Registration & Pre-Qualification

Fill out the fields below. Fields marked with (*) are mandatory.

	PRIMARY PURCHASER:
First Name:*
Last Name:*
Address:*
City:*
State:*	Pick State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist. 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
Zip:*
Phone:*
Work:
E-mail:*
Spouse or Co-Buyer?*	No Co-buyer Spouse Other Co-buyer
	Fill out below if Co-buyer
	CO-PURCHASER/ SPOUSE:
First Name:*
Last Name:*
Address:*
City:*
State:*	Pick State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist. 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
Zip:*
Phone:*
Work:
E-mail:*
	I am interested in the following homes in the order of preference below:
1st
2nd
3rd
4th
Financing:*	Pre-qualify me Third party financing
	Fill out below if Third party finacing
Lender Name:*
Lender Contact:*
	FINANCIAL INFORMATION:
Employer:*
Job Title*
Years at Job:*
Self Employed:*	No Yes
If Yes, can your stated income be verified:*	No Yes
Combined Gross Annual Household Income:* ------ Select One ------ $25,000 - $49,999 $50,000 - $74,999 $75,000 - $99,999 $100,000 - $124,999 $125,000 - $174,999 $175,000 - $200,000 $200,000+
What Would Your Total Down Payment Be At Purchase?* ------ Select One ------ Less than $10,000 $10,000 - $19,999 $20,000 - $29,999 $30,000 - $39,999 $40,000 - $49,999 $50,000 - $59,999 $60,000 - $69,999 $70,000 - $79,999 $80,000 - $89,999 $90,000 - $99,999 $100,000+
Do You Currently Own Your Home? Yes No
Source Of Down Payment Funds:* ------ Select One ------ Checking/Savings Liquidation of Retirement funds Stocks and Bonds Equity line on current residence or other property Cash out proceeds on current residence or other property Gift funds
How Would You Rate Your Credit?* ------ Select One ------ Excellent, I pay all bills on time, every time (credit score range of 681 - 850) Good, I pay all my bills on time, most of the time (credit score range of 640-680) Fair, I have a few late pays (credit score range of 620 - 639) Poor, My credit is not very good (credit score range 580 - 619)

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