Buyer Questionnaire Form

Homebuyer Prequalification Intake Form

Brenda McMillian, Real Estate Broker, Accredited Buyer Representative
Please complete the following questionnaire and submit it as soon as possible. Exchanging this information prior to seeing properties helps me find exactly the loan and the right home for you. In addition to relating the physical requirements you want in your desired home, this questionnaire will help clarify where we need to start in the homebuying process, what's really important to you, the style and values that affect the choice of the home you purchase. Please contact me with any questions--- 704-294-9150
About You
Full Name*

First & Middle NameLast Name
E-mail*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
I have lived at this address for blanks* years and blank* months.
If you have lived at the above address LESS than 2 years, please provide your previous address here:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone Number Including Area Code*
Can I Contact You Via Text Message*

YesNo
Home Phone Number (leave blank if you do not have one)
Have you worked with or are you working with another real estate agent (in the last 12 months)?*

YesNo
Are you in an Exclusive Buyer Agency Agreement with another agent?*

YesNo
Spouse/Partner Full Name (If applicable)

First NameLast Name
E-mail
example@example.com
Address (if same as above, type SAME in the street address line)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Cell Phone Number
About Your Family
Names and Ages Of People Who Will Be Moving With You*
Names/Ages
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 decisionOther
Why are you moving?*

Better AreaTired Of RentingLiving With ParentsNeed A Bigger PlaceNeed A Smaller PlaceOther
Have You Bought or Sold a Home in the past?*

YesNo
How soon are you looking to buy a home*

ASAP- within the next 60 days90 days6 monthsa year from nowOther
Do You Need to Sell a Home Before You Can Purchase Another One?*

YesNo
Are You Currently Leasing or Renting?*

YesNo
What is your monthly rent payment?*
When is your rental agreement or lease up?*
Have you or your spouse ever served in the military?*

YesNo
If Yes, do you have a Certificate of Eligibility?

YesNo
What type of loan are you interested in?*

USDAFHAConventionalVARefinanceNot Sure
Your Dream Home
Are you a first-time homebuyer? (If it has been over 3 years since you purchased a home, you will still be a first-time homebuyer.

YesNo
State You Want to Live In*

North CarolinaSouth CarolinaOther
Cities/Towns/Neighborhoods of Interest*
Are You Interested in a New Home, a Resale Home or Both?*

NewResaleBoth
Type Of Home You Want*

CondoTownhomeSingle FamilyMulti-UnitMobile Home/Modular/ Manufactured
Do you or anyone that will live in the home have any disabilities or conditions that would require specific home features?*

YesNo
If Yes, please explain.
Style Of Home*

Ranch - One Level2 StoryQuad Level (3 stories with basement)Tri-Level (3 levels)Other
Number Of Bedrooms *

2345+
Number Of Bathrooms*

1/1.52/2.53 or more
Desired Square Footage
Desired Features *

BasementFamily RoomLiving RoomDining RoomDetached GarageAttached GarageFenced In YardMain Bedroom w/BathroomOffice/Bonus RoomWalk-in Closet(s)Other
When is the best time for you to view homes*

Weekends OnlyMornings during the weekAfternoon during the weekAfter 5 during the weekAnytime
Other Things You Want Me to Know
Financial Matters
Employer (Buyer 1)*
Job Title (Buyer 1)*
How Long Have You Worked on This Job?*
Employer Buyer 2
Job Title Buyer 2
How Long Have You Worked On This Job?
What was your total income from job #1 last year*
You can get this from you last Tax Return Form 1040 line 36
Are you salary or an hourly employee?*

SalaryHourlyCommission onlyOther
For hourly employees only! I make blanks per hour. I work blank hours per week.
Other Income? Source and how much?
Other Income? Source and how much?
What is your credit score? If you do not know, what is your best estimate. (You can use credit karma or equifax app.)*
Which negative items do you have on your credit report?*

Late PaymentsCharge OffsJudgementsTax LiensDebt SettlementOtherI don't know
Are you willing to start credit repair to dispute negative items on your credit report?*

YesNoNo negative items on report
What bills do you pay monthly and how much is each bill (do not include insurance, cell phone, electric, or water bill). If you don't have any bills, write NA in the space. These would be items that have an end date for pay-off like credit cards, student loans, car payment, furniture bill, etc.*
How much money do you have saved towards purchasing your home *
Have you ever filed bankruptcy*

YesNo
If yes, how long ago?
Do You Have Student Loans *

YesNo
Are they In Deferment?

YesNoDoes not apply
If you do not have a loan officer, would you consider allowing me to assist you with your loan?*

YesNo
We Love Referrals!
Who Referred You to Me?
My Business Thrives from referrals!!!

Do you know anyone else who is in the market to buy or sell a home? If you know of anyone who I can help, let me know! I am never too busy for your referrals! Please type their name and number below.
Full Name

First NameLast Name
Phone Number
Please verify that you are human*
Should be Empty:

Homebuyer Prequalification Intake Form

About You

About Your Family

Your Dream Home

Financial Matters

We Love Referrals!