LG Realtor Buyer Intake Form
Turning Dreams Into Addresses
Are you currently working with another agent?
*
Yes
No
Buyer
*
First Name
Last Name
Buyer Email
*
example@example.com
Buyer Phone Number
*
-
Area Code
Phone Number
Buyer Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Have you ever file bankruptcy?
Yes
No
What was the date of discharge?
Current Employer Name
Phone Number
-
Area Code
Phone Number
Employer Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Years Employed
Annual Income
Previous Employer Name
Phone Number
-
Area Code
Phone Number
Employer Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Years Employed
Are you Married?
*
Yes
No
Spouse Name
First Name
Last Name
Spouse Email
example@example.com
Spouse Phone Number
-
Area Code
Phone Number
Spouse Address (If Different from above)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Current Employer Name
Phone Number
-
Area Code
Phone Number
Employer Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Years Employed
Annual Income
Previous Employer Name
Phone Number
-
Area Code
Phone Number
Employer Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Years Employed
Tell Me About Your Dream Home
How may I turn your dream into your address?
Have you been pre-approved by a lender?
*
Yes
No
Pre-Approval Amount
Type of Loan
Cash
Conventional
FHA
VA
Other
Financial Institution
Address of Financial Institution
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Lender Name
Lender Phone
-
Area Code
Phone Number
Lender Email
example@example.com
Mortgage Amount Preference
*
$-$$$ USD
Will this be your primary residence?
Residential
Rental
Business
Will this be a cash purchase?
Yes
No
Desired Location
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
Submit
Should be Empty: