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904-217-5450
11363-200 San Jose Blvd Jax, FL 32223
Services
Home Purchase
Refinance
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Aaron Bacus
Amanda Solari
Andreas Gemellas
Catherine Barker
Craig Weeks
Chris Austin
Diana Tarzia
Jason Kindler
Jennifer Kramer
Joseph Casella
Kate Bodnar
Lisa Blenden
Marta Lillard
Michelle Carn
Mitchell Weber
Rusty Davis
Samantha Taylor
Terry Cox
Gary Burmeister
Reed Burchette
Melanie Lamb
Taylor Mobley
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Please use the form below to submit your information and we'll get back to you as soon as possible.
CONTACT INFORMATION
Best Time To Contact
ASAP
Afternoon
Morning
Evening
First Name
*
Last Name
*
Phone
*
Email
*
Property Zip
Select Property Type
*
Single Family
Multi Family
Condominium
Townhouse
Manufactured Home
What is the Property Use?
*
Primary Residence
Vacation Home
Condominium
Investment
How is Your Credit Score?
*
Excellent (740+)
Very Good (700-739)
Good (680-699)
Fair (640-679)
Poor (639-)
Military Service?
*
Yes
No
TELL US ABOUT YOUR NEEDS
Loan Purpose
*
Lower Interest Rates
Lower Monthly Payment
Debt Consolidation
Change Rate / Term
Home Improvement
Take Cash Out
Estimated Purchase Price
$60000-$70,000
$70,001-$80,000
$80,001-$90,000
$90,001-$100,000
$100,001-$110,000
$110,001-$120,000
$120,001-$130,000
$130,001-$140,000
$140,001-$150,000
$150,001-$160,000
$160,001-$170,000
$170,001-$180,000
$180,001-$190,000
$190,001-$200,000
$200,001-$210,000
$210,001-$220,000
$220,001-$230,000
$230,001-$240,000
$240,001-$250,000
$250,001-$275,000
$275,001-$300,000
$300,001-$325,000
$325,001-$350,000
$350,001-$375,000
$375,001-$400,000
$400,001-$425,000
$425,001-$550,000
$550,001-$575,000
$575,001-$600,000
$600,001-$625,000
$625,001-$650,000
$675,001-$700,000
$700,001-$725,000
$725,001-$750,000
$750,001-$775,000
$775,001-$800,000
$800,001-$825,000
$825,001-$850,000
$850,001-$875,000
$875,001-$900,000
$900,001-$925,000
$925,001-$950,000
$950,001-$975,000
$975,001-$1,000,000
$1,000,001-$1,100,000
$1,100,001-$1,200,000
$1,200,001-$1,130,000
$1,300,001-$1,400,000
$1,400,001-$1,500,000
$1,500,000+
1st Mortgage Balance
Less Than $70,000
$70,001-$80,000
$80,001-$90,000
$90,001-$100,000
$100,001-$110,000
$110,001-$120,000
$120,001-$130,000
$130,001-$140,000
$140,001-$150,000
$150,001-$160,000
$160,001-$170,000
$170,001-$180,000
$180,001-$190,000
$190,001-$200,000
$200,001-$210,000
$210,001-$220,000
$220,001-$230,000
$230,001-$240,000
$240,001-$250,000
$250,001-$275,000
$275,001-$300,000
$300,001-$325,000
$325,001-$350,000
$350,001-$375,000
$375,001-$400,000
$400,001-$425,000
$425,001-$550,000
$550,001-$575,000
$575,001-$600,000
$600,001-$625,000
$625,001-$650,000
$675,001-$700,000
$700,001-$725,000
$725,001-$750,000
$750,001-$775,000
$775,001-$800,000
$800,001-$825,000
$825,001-$850,000
$850,001-$875,000
$875,001-$900,000
$900,001-$925,000
$925,001-$950,000
$950,001-$975,000
$975,001-$1,000,000
$1,000,001-$1,100,000
$1,100,001-$1,200,000
$1,200,001-$1,130,000
$1,300,001-$1,400,000
$1,400,001-$1,500,000
$1,500,000+
1st Mortgage Interest Rate
+11.00%
10.750%
10.500%
10.250%
10.000%
9.750%
9.500%
9.250%
9.000%
8.750%
8.500%
8.250%
8.000%
7.750%
7.500%
7.250%
7.000%
6.750%
6.500%
6.250%
6.000%
5.750%
5.500%
5.250%
5.000%
4.750%
4.500%
4.250%
4.000%
3.750%
3.500%
3.250%
3.000%
2.750%
2.500%
2.250%
Do You Have a 2nd Mortgage?
Yes
No
Additional Cash Out
TELL US ABOUT YOURSELF
Any Late Mortgage Payments?
Yes
No
Any Foreclosures?
Yes
No
Do You Currently Have an FHA Loan?
Yes
No
Bankruptcy in Last 7 Years?
Yes
No
Annual Household Income
$0-$30,000
$30,001-$45,000
$45,001-$60,000
$60,001-$75,000
$65,001-$90,000
$90,001-$105,000
$105,001-$120,000
$120,001-$135,000
$135,001-$150,000
+$150,000
Employment Status
Employed
Self Employed
Retired
Unemployed
Monthly Debt Payments
$0-$500
$500-$1,000
$1,001-$1,500
$1,501-$2,000
$2,001-$3,000
$3,001-$5,000
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