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Tell Us About Your Loan Needs
What type of loan do you need?
Refinance
Purchase Home
Debt Consolidation
Home Equity
Tell Us About Your Property
Where is the property located?
Property State ?
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
DC
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Property ZIP code
Property area code
Home description
Single Family
Multi Family
Town House
Condo
(No mobile or manufactured homes)
Purchase year
Purchase Year ?
2006
2005
2004
2003
2002
2001
2000
1999
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
Property use
Primary Residence
Second or Vacation Home
Investment Property
When are you likely to buy a home?
Time to Purchase ?
Immediately
30 Days
60 Days
90 Days
No Time Constraint
Have you found a home?
Yes
No
Do you have a signed contract to buy your home?
Yes
No
Do you have a real estate agent?
Yes
No
Agent name
Agent phone
Agent company
(example: Prudential, Remax)
Tell Us About Your Loan
Purpose of loan
Loan Purpose ?
Lower Monthly Payment
Lower Interest Rate
Change Terms
Pay Off Debt
Make Home Improvements
Take Out Cash
Estimated home value
$
Estimated Home Value ?
75,000 - 80,000
80,001 - 85,000
85,001 - 90,000
90,001 - 95,000
95,001 - 100,000
100,001 - 105,000
105,001 - 110,000
110,001 - 115,000
115,001 - 120,000
120,001 - 125,000
125,001 - 130,000
130,001 - 135,000
135,001 - 140,000
140,001 - 145,000
145,001 - 150,000
150,001 - 155,000
155,001 - 160,000
160,001 - 165,000
165,001 - 170,000
170,001 - 175,000
175,001 - 180,000
180,001 - 185,000
185,001 - 190,000
190,001 - 195,000
195,001 - 200,000
200,001 - 210,000
210,001 - 220,000
220,001 - 230,000
230,001 - 240,000
240,001 - 250,000
250,001 - 260,000
260,001 - 270,000
270,001 - 280,000
280,001 - 290,000
290,001 - 300,000
300,001 - 310,000
310,001 - 320,000
320,001 - 330,000
330,001 - 340,000
340,001 - 350,000
350,001 - 360,000
360,001 - 370,000
370,001 - 380,000
380,001 - 390,000
390,001 - 400,000
400,001 - 420,000
420,001 - 440,000
440,001 - 460,000
460,001 - 480,000
480,001 - 500,000
500,001 - 520,000
520,001 - 540,000
540,001 - 560,000
560,001 - 580,000
580,001 - 600,000
600,001 - 620,000
620,001 - 640,000
640,001 - 660,000
660,001 - 680,000
680,001 - 700,000
700,001 - 720,000
720,001 - 740,000
740,001 - 760,000
760,001 - 780,000
780,001 - 800,000
800,001 - 820,000
820,001 - 840,000
840,001 - 860,000
860,001 - 880,000
880,001 - 900,000
900,001 - 920,000
920,001 - 940,000
940,001 - 960,000
960,001 - 980,000
980,001 - 1,000,000
Over 1,000,000
Down payment amount
Down Payment Amount
0%
3%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
55%
60%
65%
70%
75%
80%
85%
90%
95%
100%
Other
$
.00
First mortgage balance
$
First Balance ?
50,000 - 55,000
55,001 - 60,000
60,001 - 65,000
65,001 - 70,000
70,001 - 75,000
75,001 - 80,000
80,001 - 85,000
85,001 - 90,000
90,001 - 95,000
95,001 - 100,000
100,001 - 105,000
105,001 - 110,000
110,001 - 115,000
115,001 - 120,000
120,001 - 125,000
125,001 - 130,000
130,001 - 135,000
135,001 - 140,000
140,001 - 145,000
145,001 - 150,000
150,001 - 155,000
155,001 - 160,000
160,001 - 165,000
165,001 - 170,000
170,001 - 175,000
175,001 - 180,000
180,001 - 185,000
185,001 - 190,000
190,001 - 195,000
195,001 - 200,000
200,001 - 210,000
210,001 - 220,000
220,001 - 230,000
230,001 - 240,000
240,001 - 250,000
250,001 - 260,000
260,001 - 270,000
270,001 - 280,000
280,001 - 290,000
290,001 - 300,000
300,001 - 310,000
310,001 - 320,000
320,001 - 330,000
330,001 - 340,000
340,001 - 350,000
350,001 - 360,000
360,001 - 370,000
370,001 - 380,000
380,001 - 390,000
390,001 - 400,000
400,001 - 420,000
420,001 - 440,000
440,001 - 460,000
460,001 - 480,000
480,001 - 500,000
500,001 - 520,000
520,001 - 540,000
540,001 - 560,000
560,001 - 580,000
580,001 - 600,000
600,001 - 620,000
620,001 - 640,000
640,001 - 660,000
660,001 - 680,000
680,001 - 700,000
700,001 - 720,000
720,001 - 740,000
740,001 - 760,000
760,001 - 780,000
780,001 - 800,000
800,001 - 820,000
820,001 - 840,000
840,001 - 860,000
860,001 - 880,000
880,001 - 900,000
900,001 - 920,000
920,001 - 940,000
940,001 - 960,000
960,001 - 980,000
980,001 - 1,000,000
1,000,000+
1,500,000+
2,000,000+
First mortgage interest rate
Select
3.00
3.25
3.50
3.75
4.00
4.25
4.50
4.75
5.00
5.25
5.50
5.75
6.00
6.25
6.50
6.75
7.00
7.25
7.50
7.75
8.00
8.25
8.50
8.75
9.00
9.25
9.50
9.75
10.00
10.25
10.50
10.75
11+
%
Existing
Desired
rate type
Fixed Rate
Adjustable Rate
I Don't Know
Do you have a second mortgage?
