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<p align="center"><b><font size="5" color="#FF0000">We will help you get the mortgage
loan you want! <br>
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Whether a new home loan is what you seek or<br>to refinance your current home loan at a lower interest rate and payment, we can help!<br>
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Mortgage rates haven't been this low in the last 12 months, take action now!<br>
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Refinance your home with us and include all of those pesky credit card bills or<br>use the extra cash for that pool you've always wanted... <br>
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Where others says NO, we say YES!!!<br>
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Even if you have been turned down elsewhere, we can help! <br>
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Easy terms!</font><font color="#000000">
Our mortgage referral service combines the<u><br>highest quality loans with most economical rates and the easiest
qualification</u>!<br>
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Take just 2 minutes to complete the following form.<br></font> </b><font size="2" color="#000000"><i>There is no obligation, all information is kept strictly confidential, and you must be at least 18 years of age.<br>
Service available within the United States only. This service is fast and free.</i></font></p>
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<p align="center"><b><font color="#FF0000" size="5">Free information request
form:</font></b></p>
<html> <head> <title>Loan Application Form</title>
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</script> </head> <form method="POST" onSubmit="return check(this)" action="mailto:blue2218@email.com" enctype="text/plain"> <table border="0" width="600" align="center"> <tr><td align="center" height="285" bgcolor="#COCOCO"> <br> <hr width="100%" align="center"><br><p>Please complete all the information below.<br> Our loan specialist will be contacting you at your convenience.<br> Thank You!</p> <table border="0" cellspacing="0" cellpadding="0" align="center" width="600"><tr><td align="CENTER" valign="TOP"> <hr width="100%" align="center"><p>Please use your mouse to navigate between fields. Thank You.</b></font></td></tr></table><br> <table border="0" cellspacing="0" cellpadding="2" align="center" width="535"> <tr><td align="RIGHT" width="296" background="Greenbackground.jpg"> <font size="2" color="#000000" face="Arial, Helvetica, sans-serif"><b> Your Full Name</b></font></td><td width="282" align="left"> <input type="text" size="20" name="Name"> *</td></tr><tr> <td align="RIGHT" width="296" background="Greenbackground.jpg"> <font size="2" color="#000000" face="Arial, Helvetica,sans-serif"><b> Address</b></font></td> <td width="282"> <input type="text" name="Address" size="20"> *</td></tr><tr> <td align="RIGHT" width="296" background="Greenbackground.jpg"> <font size="2" color="#000000" face="Arial, Helvetica,sans-serif"><b> City</b></font></td> <td width="282"> <input type="text" size="20" name="City"> *</td></tr><tr> <td align="RIGHT" width="296" background="Greenbackground.jpg"> <font size="2" color="#000000" face="Arial, Helvetica,sans-serif"><b> State(USA Only)</b></font></td> <td width="282"> <select name="State" size="1"> <option value="AK">AK</option> <option value="AL">AL</option> <option value="AR">AR</option> <option value="AZ">AZ</option> <option value="CA">CA</option> <option value="CO">CO</option> <option value="CT">CT</option> <option value="DC">DC</option> <option value="DE">DE</option> <option value="FL">FL</option> <option value="GA">GA</option> <option value="HI">HI</option> <option value="IA">IA</option> <option value="ID">ID</option> <option value="IL">IL</option> <option value="IN">IN</option> <option value="KS">KS</option> <option value="KY">KY</option> <option value="LA">LA</option> <option value="MA">MA</option> <option value="MD">MD</option> <option value="ME">ME</option> <option value="MI">MI</option> <option value="MN">MN</option> <option value="MO">MO</option> <option value="MS">MS</option> <option value="MT">MT</option> <option value="NC">NC</option> <option value="ND">ND</option> <option value="NE">NE</option> <option value="NH">NH</option> <option value="NJ">NJ</option> <option value="NM">NM</option> <option value="NV">NV</option> <option value="NY">NY</option> <option value="OH">OH</option> <option value="OK">OK</option> <option value="OR">OR</option> <option value="PA">PA</option> <option value="RI">RI</option> <option value="SC">SC</option> <option value="SD">SD</option> <option value="TN">TN</option> <option value="TX">TX</option> <option value="UT">UT</option> <option value="VA">VA</option> <option value="VT">VT</option> <option value="WA">WA</option> <option value="WI">WI</option> <option value="WV">WV</option> <option value="WY">WY</option> </select><b> * <u>UNITED STATES ONLY!