Please fill out the information below and we will contact you within 24 hours with specific information about your mortgage loan options. Desired Loan Amount Type of Property SFR Condo 2-4 Units Type of Loan Purchase Refi Cash Out Refi Credit Rating Excellent (740 - 850) Very Good (700 - 739) Good (660- 699) Fair (620 - 659) Poor (580 - 619) Estimated home value First Name Last Name Zip Code *Phone # ( ) - (required) *E-mail (required) Additional Comments We respect your privacy and will not share your information with anyone.

United Capital Mortgage Solutions, Inc. • NMLS#270987 • Laguna Beach, CA 92651-7605 • (949) 290-3831

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