Online Questionnaire Please enable JavaScript in your browser to complete this form.Name *FirstLastCurrent AddressAddress Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeEmail *Cell PhoneCan this phone receive text messages?YesHow long have you been at this address?When does your current lease expire (if applicable)?When are you expecting to move?Why are you moving?Are you a first-time home buyer, or have you purchased a home before?First time home buyerPurchased home beforeHow much is your current rent / mortgage?What does your rent / mortgage payment include?What is the maximum monthly payment you can afford?What is your combined gross household income (before any deductions)?Does the above income reflect income per month or year?MonthYearHow much do you have for a down payment on your new home?If no down payment now, do you have a plan to raise a down payment?YesNoMaybeHow would you rate your credit score?ExcellentVery GoodGoodFairPoorWhat do you think your credit score is currently (if known)?Have you ever had the following?BankruptcyForeclosureEvictionWhat city, neighborhood or part of town are you looking to own in?How many bedrooms do you need?How many bathrooms do you need?How many people will be living in your home?Do you currently have any pets?List anything else that may be important to youWould you like to proceed?YES!! I'm ready to move forward and receive my commitment letter.No, I'm not ready to move forward (please explain in the next block)What's holding you back from moving forward?Submit