LET'S GET STARTED:

Complete the following prequalifying information as thoroughly as possible.  If you desire our most efficient transaction, be sure to provide your social security number so that a credit report may be obtained prior to our calling you back.  When you have completed the form, press the SUBMIT button.

Note: Red fields are required.

BORROWER

CO-BORROWER
Full Name: Full Name:
Address: Address:
City: City:
State: State:
Zip: Zip:
Home Phone: Home Phone:
Work Phone: Work Phone:
Fax Phone: Fax Phone:
E-mail address: E-mail address:
Social Security No.*: Social Security No.*:

* Completion of the social security number field signifies permission to run a credit check.

 Please provide your best responses to the following questions:

1) What will you use the money for?
2) What loan term would you prefer?
3) Zip code or address of the property that you wish to finance:
4) What type of property is this?
5) What loan program are you interested in?
6) What is the (combined) total monthly income of your household?
7) Please list your currently liquid assets (in banks, stocks, bonds, etc.):
8) What is the total amount you pay each month in revolving and installment accounts?
9) What is the current estimated value of your property?
10) Balance owing on your first mortgage?
        Interest rate?
11) Balance owing on your second mortgage?
        Interest rate?
12) How much cash do you need to accomplish your goals from this refinance?
13) How long have you been on your current job?
        What about your spouse?
14) Are either you or your spouse self-employed or recipients of commission income? Yes   No
15) How would you best describe your credit?
16) What is the best time of day to contact you?
        At what telephone number?
17) Credit report payment on ($22):
        Credit card number:
        Expiration date:
        Three-digit security code:


18) Name and telephone number of your realtor:
I have no realtor.
19) Who referred you to aNetLoan.com?