Refinance Inquiry Form

First Name *

Last Name *

Phone *

Email *

Current address

Address

Street Address

City

State

Country

Country

Postal code

Property Information

Property Address

Address
City
State
Zip Code

What's the value of your home?

$

Type of Property: *

Primary Residence

Secondary Home

Investment Property

Property Type: *

Single-Family

Condominium

Multi-Unit

Townhouse

Mobile Home

Loan Details

Current Loan Type: *

Fixed Rate

Adjustable Rate

FHA

VA

USDA

Other...

Current Interest Rate:

Monthly Payment

Are Property Taxes and Homeowners Insurance incleded? *

Yes

No

Are you interested in cash-out refinancing? *

yes

no

If yes, desired cash-out ammount

Employment and Income Information

What is your current employment status? *

Employed

Self-Employed/1099 Independent Contractor

Retired

Other...

What is your gross income per month? *

$

Credit and Financial Information

What is your credit score? *

Excellent 740+

Good 700-739

Average 660-699

Fair 600-659

Poor < 600

Do you have any outstanding judgments, liens, or bankruptcies? *

Yes

No

If yes, please provide details.

Additional Information

Are you interested in shortening your loan term? *

Yes

No

Any additional questions or comments?

Authorization and Agreement

I authorize Secured Lending Group to review my financial

information for the purpose of assessing my refinance eligibility.

Date

Signature *

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