South Bay Mortgage and Capital


Thank you for taking the time to fill out this pre-qualifying application. We value your privacy and our web-site is secure. However, if you would prefer not to include your social security number in this web-based form, then please leave the section blank and call our toll free number to complete the application.
Pre-qualify APPLICATION:
BORROWER INFORMATION: *(Required information please fill out completely)
First Name:*
Last Name:*
Date of Birth:*	/ /
Social Security No:	- -
Current Mailing Address:
Street:*
Additional:
City:*
State:*
Zip Code:*
Daytime Phone:*	(i.e.) 123-456-7890			Ext.
Evening Phone:*	(i.e.) 123-456-7890			Ext.
Email Address:*
Confirm Email Address:*

loan request INFORMATION:

Requested Loan Amount		$	.00
Estimated Home Value		$	.00
(Help find Home Value)


Disclosure:
I/We agree that South Bay Mortgage & Capital may obtain and exchange such personal information (including credit experience and financial information) as may be required by South Bay Mortgage & Capital in connection with my/our accounts. I/we agree and authorize South Bay Mortgage & Capital to conduct a credit bureau search in order to determine my/our eligibility for the mortgage account. I/we confirm that I/We have read and consent to the treatment of my/our personal information according to South Bay Mortgage & Capital Privacy code. I/We agree that the personal information collected, used or disclosed in connection with this mortgage account can be shared with South Bay Mortgage & Capital, co-applicants and/or granters.
Do you agree with the terms?			Yes	No


	South Bay Mortgage & Capital Inc. 2301 Rosecrans Avenue, Suite # 4120 El Segundo, CA 90245 Phone: (310) 536-5173 Fax: (310) 536-5174 CA Lic # 01521685

	Palisades Mortgage Group, LLC 2301 Rosecrans Avenue, Suite # 4120 El Segundo, CA 90245 Phone: (310) 536-0643 Fax: (310) 536-5174

“Home mortgage and home equity approvals are subject to underwriting review and credit approval. South Bay Mortgage & Capital is a California Corporation and member of the Better Business Bureau. South Bay Mortgage & Capital is not a direct lender. Information provided to us is kept confidential and will only be used to determine a borrower’s credit worthiness. South Bay Mortgage & Capital does not issue loan commitments or lock-in agreements. Loans are subject to borrower qualifications, property evaluation and credit approval. All rates and program guidelines are subject to change without notice. South Bay Mortgage & Capital services are administrative only. You should rely on your own judgment in deciding which loan product and program best suits your needs.”

	South Bay Mortgage & Capital, Inc. All Rights Reserved. This site is directed at, and made available to, persons in the continental U.S., Alaska and Hawaii, only. California Department of Real Estate Broker License #01521685. We are an Equal Housing Lender. South Bay Mortgage & Capital is not a direct lender. Palisades Mortgage Group, LLC is a California Corporation. Palisades Mortgage Group is the exclusive marketing affiliate for South Bay Mortgage & Capital, Inc. Palisades Mortgage Group is not a licensed real estate broker or direct lender. Information provided by us is kept confidential and will only be used to determine a borrower’s credit worthiness. All rates and program guidelines are subject to change without notice.
Disclosures:	Patriot Act / Housing Financial Discrimination Act of 1977 / Equal Credit Opportunity Act