The Mortgage Gallery  
546 E. Sandy Lake Road Suite 100B
Coppell, TX 75019
Phone: (972) 393-0900
Email: mike@mikebanes.com
  Short Application  
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First Name: *
Last Name: *
Email Address: *
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Loan and Property Info
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Property Type
Property Will Be: *
Purpose of Loan: *
Estimated Property Value $ *
Loan Amount $ *
Loan Type : *
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