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Home Loan Purchase Assistant

• We'll help you get fast, free, no obligation quotes for a great home loan.
• Please answer as many questions as you can and submit this easy form:

If you have already found a home, please answer these questions about your new home:
Have you signed a purchase contract?	YesNo
What type of home are you purchasing?	--- Select --- Primary - Single Family Primary - Condo Primary - Mobile Home Primary - Townhome Primary - Multiple Family Dwelling 2nd Home - Condo 2nd Home - Mobile Home 2nd Home/Vacation - Single Family 2nd Home - Townhome 2nd Home - Multiple Family Dwelling Investment - Condo Investment - Mobile Home Investment - Townhome Investment - Multiple Family Dwelling
What is the street address of your new home?
In what city is your new home?
In what state is your new 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
What is the ZIP code of your new home?
What is your estimated purchase date?	--- Select --- 0-3 months 4-6 months 7-9 months 10-12 months Over 12 months
If you have not yet found a home, please answer these questions about the home you'd like:
Minimum Square Footage:	--- Select --- Under 1000 1250 1500 1750 2000 2250 2500 2750 3000 3500 4000 4500 5000 over 5000
Minimum # of Bedrooms:	--- Select --- 1 2 3 4 5 6 7 8 or more
Minimum # of Bathrooms:	--- Select --- 1 2 3 4 5 or more
Desired Property Zip Codes:
Please answer these questions about the new home loan you'd like (all fields required in this section):
What type of loan are you looking for?	--- Select --- 30 Year Fixed 30 Year Adjustable 15 Year Fixed 15 Year Adjustable Other
Are you a first time home buyer?	YesNo
What is the price of your new home?	--- Select --- $75,000 or less $75,001 - $80,000 $80,001 - $85,000 $85,001 - $90,000 $90,001 - $95,000 $95,001 - $100,000 $100,001 - $105,000 $105,001 - $110,000 $110,001 - $115,000 $115,001 - $120,000 $120,001 - $125,000 $125,001 - $130,000 $130,001 - $135,000 $135,001 - $140,000 $140,001 - $145,000 $145,001 - $150,000 $150,001 - $155,000 $155,001 - $160,000 $160,001 - $165,000 $165,001 - $170,000 $170,001 - $175,000 $175,001 - $180,000 $180,001 - $185,000 $185,001 - $190,000 $190,001 - $195,000 $195,001 - $200,000 $200,001 - $210,000 $210,001 - $220,000 $220,001 - $230,000 $230,001 - $240,000 $240,001 - $250,000 $250,001 - $260,000 $260,001 - $270,000 $270,001 - $280,000 $280,001 - $290,000 $290,001 - $300,000 $300,001 - $310,000 $310,001 - $320,000 $320,001 - $330,000 $330,001 - $340,000 $340,001 - $350,000 $350,001 - $360,000 $360,001 - $370,000 $370,001 - $380,000 $380,001 - $390,000 $390,001 - $400,000 $400,001 - $425,000 $425,001 - $450,000 $450,001 - $475,000 $475,001 - $500,000 $500,001 - $525,000 $525,001 - $550,000 $550,001 - $575,000 $575,001 - $600,000 $600,001 - $625,000 $625,001 - $650,000 $650,001 - $675,000 $675,001 - $700,000 $700,001 - $725,000 $725,001 - $750,000 $750,001 - $775,000 $775,001 - $800,000 $800,001 - $825,000 $825,001 - $850,000 $850,001 - $875,000 $875,001 - $900,000 $900,001 - $925,000 $925,001 - $950,000 $950,001 - $975,000 $975,001 - $1,000,000 Over $1,000,000
How much will you be putting down?	--- Select --- No down payment 1 - 3 % 3 - 5 % 5 - 7 % 7 - 10 % 10 - 15 % 15 - 20 % 20 - 25 % Over 25 %
Source of down payment:	--- Select --- No Down Payment Money in the Bank Sale of Existing Home Gift Other
If you currently own a home, please answer these questions:
