Home Buyer Information Form | Dream Home Wish List

ADVANCED EXIT STRATEGIES LLC A Real Estate Solutions Company 225-907-8392

Buyer Information Submission Form

Buyer Information: Tell Us About Yourself and Your Contact Info

First Name:
Last Name:
Address:
City:
State:
Zip Code:

Home Phone:
Work Phone:
Mobile Phone:
E-mail Address:

Wish List: Tell Us About the Kind of Property and Location You Are Interested In

Are you looking to purchase:
In the next 30 days
30-90 days
Whenever I spot a good enough deal

Property Type

Rent/Own

Pre-Approved?

YesNo

I would like a 1st/2nd
option regarding rates
and terms for a mortgage:

YesNo

City of Interest #1:

City of Interest #2:

City of Interest #3:

City of Interest #4:

City of Interest #5:

State of Interest:

Min. # of Bedrooms:

Min. # of Bathrooms:

Price Range:

Minimum	Maximum

Monthy Payment:

Down Payment:

The ideal home for me would be (describe):
Promo Code:
Are you interested in:	Buying for yourself Lease Option or Land Contract Buying an investment property to rent out Buying an investment property to rehab

Financing: Please Provide the Information Below to Get Pre-Qualified for a Mortgage

We will use this information to qualify you for a loan through a traditional lender or
a professional mortgage broker we work with. A current credit report may or may not be obtained.

Social Security Number:
Date Of Birth:
Date Of Employment:
Job Title:
Employer Name:
Date Of Residence:
Gross Monthly Income:
Monthly Rent/Mortgage:
Housing Status:	RentOwn
Checking Account:	YesNo
Savings Account:	YesNo
Marital Status:	SingleMarried

Click the Finish Button to Submit Your Information and Someone Will Contact You Shortly