MALoans: Quick Qualifier

Confidential Statement of Information

To allow us to assist you promptly, we ask that you complete the following form. You can be confident that the information provided is used only for processing your application and will never be offered to any other entity. There is no obligation in filling out the following information.

If you’d prefer to print and fax your form, a PDF version is provided for download. Fax the completed form to (408) 296-1588 or the fax number of your nearest office. If you have any questions, feel free to contact us.

*Required field


*First Name	*Full Middle Name	*Last Name

Business Phone	*Home Phone	Social Security No.

Spouse’s Name	Full Middle Name	Last Name

Business Phone	Social Security No


Residence last three years
Number & Street	City, State & Zip Code	From	To

Number & Street	City, State & Zip Code	From	To

Number & Street	City, State & Zip Code	From	To


Occupation last three years
Applicant’s Occupation	Firm Name	Annual Income	No. of Yrs

Applicant’s Occupation	Firm Name	Annual Income	No. of Yrs

Co-Applicant’s Occupation	Firm Name	Annual Income	No. of Yrs

Co-Applicant’s Occupation	Firm Name	Annual Income	No. of Yrs


Property Address:
Street Address of the property in this transaction:


I/We the above, do hereby give my/our consent to have Mortgage Assistance Lending Group or any company which is designated by it, to obtain any and all information concerning my/our employment, checking and/or savings accounts and all other credit rating information which they may require in conjunction with my/our application for a loan. This form may be reproduced and a copy shall serve to be as effective a consent as the original I have submitted.