Do you have a question for an AMERA representative? Please fill out the form below and we will contact you within twenty-four hours*. Your Full Name: E-mail Address: Phone Number: - Select Morning Afternoon Evening 2nd Phone: - Select Morning Afternoon Evening I would prefer to be contacted by: Select E-mail Telephone I would like more information on: (select all that apply) A New Loan Refinancing Debt Consolidation A Construction Loan An Investment Property Loan Pre-Qualification If you are an AMERA customer and have questions regarding your account, please describe below: Comments or questions: How did you hear about AMERA Mortgage Corporation? Select Direct Mail Telemarketing Press Release Print Advertisement Word of Mouth Past Customer Web Surfing Web Ad Other If you found AMERA Mortgage Corporation on the internet, what web site, search engine, directory, etc. brought you to our site? *Hours of operation for AMERA Mortgage Corporation are 8:30 a.m. - 5:00 p.m. Monday-Friday. All questions submitted after hours will be handled the next working business day.

	1050 Corporate Office Drive, Suite 200 Milford, Michigan 48381 Phone (248) 685-1700 Toll Free (800) 968-1624 Fax (248) 685-1755 E-mail: amerahq@ameramortgage.com
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