Your Name: ________________________________________________

Street Address: ___________________________________________

City: ____________________ State: _________ Zip: __________

Phone (In case I have any questions): (_____)______________

(1) Original Mortgage Amount: $_________________

(2) Fixed Rate(F) or Adjustable Rate(ARM): ________
If you have an ARM, please complete the following items:
Adj. Period Rate Cap: ___________%
Lifetime Rate Cap: ___________%
Adj. Period Payment Cap: ___________

(3) Interest Rate: ________________%

(4) Date You Made Your First Payment: ______/_____/________

(5) Mortgage Term(15 Yrs, 30 Yrs, etc.): _____________

IMPORTANT: How much extra could you comfortably afford to add to your current payment? If you knew, it would help reduce your mortgage by THOUSANDS and cut your remaining payments down considerably.

For example, just by adding an extra $50.00 to your monthly payment, you will save $53,095 in interest charges alone and will reduce the term of your mortgage by 75 payments. Based on your current financial situation, place a check to the right of the amount that you feel you could comfortably afford to add to your current monthly payment.

$10____ $20____ $30____ $50____ $100____ You choose $_____.___

Mail this completed sheet, along with your one-time processing charge of $65.00 (Cash, Check, or Money Order) to me at the address below. Please allow 7-10 working days for final processing. Thank You!

Mail to:	Make Check / Money Order payable to:
MRA 4N715 Wood Dale Rd. Wood Dale, Illinois 60191	Raymond Sargent 4N715 Wood Dale Rd. Wood Dale, Illinois 60191