Type of Loan 
                    New Mortgage 
                    Mortgage Renewal 
                    Home Refinance 
                    Equity Takeout 
                    Other 
                 
            
            
                
                    Type of Property 
                    Single Family 
                    Condo 
                    Townhouse 
                    Mobile House 
                    Other 
                 
            
            
                
                    Estimated Price/Value 
                    Less than $75,000 
                    $75,000 - $100,000 
                    $100,000 - $150,000 
                    $150,000 - $200,000 
                    $200,000 - $250,000 
                    $250,000 - $300,000 
                    $300,000 - $350,000 
                    $350,000 - $400,000 
                    $400,000 - $450,000 
                    $450,000 - $500,000 
                    $500,000 - $600,000 
                    $600,000 - $700,000 
                    $700,000 - $800,000 
                    $800,000 - $900,000 
                    $900,000 - $1,000,000 
          			Over $1,000,000 
                 
            
            
                
                    Down Payment 
                    $0.00 
                    $10,000 
                    $15,000 
                    $20,000 
                    $25,000 
                    $30,000 
                    $35,000 
                    $40,000 
                    $45,000 
                    $50,000 
                    $60,000 
                    $70,000 
                    $80,000 
                    $90,000 
                    $100,000 
                    $100,000 
                    $110,000 
                    $120,000 
                    $130,000 
                    $140,000 
                    $150,000 
                    $160,000 
                    $170,000 
                    $180,000 
                    $190,000 
                    $200,000 
                    $210,000 
                    $220,000 
                    $230,000 
                    $240,000 
                    $250,000 
                    Over $250,000 
                 
            
            
                
                    Mortgage Balance Owing 
          $0 - $50,000 
          $50,000 - $100,000 
          $100,000 - $150,000 
          $150,000 - $200,000 
          $200,000 - $300,000 
          $300,000 - $400,000 
          $400,000 - $500,000 
          $500,000 - $600,000 
          $600,000 - $700,000 
          $700,000 - $800,000 
          $800,000 - $900,000 
          $900,000 - $1,000,000 
          Over $1,000,000 
                 
            
            
                
                    How Much To Borrow 
                    $0 - $50,000 
          $50,000 - $100,000 
          $100,000 - $150,000 
          $150,000 - $200,000 
          $200,000 - $300,000 
          $300,000 - $400,000 
          $400,000 - $500,000 
          $500,000 - $600,000 
          $600,000 - $700,000 
          $700,000 - $800,000 
          $800,000 - $900,000 
          $900,000 - $1,000,000 
          Over $1,000,000 
                 
            
            
                
                    How Is Your Credit Score 
                    Excellent 
                    Good 
                    Some Problems 
                    Major Problems 
                 
            
            
                
                    How Did You Hear About Us 
                    Radio/Print Advertising 
                    Internet 
                    Realtor 
                    Friend 
                    Other