600
Website: www.Region.Mortgage
Email: ed@region.mortgage

NMLS Consumer Access

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