Mortgage One Group, wants to make easy the pre-qualification process of your loan.  For you convenience we have designed this form.

Please complete the form and send us your information.  One of our representatives will contact you soon.

Our customers is our first priority.  Remember, in Mortgage One Group, We

are the door to your Home.

Type of Loan:      Construction Loans Sales Contract Refinancing Second Mortgage Loans Other      

Name:      

Mail Address:                                                                                            

 City:      State:   Zip code:                 

 Physical Address:

 City:     State:   Zip code:

     Telephones:  ()--  Day Night Celular Fax Other        ()-- Night Day Celular Fax Other

                           ()--  Celular Day Night Fax Other        ()-- Fax Day Night Celular Other

        e-mail:

 Type of Employment:       Company:    

        Salary:         Annual Monthly Per Hour      Year of services:      Type of Income: Salary Owned Business Pension Other

          List of Debts:

       Institution    Monthly Payment    Balance 

        Saving Accounts:

            Institution          Account No. 

        Comments: