MORTGAGE RATES REQUEST FORM
(FOR CALIFORNIA BASED PROPERTIES ONLY)

 First Name
 
           
 Last Name
 
     
 Work PhoneExt.
        -       
           
 Home Phone
 
           
 What is your Email address?
   
           
 

  Best Time to Contact You Between 7:00AM and 9:00AM Between 9:00AM and 11:00AM Between 12:00PM and 2:00PM Between 3:00PM and 5:00PM Between 6:00PM and 8:00PM

  Select Credit History Rating Perfect - always pay debts on time Near Perfect - some late payments over 4 years ago Very Good - some late payments over 2 years ago Good - some late payments over 1 year ago OK - some late payments within past year Poor - many recent late payments Horrible - everything is currently late Currently in bankruptcy

  Purpose of the Loan Purchase of a new home not yet identified Purchase of a new home I have identified Refinance existing mortgage balance only Refinance existing mortgage and add closing costs to loan amount Refinance existing mortgage taking cash out Refinance existing mortgage combining 1st & 2nd Refinance 1st mortgage, leave 2nd Mortgage/home equity loan intact Home equity loan Home improvement loan Second mortgage Debt consolidation loan

  Preferred Mortgage Product 30 Year Fixed Rate 25 Year Fixed Rate 20 Year Fixed Rate 15 Year Fixed Rate 10 Year Fixed Rate 30 Year Adjustable Rate 15 Year Adjustable Rate 5/1 Year Adjustable Rate 7/1 Year Adjustable Rate 10/1 Year Adjustable Rate 5 Year Balloon 7 Year Balloon

  Select Desired Loan Amount $100,000 or less $100,000 + $150,000 + $200,000 + $250,000 + $300,000 + $350,000 + $400,000 + $450,000 + $500,000 + $550,000 + $600,000 + $650,000 + $700,000 + $750,000 + $800,000 + $850,000 + $900,000 + $950,000 + $1,000,000 + $1,500,000 + $2,000,000 + $2,500,000 + $3,000,000 + $5,000,000 + $10,000,000 +
           

 Purchase Price of Home or Approximate Value for a Refinance   
 
  Select Property Type Single-Family Detached Townhouse Condominium Mobile Home Modular None of the above
 If purchasing a new home you have identified, when is the closing date?
   

 Have you ever had a bankruptcy?  Never Bankruptcy discharged over 10 years ago Bankruptcy discharged over 4 years ago Bankruptcy discharged over 2 years ago Bankruptcy discharged over 1 year ago Bankruptcy discharged less than 1 year ago Currently in bankruptcy

 Will you document your income?  Yes No

  
 Additional information, comments, and questions.