What is your home financing goal?

Where are you at in the homebuying journey?

How much do you plan to spend on your new home?

What kind of home are you looking for?

How will you use your new home?

Is this your first time purchasing a home?

When are you planning to make your home purchase?

Have you or your spouse ever served in the US military?

How much of a down payment would you like to make?

How much do you currently have saved for a down payment?

What is your current employment status?

What is your household gross (before taxes) annual income?

Have you declared bankruptcy in the last 2 years?

What is your current credit score?

Where are you looking to buy or refinance?


What is your current zip code?

What is your email address?

What is your name?

What is your home loan refinancing goal?

What is the value of your home?

(An estimate is fine)

What's the remaining balance of your current loan?

(An estimate is fine)

What is your current mortgage interest rate?

*

What kind of home do you currently own?

How are you using this home?

Have you made any late mortgage payments in the last 12 months?

What's the best number to reach you?

By submitting, I am providing my electronic signature and I agree my information may be shared and that I may be contacted at this number (including through emails, and/or autodialed or pre-recorded calls or texts or generative AI, carrier rates may apply) by the company I may select in the next part of this form, or their designated agent, for marketing purposes and for receiving lending or homebuying assistance or information, even if I am on a Do Not Call List.

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