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Financial Information

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     Contact Person(s)

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First Name: 

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Last: 

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First Name: 

Last: 

     Contact Information:

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Phone: 

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Alternate phone: 

 

Best time to call: 

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Email: 

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Your Credit:  

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     Property Information

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Address: 

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Address Line 2: 

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City: 

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State: 

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Zip: 

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Type of Property:  

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In Foreclosure?  

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     1st Mortgage:

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Lender: 

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Loan Balance: 

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Type Of Loan: 

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Current Interest Rate: 

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Current Payment: 

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Behind on Payments?  

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     2nd Mortgage:

 

Lender: 

 

Loan Balance: 

  if not sure please estimate

 

Type Of Loan: 

 

Current Interest Rate: 

 

Current Payment: 

 
 

Behind on Payments?  

 

 
Comments:

 

 

 
 

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