Input Buyer Buyer Information First Name: Last Name: Address: City: State/Prov: AlabamaAlaskaAlbertaAmerican SamoaArizonaArkansasBritish ColumbiaCaliforniaColoradoConnecticutDelawareDist of ColumbiaFed. St. of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineManitobaMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew BrunswickNew HampshireNew JerseyNew MexicoNew YorkNewfoundlandNorth CarolinaNorth DakotaNorthern Mariana IslandsNorthwest TerritoryNova ScotiaNunavutOhioOklahomaOntarioOregonPennsylvaniaPrince Edward IslandPuerto RicoQuebecRhode IslandSaskatchewanSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyomingYukon Territory Zip/Postal Code: Home Phone: Work Phone: Mobile Phone: Receive SMS Notifications: E-mail Address: Are you looking to purchase: Immediately Within 90 days 3-6 months Property Type Single FamilyMobile W/ landMulti Family HomeTownhouseCondominiumManufactured Home Rent/Own RentOwn Pre-Approved? YesNo City of Interest #1: City of Interest #2: City of Interest #3: City of Interest #4: City of Interest #5: City of Interest #6: City of Interest #7: City of Interest #8: City of Interest #9: City of Interest #10: State/Prov of Interest: AlabamaAlaskaAlbertaAmerican SamoaArizonaArkansasBritish ColumbiaCaliforniaColoradoConnecticutDelawareDist of ColumbiaFed. St. of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineManitobaMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew BrunswickNew HampshireNew JerseyNew MexicoNew YorkNewfoundlandNorth CarolinaNorth DakotaNorthern Mariana IslandsNorthwest TerritoryNova ScotiaNunavutOhioOklahomaOntarioOregonPennsylvaniaPrince Edward IslandPuerto RicoQuebecRhode IslandSaskatchewanSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyomingYukon Territory Min. # of Bedrooms: Min. # of Bathrooms: Price Range: Minimum Maximum Monthly Payment: Down Payment: The ideal home for me would be (describe): Are you interested in: Buying for yourself Lease Option or Land Contract Buying an investment property to rent out Buying an investment property to rehab Interested in renting Commercial Financing (A current credit report may or may not be obtained) (We will use this information to qualify you for a loan through a traditional lender or through our owner financing program) Date Of Birth: Date Of Employment: Job Title: Employer Name: Date Of Residence: Gross Monthly Income: Monthly Rent/Mortgage: Housing Status: RentOwn Checking Account: YesNo Savings Account: YesNo Marital Status: SingleMarried