Building a New Home? Let's Get Started! Complete in Minutes - Fast, Easy, No Account Sign-Up & Fully Secure Step 1 of 10 10% Home DetailsWhat Type of Home is Being Built?*Select OneSingle FamilyMulti-FamilyTownhomeBarndominiumWhat is the Estimated Construction Cost of Home?What Type of Mortgage Loan Needed? (If Known)*Select OneFHAVAUSDANative AmericanConventionalNot sure, Compare OptionsWhat State will the Property Be Located?*Select OneAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificLand DetailsDo You Own the Land?*Select OneYesNoWhat is the Value of the Land?What is the Amount Owed on the Land?What is the Estimated Purchase Price of Land? Borrower DetailsName* First Last Current Address:* Street Address City State / Province / Region ZIP / Postal Code Phone*Email* Date of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920SSN Social Security # is required to obtain a credit report and provide the loan pre-approval. If you do not want to provide your Social Security # online, a loan officer will contact you to obtain and go over your mortgage options.Estimated Credit Score*Select OneExcellent (720+)Good (680-719)Average (620-679)Fair (580-619)Poor (<580)Not SureAre you a Veteran?*Select OneYesNoAre you a Native American?*Select OneYesNoWhat Tribe Are You a Member of?* Borrower Income/ AssetsIncome Type*Select OneW-2 EmployeeSelf EmployedRetired / DisabilityEmployer / Company* Monthly Income(W2 Employee: Include Gross Salary, Overtime, Commissions, Etc.) - (Self Employed: Net After Expenses) - (Retired: Pension, SSI, Disability Awards)Total Assets(Checking, Savings, & Liquidable Retirement Accounts) Borrower DebtsDo You Pay Alimony / Child Support Amount?*Select OneYesNoAlimony / Child Support Amount?Do You Currently Own a Home?*Select OneYesNoHave You had a Bankruptcy or Foreclosure in the Last 7 Years?*Select OneYesNo Spouse or CoBorrowerAre You Married?*Select OneYesNo“Primary Residence” requires spouse information on all FHA, VA, USDA, HUD 184 Loans in Community Property States – AZ, CA, ID, LA, NV, NM, TX, WA, WI? - Please select Yes for co-borrower if applicable.Is Your Spouse Going to be or Do You Have a Coborrower?*Select OneYesNo Spouse/Co-Borrower InformationName* First Last Different Home Address?*Select OneYesNoAddress* Street Address City State / Province / Region ZIP / Postal Code Phone*Email* Date of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920SSN Social Security # is required to obtain a credit report and provide the loan pre-approval. If you do not want to provide your Social Security # online, a loan officer will contact you to obtain and go over your mortgage options.Estimated Credit Score*Select OneExcellent (720+)Good (680-719)Average (620-679)Fair (580-619)Poor (<580)Not SureAre You a Veteran?*Select OneYesNoAre You a Native American?*Select OneYesNoWhat Tribe Are you a Member of?* Spouse/Co-Borrower Income / AssetsIncome Type*Select OneW-2 EmployeeSelf EmployedRetired / DisabilityEmployer / Company* Monthly Income(W2 Employee: Include Gross Salary, Overtime, Commissions, Etc.) - (Self Employed: Net After Expenses) - (Retired: Pension, SSI, Disability Awards)Total Assets(Checking, Savings, & Liquidable Retirement Accounts) Spouse/Co-Borrower DebtsDo You Pay Alimony / Child Support Amount?*Select OneYesNoAlimony / Child Support Amount?Do You Currently Own a Home?*Select OneYesNoHave you had a Bankruptcy or Foreclosure in the Last 7 Years?*Select OneYesNo How Did You Hear About Us?*Select OneWeb SearchFamily/FriendRealtor/BrokerBuilder / DeveloperWebSearch*Select OneGoogleYahooBingFamily/Friend Realtor InformationRealtor/Broker Name* Realtor/Broker Number*Builder InformationBuilder Name* Builder Location (City)* Builder Salesperson* Builder Salesperson Number*Builder Salesperson Email* Authorization / SubmissionCredit Authorization*Select OneYesNoSpouse or Coborrower Credit Authorization*Select OneYesNoContact Consent* I Agree to be ContactedCapital Home Mortgage at Premier Mortgage Resources, LLC ("PMR") uses multiple systems, including Floify, to efficiently communicate important information to our customers. By clicking "SUBMIT" below, you are also providing express written consent to contact you, using the information you provided above and/or the information you provide in your initial application, which may also be noted above, including phone (land, mobile, or VoIP), email address, and/or mailing address, to include contacting you through automated means, such as 1) autodialing, text, and pre-recorded messaging via telephone, 2) mobile device, including SMS and MMS, even if have indicated above that you do not want to receive text messages through Floify, and/or 3) email, even if you are on a corporate, state, or national Do Not Call Registry. Δ