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Fill and Sign the Boy Scout Informed Consent Release Agreement and

Fill and Sign the Boy Scout Informed Consent Release Agreement and

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Ann Sugai g Inouye y Century City Los Angeles, CA Branch W Hollywood Hotel & Residences Pre-qualification Information Borrower Information First Name: Middle Name: Last Name: Co-Borrower Information (if applicable) First Name: Middle Name: Last Name: Borrower Current Residence Address: Address (2nd line): City: y State: Zip Code: Own or Rent: Rent Own Home Work (circle one) Borrower Contact Information Best Method of Contact: H Home Ph Phone: ( ) - Work Phone: ( ) - Cell Phone: ( ) - Cell (circle any) E-mail Address: Purchase Information Address of Property I wish to Purchase: Address (2nd line): City: State: Zip Code: Approximate Sales Price: $ % Estimated Down Payment %: or Estimated Loan Amount: $ Page 1 of 2 Using Home As: Buying : Primary Residence 2nd Home Investment Condo Single Family Co-Op 2-4 Unit (circle one) (circle one) Who Referred you to Us: Contact: Loan Information Type of Loan I Want: Not Sure 1/1 ARM 5/1 ARM Interest Only 30 Yr Fixed 3/1 ARM 7/1 ARM Interest Only 20 Yr Fixed 5/1 ARM 10/1 ARM Interest Only 15 Yr Fixed 7/1 ARM (circle one) 10/1 ARM Number of Points Willing to Pay: Do you currently have a Chase mortgage: Yes No (circle one) If Yes, please enter Loan Number: Total Yearly Income: $ *Note: Alimony, child support or separate maintenance income need not be revealed if you do not choose to have it considered for repayment. Total Monthly Debt: $ *Note: Total MONTHLY debt on other loans, credit cards, auto loans, installment loans, student loans, loans auto leases, leases other mortgage loans, loans etc. etc Total Liquid Assets: $ Social Security Number Information * Note: We need your social security number to check your credit report when pre-qualifying you. Please note that by providing us with your social security number you authorize us to request a copy of your credit report. You may wait until a loan officer contacts you to give your social security number, but this will delay the pre-qualification process. Borrower SSN: - - Co-Borrower SSN: - - © 2008 JPMorgan Chase & Co. Page 2 of 2

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