Select Loan Type Home Purchase Home Refinance Home Equity Next SELECT PROPERTY TYPE Single Family Multi Family Condominium Townhouse Manufactured Home BackNext WHAT IS THE PROPERTY USE Primary Residence Vacation Home Investment BackNext HOW IS YOUR CREDIT? Excellent Very Good Good Fair Poor BackNext MILITARY SERVICE? Yes No BackNextTELL US ABOUT YOUR NEEDS Loan Purpouse ---Lower Interest RateLower Monthly PaymentDebt ConsolidationChange Rate/TermHome ImprovementTake Cash Out Estimated Property Value ---Less Than $10,000$10,001 - $ 20,000$20,001 - $ 30,000$30,001 - $ 40,000$40,001 - $ 50,000$50,001 - $ 60,000$60,001 - $ 70,000$70,001 - $ 80,000$80,001 - $ 90,000$90,001 - $ 100,000$100,001 - $ 110,000$110,001 - $ 120,000$120,001 - $ 130,000$140,001 - $ 150,000$150,001 - $ 160,000$160,001 - $ 170,000$170,001 - $ 180,000$180,001 - $ 190,000$190,001 - $ 200,000$200,001 - $ 210,000$210,001 - $ 220,000$220,001 - $ 230,000$230,001 - $ 240,000$240,001 - $ 250,000$250,001 - $ 275,000$275,001 - $ 300,000$300,001 - $ 325,000$325,001 - $ 350,000$350,001 - $ 375,000$375,001 - $ 400,000$400,001 - $ 425,000$425,001 - $ 450,000$450,001 - $ 475,000$475,001 - $ 500,000$500,001 - $ 525,000$525,001 - $ 550,000$550,001 - $ 575,000$575,001 - $ 600,000$600,001 - $ 625,000$625,001 - $ 650,000$650,001 - $ 675,000$675,001 - $ 700,000$700,001 - $ 725,000$725,001 - $ 750,000$750,001 - $ 800,000$800,001 - $ 825,000$850,001 - $ 875,000$875,001 - $ 900,000$900,001 - $ 925,000$925,001 - $ 950,000$950,001 - $ 975,000$975,001 - $ 1,000,000$1,000,001 - $ 1,100,000$1,100,001 - $ 1,200,000$1,200,001 - $ 1,300,000$1,300,001 - $ 1,400,000$1,400,001 - $ 1,500,000$1,500,000 + 1st Mortgage Balence ---Less Than $30,000$30,001 - $ 40,000$40,001 - $ 50,000$50,001 - $ 60,000$60,001 - $ 70,000$70,001 - $ 80,000$80,001 - $ 90,000$90,001 - $ 100,000$100,001 - $ 110,000$110,001 - $ 120,000$120,001 - $ 130,000$140,001 - $ 150,000$150,001 - $ 160,000$160,001 - $ 170,000$170,001 - $ 180,000$180,001 - $ 190,000$190,001 - $ 200,000$200,001 - $ 210,000$210,001 - $ 220,000$220,001 - $ 230,000$230,001 - $ 240,000$240,001 - $ 250,000$250,001 - $ 275,000$275,001 - $ 300,000$300,001 - $ 325,000$325,001 - $ 350,000$350,001 - $ 375,000$375,001 - $ 400,000$400,001 - $ 425,000$425,001 - $ 450,000$450,001 - $ 475,000$475,001 - $ 500,000$500,001 - $ 525,000$525,001 - $ 550,000$550,001 - $ 575,000$575,001 - $ 600,000$600,001 - $ 625,000$625,001 - $ 650,000$650,001 - $ 675,000$675,001 - $ 700,000$700,001 - $ 725,000$725,001 - $ 750,000$750,001 - $ 800,000$800,001 - $ 825,000$850,001 - $ 875,000$875,001 - $ 900,000$900,001 - $ 925,000$925,001 - $ 