I have my own:.
I need to have at least          bedrooms.
I must have:
I would like to get if possible:
To help us understand your needs and wants please fill in the following questions.
What's the most that you want to pay per month with taxes and insurance  $.
On what day, do you want to move in?   .          /          / 2011  
Which cities would you consider. (list as many as possible so we can give you a good selection)
QUALIFING FORM
1.) We help you find your new home to own
2.) We prepare all the purchase contracts.
3.) We handle the financing.
4.) Were with you all the way, step be step. 
Contact phone number
Best time to call you?
FILL OUT THIS SHORT 1/2 PAGE FORM AND WE WILL GET STARTED
or
BORROWER
Name:
Address:
Birth date:
Soc. Sec. Number:
Current Housing
Do you currently rent:
If Yes, How much is your payment?  $
How long at your current address?
Income per month
Co BORROWER
Name:
Address:
Birth date:
Soc. Sec. Number:
Current Housing
Do you currently rent:
If Yes, How much is your payment?  $
How long at your current address?
Income per month
REMEMBER!
Our qualifying you, is only as good as the accuracy of the information you entered above. So don't round income off.
EMail Address:
EMail Address:
Dining Room
Fire Place
Basement
Garage
Stove
Refridgerator
Washer
Dryer
Fin. Basement
More than 1 bath
Dining Room
Fire Place
Basement
Garage
Fin. Basement
More than 1 bath
MorningAfternoonEvening
YesNo
Work
SSI per month  $
Disabilty per month  $
Pension per month  $
FIA per month  $
2nd. job
Paid hourly, $                per hr.@             hrs.per wk.
Paid salary, Gross per month $
Paid hourly, $                per hr.@           hrs.per wk.
Paid salary, Gross per month $
YesNo
Work
SSI per month  $
Disabilty per month  $
Pension per month  $
FIA per month  $
2nd. job
Paid hourly, $                per hr.@             hrs.per wk.
Paid salary, Gross per month $
Paid hourly, $               per hr.@            hrs.per wk.
Paid salary, Gross per month $