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Pre-Qualification Application        
All fields with an asterisk (*) are required

How did you hear about us?

Borrower Information
First Name *
Middle Initial
Last Name *
Street *
City *
State *
Zip Code *
Home Phone *
Mobile Phone *
E-mail Address *
S.S. # *
Birth Date
*
Marital Status
Years at Location Under Two Over Two *
Rent or Own Own Rent

Assets and Income
Monthly Income (Gross) *
Sources of Income * Self-employed
Commissions
Salary
Hourly
Other

Employer *
Job Title *
Years at Position *
Assets Checking/Savings Balance

Market Value of Real Estate

Other Assets

Co-Borrower Information
First Name
Middle Initial
Last Name
Street
City
State
Zip Code  Copy Borrower Address
Home Phone
Mobile Phone
E-mail Address
S.S. #
Birth Date
Marital Status
Years at Location Under Two Over Two
Rent or Own Own Rent

Assets and Income
Monthly Income (Gross)
Sources of Income Self-employed
Commissions
Salary
Hourly
Other

Employer
Job Title
Years at Position
Assets Checking/Savings Balance

Market Value of Real Estate

Other Assets

Questions or Comments


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Contact Us| Privacy & Security| NMLS # 2427

Golden Empire Mortgage, Inc. ("GEM") [NMLS ID No. 2427] is a California corporation whose principal business office is located at 1200 Discovery Drive, Ste. 300, Bakersfield, California 93309. GEM is a residential mortgage lender and servicer licensed by the Department of Business Oversight pursuant to the California Residential Mortgage Lending Act under license no. 413-0360. GEM conducts residential mortgage lending activities in the following additional states as follows:

Arizona: GEM conducts business in the state of Arizona as Golden Empire Mortgage, Inc. under Mortgage Bankers license no. 0906440 issued by the Arizona Department of Financial Institutions.

Colorado: GEM conducts business in the state of Colorado pursuant to a Mortgage Company Registration issued by the Colorado Division of Real Estate.

Hawaii: GEM conducts business in the state of Hawaii under Mortgage Loan Originator Company license no. HI-2427 issued by the Hawaii Division of Financial Institutions, Department of Commerce and Consumer Affairs.

Oregon: GEM conducts business in the state of Oregon under Mortgage Lending License no. ML-2891 issued by the Division of Finance and Corporate Securities, Department of Consumer and Business Services.

Texas: GEM conducts business in the state of Texas as GEM Mortgage, Inc. pursuant to a Mortgage Bankers Registration issued by the Texas Department of Savings and Mortgage Lending. Notice to Texas Loan Applicants

Washington: GEM conducts business in the state of Washington under Consumer Loan Company License no. CL-2427 issued by the Washington Division of Consumer Services, Department of Financial Institutions.

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