Rate Alert

Please fill out the following Rate Alert form to specify the rate, points and program you'd like. The Rate Alert program will scan our rates and programs until a match is found. A representative from Discount Mortgage will contact you by telephone or email. Once you have completed this expression of interest or application, your information will be sent to Discount Mortgage. By submitting your expression of interest you are consenting to receive telephone calls or email from Discount Mortgage.

CONTACT AND BORROWER INFORMATION

First Name	Last Name	Email Address
**	**	**
Current Street Address

City	State	Zip Code
		**

Primary Phone	Alternate Phone	Best Time To Call
******	***

LOAN AND PROPERTY DETAILS

Target Rate	Target Points	Credit History
*	*	*

Loan Amount	Property Value
**	**

Program	Time Frame
*	*

Property Type	Loan Type
*	*

COMMENTS
*