Informational Request Form The first step in taking advantage of the amazing program is to provide some basic information about yourself here. This informational request form will prepare us to discuss the program to meet your specific needs. This is not a financial form and your credit report will not be ordered. Our lenders cannot offer financing outside the U.S.A.

Fields marked in red are required. First Name: Last Name: Address 1: Address 2: City: State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Utah Vermont Virginia Washington Washington, DC West Virginia Wisconsin Wyoming Other   (No Texas loans) Zip: Primary Phone:   Use Format: xxx-xxx-xxxx Work Phone:   Use Format: xxx-xxx-xxxx Fax:   Use Format: xxx-xxx-xxxx Email: Cell Phone:   Use Format: xxx-xxx-xxxx  Annual Household Income:  Do you rent or own?   Rent   Own  Monthly rent or mortgage:  Do you own land?   Yes   No  If you do own land, is it paid for?   Yes   No  If you do own land, what is the land's value?  What is your credit rating?   --- Please Select --- Excellent Good Fair  Have you ever filed bankruptcy?   Yes   No  If yes, how long ago?  What kind of work contributions would you bring to this project (i.e. overseeing project, management skills, painting skills, carpentry skills, etc.)?  Best time to contact you:   --- Please Select --- Morning at home Morning at work Evening at home During the day at home During the day at work Other: specifiy in comments  Okay to call you at work?   Yes   No  When do you plan to build?   Please Select As soon as possible Within 3 months 3-6 months 6-12 months Not sure  Comments:

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