First Name
Last Name
Phone
*
Email
*
Language
Language
English
Spanish
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Loan Officer
Mark Cruz
Lindsay Babineau
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Referral Source
Purpose
*
Purchase - Refi
Purchase
Refinance
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Type of Loan
FHA - Conventional - VA - Jumbo
Conventional
FHA
VA
Jumbo
USDA
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Occupancy
Primary - Investment - Secondary - Own Oc.
Primary residence
Investment property
Second residence
Owner ocupied
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Credit Score
Debts
Income
Assets
FTHB?
Yes
No
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Bankruptcy
Yes
No
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Forbearance
Yes
No
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Estimated Purchase Price
$
Max Approval?
Yes
No
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CCA
Yes
No
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Type of Property
Zip Code or Area
Refinance Type
Rate & Term
Cash Out
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Mortgage Balance
$
Property Value
$
Mortgage Insurance
Main Goal with Refinance
Are you planning to apply with a Co-Borrower
Yes
No
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Co borrower name
Co borrower Last Name
Co Borrower Phone Number
Co borrower Email Address
Relationship with Borrower
Co borrower credit score
Coborrower's debts
Coborrower's income
What is the best time to call you?
9:00 am - 12:00 pm
12:00 pm - 3:00 pm
3:00 pm - 6:00 pm
6:00 pm - 9:00 pm
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Notes