| |
| First Name: |
|
| Last Name: |
|
| E-mail: |
|
| Daytime Phone: |
|
| Night Phone: |
|
| Fax: |
|
| |
|
| I would refi if
I could get a |
|
| with a rate of |
percent; |
| or a payment
that's at least |
dollars
per month |
| lower than my
current payment of: |
dollars per
month. |
| My current loan
balance is: |
|
| I think my
house is worth about: |
|
| The property is
in: |
|
| |
|
