PREQUALIFICATION - only for PA properties -


     By completing the following information, PMC can accurately profile you both quantitatively and qualitatively -- at no cost. Your financial profile (income, debt., & assets) will determine purchasing power under various mortgage scenarios that you may wish us to test. The details of each scenario will be professionally displayed on a mortgage analysis report. The qualitative analysis is assembled and reviewed via a prequalification credit report (3-bureau, merged in-file with FICO scores*). [ * - See Credit Report Info ] The combination of the financial analysis and credit report serves to ensure the likelihood of approval in a timely fashion without frustration. Prequalification performed prior to a sales offer being put forth also enhances your negotiating position with the realtor and seller. Expect a 24-48 hour response once this form is received.

     You can either print this form, fill in the information and fax/mail it to us, or provide the information  electronically (see below).

     I/We are interested in the following mortgage programs:


Program Options 
(Click on any program for  detailed explanation)
Investment or Second Residence: Call our office

Borrower Co-Borrower Cumulative
Income (annual):
Salary: $ $
*O.T.: $ $
*Bonus: $ $
*Commission: $ $
*Part-Time Job: $ $
TOTAL: $ + $


* = must be earned for at least two years. If applicable, amount is equal to the average of 2 year totals

Call our office

Debt (monthly)
Auto(s): $ $ Exact Req'd Pymt
Mortgage(s): $ $ "
Student(s): $ $ "
Personal(s): $ $ "
Alimony/Child Support/Etc.: $ $


Credit Card: $ $ Min. Req'd Pymt
Credit Card: $ $ "
Credit Card: $ $ "
Credit Card: $ $ "
TOTAL: $ + $
Available Cash
Very Liquid Accounts: $ $ Checking, savings, money market accounts, etc.
Less Liquid Accounts: $ $ CDs, stocks, bonds, mutual funds, etc. (not retirement)
Gift: $ $
Equity: $ $
Other: $ $
TOTAL: $ + $
This is for general evaluation only:
Retirement $ + $ Rough vested balances in IRA, 401k, 203b, etc.

First Name/ Middle Initial
Last Name/ (Jr./Sr.)

Are you a U.S. citizen?

If no, explain your legal residecy status

Date of Birth:

Address (2 year period)


Phone Numbers:         

at least one of the phone numbers must be filled in. This is for questions regarding the material; not for solicitation purposes





Social Security Numbers:
(if printing page)
E-Mail Address Where the report is to be sent

How would you honestly rate your credit history? Excellent Very Good Good Fair Poor

Check this box to authorize PMC, under the fair credit reporting act, to obtain information from your personal credit profile or other information from Experian, TransUnion and Equifax.


After completing this form, you can either print it and mail/fax it to PMC, or you may electronically submit this information directly to our server (secure transmission). All your information will be kept confidential and will not be released to non-authorized personnel. If you wish to electronically submit this form, please click on the "Submit" button below when you are finished.

By submitting this form with your telephone number you are consenting for Laurence Ostrom and all authorized representatives to contact you even if your name is on a Federal or State "Do not call List."

The information provided above is accurate and to the best of my/our record-keeping ability.
I/We understand that the accuracy of PMC's prequalification report is only as accurate as the information I/we have provided.
I/We give permission to Professional Mortgage Consultants to access my/our credit history for the sole purpose of prequalification and better evaluation to place a mortgage.
I/We understand that this confidential information will only be disclosed to myself/ourselves and my/our selling agent (if acting in a buyer-broker capacity).
If and when the mortgage is settled, the credit report will be destroyed and discarded.



PA Dep't of Banking
& Securities

License #20481

NMLS (Nationwide Mortgage Licensing System)
Originator ID #135687
Company ID #111211


The Lending Integrity Seal of Approval helps homebuyers find hardworking, ethical mortgage professionals. To earn the Lending Integrity Seal of Approval, professionals undergo a rigorous process—complete continuing education, pass a criminal background check, and pledge to adhere to a strict code of ethics, best business practices and an ethics grievance review process.

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