Will you be selling your home in order to purchase a new home?	YesNo
If you will be selling your home, how soon do you want to sell:	--- Select --- Now! within 1 month within 3 months within 6 months within 9 months within 12 months over a year from now
Type of Home:	--- Select --- Single-Family Condo/Townhome Multiple Family Other
Square Footage:	--- Select --- Under 1000 1250 1500 1750 2000 2250 2500 2750 3000 3500 4000 4500 5000 over 5000
# of Bedrooms:	--- Select --- 1 2 3 4 5 6 7 8 or more
# of Bathrooms:	--- Select --- 1 2 3 4 5 or more
What is the estimated value of your current home?	--- Select --- $75,000 or less $75,001 - $100,000 $100,001 - $125,000 $125,001 - $150,000 $150,001 - $175,000 $175,001 - $200,000 $200,001 - $225,000 $225,001 - $250,000 $250,001 - $275,000 $275,001 - $300,000 $300,001 - $325,000 $325,001 - $350,000 $350,001 - $375,000 $375,001 - $400,000 $400,001 - $425,000 $425,001 - $450,000 $450,001 - $475,000 $475,001 - $500,000 $500,001 - $525,000 $525,001 - $550,000 $550,001 - $575,000 $575,001 - $600,000 $600,001 - $625,000 $625,001 - $650,000 $650,001 - $675,000 $675,001 - $700,000 $700,001 - $725,000 $725,001 - $750,000 $750,001 - $775,000 $775,001 - $800,000 $800,001 - $825,000 $825,001 - $850,000 $850,001 - $875,000 $875,001 - $900,000 $900,001 - $925,000 $925,001 - $950,000 $950,001 - $975,000 $975,001 - $1,000,000 Over $1,000,000
What is the total amount you owe on your 1st and 2nd mortgages?	--- Select --- $50,000 or less $50,001 - $75,000 $75,001 - $100,000 $100,001 - $125,000 $125,001 - $150,000 $150,001 - $175,000 $175,001 - $200,000 $200,001 - $225,000 $225,001 - $250,000 $250,001 - $275,000 $275,001 - $300,000 $300,001 - $325,000 $325,001 - $350,000 $350,001 - $375,000 $375,001 - $400,000 $400,001 - $425,000 $425,001 - $450,000 $450,001 - $475,000 $475,001 - $500,000 $500,001 - $525,000 $525,001 - $550,000 $550,001 - $575,000 $575,001 - $600,000 $600,001 - $625,000 $625,001 - $650,000 $650,001 - $675,000 $675,001 - $700,000 $700,001 - $725,000 $725,001 - $750,000 $750,001 - $775,000 $775,001 - $800,000 $800,001 - $825,000 $825,001 - $850,000 $850,001 - $875,000 $875,001 - $900,000 $900,001 - $925,000 $925,001 - $950,000 $950,001 - $975,000 $975,001 - $1,000,000 Over $1,000,000
A few questions about Real Estate Agents:
Are you currently working with a Real Estate Agent?	YesNo
If no, would you like help finding a Real Estate Agent?	YesNo
Would you like help finding an Agent to buy your new home?	YesNo
Would you like help finding an Agent to sell your current home?	YesNo
A few questions about yourself (all fields required in this section):
Your first name:
Your last name:
Your E-mail address:
Your Street Address:
Your City:
Your State:	--- 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
Your ZIP Code:
Home phone number:	() -
Are you self employed?	YesNo
How long have you been at your current job?	--- Select --- Not Applicable Less than 6 months 6-12 months 1-2 years More than 2 years Retired
What is your household's Gross Annual income?	--- Select --- $30,000 or less $30,001 - $45,000 $45,001 - $60,000 $60,001 - $75,000 $75,001 - $90,000 $90,001 - $105,000 $105,001 - $120,000 Over $120,000
Please estimate your credit rating:	--- Select --- Excellent Good Fair Needs Improvement Poor
Have you had a foreclosure or bankruptcy in the last 7 yrs?	--- Select --- No 1 Year Ago 2 Years Ago 3 Years Ago 4 Years Ago 5 Years Ago 6 Years Ago 7 Years Ago More than 7 Years Ago

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