PreQualify for Purchase This Form Requires Javascript. Please Turn on Javascript. 1 What type of home are you looking to purchase? 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 2 What is the price range of your new 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 3 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 % 4 Source of down payment Select Money in the Bank Sale of Existing Home Gift Other No Down Payment 5 Have you already found a home? Yes No 5a What County is the property located? ---Select County--- Appling Atkinson Bacon Baker Baldwin Banks Barrow Bartow Ben Hill Berrien Bibb Bleckley Brantley Brooks Bryan Bulloch Burke Butts Calhoun Camden Candler Carroll Catoosa Charlton Chatham Chattahochee Chattooga Cherokee Clarke Clay Clayton Clinch Cobb Coffee Colquitt Columbia Cook Coweta Crawford Crisp Dade Dawson Decatur DeKalb Dodge Dooly Dougherty Douglas Early Echols Effingham Elbert Emanuel Evans Fannin Fayette Floyd Forsyth Franklin Fulton Gilmer Glascock Glynn Gordon Grady Greene Gwinnett Habersham Hall Hancock Haralson Harris Hart Heard Henry Houston Irwin Jackson Jasper Jeff Davis Jefferson Jenkins Johnson Jones Lamar Lanier Laurens Lee Liberty Lincoln Long Lowndes Lumpkin Macon Madison Marion McDuffie McIntosh Meriwether Miller Mitchell Monroe Montgomery Morgan Murray Muscogee Newton Oconee Oglethorpe Paulding Peach Pickens Pierce Pike Polk Pulaski Putnam Quitman Rabun Randolph Richmond Rockdale Schley Screven Seminole Spalding Stephens Stewart Sumter Talbot Taliaferro Tattnall Taylor Telfair Terrell Thomas Tift Toombs Towns Treutlen Troup Turner Twiggs Union Upson Walker Walton Ware Warren Washington Wayne Webster Wheeler White Whitfield Wilcox Wilkes Wilkinson Worth 5b City, State, Zip Code of property: Select AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY 5c Have you signed a purchase contract? Yes No 5d What is your estimated purchase date? 5e What type of loan are you looking for? 30 Year Fixed 30 Year Adjustable 15 Year Fixed 15 Year Adjustable Other 6 Do you currently own a home? Yes No 5a Desired area of new home 5b What is your estimated purchase date? Select 0-3 months 4-6 months 7-9 months 10-12 months Over 12 months 5c What type of loan are you looking for? 30 Year Fixed 30 Year Adjustable 15 Year Fixed 15 Year Adjustable Other 6 Do you currently own a home? Yes No 6a What is the estimated value of your 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 6b What is the total amount that you owe on your 1 st & 2 nd 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 6c Will you be selling your current home in order to purchase a new home? Yes No 7 Do you have a Real Estate Agent? Yes No 7 Do you have a Real Estate Agent? Yes No 7a Are you a first time home buyer? Yes No 7b Would you like help finding a Real Estate Agent? Yes No 7c Would you like help finding a Real Estate Agent to sell your current home? Yes No 7d Would you like help finding a Real Estate Agent to buy your new home? Yes No 8 What is your household's Gross Annual income? (Include commissions, bonuses & child support.) 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 9 Please estimate your credit history Select Excellent Good Fair Needs Improvement Poor 10 Have you had a foreclosure or filed 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 11 Are you self employed? Yes No 12 How long have you been at your current job? Less than 6 months 6-12 months 1-2 years More than 2 years Retired 13 Your name: First Last 11 Your E-mail address: (jdoe@msn.com) 15 Please supply your home/Cell phone numbers: Home/Cell Best time to call Please Choose Anytime Morning Midday(Noon) Afternoon Early Evening Late Evening 15a Please supply your Work phone numbers: Not Required Work Ext. Best time to call Please Choose Anytime Do Not Call Work Morning Midday(Noon) Afternoon Early Evening Late Evening 17 Comments:
What type of home are you looking to purchase?
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
How much will you be putting down?
Source of down payment
Have you already found a home?
What County is the property located?
City, State, Zip Code of property:
Have you signed a purchase contract?
What is your estimated purchase date?
Do you currently own a home?
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Conventional Loan 