|
Name:* |
|
|
Address:* |
|
|
City, State, Zip:* |
,
,
|
|
Home Phone: |
|
|
Work Phone:* |
ext:
|
|
E-mail Address:* |
|
|
Please contact me by: |
email,
home phone,
work phone |
| Best
time to reach me: |
|
|
Occupation: |
|
|
Annual Income: |
|
|
Credit Status: |
|
|
Land
Information |
| Approx. Property
Value:* |
$
|
| Property
Purchase Price:* |
$
|
| Property
Purchase Date:* |
|
| Any
foreclosures, bankruptcies, leins, or judgements?* |
|
|
Land Type:* |
|
|
Land Address:* |
|
|
Property City & State:* |
,
|
|
Land Size: |
|
|
Existing
First Trust Deed |
|
Present Balance:* |
$
(if none type "0") |
|
Original Balance: |
$
|
|
Monthly Payment: |
$
,
current or past due:
|
|
Interest Rate: |
, Term:
|
|
Existing
Second Trust Deed |
|
Present Balance: |
$
|
|
Original Balance: |
$
|
|
Monthly Payment: |
$
,
current or past due:
|
|
Interest Rate: |
, Term:
|
|
Loan
Quote Request |
| Requested
Loan Type:* |
|
| Amount
of Loan Requested:* |
$
|
| Purpose
of Loan: |
|
| Amount
of Down Payment (if applicable): |
$
|
|
Term
Desired:* |
|
|
Comments/other
issues: |
|
|
|
