EASTERN MORTGAGE SERVICES
3 Greentree Centre - Suite 103
Marlton, NJ 08053

PRE-QUALIFICATION

Borrower's Signature Authorization Form



I/We hereby authorize Eastern Mortgage Services to verify my/our past and present credit history by ordering a tri-merged consumer credit report. The information that Eastern Mortgage obtains will be used to determine whether I/we will qualify for a mortgage loan.

Borrower's Signature
Date
Borrower's Signature
Date
Borrower #1 Borrower #2
Name
Name
Address, Zip
Address, Zip
Home Phone Number
Home Phone Number
Social Security Number
Social Security Number
Name of Employer
Name of Employer
Phone Number of Employer
Phone Number of Employer
Weekly Gross Income
Weekly Gross Income
Length of Current Employment
Length of Current Employment
Other Income
Other Income

Please fax completed information to: 800-343-5572

Attention:
Raymond Johnston, Jr.
Construction Finance Consultant
Phone: 800-245-1175 (Ext. 3277)
Pager: 800-493-0767

Builder Name: Dennis Link
Builder Phone: 856-696-0943