How did you hear of Homebuyer Associates?

Applicant:
Age:
Home Phone:
Address:
City:
State:
Zip:
E-mail:

Adjusted Gross Income
(from tax return)
(total)

Assets

Cash/Checking: $
Savings: $
Money Market Accounts: $
Real Estate (estimated value): $
Other: $

Will you receive a gift/loan for
any of your down payment?
If yes how much?
$

Have you ever been involved in a bankruptcy action
Yes No

Home Type (please check those types/preferences you are interested in.)

Single Family
Duplex
Condominium

Cape Cod
Colonial
Bungalow
Contemporary
Ranch
Tri-level
Victorian
Other

Brick
Wood Frame
Aluminum

No. of Bedrooms
2 3 4

Dining Room
Yes No Optional

Garage
Yes No Optional

Aluminum storms/screens
Yes No Optional

Are you interested in a home requiring some rehab other than painting/carpenting/ect?
Yes No

City of Milwaukee:
north south east west

Milwaukee County:
Bayside Brown Deer Cudahy Fox Point Franklin Glendale
Greendale Greenfield Wauwatosa Oak Creek Shorewood
Hales Corners South Milwaukee St. Francis West Allis
West Milwaukee Whitefish Bay

Waukesha County:
list city

Ozaukee County:
list city

Washington County:
list city

Walworth County:
list city

Southern Racine County:
list city

*areas in red are required*