Typical Lead Request Format
- Loan Information -
Desired Loan Type*
Select One
Refinance
Construction Loan
Debt Consolidation
Home Improvement
Second Mortgage
Purchase
Line of Credit
Property Value*
$
Down Payment for Purchases*
$
Loan Amount Wanted*
$
Property Use*
-
Primary Residence
Investment
Vacation
Property Type*
-
Single Family Residence
Condo
Commercial
Manufactured
Mobile Home
Multi Unit
Loan Rate Type*
-
Fixed
Adjustable
Term of Loan*
yr(s)
Cash Out
$
- Current Loan Information -
Have Mortgage*
Yes
No
1st Mortgage Amount
$
Monthly Mortgage Payment
$
1st Mortgage Rate*
5.9% and lower
6.0%
6.1%
6.2%
6.3%
6.4%
6.5%
6.6%
6.7%
6.8%
6.9%
7.0%
7.1%
7.2%
7.3%
7.4%
7.5%
7.6%
7.7%
7.8%
7.9%
8.0%
8.1%
8.2%
8.3%
8.4%
8.5%
8.6%
8.7%
8.8%
8.9%
9.0% and above
Have 2nd Mortgage*
Yes
No
2nd Mortgage Amount
$
(2nd)Monthly Mortgage Payment
$
2nd Mortgage Rate
5.9% and lower
6.0%
6.1%
6.2%
6.3%
6.4%
6.5%
6.6%
6.7%
6.8%
6.9%
7.0%
7.1%
7.2%
7.3%
7.4%
7.5%
7.6%
7.7%
7.8%
7.9%
8.0%
8.1%
8.2%
8.3%
8.4%
8.5%
8.6%
8.7%
8.8%
8.9%
9.0% and above
Year Home was Purchased
Purchase price of home
$
- Qualification Information -
Credit Rating*
------
Excellent
Good
Fair
Poor
Monthly Income*
$
Monthly Debt*
$
Employer Name*
Years with Employer*
yr(s)
- Comments or Suggestions -
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