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| First Name: |
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| Last Name: |
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| Street Address: |
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| City: |
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| State: |
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| Zip: |
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| Phone: |
(ex.
xxx-xxx-xxxx) |
| E-mail Address: |
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| Are you currently renting: |
When does your lease end:
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| What do you pay in rent today? |
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| Your Monthly Affordability: |
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How much have you saved for
a downpayment/security deposit? |
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| What proprty are you interested in? |
(Chicagoland) |
| What size of a place are you looking for? |
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| When are you looking to move: |
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| Have you had a bankruptcy? |
When?
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| Have you had a foreclosure? |
When?
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| What do you think your credit score is? |
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| Are you employed? |
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| Another source of income: |
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| How did you hear about this offer? |
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