Purchase & Refinance Survey

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Are you currently speaking or working with a Renasant Mortgage banker?* This field is required.Please select an option below

YESNO

2

Please provide the mortgage bankers namePlease provide first and last name if possible.

3

Are you purchasing or refinancing?* This field is required.Please select an option below

Purchasing

Refinancing

HELOC

4

In what state will you be purchasing of refinancing?* This field is required.

5

In what state are you looking to get a HELOC?* This field is required.Only available states are listed

6

What is the current address?* This field is required.

Street Address

City

State

Zip Code

Country

7

We regret to inform you that Renasant Mortgage does not currently lend in the state you selected. However, we offer other services that may be of interest to you. If you would like someone to contact you with more information, please provide your contact details, and we will reach out promptly.

8

How are you currently using or planning to use this property?* This field is required.

My primary home

As a rental property

A secondary home

Land Only

9

Will this be your first property purchase?* This field is required.Please select you or now

YES

NO

10

What is your refinance purpose?* This field is required.Please select an option below

Rate Term

Cash Out

11

What type of property?* This field is required.Please select option below.

Single Family Home

Condominium

Townhome

Multi-Family Home

Not sure? Our loan officers can help!

12

What is your current ZIP code?* This field is required.Please enter zip code below

Postal/ Zip Code

13

What is the current value of your property?* This field is required.Please please value below

14

How close are you to purchasing a property?* This field is required.Please select an option below.

I've signed a purchase agreement

I've found a property, and/or have made an offer

I'm planning to buy over the next six months

I'm just researching options

15

What's the price of the property? If you're not sure, give us your best guess.* This field is required.Please place amount below

16

What's the ZIP code of where you are considering a purchase?* This field is required.Please enter Zip code below.

17

Are you using, or do you plan to use, a real estate agent?* This field is required.Please select an option below

YES

NO

18

What percentage of the total price can you cover as a down payment?* This field is required.Please enter percentage below.

20

How would you rate your credit score? (If you don't know your exact score, give it your best shot.)* This field is required.Please select an option below.

Excellent (740+)

Fair (600-659)

Good (700-739)

Poor (< 600)

21

What's your annual household income?Please place amount below.

Please enter a number from 0 to 500,000.

22

Have you experienced bankruptcy, foreclosure, or a short sale during the past three years?* This field is required.Please select an option below

NO

YES

23

Can you show us proof of income? * This field is required.Income verification is a necessary step toward any form of lending. Your W2s, pay stubs or tax returns can all do the trick.

YES

NO

24

What is your name?* This field is required.Please enter first and last name below.

First Name

Last Name

25

What is your preferred method of contact?* This field is required.The information you provide will be used for communication purposes only.

Cell

Email

26

What is your email address?* This field is required.Please provide an email below. The email provided will be used for communication purposes only.

example@example.com

27

What is your phone number?* This field is required.Please verify the accuracy of your phone number for proper communication. The number provided will NOT be used for electronic solicitations or robo calls

Please enter a valid phone number.

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Please click submit

Submitting this form does not constitute a prequalification or preapproval. By clicking submit you acknowledge and agree to our Terms of Use and Privacy Policy, to be contacted at the phone number (including any mobile or cellular phone number) and email previously provided, to be contacted despite being included on any Do Not Call registry or CAN-SPAM email opt-out registry, that you may be contacted utilizing an automated telephone dialing system or utilizing pre-recorded messages, that this submission does not constitute a loan application, that you may unsubscribe or otherwise opt-out of any calls or emails you receive from us, that you are not required to agree (as a condition of purchasing any property, goods, or services) to be contacted at the given phone number for calls through automated telephone dialing systems or pre-recorded message systems, and in the event you clicked on “Get my rate,” our provision of a rate to you may be subject to further verification of information you provided, up to and including the ordering of a credit report.

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