In order to complete the initial prequalification for a mortgage loan, please provide the information below and click the submit button. Completing the form does not obligate you to North State Bank, but we will be happy to pre-qualify you at no cost. You do not have to be a North State Bank customer to qualify for a loan. To see our privacy statement regarding any information you submit, click here Note: Because this is a preliminary step in the mortgage loan process, we will not request your credit report from the reporting agencies. In order to complete the loan process, however, we will need additional information and a credit report will be requested from credit reporting agencies. Please fill out all fields as best you can.  Name  Co-borrower’s Name (if any):  Address:  City:  State:  Zip:  Phone:  Best time to call:  Email Address:  Gross annual income:  Cash on deposit:  Monthly car payments:  Minimum monthly credit card payments:  Other payments (loan, child support, alimony, student loan, other):  Would you like to purchase a new home  or refinance a current mortgage loan? Purchase Refinance      If refinancing: What is the approximate value of your present home? What is the balance on your first mortgage? What is the balance on your equity line?  Is this your first home? No Yes  What would you like your TOTAL monthly payment to be?  including principal and interest, private mortgage insurance (PMI)  homeowner’s insurance, and taxes  Are you a North State Bank customer? No Yes  How did you learn about this web site?  Comments or other information you would like to provide

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