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Mortgage Assessment Form for Refinancing

At this time we are only able to originate loans in Texas and the surrounding states.

Please send us a little information so we can better serve you:

First Name:
Last Name:
Title:
Company:
Street Address:
City:
State:
Zip Code:
Telephone:
FAX:
Email:
Where is the property you are buying/refinancing located?:

Tell us a little bit about your Mortgage Needs

What is your present balance?
Current interest rate?
Program type (i.e. 30 fixed, ARM, balloon, etc)?
Is your loan Conventional or FHA?
What do you think is your home's appraised value?
How long have you been in your existing mortgage?
How long do you plan to stay?
Why are you refinancing? Choose all that apply: Lower Rate
Change program type
Lower Payment
Shorten term
What type of mortgage are you shopping
for? (if unsure, please indicate)
Desired Monthly Payments:
When do you plan to purchase/refinance?
What type of Mortgage do you presently have?

Are You interested in a Free Pre qualification? Yes No

Would you like us to contact you by phone with additional information? Yes No

If 'yes,' when is the best time to contact you?

Would you be interested in information on highly qualified Realtors? Yes No

How did you find us? Realtor Web Page Search Engine Other

Comments or questions?


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