Mortgage
Leads List Count Request Form
Please note that
all fields followed by an asterisk must be filled in.
First Name*
First Name*
Last Name*
Last Name*
E-mail Address*
E-mail Address*
Company*
Company*
Phone*
Phone*
Quantity Needed:
Brief Description of
your Marketing Campaign.*
Brief Description of
your Marketing Campaign.*
Format
and Usage Options
Usage Type:*
Usage Type:*
Format Type:*
Format Type:*
Geographic
Selections
Targeted
State(s)
---Select---
All States
All States
& USA Territories
USA Territories
Northeastern States
Southeastern States
Northern Central
States
Southern Central
States
Western States
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Additional
State(s)
---Select---
Northeastern States
Southeastern States
Northern Central
States
Southern Central
States
Western States
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Additional
State(s)
---Select---
Northeastern States
Southeastern States
Northern Central
States
Southern Central
States
Western States
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Additional
State(s)
---Select---
Northeastern States
Southeastern States
Northern Central
States
Southern Central
States
Western States
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Other
Geography Selections
Geography Description
Demographic
Selctions
Adult Age
(2-year Increments)
Available Home Equity
Child Age
Credit Card
Buyer
Date of Birth
Delinquent
Tax Flag
Delinquent Tax Year
Dwelling
Type
First Loan Amount
First Loan
Amount Range
$1 - $4,999
$5,000 - $9,999
$10,000 - $19,999
$20,000 - $29,999
$30,000 - $49,999
$50,000 - $74,999
$75,000 - $99,999
$100,000 - $149,999
$150,000 - $199,999
$200,000 - $249,999
$250,000 - $299,999
$300,000 - $349,999
$350,000 - $399,999
$400,000 - $499,999
$500,000 - $749,999
$750,000 - $999,999
$1,000,000 - $1,999,999
$2,000,000+
Uncoded/Null
Select All
First Loan Date (ccyymmdd)
First Loan
Interest Rate Type
First Loan
Lender Type
Garage
Head HH
Occupation
Heating
& Cooling System
Home Assesed Value
Home Market Value
Home Purchase Amount
Home Size (sq.ft.)
Homeowner
Type
InfoBase
Networth
$0
$1 - $4,999
$5,000 - $9,999
$10,000 - $24,999
$25,000 - $49,999
$50,000 - $99,999
$100,000 - $249,999
$250,000 - $499,999
$500,000 +
Uncoded/Null
Select All
Lendable Home Equity
Length of Residence
Loan to Value
Lot Size (sq.ft.)
Mail Order
Buyer
Mail Order
Responder
Marital
Status
Net Worth -
Premier
< $0
$1 - $4,999
$5,000 - $9.999
$10,000 - $24,999
$25,000 - $49,999
$50,000 - $99,999
$100,000 - $249,999
$250,000 - $499,999
$500,000 - $999,999
$1,000,000 - $1,999,999
Greater than $1,999,999
Default
Select All
Number of
Bedrooms
Number of
Units
Personicx
Cluster Codes
Presence of
Pool
Property
Type
Real Estate Investor Property Count
RITAA
(Ranking Invitation to Apply Approvals)
Seasonal Loan Amount
Second Loan Date (CCYMMDD)
Second Loan
Interest Rate Type
Telephone
Number
Third Loan Amount
Third Loan Date (CCYYMMDD)
Third Loan
Interest Rate Type
Year Home Built
Postcard
Printing Options
Design
Services:
---Select---
I have my
own design artwork
I need my
postcard designed
Postcard
Size:
---Select---
4" x 6" Postcards
5" x 7" Postcards
6" x 9" Postcards
Paper/Stock:
Coating/Finish:
---Select---
Aqueous Both Sides
UV Front/Aqueous
UV Both Sides
UV
Front/No Coat Back (C1S stock)
Proof
Type:
---Select---
No Proof
Email Proof
Overnight Proof
Special Instructions
Postcard
Mailing Service Options
Mailing
Services:
---Select---
First Class Postage
I
will mail the Marketing Pieces Myself
Special Instructions:
Please enter the word that you see below.