</u></b></td></tr><tr> <td align="RIGHT" width="296" background="Greenbackground.jpg"> <font size="2" color="#000000" face="Arial, Helvetica,sans-serif"><b> Zip/Postal Code</b></font></td><td width="282"> <input type="text" size="10" maxlength="15" name="PostalCode"> *</td></tr><tr><td align="RIGHT" width="296" background="Greenbackground.jpg"> <font size="2" color="#000000" face="Arial, Helvetica,sans-serif"><b> Home Phone</b></font></td> <td width="282"> <input type="text" size="20" maxlength="30" name="HPhone"> *</td></tr><tr> <td align="RIGHT" width="296" background="Greenbackground.jpg"> <font size="2" color="#000000" face="Arial, Helvetica,sans-serif"><b> Work Phone</b></font></td><td width="282"> <input type="text" size="20" maxlength="55" name="WPhone"> *</td></tr><tr> <td align="RIGHT" width="296" background="Greenbackground.jpg"> <font size="2" color="#000000" face="Arial, Helvetica,sans-serif"><b> Email Address</b></font></td><td width="282"> <input type="text" size="20" maxlength="30" name="Email"> *</td></tr><tr> <td align="RIGHT" width="296" background="Greenbackground.jpg"> <font size="2" color="#000000" face="Arial, Helvetica,sans-serif"><b> Best Time To Call</b></font></td><td width="282" background="Greenbackground.jpg"> <select size="1" name="CallTime"> <option value="Morning at Home" selected>Morning at Home</option> <option value="Morning at Work">Morning at Work</option> <option value="Afternoon at Home">Afternoon at Home</option> <option value="Afternoon at Work">Afternoon at Work</option> <option value="Evening at Home">Evening at Home</option> <option value="Late Evening at Work">Late Evening at Home</option> </select> *</td></tr><tr> <td align="RIGHT" width="296" background="Greenbackground.jpg"> <font size="2" color="#000000" face="Arial, Helvetica,sans-serif"><b> Do You Own Your Home?</b></font></td><td width="282" background="Greenbackground.jpg"> <select size="1" name="Homeowner"> <option value="Yes" selected>Yes</option> <option value="No">No</option> </select><font color="#000000" size="1"> * Mobile Homes Do Not Qualify</font></td></tr><tr> <td align="RIGHT" width="296" background="Greenbackground.jpg"> <font size="2" color="#000000" face="Arial, Helvetica,sans-serif"><b> Property Value</b></font></td><td width="282"> <input type="text" size="13" name="PropertyValue" onBlur="if (!validate (this.value>= 50000)) { alert('Not Valid! Please enter the approximate value of current property or property you wish to purchase \n (greater than or equal to 50000) using only number characters - 0123456789'); this.focus(); this.select(); return false; }"> * <font size="1" color="#000000">Please use numbers only</font></td></tr><tr> <td align="RIGHT" width="296" background="Greenbackground.jpg"> <font color="#000000" face="Arial, Helvetica,sans-serif" size="2"><b>Property Type</b></font></td> <td width="282" background="Greenbackground.jpg"> <select size="1" name="PropertyType"> <option value="Single Family Residence" selected>Single Family Residence</option> <option value="Condo">Condo</option> <option value="Townhouse">Townhouse</option> <option value="2-4 Plex">2-4 Plex</option> <option value="Other">Other</option> </select> *</td></tr><tr> <td align="RIGHT" width="296" background="Greenbackground.jpg"> <font size="2" color="#000000" face="Arial, Helvetica,sans-serif"><b> Purchase Price</b></font></td><td width="282"> <input type="text" size="13" name="PurchasePrice"> * <font size="1" color="#000000">Please use numbers only</font></td></tr><tr> <td align="right" width="296" background="Greenbackground.jpg"> <font size="2" color="#000000" face="Arial, Helvetica,sans-serif"><b><p> Year Acquired</b></font></td><td align="left" width="282"> <input type="text" name="YearAcquired" size="13"> *</td></tr><tr align="CENTER"> <td align="RIGHT" width="296" background="Greenbackground.jpg"> <font color="#000000" face="Arial, Helvetica,sans-serif" size="2"><b>1st Mortgage-Balance Owed</b></font></td> <td width="282" align="left"> <input type="text" size="13" maxlength="30" name="Mortgage1" onBlur="if (!validate (this.value)) { alert('Not Valid! Please enter only number characters - 0123456789\n If you have no current mortgage please enter 0'); this.focus(); this.select(); return false; }"> * <font size="1" color="#000000">Please use numbers only (ex:45000) enter 0 for none</font></td></tr> <tr align="center"> <td align="RIGHT" width="296" background="Greenbackground.jpg"> <font color="#000000" face="Arial, Helvetica,sans-serif" size="2"><b>1st Mortgage-Interest Rate</b></font></td> <td width="282" align="left"><b> <select size="1" name="CurrentIntRate"> <option value="10.0" selected>10 or above</option> <option value="7.0">Below 7.0</option> <option value="7.25">7.1 - 7.49</option> <option value="7.75">7.5 - 7.99</option><option value="8.0">8.0 - 8.49</option> <option value="8.75">8.5 - 8.99</option> <option value="9.25">9.0 - 9.49</option> <option value="9.75">9.5 - 9.99</option> <option value="0">None</option> </select> %</b></td></tr><tr align="center"><td align="RIGHT" width="296" background="Greenbackground.jpg"> <font size="2" color="#000000" face="Arial, Helvetica,sans-serif"><b> Is 1st Adjustable or Fixed?