New Homeowner Buyer Intake Form
Turn Your Dream Into a Permanent Address
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Employment
*
Full Time
Part Time
Self Employed
Are you Married?
*
Please Select
Yes
No
Spouse Name
First Name
Last Name
Spouse Email
example@example.com
Spouse Address (If Different from above)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Format: (000) 000-0000.
Are you looking to purchase a Home or Land?
Check an option below
Home
Land
Please provide more information
Indicate Price Range
*
$-$$$ USD
Location Preference
Have you been approved by a lender?
*
Please Select
Yes
No
If Yes Specify Lender Name
Are you currently working with another agent?
*
Please Select
Yes
No
Indicate the primary purchase of property
Please Select
Residential
Commercial
Land for residential use
Land for commercial use
Preferred style of home
Single occupancy house
Apartment/Loft
Flat
Ranch Style
Bungalow
Split Level
Duplex
Number of Bedrooms
Number of Bathrooms
Square Feet
Enter a range (ex: 1000-2000)
Acres
Enter a range (ex: 1000-2000)
Amenities
Central Air Conditioning
Appliances
All Electric
Sky Lights
Other
Specify additional amenities
Additional Information
Are you on section 8 housing?
*
Yes
No
Estimated Credit Score
*
Under 580
600-639
640 or higher
Are you currently renting? If so, when does your lease end?
How would you prefer to be contacted?
*
Phone
Email
Text
Submit
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