Your Personal Information:

Name:

Address:

City:     State: MI AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY     Zip:     Phone:

E-mail Address:

Your Property Information:

The Mortgage Type You Are Looking For: Mortgage Refiance / Debt Consolidation Home Purchase Loan Home Equity Loan / 2nd Mortgage

Property Location: (State) MI AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY     Property Type: Single-Family Home Condominium Multiple-Family Dwelling Manufactured Home Mobile Home

Property Use: Primary Residence Secondary Residence Vacation Home Investment

Are You A First Time Home Buyer?    Yes No     Have You Found A Home?   Yes No

Do You Have A Real Estate Agent?   Yes No

Your Loan Information:

Estimated Property Value:          Down Payment Amount:  %

Rate Type:  Fixed     Adjustable                     Preferred Loan Term:   10 Years 15 Years 20 Years 30 Years

Your Personal Financial Information:

Credit Status:   Excellent, Never any issues Good, No recent issues Fair, Recent issues or history of issues Poor, Major issues or Limited credit history

Annual (pre-tax) Income:      Occupation Status: Employed Self-Employed Retired Not Employed

Have You Ever Declared Bankruptcy: No / Not in the last 7 years 5-7 years ago 2-5 years ago 1-2 years ago Less than 12 months ago

When Do You Want To Close This Loan?  30 Days 60 Days 90 Days I have no time constraints

What Is Your Current Loan Goal?   I am looking for a Lender an comparing loans I have a Lender, but am looking at other loan options I am just checking rates