| Your Full Name | * |
| Address | * |
| City | * |
| State(USA Only) | AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY * UNITED STATES ONLY! |
| Zip/Postal Code | * |
| Home Phone | * |
| Work Phone | * |
| Email Address | * |
| Best Time To Call | Morning at Home Morning at Work Afternoon at Home Afternoon at Work Evening at Home Late Evening at Home * |
| Do You Own Your Home? | Yes No * Mobile Homes Do Not Qualify |
| Property Value | = 50000)) { alert('Not Valid! Please enter the approximate value of current property or property you wish to purchase \n (greater than or equal to 50000) using only number characters - 0123456789'); this.focus(); this.select(); return false; }"> * Please use numbers only |
| Property Type | Single Family Residence Condo Townhouse 2-4 Plex Other * |
| Purchase Price | * Please use numbers only |
| Year Acquired | * |
| 1st Mortgage-Balance Owed | * Please use numbers only (ex:45000) enter 0 for none |
| 1st Mortgage-Interest Rate |
10 or Above
Below 7.0
7.0-7.49
7.5-7.99
8.0-8.25
8.26-8.49
8.5-8.75
8.76-8.99
9.0-9.49
9.5-9.99
% |
| Is 1st Adjustable or Fixed? | Fixed Adjustable * |
| Employer | * |
| Monthly Gross Household Income | * Please use numbers only |
| 2nd Mortgage Balance owed | > * Please use numbers only(ex:45000) enter 0 for none |
| Amount You Wish To Borrow |
Please Select
15,000 - 30,000
30,000 - 45,000
45,000 - 60,000
60,000 - 75000
75,000 - 90,000
90,000 - 110,000
110,000 - 125,000
125,000 - 150,000
150,000 - 175.000
175,000 - 200,000
200,000 - 250,000
250,000 - 300,000
300,000 - 350,000
350,000 - 400,000
400,000 - 450,000
450,000 - 500,000
500,000 and up
* |
| Credit Rating | Good Fair Poor Excellent * |
| Monthly Debt | * Please use numbers only |
| Loan Interested In |
Please Select
Debt Consolidation
Second Mortgage
Home Improvement
Refinance W/ Cash Out
Refinance
Purchase
* |
Fast & Easy -You Are Done !
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