Short  Contact info sheet                                                                                   We do not ask for SS number.
                                     A Licensed Loan Officer will contact you via email or by telephone.

                                               Please fill out each field or (NA) For "Not Applicable".

 
First Name:
  Middle Initial:
Last Name:
Street Address:
   Apt #:
City:
State:
  Zip:
Home Phone:
Work Phone:
Cell Phone or Pager:
E-Mail Address  :   
Year Property purchased:
3 Credit scores (if known or NA) :
How's your credit?
Are you self employed ?
Yes   No
Residential or Commercial property  
Amount currently owed/ Value:
Gross Monthly Income:
  Date of birth : 
 
 
Loan Request
 
Amount Requested:
Purpose of loan:
Home Equity/ Debt Consolidation
 : Smart loan
  Low Interest Refinance
  Purchase Real Estate / 1st time buyers
  Commercial property purchase
  Commercial property Cash out
  Jumbo loan
  Other (please specify or describe completely):
 
Property Loan Information
 
Current Value of Property:
Mortgage Balance (Total 1st & 2nd Mortgages):

Current Interest Rate on 1st Mortgage:
Monthly Payment (Total 1st & 2nd Mortgages):
per month
How'd you find us? (  Google, Yahoo, MSN, TV, Radio, etc.)





Call us: 1-877- TX-LENDING
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By filling out this information you agree to be contacted by email or telephone ADAD by a licensed loan officer to discuss mortgage options and rates. We do not share any info except with the bank we get you approved through. We are NOT an internet lead company that will sell your information. We will contact you to get SS number before pulling credit and securing pricing options for you.