Buyer Questionnaire
First Name:
*
Last Name:
*
Address:
City:
State/Zip Code:
IN
--
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NN
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Daytime Phone:
*
Evening Phone:
Fax:
E-mail:
*
How long have you been looking?
Select...
_________
<1 month
1 month
2 months
3 months
4 months
5 months
6 months
7 months
8 months
9 months
10 months
11 months
12 months
>1 year
Who with?
What is the size of your family?
Select...
1
2
3
4
5
6
7
8 or +
_________
Own or rent?
Select...
Own
Rent
_________
*
If rent, how much is your payment/mo.?
If rent, when does lease expire?
If own, how soon do you want to move?
$
Select...
<1 month
1 month
2 months
3 months
4 months
5 months
6 months
7 months
8 months
9 months
10 months
11 months
12 months
>1 year
Select...
_________
<1 month
1 month
2 months
3 months
4 months
5 months
6 months
7 months
8 months
9 months
10 months
11 months
12 months
>1 year
Must you sell or complete the lease period before buying?
Select...
Yes
No
Purchase range:
Financing:
Choose...
Talked to Lender
Made Application
Pre-Approved
Need Seller Contract
Need Lease Option
Need Guidance
Don't Know
How much has a lender qualified you to borrow?
Choose...
$20,000 - $25,000
$25,000 - $30,000
$30,000 - $35,000
$35,000 - $40,000
$40,000 - $45,000
$45,000 - $50,000
$50,000 - $55,000
$55,000 - $60,000
$60,000 - $65,000
$65,000 - $70,000
$70,000 - $75,000
$75,000 - $80,000
$80,000 - $85,000
$85,000 - $90,000
$90,000 - $95,000
$95,000 - $100,000
$100,000 - $110,000
$110,000 - $120,000
$120,000 - $130,000
$130,000 - $140,000
$140,000 - $150,000
$150,000 - $160,000
$160,000 - $170,000
$170,000 - $180,000
$180,000 - $190,000
$190,000 - $200,000
$200,000 - $220,000
$220,000 - $240,000
$240,000 - $260,000
$260,000 - $280,000
$280,000 - $300,000
$300,000 - $350,000
$350,000 - $400,000
> $400,000
*
Name of lender?
Whom did you speak with?
Name of your employer:
Name of spouse's employer:
Preferred location of new property:
*
Number of bedrooms:
Select...
1
2
3
4
5 or +
Number of bathrooms:
Select...
_________
1
2
3
4
5 or +
Basement:
Select...
Yes
No
No pref.
Garage:
Select...
1 car
2 car
3 or + car
New construction:
Select...
Yes
No
No pref.
If the "Information Central" Team gives you 100% of their time will you buy with us?
Select...
Yes
No
Are you willing to sign a
"Preferred Buyer" Agreement
at no cost to you?
Select...
_________
Yes
No
Communication preference:
Choose...
E-mail
Day Phone
Evening Phone
Fax
Mail
________
Best time to call?
Select...
Mornings
Afternoons
Evenings
Weekends
_________
