*First Name: *Last Name:     *Address 1:  Address 2:     *City: *State: Select USA StateAlabama Alaska 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     *Zip Code: *Home Phone:      Work/Mobile Phone: *Email:     *Best Contact Time: - Select -Morning at HomeMorning at WorkAfternoon at HomeAfternoon at WorkEvening at HomeLate Evening at Home
*Loan Purpose: - Select -Refinance 1st MortgageRefi 1st with Cash outRefi 1st FHARefi 1st VADebt ConsolidationHome equity line of creditPurchase 1st homePurchase another home * Aproximate Home Value: 1,000,000-1,024,999975,000-999,999950,000-974,999925,000-949,999900,000-924,999875,000-899,999850,000-874,999825,000-849,999800,000-824,999775,000-799,999750,000-774,999725,000-749,999700,000-724,999675,000-699,999650,000-674,999625,000-649,999600,000-624,999575,000-599,999550,000-574,999525,000-549,999500,000-524,999475,000-499,999470,000-474,999465,000-469,999460,000-464,999455,000-459,999450,000-454,999445,000-449,999440,000-444,999435,000-439,999430,000-434,999425,000-429,999420,000-424,999415,000-419,999410,000-414,999405,000-409,999400,000-404,999395,000-399,999390,000-394,999385,000-389,999380,000-384,999375,000-379,999370,000-374,999365,000-369,999360,000-364,999355,000-359,999350,000-354,999345,000-349,999340,000-344,999335,000-339,999330,000-334,999325,000-329,999320,000-324,999315,000-319,999310,000-314,999305,000-309,999302,500-304,999300,000-302,499297,500-299,999295,000-297,499292,500-294,999290,000-292,499287,500-289,999285,000-287,499282,500-284,999280,000-282,499277,500-279,999275,000-277,499272,500-274,999270,000-272,499267,500-269,999265,000-267,499262,500-264,999260,000-262,499257,500-259,999255,000-257,499252,500-254,999- Select -250,000-252,499247,500-249,999245,000-247,499242,500-244,999240,000-242,499237,500-239,999235,000-237,499232,500-234,999230,000-232,499227,500-229,999225,000-227,499222,500-224,999220,000-222,499217,500-219,999215,000-217,499212,500-214,999210,000-212,499207,500-209,999205,000-207,499202,500-204,999200,000-202,499197,500-199,999195,000-197,499192,500-194,999190,000-192,499187,500-189,999185,000-187,499182,500-184,999180,000-182,499177,500-179,999175,000-177,499172,500-174,999170,000-172,499167,500-169,999165,000-167,499162,500-164,999160,000-162,499157,500-159,999155,000-157,499152,500-154,999150,000-152,499147,500-149,999145,000-147,499142,500-144,999140,000-142,499137,500-139,999135,000-137,499132,500-134,999130,000-132,499127,500-129,999125,000-127,499122,500-124,999120,000-122,499117,500-119,999115,000-117,499112,500-114,999110,000-112,499107,500-109,999105,000-107,499102,500-104,999100,000-102,49997,500-99,99995,000-97,49992,500-94,99990,000-92,49987,500-89,99985,000-87,49982,500-84,99980,000-82,49977,500-79,99975,000-77,4990-74,999     *Credit Rating: -Select-PoorFairGoodExcellent *Aproximate Loan Ammount: 1,000,000-1,024,999975,000-999,999950,000-974,999925,000-949,999900,000-924,999875,000-899,999850,000-874,999825,000-849,999800,000-824,999775,000-799,999750,000-774,999725,000-749,999700,000-724,999675,000-699,999650,000-674,999625,000-649,999600,000-624,999575,000-599,999550,000-574,999525,000-549,999500,000-524,999475,000-499,999470,000-474,999465,000-469,999460,000-464,999455,000-459,999450,000-454,999445,000-449,999440,000-444,999435,000-439,999430,000-434,999425,000-429,999420,000-424,999415,000-419,999410,000-414,999405,000-409,999400,000-404,999395,000-399,999390,000-394,999385,000-389,999380,000-384,999375,000-379,999370,000-374,999365,000-369,999360,000-364,999355,000-359,999350,000-354,999345,000-349,999340,000-344,999335,000-339,999330,000-334,999325,000-329,999320,000-324,999315,000-319,999310,000-314,999305,000-309,999300,000-304,999295,000-299,999292,500-294,999290,000-292,499287,500-289,999285,000-287,499282,500-284,999280,000-282,499277,500-279,999275,000-277,499272,500-274,999270,000-272,499267,500-269,999265,000-267,499262,500-264,999260,000-262,499257,500-259,999255,000-257,499252,500-254,999- Select -250,000-252,499247,500-249,999245,000-247,499242,500-244,999240,000-242,499237,500-239,999235,000-237,499232,500-234,999230,000-232,499227,500-229,999225,000-227,499222,500-224,999220,000-222,499217,500-219,999215,000-217,499212,500-214,999210,000-212,499207,500-209,999205,000-207,499202,500-204,999200,000-202,499197,500-199,999195,000-197,499192,500-194,999190,000-192,499187,500-189,999185,000-187,499182,500-184,999180,000-182,499177,500-179,999175,000-177,499172,500-174,999170,000-172,499167,500-169,999165,000-167,499162,500-164,999160,000-162,499157,500-159,999155,000-157,499152,500-154,999150,000-152,499147,500-149,999145,000-147,499142,500-144,999140,000-142,499137,500-139,999135,000-137,499132,500-134,999130,000-132,499127,500-129,999125,000-127,499122,500-124,999120,000-122,499117,500-119,999115,000-117,499112,500-114,999110,000-112,499107,500-109,999105,000-107,499102,500-104,999100,000-102,49997,500-99,99995,000-97,49992,500-94,99990,000-92,49987,500-89,99985,000-87,49982,500-84,99980,000-82,49977,500-79,99975,000-77,49972,500-74,99970,000-72,499     *First Mortgage Interest Rate: N/A 14 - 14.24 13.75 - 13.99 13.5 - 13.74 13.25 - 13.49 13 - 13.24 12.75 - 12.99 12.5 - 12.74 12.25 - 12.49 12 - 12.24 11.75 - 11.99 11.5 - 11.74 11.25 - 11.49 11 - 11.24 10.75 - 10.99 10.5 - 10.74 10.25 - 10.49 10 - 10.24 9.75 - 9.99 9.5 - 9.74 9.25 - 9.49 9 - 9.24 8.75 - 8.99 8.5 - 8.74 8.25 - 8.49 8 - 8.24 7.75 - 7.99 7.5 - 7.74 7.25 - 7.49 7 - 7.24 6.75 - 6.99 6.5 - 6.74 6.25 - 6.49 6 - 6.24 5.75 - 5.99 5.5 - 5.74 5.25 - 5.49 5 - 5.24 % *Approximate 1st Mortgage Balance: Paid in Full1,000,000-1,024,999975,000-999,999950,000-974,999925,000-949,999900,000-924,999875,000-899,999850,000-874,999825,000-849,999800,000-824,999775,000-799,999750,000-774,999725,000-749,999700,000-724,999675,000-699,999650,000-674,999625,000-649,999600,000-624,999575,000-599,999550,000-574,999525,000-549,999500,000-524,999475,000-499,999470,000-474,999465,000-469,999460,000-464,999455,000-459,999450,000-454,999445,000-449,999440,000-444,999435,000-439,999430,000-434,999425,000-429,999420,000-424,999415,000-419,999410,000-414,999405,000-409,999400,000-404,999395,000-399,999390,000-394,999385,000-389,999380,000-384,999375,000-379,999370,000-374,999365,000-369,999360,000-364,999355,000-359,999350,000-354,999345,000-349,999340,000-344,999335,000-339,999330,000-334,999325,000-329,999320,000-324,999315,000-319,999310,000-314,999305,000-309,999302,500-304,999300,000-302,499297,500-299,999295,000-297,499292,500-294,999290,000-292,499287,500-289,999285,000-287,499282,500-284,999280,000-282,499277,500-279,999275,000-277,499272,500-274,999270,000-272,499265,000-267,499262,500-264,999260,000-262,499257,500-259,999255,000-257,499252,500-254,999- Select -250,000-252,499247,500-249,999245,000-247,499242,500-244,999240,000-242,499237,500-239,999235,000-237,499232,500-234,999230,000-232,499227,500-229,999225,000-227,499222,500-224,999220,000-222,499217,500-219,999215,000-217,499212,500-214,999210,000-212,499207,500-209,999205,000-207,499202,500-204,999200,000-202,499197,500-199,999195,000-197,499192,500-194,999190,000-192,499187,500-189,999185,000-187,499182,500-184,999180,000-182,499177,500-179,999175,000-177,499172,500-174,999170,000-172,499167,500-169,999165,000-167,499162,500-164,999160,000-162,499157,500-159,999155,000-157,499152,500-154,999150,000-152,499147,500-149,999145,000-147,499142,500-144,999140,000-142,499137,500-139,999135,000-137,499132,500-134,999130,000-132,499127,500-129,999125,000-127,499122,500-124,999120,000-122,499117,500-119,999115,000-117,499112,500-114,999110,000-112,499107,500-109,999105,000-107,499102,500-104,999100,000-102,49997,500-99,99995,000-97,49992,500-94,99990,000-92,49987,500-89,99985,000-87,49982,500-84,99980,000-82,49977,500-79,99975,000-77,49972,500-74,99970,000-72,49967,500-69,99965,000-67,49962,500-64,99960,000-62,499     *Type of House: - Select -CondoMobile HomeTownhouse2-4 PlexOtherSingle family dwelling         * Mandatory fields
	“ONCE YOU HAVE COMPLETED THIS EXPRESSION OF INTEREST (OR MINI-APPLICATION) YOUR INFORMATION WILL BE SENT TO OUR PARTICIPATING LENDERS. ONE OR MORE OF OUR PARTICIPATING LENDERS WILL CONTACT YOU BY TELEPHONE. BY SUBMITTING YOUR EXPRESSION OF INTEREST YOU ARE CONSENTING TO RECEIVE TELEPHONE CALLS FROM OUR PARTICIPATING LENDERS”.