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This is not a loan application. The information you provide is sent to your Meridien Mortgage Specialist, who will review it and contact you the next business day. Meridien respects your privacy and will never sell or share your confidential information with any other parties. About the Loan You Want AMOUNT About Your Property PROPERTY TYPE Please select Single Family Residence Condominium Townhouse 2-4 Unit Commercial Land Lot Construction VALUE (ESTIMATE) AMOUNT YOU CURRENTLY OWE About You FIRST NAME LAST NAME STREET ADDRESS       State AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY      TELEPHONE E-MAIL ADDRESS GROSS INCOME Per Month  Per Year OVERALL CONSUMER CREDIT Please select Excellent Good Fair Poor   OVERALL MORTGAGE HISTORY Please select I have never been 30 days late I have been 30 days late I have been 60 days late I have been 90 days or more late I have been in foreclosure I do not currently have a mortgage   Help Us Serve You Better HOW SHOULD WE CONTACT YOU? Any Method Work Phone Home Phone Mobile Phone E-mail WHEN SHOULD WE CONTACT YOU? Any Time Morning Afternoon Evening HOW DID YOU HEAR ABOUT US? Please select Search Engine/Web Ad/Email Phone Call COMMENTS Submit this prequalification form now and a Meridien Mortgage Specialist will contact you within the next business day.

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