Mortgage Prequalification Request

Please complete the following form to request a prequalification from Bentley and Leenher Mortgage Consulting LLC. Once you have completed this expression of interest or application your information will be sent to Bentley and Leenher Mortgage Consulting LLC. A representative from Bentley and Leenher Mortgage Consulting LLC may contact you by telephone or email. By submitting your expression of interest you are consenting to receive telephone calls or email from Bentley and Leenher Mortgage Consulting LLC.

CONTACT AND BORROWER INFORMATION

First Name

Last Name

Email Address

Current Street Address

City

State

Zip Code

Primary Phone

Alternate Phone

Best Time To Call

Would you like to provide loan information?

Yes

LOAN AND PROPERTY DETAILS

Time with Current Employer

Credit History

Loan Type

Years Months

Are you Self Employed?

Monthly Income

Monthly Debt

Yes

Loan Amount

Program

Time Frame

Property Value

Intended Use

Property Type

Property Street Address

City

State

Zip Code

COMMENTS

Mortgage Applications

Prequalify Request