|
Your
Name:* |
|
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Your
Company: |
|
|
Address: |
|
|
City,
State, Zip: |
,
,
|
|
Home
Phone: |
|
|
Work
Phone:* |
ext:
|
|
E-mail
Address:* |
|
|
Please
contact me by:* |
email,
home phone,
work phone |
| Best
time to reach me: |
|
|
Property
Information |
| Approx. Property
Value:* |
$
|
| Property
Purchase Price: |
$
|
| Property
Purchase Date: |
|
| Any
foreclosures, bankruptcies, leins, or judgements?* |
|
| Property
Type:* |
|
|
Property
Description: |
|
|
Property
Address:* |
|
|
Property
City & State:* |
,
|
| Does
Your Client Own Any Other Real Estate?* |
|
|
Existing
First Trust Deed |
|
Present
Balance:* |
$
(if none type "0") |
|
Original
Balance: |
$
|
|
Monthly
Payment: |
$
,
current or past due:
|
|
Interest
Rate: |
, Term:
|
|
Existing
Second Trust Deed |
|
Present
Balance: |
$
|
|
Original
Balance: |
$
|
|
Monthly
Payment: |
$
,
current or past due:
|
|
Interest
Rate: |
, Term:
|
|
Loan
Quote Request |
| Requested
Loan Type:* |
|
| Borrower's Credit: |
|
| Amount
of Loan Requested:* |
$
|
| Purpose
of Loan: |
|
| Referral
Fee Requested: |
$
|
| Amount
of Cash Down Payment (if purchase): |
$
|
| Amount
of Seller Carryback (if applicable): |
$
|
|
Term
Desired:* |
|
|
Comments/other
issues: |
|
|
|
