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 Prime Star Mortgage Corporation
Please note that your information is confidential and is not sold to other companies.

Personal Information
 
  E-mail Address
  Name
  Contact Number
  Contact Method Preferred Phone E-Mail
  Gross Annual Income
  Type of Employment W2 1099 Self employed Disability
  Bankruptcy in last 7 years? Yes No
Current Loan Information
  Property State
  Home Description 1 Family 2+ Family Condo Commercial
  Type of Loan 30 Yr Fixed 15 Yr Fixed ARM Other
  Credit Great Good Bad Unknown
  Estimated Home Value
  Current Mortgage Balance
  Current Interest Rate
Proposed Loan Information
  Reason for New Loan Purchase Refinance Cash Out HELOC
  If Cash Out, List Reason(s)
  Mortgage Type Interested 30 Yr Fixed 15 Yr Fixed ARM Other
  Additional Comments
 
 
Jim Harrison
Prime Star Mortgage Corp.
(631) 902-2607
MortgageSales@aol.com