New Client Intake
Please help me better serve you by completing a few questions. In a world full of choices, choose those that make your life simple.
Name
*
First Name
Last Name
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
How do you prefer to be contacted
Call
Text
Email
In Person
Via Zoom
How can I serve you
*
No Obligation Market Analysis
Interview for listing agent
Interview for buyer agent
Loan Pictures / Floor Scan
Lease search
Other
Schedule a 1 hour google meet to review your needs
Seller
Time frame - How soon are you looking to sell
ASAP
1 Month
2 Months
3 Months
Other
Will you be purchasing a new home when you sell your current home
Yes
No
Not in this area
Not in this state
Renting
Have you made any updates that will impact your homes value? If yes please list all updates and approximate date they were completed
Are you in jeopardy of foreclosure
Yes
No
Notice has been given
Other
Are there any issues that you are aware of with your home? If yes please list issues.
Approximate Loan Balance
What is your interest rate
2nd Mortgage / Lien
Any Additional information you would like to share?
Buyer
Have you contacted a lender
Yes
No
Lender Name
Lender Phone #
Lender Email
Loan Type
Cash
Conventional
FHA
VA
What is the loan status
N/A
Pre-Qualified
Pre-Approved
Not Started
Cash
Budget for new house (Purchase price)
Monthly Payment Budget
If already approved please attach pre-approval letter
Browse Files
Cancel
of
Time frame
ASAP
0-3 Months
3-6 Months
6-9 Months
Other
Area(s) for desired new home
SQFT of home desired
Number of bedrooms desired
Any
1-2 Beds
2-3 Beds
3-4 Beds
4+ Beds
Other
Number of Baths desired
1 - 1.5
2 -2.5
3 - 3.5
4
Other
Any must have's? (i.e. Single story, no carpet, 55+ community, etc.)
Style of home desired
Please Select
Single Family Detached
Townhouse
Condo
Mobile Home - Singe Wide
Mobile Home - Double Wide
Land - Unimproved
Land - Improved
Other
Must Have's
HOA
Gated Community
Pool - Public
Pool on property
Designated Office
Single Story
Updated
Outdoor space
Gas Appliances
Storage
3 Car garage
Fenced
Wood Floors
Carpet
Kitchen Island
Granite Counters
Other
Any Additional information you would like to share?
Lease
How soon are you looking to move
ASAP
1 month
2 Months
3 Months
Other
Additional occupants 18 years or older
Yes
No
Name
First Name
Last Name
Name
First Name
Last Name
Monthly rent from
Monthly rent to
Search Area
Pets
Yes
No
Dog
Cat
Other
Dog Breed
Weight
Number of bedrooms
Number of bathrooms
Additional requirements
Thank you for allowing me to serve you.
If you scheduled an appointment I will send you a confirmation shortly.
Submit
Referral Partner
Please Select
AmeriSave
New American Funding
Rocket
Chase
MOVOTO
SEC
Mr. Cooper
MyAgentFinder
OptCity - Realtor.coom
Lakeview
Chase
Other Referral partner
Have you completed
Signed Representation paperwork
Met with the lender
Scheduled a time to view homes
Are you working with another agent
I have seen houses with another agent
Have not see houses with another agent
I am interviewing buyers agents
I am interviewing sellers agents
I am receiving information from another sellers agents
I have listed with another agent
Other
Submit
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