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Loan Information Form Instructions
1. Use this form to request mortgage information
2. Please fill out as much of the form as possible
3. When finished click on the send button

Loan Request
Type of Property
Loan Amount Requested
If Purchase: Sales Price
If Purchase: Settlement Date
If Refinance: Estimated Present Value
If Refinance: Year Purchased
If Refinance: Original Price
If Refinance: Balance Current Mortgage
If Refinance: Balance Current 2nd Mortgage(Loan or Line)
If Refinance: Was 2nd Mortgage Obtained at Purchase?
First Name Last Name
Property Address City
State ZIP
Home Phone Work Phone
Email Address (required)
How Would You Rate Your Credit?
Type of Property?
Best Time to Contact You
Best Way to Contact You
How did you find this web site?

For rates & info call 1-800-296-0141
or email eagle@eagle-mortgage.com