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This is where you will tell us about yourself. When you do, we'll be able to evaluate your situation and begin the process of getting you a home of your own with no bank needed!

Contact Information
Name:
First Name:
Address:
City:
State:		Alabama Alaska Arizona Arkansas California * Canada * Colorado Connecticut Delaware 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 Washington DC West Virginia Wisconsin Wyoming
Zip Code:
Home Phone:
Work Phone:
Cellular Phone:
Email:
Best time to call?:		Select One... Morning (Before Work) Morning Lunch Time Afternoon Evening Anytime
General Information
Have you ever owned a home before?:		Select One... Yes No
When & where?:
Where do you want to live, please be specific?:
Do you have a preferred school district?:		Select One... Yes No
Please indicate which one?:
How many bedrooms do you need?:		1 2 3 4 more
How many bathrooms do you need?:		1 2 3 4
Do you need a garage?:		1 2 don't need one
Describe the property / lot you need:
Anything else you want to tell us about the house you want?:
Financial Information
Describe your credit?:		Good      Bad      Ugly
Please briefly explain why:
Have you ever had a: (check all that apply)		Foreclosure Short Sale Deed In Lieu Bankruptcy Repossession Collections
Anything else you want to tell us about your situation?
Monthly provable income:		$
Current Housing Payment:		$
Housing payment you feel you can afford:		$
Maximum down payment available:		$
Are you prepared and able to maintain a home? (It will be your responsibility)		yes no
Are you prepared and able to be a good neighbor?		yes no
Marketing
How did you hear about us?:
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