Home Buyer Intake Form

1

When is your lease up if you are renting?

2

What type of home is it?* This field is required.

Single Family

Townhome

Condo

Multi-Family

3

Where are you in the home buying process?* This field is required.

Signed a purchase contract

Found a home

Looking to buy within a month

Looking to buy within 1-3 months

4

How do you plan to use your new home?* This field is required.

Primary Residence

Vacation Property

Investment Property

5

Have you or your spouse served in the US military? Veterans and active US military may be eligible for a $0 down VA loan when purchasing a home.* This field is required.

Yes

No

6

Are you actively working with a real estate agent?* This field is required.

Yes

No

7

Is this your first time purchasing a home?* This field is required.

Yes

No

8

What is the approximate purchase price of the new property? (It is okay to estimate)* This field is required.

9

How much do you have for a down payment? (It is okay to estimate)* This field is required.

10

What is your current employment status?* This field is required.

Employed

Self-Employed/1099 Independent Contractor

Retired

11

What is your household gross (before taxes) annual income?* This field is required.

Less than $30,000

$30,000 - $50,000

$50,000 - $75,000

$75,000 - $100,000

Greater than $100,000

13

Have you had a bankruptcy or foreclosure in the past 3 years?* This field is required.

Yes

No

14

What is your first and last name?* This field is required.

First Name

Last Name

15

What is your email?* This field is required.

example@example.com

16

What is your phone number?* This field is required.

Please enter a valid phone number.