Purpose of Refinance: Change rate/term Remove PMI Take cash out Debt Consolidation Home Improvement Property will be: Primary residence Second Home Investment Property
  Property type: Single family residence Condo Townhome Manufactured Housing 2-4 unit over 4 units County: State: AL AR AZ CA CO CT DC DE FL GA IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY
  Requested Loan Amount: $   Estimated Home Value: $
  Program(s) I'm interested in looking at: (ex:30yr fixed, 5/1 arm, stated income...)      I'd like to see it structured as: (multiple allowed)   No Points or Origination fees , Some Points , No Closing Costs   Costs, Fees, or Prepaid Items (ex: taxes and homeowner's insurance):   Roll into loan amount , I'll pay at closing , I plan to bring $ to closing.
  For No cash out Cash out Debt Consolidation I want $ to walk away with apply towards debt from closing.
  Est. 1st Mtg. Balance: $   Purchased: Jan. Feb. Mar. Apr. May Jun. Jul. Aug. Sep. Oct. Nov. Dec. , Year
  Do you have a 2nd mortgage or a (H)ome (E)quity (L)ine (O)f (C)redit ? No 2nd Mtg HELOC
  Estimated Balance: $   Max Available: $  
  Is it being paid off as a part of this transaction? Yes No   Close Acct.? Yes No
  When was it opened? Part of original purchase Opened after initial purchase
  Homeowners Insurance: $ Year Month   Taxes: $ Year Month
Do you currently escrow your taxes and insurance? ? Yes No No, but would consider it. Do you want to waive escrow? (must be at 80% LTV or lower) No Yes Maybe   F.Y.I. We DO NOT pull your credit from this form. You would have to fill out an application and give us your consent to pull credit. An application is NOT required to get a good faith estimate. To lock in a rate or proceed further it would then become necessary to apply.   How would you rate your credit? Excellent Good Fair Issues   First Name Last Name   Email:   Contact Number 1 Home Work Cell Pager Fax Best: Anytime Morning Afternoon After 5 p.m.   Contact Number 2 Home Work Cell Pager Fax Best: Anytime Morning Afternoon After 5 p.m.  
Do you want to waive escrow? (must be at 80% LTV or lower) No Yes Maybe   F.Y.I. We DO NOT pull your credit from this form. You would have to fill out an application and give us your consent to pull credit. An application is NOT required to get a good faith estimate. To lock in a rate or proceed further it would then become necessary to apply.   How would you rate your credit? Excellent Good Fair Issues   First Name Last Name   Email:   Contact Number 1 Home Work Cell Pager Fax Best: Anytime Morning Afternoon After 5 p.m.   Contact Number 2 Home Work Cell Pager Fax Best: Anytime Morning Afternoon After 5 p.m.  
 
  How would you rate your credit? Excellent Good Fair Issues
  First Name Last Name
  Email:
  Contact Number 1 Home Work Cell Pager Fax Best: Anytime Morning Afternoon After 5 p.m.
  Contact Number 2 Home Work Cell Pager Fax Best: Anytime Morning Afternoon After 5 p.m.