Name*:
Email:
Co-borrower name:
Address 1*:
Address 2:
City:
State: AK AL AR AZ CA CO CT DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VI VT WA WI WV WY
Postal Code*:
Country*:
Phone 1*:
Phone 2:
Fax:
Preferred Call Time:
Morning Afternoon Evening
I Would Like:
Select... Maximum Loan Amount Best Rate & Term Lowest Closing Cost Least/Lowest to Close I'm Not
Sure
Purpose of Loan*:
Select... Purchase (Property Identified) Purchase (Still Looking for
Property) Investment Refinance Home Improvement Cash Out Refinance Construction Construction (Permanent) Other
Estimated Property Value:
Estimated Loan Amount:
Amount Owed on Current
Property:
Annual Income:
Select...
$20,000
$30,000
$40,000
$50,000
$60,000
$70,000
$80,000
$90,000 $100,000 $110,000 $120,000 $130,000 $140,000 $150,000 $160,000 $170,000 $180,000 $190,000 $200,000 $250,000 $300,000 $350,000 $400,000 $450,000 $500,000 $550,000 $600,000 $650,000 $700,000 $750,000 $800,000 $850,000 $900,000 $950,000 $950,000+
Property City:
Property State: AK AL AR AZ CA CO CT DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VI VT WA WI WV WY
Have you already located a
house?
Are you using a realtor?
This information submitted via this form is being used as for purposes of prequalification only and is not an application for credit. In connection with my prequalification, I authorize CP Capital Mortgage to do an in-file credit report if they so choose. By submitting this form, I agree to accept calls regarding mortgage services offered by CP Capital Mortgage.
NOTE:
THIS FORM IS USED TO PRE-QUALIFY THE BORROWER AND IS NOT REGARDED AS A FORMAL
LOAN APPLICATION UNTIL THE BROKER SIGNS A PRELIMINARY MORTGAGE COMMITMENT.
