First Name:       Last Name:       Email:    

Home Phone:     Work Phone:      Fax Number:  

Address:        

City:                  State:      Zip:  

1) What is the sale price or price range you are looking at?  

2) How much do you want to put down?  

3) What type of property are you buying?

Choose SingleFamily Condo Townhome Duplex Triplex Units Other

4) Are you going to occupy the property?  

Choose No Yes

5)  What type of loan do you want?

Choose Fixed Rate Balloon Adjustable

6) How would you rate your credit?

Choose Excellent Good Fair Poor

7) Have you opened Escrow? If so, when is the closing date?

Choose No Yes    Close date:

8)  In order to get you the best rate you can qualify for, our loan specialist will need to run a credit check, ok?

Choose No Yes

9) To run your credit, we need your social security number:  

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