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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 Will there be a Co-Applicant? * YES NO Is this a Purchase or Refinance?* Purchase Refinance Borrower Information Primary Applicant First Name: * Primary Applicant Last Name: * Applicants SSN #: Optional xxxxxxxxx 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: * How many years at current Residence Own the home? Yes No Live Rent Free Home Phone: * xxxxxxxxxx Cell Phone: Work Phone: Ext: 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 Approx. Total Monthly Debt: $ ex.500.00 Have you filed Bankruptcy in the last 7 Yrs? Yes No Have you had a Foreclosure in the last 7 Yrs? Yes No Do you pay child support or alimony? Yes No Name of Current Employer: Gross Monthly Income: $ ex.5,000.00 Years with Current Employer: Are you self Employed?: Yes No Co-Borrower Information Co-Borrower's First Name: Co-Borrower Last Name: Co-Borrower SSN #: Optional xxxxxxxxx Street Address: City: 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: How many years at current Residence: Own the home? Yes No Live Rent Free Home Phone: xxxxxxxxxx Cell Phone: Work Phone: Ext: 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 Have you filed Bankruptcy in the last 7 Yrs? Yes No Have you had a Foreclosure in the last 7 Yrs? Yes No Do you pay child support or alimony? Yes No Name of Current Employer: Gross Monthly Income: $ ex.5,000.00 Years with Current Employer: Are you self Employed?: Yes No Purchase Information Are you working with a Realtor? Yes No If Yes, what is the Realtors Name? 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? * $ Refinance Information In what Year was your property built? 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? * If you have a 2nd mortgage, list balance: What is the 2nd mortgage rate? Contact Information Best Time To Contact You: Choose one... 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.
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