Home Loan Pre-Qualification United Bank of Union

Full Name *

Social Security Number *

Date of Birth *

Gross Monthly Income (Before Taxes) *

Years With Employer *

Do you pay Child Support or Alimony?

Yes

No

If yes, list monthly amount paid.

Mandatory Disclosure

Do you receive Child Support or Alimony?

Yes

No

If yes, list monthly amount received.

(You do not have to reveal this information if you do not want it to be considered as basis for repaying obligation.)

Street *

City *

State *

Zip *

Phone *

Email Address *

Do you have a Co-Applicant?

Yes

No

Co-Applicant Information

Full Name *

Social Security Number *

Date of Birth *

Gross Monthly Income (Before Taxes) *

Years With Employer *

Do you pay Child Support or Alimony?

Yes

No

If yes, list monthly amount paid.

Mandatory Disclosure

Do you receive Child Support or Alimony?

Yes

No

If yes, list monthly amount received.

You do not have to reveal this information if you do not want it to be considered as basis for repaying obligation.

Co-Applicant Information

Street *

City *

State *

Zip *

Phone *

Email Address *

Applicant Agreement and Disclosure *

Before typing your name below, I understand that I am submitting this form electronically and at any time I can contact United Bank of Union at 636-583-2555 and cancel my submission. I may also request at any time a paper version of this form by calling United Bank of Union. I understand there are no fees in regards to submitting this form and I understand the system requirements that are stated in our Online Service Agreement to have the ability to electronically submit this form. Please click on the following link to see our Online Service Agreement if needed. (www.ubu.bank/disclaimer-agreement.html)

By typing below, I hereby authorize United Bank of Union to obtain a credit report for the purpose of pre-qualifying for a home mortgage loan and understand I am not making application for a mortgage loan at this time.

Typed Name of Applicant *

Date *

By typing your name below, I intend to apply for joint credit, and acknowledge receipt of a copy of this notice on today's date

Typed Name of Applicant *

Applicant Date *

Typed Name of Co-Applicant *

Joint Applicant Date *

Home Loan Pre-Qualification

United Bank of Union Online Pre-Qualification

Home Loan Pre Qualification

Thank you for your submission!