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About Us
Home
Credit Rating:
Select one:
Excellent
Good
Fair
Not Sure
Type of Loan:
Select one:
Purchase
Refinance
Property State:
Select one:
North Carolina
South Carolina
C o n t a c t U s
P l e a s e f i l l o u t t h e f o l l o w i n g i n f o r m a t i o n
Name:
Email:
Phone:
Loan Amount:
Questions or Comments:
R e f i n a n c e
S t e p 1 of 2
Y o u a r e a l m o s t t h e r e
Estimated home value:
Select one:
$50,000 – $75,000
$75,001 – $100,000
$101,001 – $125,000
$125,001 – $150,000
$150,001 – $175,000
$175,001 – $200,000
$200,001 – $225,000
$225,001 – $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 – $450,000
$450,001 – $475,000
$475,001 – $500,000
$500,001 – $525,000
$525,001 – $550,000
$550,001 – $575,000
$575,001 – $600,000
$600,001 – $625,000
$625,001 – $650,000
$650,001 – $675,000
$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 – $1,250,000
$1,250,001 – $1,500,000
$1,500,001 – $2,000,000
over $2,000,000
Current Balance:
Select one:
$50,000 – $75,000
$75,001 – $100,000
$101,001 – $125,000
$125,001 – $150,000
$150,001 – $175,000
$175,001 – $200,000
$200,001 – $225,000
$225,001 – $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 – $450,000
$450,001 – $475,000
$475,001 – $500,000
$500,001 – $525,000
$525,001 – $550,000
$550,001 – $575,000
$575,001 – $600,000
$600,001 – $625,000
$625,001 – $650,000
$650,001 – $675,000
$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 – $1,250,000
$1,250,001 – $1,500,000
$1,500,001 – $2,000,000
over $2,000,000
Current Interest Rate:
Select one:
10% +
10%
9.75%
9.50%
9.25%
9%
8.75%
8.50%
8.25%
8%
7.75%
7.50%
7.25%
7%
6.75%
6.50%
6.25%
6%
5.75%
5.50%
5.25%
5%
4.75%
4.50%
4.25%
4%
3.75%
3.50%
3.25%
3%
2.75%
2.50%
2.25%
2%
Loan Type:
Select one:
Conventional Fixed
Conventional ARM
FHA Fixed
FHA ARM
VA Fixed
VA ARM
USDA
Additional Cash Desired:
Select one:
Yes
No
Email Address:
Daytime Phone:
Evening Phone:
R e f i n a n c e
S t e p 2 of 2
Y o u a r e f i n i s h e d !
Annual Income:
Time with Employer:
Select one:
1 year
2 years
3 years
4 years
5 years
6 years
7 years
8 years
9 years
10 years
11 years
12 years
13 years
14 years
15 years
16 years
17 years
18 years
19 years
20 years
over 20 years
First Name:
Last Name:
City:
State:
Zip:
N e w P u r c h a s e
S t e p 1 of 3
Home will be used for:
Select one:
Primary residence
Second home
Investment
First time buyer:
Select one:
Yes
No
Purchase Price:
Select one:
$50,000 – $75,000
$75,001 – $100,000
$101,001 – $125,000
$125,001 – $150,000
$150,001 – $175,000
$175,001 – $200,000
$200,001 – $225,000
$225,001 – $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 – $450,000
$450,001 – $475,000
$475,001 – $500,000
$500,001 – $525,000
$525,001 – $550,000
$550,001 – $575,000
$575,001 – $600,000
$600,001 – $625,000
$625,001 – $650,000
$650,001 – $675,000
$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 – $1,250,000
$1,250,001 – $1,500,000
$1,500,001 – $2,000,000
over $2,000,000
Estimated down payment:
Select one:
3.5%
5%
15%
20%
more than 20%
Timeframe for purchase:
Select one:
1-3 months
3-6 months
more than 6 months
Email Address:
N e w P u r c h a s e
S t e p 2 of 3
Y o u a r e a l m o s t t h e r e
Annual Income:
Time with Employer:
Select one:
1 year
2 years
3 years
4 years
5 years
6 years
7 years
8 years
9 years
10 years
11 years
12 years
13 years
14 years
15 years
16 years
17 years
18 years
19 years
20 years
over 20 years
Daytime Phone:
Evening Phone:
Best time to contact:
Select one:
Morning
Afternoon
Evening
Anytime
N e w P u r c h a s e
S t e p 3
Y o u a r e f i n i s h e d !
First Name:
Last Name:
City:
State:
Zip:
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Main Street Home Loans
4108 Park Road, Suite 300
Charlotte North Carolina 28209
Nationwide Mortgage License # 62966
(704) 504-1111
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