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First Name:
Last Name:
Email:
Address:
City:
State:
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Zip:
Day Phone:
Evening Phone:
Best Time To Contact:
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Morning
Afternoon
Evening
County Home Will Be Placed:
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Not Sure
Alameda
Alpine
Amador
Butte
Calaveras
Colusa
Contra Costa
Del Norte
El Dorado
Fresno
Glenn
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Yuba
Home Type:
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Custom Stick Built Home
Modular Home
Prefab Home (Panel Home)
Manufactured Home
Pole Building (Steel Building)
Log Home
Commercial Project
Desired Square Feet:
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Under 1,000
1,000 to 1,500
1,500 to 2,000
2,000 to 3,000
3,000 to 4,000
Over 4,000
Estimated Start Date:
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Immediately
1 To 3 Months
3 To 6 Months
6 To 12 Months
12 Months Or Longer
Total Budget Range:
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Under $100,000
$100,000 To $150,000
$150,000 To $200,000
$200,000 To $300,000
$300,000 To $400,000
$400,000 To $500,000
$500,000 To $700,000
$700,000 To 1 Million
1 Million To 2 Million
2 Million And More
Estimated Loan Amount:
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None
Under $100,000
$100,000 To $150,000
$150,000 To $200,000
$200,000 To $300,000
$300,000 To $400,000
$400,000 To $500,000
$500,000 To $700,000
$700,000 To 1 Million
1 Million To 2 Million
2 Million And More
Will You Finance
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Yes
No
Credit History:
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Excellent
Good
Fair
Poor
Secured Property:
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Yes
No
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