Credit To Homeownership Intake Form

1

Full Name* This field is required.

First Name

Last Name

2

E-mail* 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.

City, State

5

When are you planning to purchase a home?* This field is required.

Within 0-6 Months

As soon as my credit is in good shape

Within 6-12 months

Just exploring

6

Have you spoken to a lender previously?* This field is required.

Yes and I was approved

Yes and I was denied

Not YEt

Other

10

Do you have an OPEN Credit Card?* This field is required.

YESNO

11

Are any accounts currently past due or have high monthly payments?* This field is required.

YESNO

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

Yes I have both savings and 401k

I am actively building my savings

No, but I have a 401k or retirement account or access to money

I am waiting on my taxes

No, I do not have funds set aside yet or a plan started

13

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

Full Time Employee

Part Time Employee

Self Employed

Not currently employed

14

Are any accounts currently past due or have high monthly payments?* This field is required.

YESNO

15

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

16

Additional Comments Anything else you would like me to know