Full Name
Phone
*
Email
*
Preferred Method of Contact
Phone Call
Email
Text
What is your goal with this loan?
Purchase a home
Refinance my mortgage
What is the Target Home Price Range
$100k - $200k
$200k - $300k
$300k - $400k
$400k +
How Much do You Plan to Put Down?
Less than 10%
10 - 20%
20% or more
When do You Plan to Buy
Within 3 months
3 months or later
What is Your Homes Estimated Value?
Under $200,000
$200,000 - $350,000
$350,000 - $500,000
$500,000+
What is Your Current Mortgage Balance?
Under $100,000
$100,000 - $250,000
$250,000+
What is Your Main Reason for Refinancing
Lower my payment
Get cash out (e.g., for debt or other needs)
Shorten my loan term
What is Your Credit Score
700+ (Great)
600-699 (Good)
Below 600 (Fair)
Not sure