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We’ve helped many of home buyers and helping families across the nation to successfully finding the loans that are right for them. Our specialists are standing by to help you with the lowest rates and the best terms of loans possible in the market.Please fill out the form below to find out if you are qualified fr a loan. Our specialist will get back to you shortly.

Loan Information and Purpose of Loan <>

(Items marked with " * " are required for submission. )
Estimated Value of Home:
Loan Amount Desired:
Purpose of Loan:*
If purpose of loan is other, please explain below:
I. Borrower's Name: (include Jr. or Sr. if applicable)
First Name *
Middle Name
Last Name *
Email Address*
Social Security # *
Home Phone * (incl. area code)
Present Address
(Street, City, State, ZIP)*
Number of Years *
Street *
City *
State (Abvr.) *
Zip Code *
Gross Monthly Income *
II. Co-borrower's name: (include Jr. or Sr. if applicable) Do you have a Co-borrower?
Authorization to Release Information *
You are free to disagree or agree with the acknowledgment below, however, please understand that if select 'DISAGREE' that your application automatically cannot be processed or pre-approved.

I authorize Prime Choice Funding, Inc. to verify any and all information that is needed to complete the loan process. Such information includes, but is not limited to, employment history and income; bank, money market and similar account balances; credit history; and copies of income tax returns.

Additional Information
When would you like us to contact you *
How did you hear about us? *
If you answered, 'G, H, or I' to the above question, please specify the first and last name of the contact person who referred you to in the box on the right to ensure that proper credit is given to the appropriate loan originator.
Borrower/Co-borrower Signatures
Borrower's Signature *
Type in Name
Date *
Co-borrower's Signature
Type in Name