Buyer In-take Form

Congratulations! You have taken the first steps to your real estate goals!

Please complete the following questionnaire. This form will allow us to come up with a plan to reach your goals.
About You
Full Name*

First NameLast Name
E-mail*
example@example.com
Cell Phone Number*
Birth Date

MonthDayYear
Can I Contact You Via Text Message

YesNo
Phone Number
Spouse/Partner Full Name

First NameLast Name
Birth Date

MonthDayYear
E-mail
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
What is your preferred method of communication

PhoneTextEmailAll Of the Above
About Your Family
Names and Ages Of People Who Will Be Moving With You
Do You Have Pets

Cats(s)Dog (s)No PetsOther
Are you the only decision maker when it comes to the purchase of this home?

I am the ONLY decision makerMy spouse/partner will help me make a decisionI have a family member who will help me make the decisionMy child/children will help me make the decisionOther
Why are you moving?

Better AreaTired Of RentingLiving With ParentsNeed A Bigger PlaceNeed A Smaller PlaceOther
How soon are you looking to buy a home

ASAP- within the next 60 days90 days6 monthsa year from nowOther
Are you currently in a lease?

YesNo
If so, when does your lease expire?
Are schools important to you?

YesNoSchool District You Prefer
Your Dream Home
Type of Home

CondoTownhomeSingle FamilyMulti-Unit
Style of Home

Rambler - One LevelSplit FoyerRaised RamblerColonialTownhouse (No Basement)Townhouse (including basement)New ConstructionOther
Number of Bedrooms

12345+
Number of Bathrooms

11.522.53+
Desired Features

BasementFamily RoomLiving RoomDining RoomDetached GarageAttached GarageFence YardMaster Bathroom
What is the best time for you to view homes?

Weekends OnlyMornings during the weekAfternoons during the weekAfter 5 during the weekAnytime
What areas are you interested in?
Notes You Want Me to Know
Financial Matters
How much can you pay in monthly mortgage?
How much money do you have saved towards a major purchase, such as a home?
Do you have a 401k or IRA

YesNoOther
Do you have a family member that would be willing to co-sign for you

YesNo
Have you ever filed bankruptcy

YesNo
If so, when was it discharged?

MonthDayYear
What is your current credit score range?

850-750749-650649-600Below 600
Do you need down payment assistance?

YesNo
Do You Have Student Loans

YesNo
Are they In Deferment

YesNoUntil When?
If you are already Pre-Qualified, What is the name and number of your Mortgage Professional
Full Name

First NameLast Name
E-mail
example@example.com
Phone Number
I work with some great loan officers who offer competitive rates and grants, can I have someone contact you about financing?

YesNo
Currently, to be mortgage ready you need at least a 640 credit score, If you are not mortgage ready would you be open to speaking with a lender to start a plan to get you into a home?

Yes, Sign Me Up-- I am serious about purchasing a homeNo, not at this timeMaybe later, right now buying a home is not a top priority
Are You An Entrepreneur?
Do you currently provide a service or product?

YesNo
If yes, do you mind sharing what it is? I love supporting small businesses!
We Love Referrals!
How did you hear about us?
Our Business Thrives from referrals!!! Do you know anyone else who is in the market to buy a home or sell a home? If you know of anyone who we can help, let us know! We are never too busy for your referrals! Please type their name and number.
Full Name

First NameLast Name
Phone Number
Email
Should be Empty:

About You

About Your Family

Your Dream Home

Financial Matters

Are You An Entrepreneur?

We Love Referrals!