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Homebuyer & Investment Consultation
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20
Questions
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1
Applicant
*
This field is required.
First Name
Middle Name
Last Name
Suffix
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2
Co-Applicant
First Name
Middle Name
Last Name
Suffix
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3
E-mail
*
This field is required.
example@example.com
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4
Phone Number
*
This field is required.
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5
Preferred Contact Method?
*
This field is required.
Phone Call
Text
Email
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6
How can I assist you?
*
This field is required.
Please Select
Financing
Realtor
Both
Please Select
Please Select
Financing
Realtor
Both
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7
Please provide the name of your Realtor:
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8
What is your goal?
*
This field is required.
Please Select
Purchase
Refinance
Sell
Please Select
Please Select
Purchase
Refinance
Sell
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9
Property type?
*
This field is required.
Please Select
Primary Residence
Secondary Residence
Investment Property
Please Select
Please Select
Primary Residence
Secondary Residence
Investment Property
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10
Do you currently own a home?
*
This field is required.
Primary, Secondary or Rental
YES
NO
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11
If yes, provide address of owned property
Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
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12
Previously or currently in foreclosure?
*
This field is required.
YES
NO
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13
Have you filed bankruptcy in the last seven years?
*
This field is required.
YES
NO
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14
If yes, what chapter and date of discharge?
If chapter 13 - have you completed 1 year of payment?
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15
Estimated credit score
*
This field is required.
Please Select
Below 580
580–619
620–679
680–739
740+
Please Select
Please Select
Below 580
580–619
620–679
680–739
740+
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16
Estimated household income
*
This field is required.
Please Select
Under $50,000
$50,001–$75,000
$75,001–$100,000
$100,001–$150,000
$150,001+
Please Select
Please Select
Under $50,000
$50,001–$75,000
$75,001–$100,000
$100,001–$150,000
$150,001+
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17
What price range are you considering?
*
This field is required.
Please Select
Under $250,000
$250,000–$350,000
$350,000–$500,000
$500,000+
Please Select
Please Select
Under $250,000
$250,000–$350,000
$350,000–$500,000
$500,000+
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18
What is your timeline?
*
This field is required.
Please Select
ASAP (0–30 days)
1–3 Months
3–6 Months
6+ Months
Please Select
Please Select
ASAP (0–30 days)
1–3 Months
3–6 Months
6+ Months
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19
Are you a Veteran or Active Duty?
*
This field is required.
YES
NO
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20
What are your goals or concerns?
*
This field is required.
0/300
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