Customer Questionnaire

Full Name

Home Address

City, State, Zip Code

Home Phone Number

Cell Phone Number

Email Address

Preferred Contact Method Preferred Contact Method Home Phone Number Cell Phone Number Email Address

Preferred Contact Times

Current Profession

Current Employer

Work Phone Number

Reason For Purchase

First Time Buyer First Time Buyer Yes No

Married Married Yes No

Children Children Yes No

How Many

Pets Pets Yes No

How Many

Other Family Other Family Yes No

How Many

Do You Have A Co-Buyer Do You Have A Co-Buyer Yes No

Co-Buyer Full Name

Co-Buyer Relation To You

Co-Buyer Phone Number

Co-Buyer Email

Payment Method Payment Method Cash Financing

Name Of Your Lender

Have You Been Pre-Qualified Have You Been Pre-Qualified Yes No

Have You Been Pre-Approved Have You Been Pre-Approved Yes No

What Amount Have You Been Pre-Qualified Or Pre-Approved For

Will Your Lender Issue A Pre-Qualified Or Pre-Approval Letter Stating This Amount Will Your Lender Issue A Pre-Qualified Or Pre-Approval Letter Stating This Amount Yes No

Do You Need To Sell A House Before You Can Purchase Another Do You Need To Sell A House Before You Can Purchase Another Yes No

If You Find A Property You Like, Are You Ready To Move Forward Now If You Find A Property You Like, Are You Ready To Move Forward Now Yes No

What Price Range Are You Considering

What Down Payment Amount Are You Considering

Desired City, Area, Or Neighborhood

How Many Squarefeet

How Many Bedrooms

How Many Bathrooms

How Large Do You Want Your Garage

Do You Want An Office Or Den? Do You Want An Office Or Den? Yes No

How Large

Any Detached Structures Any Detached Structures Yes No

What Kind What Kind RV Hobby Car Casita Guest House Other

Please Specify

Please Briefly Describe Your Desired Style Of Home