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Buyer Information Template 2 -Form Fill

Section One
Q1

Full Name

First Name
Q2

Full Name

Last Name
Q3

E-mail
Q4

Cell Phone Number

Phone Number
Q5

Birth Date

Month
Q6

Birth Date

Day
Q7

Birth Date

Year
Q8

Can I Contact You Via Text Message
Q9

Home Phone Number

Phone Number
Q10

Work Phone Number

Phone Number
Q11

Extension
Q12

May I Call You At Work
Q13

Spouse/Partner Full Name

First Name
Q14

Spouse/Partner Full Name

Last Name
Q15

Birth Date

Month
Q16

Birth Date

Day
Q17

Birth Date

Year
Q18

E-mail
Q19

Cell Phone Number

Phone Number
Q20

Address

Street Address
Q21

Address

Street Address Line 2
Q22

Address

City
Q23

Address

State / Province
Q24

Address

Postal / Zip Code
Q25

Address

Country
Q26

Do You Have A FaceBook Page
Q27

What is your preferred method of communication
Q28

Names and Ages Of People Who Will Be Moving With You
Q29

Do You Have Pets
Q30

Are you the only decision maker when it comes to the purchase of this home?
Q31

Why are you moving?
Q32

How soon are you looking to buy a home
Q33

LOCATIONS & NEIGHBORHOODS OF INTEREST
Q34

Are schools important to you?
Q35

Type Of Home
Q36

Style Of Home
Q37

Number Of Bedrooms
Q38

Number Of Bathrooms
Q39

Desired Features
Q40

When is the best time for you to view homes
Q41

Notes You Want Me to Know
Q42

Employer
Q43

Job Title
Q44

Employer
Q45

Job Title
Q46

What is your adjusted gross income from last year
Q47

Other Income
Q48

Other Income
Q49

Year To Date Income
Q50

How much money do you have saved towards a major purchase, such as a home
Q51

Do you have a 401k or IRA
Q52

Do you have a family member that would be willing to co-sign for you
Q53

Have you ever filed bankruptcy
Q54

If so, when was it discharged?

Month
Q55

If so, when was it discharged?

Day
Q56

If so, when was it discharged?

Year
Q57

Do You Have Student Loans
Q58

Are they In Deferment
Q59

Full Name

First Name
Q60

Full Name

Last Name
Q61

E-mail
Q62

Phone Number

Phone Number
Q63

I work with some great loan officers who offer competitive rates and grants, can I have someone contact you about financing?
Q64

Currently, to be mortgage ready you need at least a 640 credit score, If you are not mortgage ready would you consider working with a credit restoration company that can guarantee you a 640 credit score within 6-9 months
Q65

Who Referred You?
Q66

Full Name

First Name
Q67

Full Name

Last Name
Q68

Phone Number

Phone Number