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Loan And Foreclosure Protection Application

IMPORTANT: If your home is not in California, please DO NOT submit an online loan application. We cannot process loans for anyone outside of California. Safe Haven Funding is currently licensed to operate ONLY in the state of California. We apologize for the inconvenience and hope to offer services to the continental US in the near future.

By completing this form as completely as possible, you'll help us start creating a customized foreclosure protection plan for you even before we meet. That way we'll make the most of your time.

Your privacy on this site is completely protected and guaranteed. We never share our information with other businesses and entities and will use it only to get in touch with you and create a foreclosure protection plan suitable to your needs.

Your Information

First Name:

Last Name:

Street Address:

City:

State:

Zip:

Best Contact Number: 555-555-5555 format

Email:

Select your type of dwelling:

Present Market Value of Property:

Principle Amount Owed:

Is there a second mortgage? Yes No	Amount Owed:
Is there a third mortgage? Yes No	Amount Owed:

Is there a co-borrower?
Yes No

First Name:

Last Name:

Street Address:

City:

State:

Zip:

Best Contact Phone: 555-555-5555 format