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| What type of loan do you need? |
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| Where is the property located? |
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| Property ZIP code |
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| Property area code |
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| (No mobile or manufactured homes) |
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| Purchase year |
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| Property use |
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| When are you likely to buy a home? |
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| Have you found a home? |
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| Do you have a signed contract to buy your home? |
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| Do you have a real estate agent? |
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| Agent name |
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| Agent phone |
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| (example: Prudential, Remax) |
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| Purpose of loan |
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$ .00 |
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| First mortgage interest rate |
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| ExistingDesired rate type |
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| Do you have a second mortgage? |
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| Second mortgage balance |
$ |
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| Second mortgage interest rate |
% |
How much additional cash would you like
to borrow? How much cash do you want for your
equity loan? How much debt do you wish to consolidate? |
$ |
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| Credit status |
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| Occupational status |
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| Have you ever declared bankruptcy? |
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| Are you a first time buyer? |
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