How did you hear about NEXA Mortgage?

Were you referred or currently working with one of our NEXA Loan Officers? If yes, please share their name; if not, simply type NA.

Zip Code

What type of property are you refinancing?

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Estimate your credit score.

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What year did you purchase your home?

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Please estimate the value of the property.

Is this your first property purchase?

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What is the remaining 1st mortgage balance?

What is your 1st mortgage interest rate?

How will this property be used?

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What kind of rate do you prefer?

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Do you have a second mortgage?

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Would you like to borrow additional cash?

What is your gross annual household income?

What is your employment status?

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Bankruptcy, short sale, or foreclosure in the last 3 years?

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Can you show proof of income?

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What is your average monthly income?

What are your average monthly expenses?

Do you currently have a FHA loan?

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Any late mortgage payments in the last 12 months?

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What is your full name?

What is your email address?

What is your phone number?