Smart Loan

APPLICANT
Name (First, Middle Initial, Last)*			Birth Date (MM/DD/YYYY)
Social Security Number	Married Single Widowed Separated
Present Street Address
City	State	ZipCode
Apt#	Home Phone*
Duration	Monthly Rent ($)		Cell Phone
Previous Address (if < 2 yrs)	Duration	Currently: Renting Owns Other

OTHER INCOME
SSI, Disablility, Child Support, Pension, etc	Monthly Amount($)

CASH ASSETS
Money in the Bank	$
401K - CD's - Mutual Fund - Stocks - IRA - etc	$

OTHER INFORMATION
Do you have V.A. Eligibility?	Yes No
Are you a first time Home Buyer?	Yes No
How much money do you have for a downpayment? ($)
Notes

BUYER'S CRITERIA

A: When do you plan on moving?

B: What areas interest you?

C: How many bedrooms and bathrooms needed?

D: What is the most you can pay/mo for the right home?

E: Do you have a home to sell?

F: How did you hear about us?

G: Who is the agent you are working with?

Email Address*

CO-APPLICANT
Name (First, Middle Initial, Last)			Birth Date (MM/DD/YYYY)
Social Security Number	Married Single Widowed Separated
Present Street Address
City	State	ZipCode
Apt#	Home Phone
Duration	Monthly Rent ($)		Cell Phone
Previous Address (if < 2 yrs)	Duration	Currently: Renting Owns Other

OTHER INCOME
SSI, Disablility, Child Support, Pension, etc	Monthly Amount($)

CASH ASSETS
Money in the Bank	$
401K - CD's - Mutual Fund - Stocks - IRA - etc	$

OTHER INFORMATION
Do you have V.A. Eligibility?	Yes No
Are you a first time Home Buyer?	Yes No
How much money do you have for a downpayment? ($)
Notes