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Contact
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Have you been able to make your payments on time in the past 12 months?
Please select one
Yes
No
First Name
Last Name
Phone Number
Email Address
What is the preferred mode of contact?
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Phone
Email
What is the preferred time of contact?
Please select one
Morning (8am-12pm)
Afternoon (12pm-5pm)
Evening (5pm-8pm)
How will the property be used?
Please select one
Primary
Second Home
Investment
Would you like to take equity from the property?
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Yes
No
Are you currently employed?
Please select one
Yes
No
What is your monthly income?
Have you had a bankruptcy, short sale or foreclosure in the past three years?
Please select one
Yes
No
Estimated Current Value of Home?
Current Remaining Balance?
Estimated Current interest rate?
What type of loan do you currently have?
Please select one
FHA
Conventional
USDA
VA
OTHER
Do you have a second mortgage?
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Yes
No
Zip Code
Type of Home
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Single Family
Condo
Manufactured Home
Estimated Credit Score
Please select one
580-669 ( FAIR )
670-739 ( GOOD )
740-799 ( VERY GOOD )
800-850 ( EXCEPTIONAL )
* Required Field