Mortgage Refinance Form

Fill out the following infromation and submit

Tell us about yourself:

First Name

Middle Initial

Last Name

Email Address

Current Property Address

Preferred Phone Number

How long have you owned this property?

What is your employment status? Full TimePart TimeSelf EmployedHomemakerStudentUnemployed

Are you or your spouse on active duty or a veteran of the U.S. military? Yes  No

How would your describe your credit? ExcellentGoodFairPoor

If you have ever declared Bankruptcy, when was it discharged? Never DeclaredCurrently in Bankruptcy1-12 months13-24 months25-36 months37-48 months49-60 months61-72 monthsover 72 months

Do you have any forclosures? Never ForeclosedCurrently in Foreclosure1-12 months13-24 months25-36 months37-48 months49-60 months61-72 monthsover 72 months

What type of property are you refinancing? Single Family DetachedTown HouseCondoManufactured Home

How do you use this property? Primary HomeSecond HomeInvestment

Which mortgage(s) do you want to refinance? Existing MortgageFirst and Second Mortgages

What is the current value of the property? $ 

What is the balance of your first mortgage? $

How much additional cash do you want to borrow if any? $

What is your current monthly housing payment? $

What is your current interest rate? %

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