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Personal Information
1- Full Name
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2- Phone Number
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3- Address:
4- City:
5- State:
6- Zip Code:
7- Email Address:
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The Mortgage Type You Are Looking For
8- Mortgage Type
Your Propert Information
9- Property Type
10- Property use
11- Estimated Property Value e.g. 100000 (estimate OK)
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Your Loan Information
12- 1st Mortgage balance on Property e.g. 50000 (estimate OK)
 *
a. Monthly payment e.g.800 (estimate OK)
 *
b. Interest Rate % e.g. 7(estimate OK)
 *
13- Are There Additional Mortgages on the Property?
No
Yes
a. Balance of Additional Mortgagee.g. 20000 (do not include balance of the first mortgage)(estimate OK)
b. Monthly Payment e.g. 800 (estimate OK)
14- Which Mortgage(s) do you wish to Refinance?
15- How Much Additional Cash Do You Wish to Borrow? e.g. 25000 (estimate OK)
16- Preferred Rate
Fixed
Adjustable
17- Preffered Loan Term
30
15
10
 
Your Financial Information
18- Credit Status
19- Annual (Pre-Tax) Income Per Year e.g. 75000 (estimate OK)
 *
20- Average Monthly Debt Payments (Not Including Housing). Per Month e.g. 3000 (estimate OK)
 *
21- Have You Ever Declared bankrutcy?
22- Occupation Status
23- When Do You Want to Close This Loan?
24- What is Your Current Loan Goal?
25- Comment
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460 Riverhills Business Park
Birmingham, Alabama 35242
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