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Your First Name:
 
Your Last Name:
 
Address:
 
City:
 
State:
 
Zip Code:
 
Home Phone:
 
Work Phone:
 
Best Time to Contact:  
Email:
 
Credit Rating:
 
Home Owner:
 
Home Value $:
 
Type of House:
 
1st Mortgage Balance:
 
Current Interest Rate:
 
Loan Amount Desired:
 
Loan Purpose:
 
Once you have completed this expression of interest your data will be sent to our participating lenders. One or more of our participating lenders will contact you by phone. By submitting your expression of interest, you are consenting to receive phone calls from our participating lenders, even if you are currently on the DNC list."
My1Mortgage does not offer mortgage loans and is not the lender or mortgage broker in any transaction. By submitting your request to be contacted, you are consenting to have the data contained in your information sheet sent to one or more mortgage brokers or lenders who may contact you by telephone, email and/or mail, even if you opted into the Federal Trade Commission's National Do Not Call List, any state Do Not Call List, and/or any company's internal Do Not Call List. Mortgage lenders or brokers who contact you may include but are not limited to: NovaStar Mortgage Inc. , Quicken Loans, Premier Mortgage, and Warshaw Capital. You understand that mortgage lenders and brokers may maintain information you submitted whether you elect to use their services or not. You agree to notify any particular lender or mortgage broker directly if you no longer want to receive communications from that particular mortgage lender or broker. You understand that participating mortgage lenders or brokers to whom you are matched are responsible for rate, product, terms, loan amounts, and other information offered to you. Participating mortgage lenders and brokers independently determine the rates, terms, loan amounts, and requirements of any product offered to you. Their offerings may vary depending on your credit history, amount of equity in the property, location, the type of property, and other factors. Their offerings may be subject to market conditions, approval, and qualification. You may not be matched with the mortgage lender or broker making a specific offer. You also permit our company or a related company to contact or send you periodic updates of mortgage or other information. By using this site and submitting your request, you have read, understood and agreed to the terms set forth in our Privacy Policy and User Agreement that can be read by clicking on the underlined links.

Participating mortgage lenders and brokers are required to comply with all Federal, State, and local laws, including those governing equal opportunity lending, and fair housing.

Your Information Sheet may be provided to more than four mortgage professionals in certain situations as explained in the user agreement.

Your Information Sheet can only be used for the purposes defined in the user agreement and unauthorized Licensed or unlicensed Mortgage professionals, lead professionals or others using this form for any purpose other than those outlined in the user agreement understand the actions that may follow as outlined in the user agreement.