Homebuyer Intake Form

1
Full Name* This field is required.
First Name
Last Name
2
Email Address* This field is required.
example@example.com
3
Phone Number* This field is required.
Please enter a valid phone number.
4
City, State* This field is required.
5
Are You A First Time Home Buyer ?* This field is required.
Yes , this would be my first home
No, I have owned before
I am currently homeowner
Other
6
If not represented, are you looking for me to be your Realtor ?* This field is required.
YESNO
7
Have you been Pre-Approved by a lender ?* This field is required.
YES
NO
Not yet but ready to start
Other
8
How soon are you looking to purchase a home ?* This field is required.
0 to 3 months
6 to 12 months
3 to 6 months
As soon as my credit is ready
Just Exploring For Now
No Time Soon
Other
9
Are you currently in a lease ?If so when does your current lease expire
10
What is your estimated current credit score ?* This field is required.
Below 580
580-599
600-620
620-650
650 above
700 and above
I am not sure but it is low
Below 580 Need to sign up for credit program
Other
11
What types of accounts are currently reporting on your credit ?* This field is required.(Select all that apply)
Credit Cards
Personal Loans
Auto Loans
Collections
Student Loans
Charge Offs
Medical Debt
Bankruptcy
Foreclosure
None of the above
I am not sure
Late Payments
Other
12
Do you currently have funds available for your home purchase ?* This field is required.
Yes I have money saved in a checking or savings account
No, but I have a 401k or retirement account or access to money
Yes, I have both savings and 401k
I am actively building my savings
No, I do not have funds set aside yet
I am waiting on my taxes
13
What is your current employment status ?* This field is required.
Full Time Employee
Part Time Employee
Self Employed
Commission Based Income
Retired/Retired Veteran
Not currently employed
14
How long have you been with your current employer or in your current field ?* This field is required.
Less than 1 year
1 to 2 years
2 years of more
15
Are you a veteran, active duty service member , or surviving spouse who may qualify for a VA loan ?* This field is required.
YESNO
16
Preferred Locations & State* This field is required.
17
Preferred Property Type* This field is required.
Single Family Home
Condo/Apartment
Townhouse
New Construction
Commercial
Land
Other
18
Do you currently have any car loans, personal loans, or credit cards with high monthly payments ?* This field is required.
YESNO
19
If your credit needs improvement before approval, are you willing to invest in a credit package and follow a structured plan ?* This field is required.
YESNO
20
Additional Comments Anything you would like to let me know
Should be Empty: