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Loan Type	Refinance Cash Out Refinance No Cash Out 125% Equity Loan Equity Line of Credit Equity Loan Fixed Rate Purchase - Still Home Searching Purchase - Already Found Property Please Select Your Loan Type
Loan Amount	.00
Down Payment	0 Down 3% Down 5% Down 10% Down 15% Down 20% Down 30% Down 35% Down 40% Down 45% Down 50% Down Other Please Select
	Borrower
First Name
Last Name
Street Address
Address (cont.)
City
State	Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Missouri Montana Nebraska Nevada New Hampshire North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvannia South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State
Zip/Postal Code
E-mail
Home Phone
Work Phone
Best Time to Call	Please Select Call Now! Anytime Home Morning Home Afternoon Home Evening Work Morning Work Afternoon Work Evening
Employer
Occupation
Time on Job	Select Years 1 Year 2 Years 3 Years 4 Years 5 Years 6 Years 7 Years 8 Years 9 Years 10 Years 10 Years +      0 Months 1 Month 2 months 3 Months 4 Months 5 Months 6 Months 7 Months 8 Months 9 Months 10 months 11 Months Select Months
Monthly Gross	Select Income lest than $500 $500 $750 $1,000 $1,250 $1,500 $1,750 $2,000 $2,500 $3,000 $3,500 $4,000 $4,500 $5,000 $5,500 $6,000 $6,500 $7,000 $7,000 +
Credit Rating	Select Excellent Good Fair Poor
	Co-Borrower
First Name
Last Name
Employer
Occupation
Time on Job	Select Years 1 Year 2 Years 3 Years 4 Years 5 Years 6 Years 7 Years 8 Years 9 Years 10 Years 10 Years +    0 Months 1 Month 2 months 3 Months 4 Months 5 Months 6 Months 7 Months 8 Months 9 Months 10 months 11 Months Select Months
Monthly Gross	Select Income lest than $500 $500 $750 $1,000 $1,250 $1,500 $1,750 $2,000 $2,500 $3,000 $3,500 $4,000 $4,500 $5,000 $5,500 $6,000 $6,500 $7,000 $7,000 +
Credit Rating	Select Excellent Good Fair Poor
	Property Information For Purchases
Property Type	Please Select Single Family Condo Townhome Duplex Triplex 4 Units 5-10 Units
Property Status	Please Select Already Found Property Still Home Searching
	Information for Property Owned
Property Type	Please Select Single Family Condo Townhome Duplex Triplex 4 Units 5-10 Units
Property Value	.00
Time in Home	Select Years 1 Year 2 Years 3 Years 4 Years 5 Years 6 Years 7 Years 8 Years 9 Years 10 Years 10 Years +     0 Months 1 Month 2 months 3 Months 4 Months 5 Months 6 Months 7 Months 8 Months 9 Months 10 months 11 Months Select Months
Current Loan Type	Please Select FHA VA Conventional Jumbo First / Second
Current Interest Rate	%
Mortgage Payment	.00
Mortgage Balance	.00
Purchase Price	.00
Current Value	.00
	Communication
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	Additional Comments