first lead form "*" indicates required fields Are you looking to purchase or refinance? Purchase Refinance What is your goal? Lower Rate Get Cash Back Are you or your spouse retired or active military? Yes No Active Military or Retired? Active Retired Are you receiving military retirement or VA Disability pay Yes No Have you received PCS orders? Yes No Where are you in the buying process? I’m under contract Ready to make an offer Buying in 1-3 months Buying in 3+ months What is the estimated purchase price?$0 to $10,000$10,001 to $20,000$20,001 to $30,000$30,001 to $40,000$40,001 to $60,000$60,001 to $80,000$80,001 to $100,000$100,001 to $120,000$120,001 to $140,000$140,001 to $160,000$160,001 to $180,000$180,001 to $200,000$200,001 to $250,000$250,001 to $300,000$300,001 to $350,000$350,001 to $400,000$400,001 to $450,000$450,001 to $500,000$500,001 to $550,000$550,001 to $600,000$600,001 to $650,000$650,001 to $700,000$700,001 to $750,000$750,001 to $800,000$800,001 to $850,000$850,001 to $900,000$900,001 to $950,000$950,001 to $1,000,000$1,000,001 to $1,500,000$1,500,001 to $2,000,000Over $2,000,000 $350k - $400k $0 $2m + This field is hidden when viewing the formWhere will your new home be located?City or Zip CodeAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificWhere will your new home be located?* This field is hidden when viewing the formEnter the property addressAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificEnter the property address Is this the first use of your VA entitlement? Yes No What is your credit score? 740 or higher 720 - 739 680 - 719 620 - 679 580 - 619 Below 580 Do you currently have a home to sell? Yes No Do you currently have a VA loan on your property?* Yes No Please estimate the value of the property$0 to $10,000$10,001 to $20,000$20,001 to $30,000$30,001 to $40,000$40,001 to $60,000$60,001 to $80,000$80,001 to $100,000$100,001 to $120,000$120,001 to $140,000$140,001 to $160,000$160,001 to $180,000$180,001 to $200,000$200,001 to $250,000$250,001 to $300,000$300,001 to $350,000$350,001 to $400,000$400,001 to $450,000$450,001 to $500,000$500,001 to $550,000$550,001 to $600,000$600,001 to $650,000$650,001 to $700,000$700,001 to $750,000$750,001 to $800,000$800,001 to $850,000$850,001 to $900,000$900,001 to $950,000$950,001 to $1,000,000$1,000,001 to $1,500,000$1,500,001 to $2,000,000Over $2,000,000 $350k-$400k $0 $2m + What is your mortgage balance?I don’t have a mortgage$10,001 to $20,000$20,001 to $30,000$30,001 to $40,000$40,001 to $50,000$50,001 to $60,000$60,001 to $70,000$70,001 to $80,000$80,001 to $90,000$90,001 to $100,000$100,001 to $120,000$120,001 to $140,000$140,001 to $160,000$160,001 to $180,000$180,001 to $200,000$200,001 to $250,000$250,001 to $300,000$300,001 to $350,000$350,001 to $400,000$400,001 to $450,000$450,001 to $500,000$500,001 to $550,000$550,001 to $600,000$600,001 to $650,000$650,001 to $700,000$700,001 to $750,000$750,001 to $800,000$800,001 to $850,000$850,001 to $900,000$900,001 to $950,000$950,001 to $1,000,000$1,000,001 to $1,500,000$1,500,001 to $2,000,000Over $2,000,000 $200k - $250k $0 $2m + How much cash would you like to borrow?$10,001 to $20,000$20,001 to $30,000$30,001 to $40,000$40,001 to $50,000$50,001 to $60,000$60,001 to $70,000$70,001 to $80,000$80,001 to $90,000$90,001 to $100,000$100,001 to $120,000$120,001 to $140,000$140,001 to $160,000$160,001 to $180,000$180,001 to $200,000$200,001 to $250,000$250,001 to $300,000$300,001 to $350,000$350,001 to $400,000$400,001 to $450,000$450,001 to $500,000$500,001 to $550,000$550,001 to $600,000$600,001 to $650,000$650,001 to $700,000$700,001 to $750,000$750,001 to $800,000$800,001 to $850,000$850,001 to $900,000$900,001 to $950,000$950,001 to $1,000,000$1,000,001 to $1,500,000$1,500,001 to $2,000,000Over $2,000,000 $100k -$120k What is the rate on your loan ? 3% - 3.99% 4% - 4.99% 5% - 5.99% 6% - 6.99% Over 7% Enter your contact detailsName* First Last Email* Phone* By providing your name, email, and phone number, you consent to share this information with our network of VA loan specialists and lenders to assist you in your VA loan application process. Your information will be handled securely and used solely for this purpose. PhoneThis field is for validation purposes and should be left unchanged.
