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Contact Information |
| Name:
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| Address:
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| City:
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| State:
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| Zip code:
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| Phone:
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| Fax:
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| Email address:
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| Best time to contact you:
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| Best method to contact you:
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Personal Information |
| Gender:
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Male
Female
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| Age:
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| Household income:
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Have you ever declared bankruptcy:
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Yes
No
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Have you ever defaulted on a school loan:
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Yes
No
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May we run a credit report:
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Yes
No
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Interest/Needs |
| In what City/Area are you interested in buying:
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| In what State are you interested in buying:
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| How soon do you wish to purchase a home:
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Do you have a home that you are selling:
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Yes
No
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| Loan type:
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| Approximate loan amount:
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| Market value of your home:
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| Current total mortgage balance:
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| Current mortgage interest rate:
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Other Information: |
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Have you found a home that you wish to purchase:
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Yes
No
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If so, what is the address:
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| Address:
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| City:
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| State:
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| Zip code:
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If so, tell us about it( How many bedrooms, bathrooms, describe is for us:
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If not, may we help you find the home you are looking for:
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Yes
No
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Comments:
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