950,000$950,001 - $ 975,000$975,001 - $ 1,000,000$1,000,001 - $ 1,100,000$1,100,001 - $ 1,200,000$1,200,001 - $ 1,300,000$1,300,001 - $ 1,400,000$1,400,001 - $ 1,500,000$1,500,000 + 1st Mortgage Interest Rate ---11.000% ++10.750%10.500%10.250%10.00%9.750%9.500%9.250%9.000%8.750%8.50%8.25%8.00%7.750%7.500%7.250%7.000%6.750%6.50%6.250%6.000%5.750%5.500%5.250%5.000%4.750%4.500%4.250%4.00%3.750%3.500%3.250%3.000%2.750%2.500%2.250% Do you have a Second Mortgage? ---YesNo 2nd Mortgage Balence ---Less Than $10,00010,001 - $ 20,000$20,001 - $ 30,000$30,001 - $ 40,000$40,001 - $ 50,000$50,001 - $ 60,000$60,001 - $ 70,000$70,001 - $ 80,000$80,001 - $ 90,000$90,001 - $ 100,000$100,001 - $ 110,000$110,001 - $ 120,000$120,001 - $ 130,000$140,001 - $ 150,000$150,001 - $ 160,000$160,001 - $ 170,000$170,001 - $ 180,000$180,001 - $ 190,000$190,001 - $ 200,000$200,001 - $ 210,000$210,001 - $ 220,000$220,001 - $ 230,000$230,001 - $ 240,000$240,001 - $ 250,000$250,001 - $ 275,000$275,001 - $ 300,000$300,001 - $ 325,000$325,001 - $ 350,000$350,001 - $ 375,000$375,001 - $ 400,000$400,001 - $ 425,000$425,001 - $ 450,000$450,001 - $ 475,000$475,001 - $ 500,000$500,001 - $ 525,000$525,001 - $ 550,000$550,001 - $ 575,000$575,001 - $ 600,000$600,001 - $ 625,000$625,001 - $ 650,000$650,001 - $ 675,000$675,001 - $ 700,000$700,001 - $ 725,000$725,001 - $ 750,000$750,001 - $ 800,000$800,001 - $ 825,000$850,001 - $ 875,000$875,001 - $ 900,000$900,001 - $ 925,000$925,001 - $ 950,000$950,001 - $ 975,000$975,001 - $ 1,000,000$1,000,001 - $ 1,100,000$1,100,001 - $ 1,200,000$1,200,001 - $ 1,300,000$1,300,001 - $ 1,400,000$1,400,001 - $ 1,500,000$1,500,000 + 2nd Mortgage Interest Rate ---11.000% ++10.750%10.500%10.250%10.00%9.750%9.500%9.250%9.000%8.750%8.50%8.25%8.00%7.750%7.500%7.250%7.000%6.750%6.50%6.250%6.000%5.750%5.500%5.250%5.000%4.750%4.500%4.250%4.00%3.750%3.500%3.250%3.000%2.750%2.500%2.250% BackNextTELL US ABOUT YOUR NEEDS Any Late Mortgage Payment? ---YesNo Any Foreclosures? ---YesNo Do you currently have any FHA loan? ---YesNo Bankruptcy in last 7 years? ---YesNo Annual Household Income---$0 - $ 30,000$30,001 - $ 45,000$45,001 - $ 60,000$60,001 - $ 75,000$75,001 - $90,000$90,001 - $ 105,000$105,001 - $ 120,000$120,001 - $ 135,000$135,001 - $ 150,000$150,000 ++ Employment Status EmployedSelf EmployedRetiredUnemployed Monthley Debt Payment ---$0 - $500$501 - $1000$1001 - $2000$2001 - $3000$3001 - $4000$4001 - $5000S5000++ BackNextPROPERTY ADDRESS BackNextCONTACT INFORMATION Best time to Contact ---ASAPAfternoonMorningEvening Your first name Your Last name Your Email Your Phone Your Alternate Phone Back
