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Debt Elimination Form

Complete this form to help determine the best debt elimination options for you! Simply answer the questions the best you can. Keep in mind, the more information you give us, the more accurate the response. Don't bother with phone calls and emails - get your debt elimination information now!

 

Property Information
Property location:  

Property use:

 
Current Value of Property: $

How long do you plan on keeping the property?

 

Current Situation
How would you rate your credit?  

Your monthly income:

$

Your monthly expenses:

$
Your employment status:  
Your total credit card debt: $
Unsecured debt (including medical bills, personal loans, etc): $

Loan Information
Are you the primary borrower?   Yes No

Is there a co-borrower?

  Yes No
Current interest rate: %

Current Loan Program:

 
Current Loan Balance: $

Have you filed bankruptcy in the last seven years?

  Yes No

Contact Information
First Name:  
Last Name:  
Email:  
Phone:  



4213 A 85th Street   Lubbock, TX 79423  Phone: 806-698-6853  Fax: 806-698-9031  Mobile: 806-786-2556

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NMLS License #: 285922