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This application is confidential and it will NOT affect your credit.
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) are required.
CONFIDENTIAL - NO OBLIGATION
About Me
First Name:
*
Last Name:
*
Street:
Apt. No:
City:
State:
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E-mail Address:
*
Preferred contact time:
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Mountain
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Anytime
5:00am-6:00am
6:00am-7:00am
7:00am-8:00am
8:00am-9:00am
9:00am-10:00am
10:00am-11:00am
11:00am-12:00pm
12:00pm-1:00pm
1:00pm-2:00pm
2:00pm-3:00pm
3:00pm-4:00pm
4:00pm-5:00pm
5:00pm-6:00pm
6:00pm-7:00pm
7:00pm-8:00pm
8:00pm-9:00pm
Home Phone:
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Extension:
Work Phone:
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Extension:
Other Phone:
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About The Loan...
Total Household Income: $
*
Amount of Current Loan: $
(if applicable)
Amount of Requested Loan: $
*
Loan type:
Purchase
Pre-approval
Refinance
Debt Consolidation for Homeowners
Home Equity Loan
Home Equity Line of Credit
Getting my loan in:
Select one of the following...
30 Days
60 Days
90 Days
more than 90 days
Down payment: $
(
Home Purchase Only
)
Comments:
*Lines of Credit may not be available in all states.
Within one business day, a Loans Consultant will contact you at your preferred contact time to discuss your home loan options.
Office No. 805.579.1116 • Fax No. 805.578.0834 • 559 Country Club Dr., Simi Valley, CA 93065