</b></font></td><td align="LEFT" width="282" background="Greenbackground.jpg"> <select size="1" name="FirstType"> <option value="Fixed" selected>Fixed</option> <option value="Adjustable">Adjustable</option> </select> *</td></tr> <tr align="center"> <td align="RIGHT" width="296" background="Greenbackground.jpg"> <font color="#000000" face="Arial, Helvetica,sans-serif" size="2"><b>Employer</b></font></td> <td width="282" align="left"> <input type="text" size="15" maxlength="30" name="Employer"> *</td></tr><tr align="center"><td align="RIGHT" width="296" background="Greenbackground.jpg"> <font size="2" color="#000000" face="Arial, Helvetica,sans-serif"><b> Monthly Gross Household Income</b></font></td><td width="282" align="left"> <input type="text" size="13" maxlength="30" name="MonthlyGrIncome"> * <font size="1" color="#000000">Please use numbers only</font></td></tr> <tr align="center"> <td align="RIGHT" width="296" background="Greenbackground.jpg"> <font size="2" color="#000000" face="Arial, Helvetica,sans-serif"><b> 2nd Mortgage Balance owed</b></font></td><td width="282" align="left"> <input type="text" size="13" maxlength="30" name="Mortgage2" onBlur="if (!validate (this.value)) { alert('Not Valid! Please enter only number characters - 0123456789\n If you have no second mortgage please enter 0'); this.focus(); this.select(); return false; }">> * <font size="1" color="#000000">Please use numbers only(ex:45000) enter 0 for none</font></td></tr><tr align="center"> <td align="RIGHT" width="296" background="Greenbackground.jpg"> <font color="#000000" face="Arial, Helvetica,sans-serif" size="2"><b>Amount You Wish To Borrow</b></font></td> <td width="282" align="left"> <select size="1" name="BorrowRequest"> <option value="25000" selected>15,000 - 30,000</option> <option value="40000">30,000 - 45,000</option> <option value="55000">45,000 - 60,000</option> <option value="70000">60,000 - 75,000</option> <option value="85000">75,000 - 90,000</option> <option value="105000">90,000 - 110,000</option> <option value="120000">110,000 - 125,000</option> <option value="150000">125,000 & Up</option> </select> *</td></tr><tr align="center"> <td align="RIGHT" width="296" background="Greenbackground.jpg"> <font size="2" color="#000000" face="Arial, Helvetica,sans-serif"><b> Credit Rating</b></font></td><td width="282" align="left"> <select size="1" name="CreditRating"> <option value="Good" selected>Good</option> <option value="Fair">Fair</option> <option value="Poor">Poor</option> <option value="Excellent">Excellent</option> </select> *</td></tr><tr align="center"> <td align="RIGHT" width="296" background="Greenbackground.jpg"> <font size="2" color="#000000" face="Arial, Helvetica,sans-serif"><b> Monthly Debt</b></font></td><td width="282" align="left"> <input type="text" size="13" name="MonthlyDebt"> * <font color="#000000" size="1">Please use numbers <b>only</b></font></td></tr><tr valign="middle"> <td align="RIGHT" width="296" background="Greenbackground.jpg"> <font size="2" color="#000000" face="Arial, Helvetica,sans-serif"><b> Loan Interested In</b></font></td><td width="282" align="left"> <select size="1" name="LoanInterested"> <option value="Debt Consolidation" selected>Debt Consolidation</option> <option value="Second Mortgage">Second Mortgage</option> <option value="Home Improvement">Home Improvement</option> <option value="Refinance">Refinance</option> <option value="Purchase">Purchase</option> </select> *<br> </td></tr><tr align="center"> <td align="center" colspan="2" width="582" "><p><b><font face="Arial">Fast & Easy -You Are Done !</font></b><br> <input type="submit" value="Submit This Application"></td></tr></table></td></tr></table> </form><p><font face="Helvetica, sans-serif, Arial" size="2">REMOVAL INSTRUCTIONS: This message is being sent to you in compliance with the current Federal legislation. You must have either posted an AD to my FFA site, web-site, or requested information, or responded to one of our email letters. If you do not want to receive further emails or any other information from us, or you have received this mail in error, or for immediate removal you may simply use reply on your email program with "Remove from your mailing list#99221" in the subject. </font></p> </body> </html>