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Intake form
Help us serve you better
Name
*
Email address
*
What type of mortgage are you interested in?
Please select at least one option.
Fixed-rate mortgage
Adjustable-rate mortgage
FHA loan
VA loan
USDA loan
Jumbo loan
What is your current credit score range?
Select
Below 580
580 - 639
640 - 699
700 - 759
760 and above
What is your annual income?
What is your employment status?
Select
Employed
Self-employed
Unemployed
Retired
Student
What is the purpose of your mortgage?
Select
Purchase a new home
Refinance an existing mortgage
Investment property
Second home
When do you plan to apply for the mortgage?
Select
Immediately
Within 1 month
Within 3 months
More than 3 months
Have you previously applied for a mortgage?
Select
Yes
No
What credit repair services are you interested in?
Please select at least one option.
Credit score improvement
Debt negotiation
Credit report analysis
Identity theft protection
Credit monitoring
Additional questions or comments
Submit
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