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* Denotes Required Fields

* Name:
* Address:
* City:
* State:
* Zip:
E-mail:
Home Phone:	###-###-####
I am requesting mortgage information regarding:	Purchase Refinance Construction Vacant Land Loan Bridge Loan Home Improvement/Renovation Mortgage
The best way to contact me is:	Home Phone Work E-mail Cellular Other
* I can be reached at (phone number):
If you are a member of a credit union, which one?
How did you hear of The Construction Loan Company, Inc.?
If this request pertains to a construction loan, please complete the following:
I (we) plan to build a home:	Immediately 3-6 Months 6-12 Months Over 1 Year
I (we) will most likely:	Use a professional builder General contract on own (license not required)
Have you purchased land for your home?	Yes No
If you have purchased land:	How long ago?
	Purchase price:
	Balance owed?

Fenton:
15266 Silver Parkway
Fenton, MI 48430
Tel: (810) 629-8700
Fax: (810) 629-6806

Imlay City:
301 E. First Street
Suite 100
Imlay City, MI 48444
Tel: (810) 721-2400
Fax: (810) 721-9600

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