OFFICIAL PURCHASE/REFINANCE QUOTE FORM Please complete the following information as completely and accurately as possible General Information Required Fields* Valid Characters A-Z a-z 0-9 . , @ # _ Property State : * Select State Alaska Alabama Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Other State Is this a Purchase or Refinance?* Purchase Refinance Are You a First Time Buyer?* Yes No Are You or your Spouse Active or Retired Military?* Yes No Borrower Information Primary Applicant First Name: * Primary Applicant Last Name: * Street Address: * City: * State: * Select State Alaska Alabama Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Other State Zip Code: * Home Phone: * xxxxxxxxxx Cell Phone: Current Email Address: * How would you rate your Credit? * Select Credit... Excellent >700+ Good 640-700 Fair 580-640 Poor < 580 Don't know? Get your FREE CREDIT SCORE Own the home? Yes No Live Rent Free Have you filed Bankruptcy in the last 7 Yrs? Yes No Have you had a Foreclosure in the last 7 Yrs? Yes No Gross Monthly Income: $ ex.5,000.00 Purchase Information Are you working with a Realtor? Yes No Do you a home picked out? Yes No What County will the Property be located? Property Type? * Select Property... Single Family Condo Townhouse Multi Family Double Wide Manufactured Home Single Wide Manufactured Home Property Use? Primary Residence Secondary Residence Investment Property Desired new loan amount? * $ Estimated Purchase Price? * $ Contact Information Best Time To Contact You: Any Time Morning At Home Afternoon At Home Evenings At Home Morning At Work Afternoon At Work Evenings At Work Email Only Refinance Information What County will the Property be located? Property Type? * Select Property... Single Family Condo Townhouse Multi Family Double Wide Manufactured Home Single Wide Manufactured Home Property Use? Primary Residence Secondary Residence Investment Property Current Property Value? * $ Desired new loan amount? * $ What is the balance of the 1st mortgage? * What is current rate on the 1st mortgage? * Current Mortgage Status? Current on Payment 31 - 60 Days Late 61 - 90 Days Late 90+ Days Late Contact Information Best Time To Contact You: Any Time Morning At Home Afternoon At Home Evenings At Home Morning At Work Afternoon At Work Evenings At Work Email Only Thank You for Allowing our Loan Specialist to Assist You. By submitting this form with your telephone number you are consenting for FHAInfo.com, any of its affiliates, providers, business partners or authorized representatives to contact you even if your name is on the Federal "Do not call List" to discuss the information in your request.
Please complete the following information as completely and accurately as possible
Required Fields* Valid Characters A-Z a-z 0-9 . , @ # _
Thank You for Allowing our Loan Specialist to Assist You.
By submitting this form with your telephone number you are consenting for FHAInfo.com, any of its affiliates, providers, business partners or authorized representatives to contact you even if your name is on the Federal "Do not call List" to discuss the information in your request.
