First Name

Last Name

Phone Number

Email Address

Street Address

Street Address Line 2

City

State/Province

Postal/Zip Code

What Program are you interested in? Please select an option. What Program are you interested in? Please select an option. Traditional Homebuyer Option (minimum 620 credit score) Rent-To-Own Homebuyer Option (rent while improving your credit then purchase)?

Have you ever purchased a home? If so, what year?

Have you owned a home in the last 3 years? If so, what year?

Have you had a home deeded (given) to you within the last 3 years?

If so, do you still own the home?

What is your FICO credit score?

Have you spoken with a mortgage lender, within the past year, about a home loan? If so, when?

What city are you wanting to purchase a home in?

What area of that city would you like to purchase your home in?

How many will be living in your home, including yourself?

If more than you, how many are over the age of 17, including yourself?

Do you have any savings to apply towards the down payment of a new home?

If so, how much?

Are you currently under a lease or rental agreement at your current residence?

If so, when does the lease or rental agreement expire?

Have you ever filed for bankruptcy? Have you ever filed for bankruptcy? Yes No

If so, was it chapter 7 or 13?

If so, has the bankruptcy been discharged?

If so, what year was it discharged?

Have you had any judgements or liens filed against you?

If so, please explain.

If so, have the lien(s) been resolved?

If so, when?

Do you have any student loans?

If so, what is the balance?

If so, are you on an income driven program?

Are you employed?

If so, how long have you been with your current employer?

Are you self-employed?

If so, have you filed federal taxes in the past 2 years?

If unemployed, when was your last day of work?

What is your annual income?

Please list ALL sources of income: