Apply Now! Web Site First Name: * Last Name: * Date of Birth: * Social Security Number: * 000-000-0000 Will there be a co-borrower? * YES NO E-mail: * Phone Number: * Present Address: * Best time to contact you: 7am 8am 9am 10am 11am 12pm 1pm 2pm 3pm 4pm 5pm 6pm 7pm 8pm Marital Status: * Single Marrie What is this loan for? * Price Range Desired: * $50,000 - $100,000 $100,000 - $150,000 $150,000 - $200,000 $250,000 - $500,000 Above $500,000 What type of loan are you applying for? * FHA VA Conventional Jumbo Fix & Flip Other Your down payment amount: * Desired loan term: * 10 years 15 years 20 years 30 years Desired area for your property? * What type of property are you looking for? * Single Family Home Condominium / Townhome Manufactured Multiple Units Warehouse Empty Lot Other Employment Status: * Self-employed Full-time Part-time Retired Household Monthly Income After Taxes * Current Rent / Mortgage: * Total Other Monthly Payments (i.e. Child support, Alimony): * How did you hear about us? * Billboard Radio TV Lender Bing Yahoo Google Facebook Twitter Craigslist Realtor Friend Family Other What Lux Dominor member have you talked to? * Jessica Flores Morgan Davis Alex Flores Jose Raul Flores Tony Flores Are you currently working with a Realtor? * YES NO Upload your documents (last 3 paycheck, monthly bills, etc..): Provide additional comments/info here: We will send a confirmation to your email address. If you don’t receive it within half a day, you may need to check your junk mail folder. The results of your prequalification amount will be sent within 72 hours or less.