Yes
No
Second mortgage balance
$
Second Balance ?
1 - 5,000
5,001 - 10,000
10,001 - 15,000
15,001 - 20,000
20,001 - 25,000
25,001 - 30,000
30,001 - 35,000
35,001 - 40,000
40,001 - 45,000
45,001 - 50,000
50,001 - 55,000
55,001 - 60,000
60,001 - 65,000
65,001 - 70,000
70,001 - 75,000
75,001 - 80,000
80,001 - 85,000
85,001 - 90,000
90,001 - 95,000
95,001 - 100,000
100,001 - 105,000
105,001 - 110,000
110,001 - 115,000
115,001 - 120,000
120,001 - 125,000
125,001 - 130,000
130,001 - 135,000
135,001 - 140,000
140,001 - 145,000
145,001 - 150,000
150,001 - 155,000
155,001 - 160,000
160,001 - 165,000
165,001 - 170,000
170,001 - 175,000
175,001 - 180,000
180,001 - 185,000
185,001 - 190,000
190,001 - 195,000
195,001 - 200,000
Over 200,000
Second mortgage interest rate
Select
3.00
3.25
3.50
3.75
4.00
4.25
4.50
4.75
5.00
5.25
5.50
5.75
6.00
6.25
6.50
6.75
7.00
7.25
7.50
7.75
8.00
8.25
8.50
8.75
9.00
9.25
9.50
9.75
10.00
10.25
10.50
10.75
11+
%
How much additional cash would you like
to borrow?
How much cash do you want for your
equity loan?
How much debt do you wish to consolidate?
$
Additional Cash?
0
1 - 5,000
5,001 - 10,000
10,001 - 15,000
15,001 - 20,000
20,001 - 25,000
25,001 - 30,000
30,001 - 35,000
35,001 - 40,000
40,001 - 45,000
45,001 - 50,000
50,001 - 55,000
55,001 - 60,000
60,001 - 65,000
65,001 - 70,000
70,001 - 75,000
75,001 - 80,000
80,001 - 85,000
85,001 - 90,000
90,001 - 95,000
95,001 - 100,000
100,001 - 105,000
105,001 - 110,000
110,001 - 115,000
115,001 - 120,000
120,001 - 125,000
125,001 - 130,000
130,001 - 135,000
135,001 - 140,000
140,001 - 145,000
145,001 - 150,000
150,001 - 155,000
155,001 - 160,000
160,001 - 165,000
165,001 - 170,000
170,001 - 175,000
175,001 - 180,000
180,001 - 185,000
185,001 - 190,000
190,001 - 195,000
195,001 - 200,000
200,001 - 210,000
210,001 - 220,000
220,001 - 230,000
230,001 - 240,000
240,001 - 250,000
250,001 - 260,000
260,001 - 270,000
270,001 - 280,000
280,001 - 290,000
290,001 - 300,000
300,001 - 310,000
310,001 - 320,000
320,001 - 330,000
330,001 - 340,000
340,001 - 350,000
350,001 - 360,000
360,001 - 370,000
370,001 - 380,000
380,001 - 390,000
390,001 - 400,000
400,001 - 420,000
420,001 - 440,000
440,001 - 460,000
460,001 - 480,000
480,001 - 500,000
500,001 - 520,000
520,001 - 540,000
540,001 - 560,000
560,001 - 580,000
580,001 - 600,000
600,001 - 620,000
620,001 - 640,000
640,001 - 660,000
660,001 - 680,000
680,001 - 700,000
700,001 - 720,000
720,001 - 740,000
740,001 - 760,000
760,001 - 780,000
780,001 - 800,000
800,001 - 820,000
820,001 - 840,000
840,001 - 860,000
860,001 - 880,000
880,001 - 900,000
900,001 - 920,000
920,001 - 940,000
940,001 - 960,000
960,001 - 980,000
980,001 - 1,000,000
1,000,000+
1,500,000+
2,000,000+
Tell Us About Your Personal Finances
Credit status
Excellent
Good
Fair
Poor
Annual income
$
Income ?
Less than 30,000
30,000 – 44,999
45,000 – 59,999
60,000 – 74,999
75,000 – 89,999
90,000 – 104,999
105,000 – 120,000
Over 120,000
Occupational status
Employed
Self Employed
Retired
Not Employed
Have you ever declared bankruptcy?
No/Not in Past 7 Years
5 – 7 Years Ago
2 – 5 Years Ago
1 – 2 Years Ago
Less Than 12 Months Ago
Monthly debt payments
$
Monthly Debt ?
0 - 249
250 - 499
500 - 749
750 - 1,000
Over 1,000
(do not include housing)
Are you a first time buyer?
Yes
No
Your Contact Information
First name
Last name
Street address
City
State
Contact State ?
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Iowa
Idaho
Illinois
Indiana
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Missouri
Mississippi
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip
Email
Primary phone
Secondary phone
Best contact time
Morning on Primary
Afternoon on Primary
Evening on Primary
Morning on Secondary
Afternoon on Secondary
Evening on Secondary
Yes, I want to receive information and offers
from LoanSolutionEmail.com.
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