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Your Trusted

Mortgage Expert Antonio Perez Jr.

(480) 625-8278

6751 N Sunset Blvd. Suite E430 Glendale , AZ 85305

We are excited to provide 1st Class service to your clients! Please enter their information below:


1. Buyer Information:

2. Employment & Income

3: Credit Score

4: Type of Lead

5: Realtor's Information

NOTE: Skip this section if Type of Lead = Refinance.

6: Additional Notes