EmailMe Form - Getting to know you and your new home!

Name

First Last

Spouse/ Co-Borrower

First Last

Email

Marital Status

Married

Unmarried(Single, divorced, widowed)

Separated

Current Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code

Phone

### - ### - ####

Phone- Alt

### - ### - ####

Date of birth

MM / DD / YYYY

Best time to reach you

Are you a first-time home buyer, or have you purchased a home before?

First-time home buyer

Purchased home before

Do you need to sell property before you can purchase

Yes

No

Are you currently working with a REALTOR?

Yes

No

Are you currently in a lease agreement?

Yes

No

If so, when does it end?

MM / DD / YYYY

What city/cities would you like to purchase your new home

Input multiple cities if you want different areas.

What monthly payment range would you feel comfortable with?

$ Dollars . Cents

How soon do you want to be in a new home

MM / DD / YYYY

How much money do you have saved for a down payment?

$ Dollars . Cents

Mortgage Status

I'm Prequalified

I haven't applied

Cash buyer

If yes, what amount have you been pre-qualified/pre-approved for?

$ Dollars . Cents

How would you rate your credit score

How many dependents do you have?

Are you a Veteran?

Yes

No

How many years have you been employed in your current line of work?

Employment Status

W-2 Employee

Self Employed

Retired

Current Employer (Include employer name, Position, Address, and Start date)

My monthly base salary is:

$ Dollars . Cents

My estimated monthly overtime/ bonuses/ commissions is:

$ Dollars . Cents

Please indicate any source of additional income

Amount

$ Dollars . Cents

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