BUYERS PRELIMINARY INTERVIEW
THIS IS NOT AN APPLICATION - FOR INFORMATION PURPOSES ONLY
Special Features of Financing:
Present Address:
Type of Loan: _ FHA _ VA _ Conventional _ ARM
Phone:
BORROWER:				CO-BORROWER:
Occupation				Occupation
Employed at				Employed at
Years Employed				Years Employed
Monthly Income:				Monthly Income:
Hourly Rate + C.O.L.A.				Hourly Rate + C.O.L.A.
If Salary, Base Pay				If Salary, Base Pay
Other Income				Other Income
Prev.Yrs. Income 19				Prev.Yrs. Income 19
19 ____				19 ____
WERE YOU IN MILITARY SERVICE F Yes F No If yes, from ____________ to ____________
NO. OF DEPENDENTS _____________________				AGES
_____________________________
1	Are you obligated for child support or alimony payments _ Yes F No
2	If yes, how much per month $ __________, and for how many children
3	Are your child support payments current F Yes F No
4	If no, how far behind are you in your support payments $
A LETTER IS NEEDED FROM FRIEND OF THE COURT RE: CHILD SUPPORT PAYMENTS
ON ALL CASES. MUST BE CURRENT:
5	Do you intend to occupy the property you are now purchasing F Yes F No
6	Do you own other properrty F Yes F No
7	Type of Mortgage: FHA ____ VA ____ LAND CONTRACT ____ CONVENTIONAL
Present balance $ ________________ Orig. Mtg. Amt. $ __________________ Mo. Pmts.
Do you intend to rent F Yes F No If yes, $ ___________________ per month
Do you intend to sell F Yes F No It yes, Sales Price will be $ _______________________
	DEBTS:				ASSETS
	Appx. Balance	Being Paid To	Mo. Payment		Bank ____________
Auto Loan _____________________________					Bank ___________
Real Estate ____________________________					Bank ____________
Finance Co. ______________________					Cr. Un. _________
Finance Co. _______________________					Stocks ___________
Finance Co. ____________________________					Bonds ___________
Payroll Deduction __________________________ $ _________					Auto _____________
Credit Union ______________________________			_____________		Furn.(# rms.)
_ _____________	_____________
	Retail _________________________________		_____________
______	____________
	Retail _________________________________		_____________
________________	____________
	Retail _________________________________		_____________
________________	____________
	Child Support _____________________________ $ _________		_____________
_ _________________	_____________
	Alimony _______________________________ $ _________		_____________
_________________	____________
Have you borrowed funds for the down payment or closing costs?							No
Are you a co-maker or endorser on any notes?							No
Will you be using any gift money for down payment or closing costs?							No
Are all above accounts up-to-date in payments?							No
If no, why?
Amount of Life Insurance $ ___________________ Amt. of Premium $			______
___________
Is this insurance paid by your employer?						F' Yes F; No
Have you had any bankruptcies, or repossessions in the last two years?						Yes ¼
If yes, please list on reverse side of this form.
Is your credit F Good F; Poor - if poor, why?
I certify that the above information is true to the best of my knowledge and belief. I authorize
release of this information to the seller of
any property in which I have submitted an offer to purchase.
Date		Buyer
	Form 218.0 Rev. 6195