Basic Information Questionnaire
Note! Information provided stays exclusively between us. No 3rd party invited.
I am looking for information regarding
Please Select
Refinance to lower my rate
Refinance to pay off some debt
Refinance to get cash
Purchase a new home
To determine an idea for urgency, what is your time frame (No Pressure)
Please Select
ASAP
30 days
60 days
90 days
Just Looking
Name
First Name
Last Name
Email
example@example.com
Your Phone Number - (we do not share with anyone)
We'll use this number to call or text.
What is the city and state of the property
Your City
State
How will the property be used
Please Select
Primary Residence
Investment property
2nd home
If You're Looking to Refinance - Continue Here
Estimated value of your home
What is the existing mortgage balance
Month / Year you purchased the home
If You're Looking to Purchase a Home - Continue Here
What purchase price do you have in mind
How much money is available for a down payment
Approximately when do you intend to start shopping
A Couple of Question About Income and Debt
What is your total credit card debt and monthly payment
Combined credit card balance
Total combined credit card payment
How about car loans
Outstanding Car Loans
Total Monthly Payment
Finally, other outstanding loans - if any (Enter 000 if does not apply)
Total other loan amounts
Total other payments
What is your gross total household income
And Finally - About Your Credit
How would you consider your credit rating - (It's Confidential)
Please Select
Excellent
Good
Fair
Not So Great
If you know your credit score, please enter it here - (It's Confidential)
Submit
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