Request Form State where you are buying home: Select... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming * County where you are buying home: * Approximate Price of Home you seek to buy: Select... Please Select... under $50,000 $50,000 $60,000 $70,000 $80,000 $90,000 $100,000 $110,000 $120,000 $130,000 $140,000 $150,000 $160,000 $170,000 $180,000 $190,000 $200,000 $210,000 $220,000 $230,000 $240,000 $250,000 $260,000 $270,000 $280,000 $290,000 $300,000 $310,000 $320,000 $330,000 $340,000 $350,000 $360,000 $370,000 $380,000 $390,000 $400,000 over $417,000 * When are you looking to buy? Select... Immediately Within a month in 2-6 months over 6 months Are you currently working with Realtor? Yes No Rate Your Credit: Select... Excellent: Credit Score over 780 Good: Credit Score 680-780 Fair: Credit Score 580-680 Poor: Credit Score Below 580 * *** if you don't know your credit score, get it now at www.annualcreditreport.com What is your total monthly income? * Have you filed for bankruptcy? Select... Within the Last 12 Months 1-2 years ago Over 2 years ago * Have you filed for or ever had a foreclosure? Select... Within the Last 12 Months 1-2 years ago Over 2 years ago * Have you been late on mortgage payments in the last 12 months? Yes No What is your total MINIMUM payments per month for credit cards? * Have you been late on credit card payments in the last 12 months? Yes No What is your total payments per month for car loans? * What is your total payments per month for student loans? * Do you have over $ 5,000 in collections? In other words, do you have $ 5,000 owed that debt collectors are calling you on? Yes No First Name: * Last Name: * Phone #: * Email: * How did you hear about us? Comments: * required
State where you are buying home: Select... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming *
County where you are buying home: *
Approximate Price of Home you seek to buy: Select... Please Select... under $50,000 $50,000 $60,000 $70,000 $80,000 $90,000 $100,000 $110,000 $120,000 $130,000 $140,000 $150,000 $160,000 $170,000 $180,000 $190,000 $200,000 $210,000 $220,000 $230,000 $240,000 $250,000 $260,000 $270,000 $280,000 $290,000 $300,000 $310,000 $320,000 $330,000 $340,000 $350,000 $360,000 $370,000 $380,000 $390,000 $400,000 over $417,000 *
When are you looking to buy? Select... Immediately Within a month in 2-6 months over 6 months
Are you currently working with Realtor? Yes No
Rate Your Credit: Select... Excellent: Credit Score over 780 Good: Credit Score 680-780 Fair: Credit Score 580-680 Poor: Credit Score Below 580 *
*** if you don't know your credit score, get it now at www.annualcreditreport.com
What is your total monthly income? *
Have you filed for bankruptcy? Select... Within the Last 12 Months 1-2 years ago Over 2 years ago *
Have you filed for or ever had a foreclosure? Select... Within the Last 12 Months 1-2 years ago Over 2 years ago *
Have you been late on mortgage payments in the last 12 months? Yes No
What is your total MINIMUM payments per month for credit cards? *
Have you been late on credit card payments in the last 12 months? Yes No
What is your total payments per month for car loans? *
What is your total payments per month for student loans? *
Do you have over $ 5,000 in collections? In other words, do you have $ 5,000 owed that debt collectors are calling you on? Yes No
First Name: *
Last Name: *
Phone #: *
Email: *
How did you hear about us?
Comments:
* required
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