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Lyn MacCarty at RBC Mortgage
Pre-qualification & Authorization
Phone: (269) 473-2778 Ext. 222 or (269) 208-3377

Please fill out the following information accurately and press the I AGREE button to begin a mortgage
pre-qualification. Lyn MacCarty at RBC Mortgage will contact you to complete the application process
at no cost or obiligation.

* Indicates a required field
Date: 
Loan Officer Name: 
 Lyn MacCarty
Realtor/Contractor: 
 Keller Williams Realty
Agent Name: 
Liz Beck
Borrower's Name: 
*
Borrower's SSN: 
 *
Borrower's Date of Birth:  *
Co-Borrower's Name: 
Co-Borrower's SSN: 
Co-Borrower's Date of Birth: 
Current Address: 
*
City/State/Zip Code: 
* *
Do you currently Rent or Own?:
*
How long have your lived here?:
*
Home Phone #: 
 *
Work Phone #: 
Borrower's Employer: 
* How Long?:  *
Co-Borrower's Employer: 
How Long?: 
Borrower's Gross Monthly Income: 
 $ *
Co-Borrower's Gross Monthly Income: 
 $
Are there any other sources of income? If so please list amounts and type of income: 
Down Payment (enter 0 if none):  $ *
By clicking on the button below, the above individual(s), hereby authorizes RBC Mortgage to obtail a FREE In-file Credit Report on them for the purposes of pre-qualifying them for a Mortgage Loan. RBC Mortgage will contact these individuals directly to discuss the results of the pre-qualification.