PEOPLE'S BANK MORTGAGE PRE-QUALIFICATION
     

Is this an individual or joint mortgage?:	Individual Joint
Account Holder Information
Last Name:
First Name:
Middle Name:
Social Security Number:
Current Address:
City:
State:	TN
Zip:
Home Phone:
Business Phone:
Email:
Contact Information
Time available for contact:	A.M P.M.
Contact at:	Home Work
Co-Account Holder Information
Last Name:
First Name:
Middle Name:
Social Security Number:
Current Address:
City:
State:	TN
Zip:
Home Phone:
Business Phone:
Email:
Contact Information
Time available for contact:	A.M P.M.
Contact at:	Home Work
Optional Information To further assist in pre-qualification, please provide the following optional information (please do not use commas or dollar signs in any answer).
A complete application will sent to the above address.
Gross Income:	$ (Borrower)
	$ (Co-Borrower)
Total Revolving Debt:	$ (Per Month)
Total Installment Debt:	$ (Payments on existing installment loans per month)
Value / Sale Price of Property	$
Loan Amount:	$
Taxpayer Identification Number Certification
Social Security Number(s): The Social Security Number(s) shown above is my correct SSN.
Backup Withholding: I am not subject to backup withholding either because I have not been notified that I am subject to backup withholding as a result of a failure to report all interest or dividends, or the Internal Revenue Service has notified me that I am no longer subject to backup withholding.
Exempt Recipients: I am an exempt recipient under the Internal Revenue Service Regulations.
Nonresident Alien: I am not a United States person, or if I am an individual, I am neither a citizen nor a resident of the United States.
I certify under penalties of perjury the statements checked in this section are true.
I authorize Peoples Bank & Trust to obtain a copy of my current credit report as a condition of acceptance of this application and for the purpose of extension of or renewal of credit.
I would like to access this account through Online Banking.
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* Only available for Tennessee residents