Buyer and Rent-to-Own
Information Form

Buyer Personal Information

Buyer Name:
Buyer Address: 
Buyer Home Phone: 
Buyer Cell Phone: 
Buyer E-mail Address: 
Buyer - how long have you lived at current address: 
Buyer Employer: 
Buyer - how long with current employer:
Buyer Income (Yearly): 

Joint Buyer Personal Information

Joint Buyer Name:
Joint Buyer Address: 
Joint Buyer Home Phone: 
Joint Buyer Cell Phone:
Joint Buyer E-mail Address: 
Joint Buyer - how long have you lived at current address: 
Joint Buyer Employer: 
Joint Buyer - how long with current employer:
Joint Buyer Income (Yearly): 

Home Search Criteria

What type of house are you looking for:
What part of the Pittsburgh Area are you interested in:
How many Bedrooms are you looking for:
How many Bathrooms are you looking for: 
Looking for a Garage:    Yes:      No:
What size lot in acreage do you think you would like:

Financial Profile

Do you presently Rent or Own:    Rent:       Own:
What is your Monthly Rent or Mortgage Payment:
What would you consider your credit to be: 
Have you ever filed for Bankrupcy:    Yes:      No:
If you have filed for Bankrupcy, has it been Discharged:    Yes:      No:
Have you been Pre-Approved for a Mortgage:    Yes:       No:
If not, can our Finance Department contact you:     Yes:       No:
If Pre-Approved, what financial limit were you approved for: 
What kind of a Down Payment can you make (in dollars):
What Monthly Payment can you make: 
 
How did you hear about us:
 
Investors...Not Realtors
Information Deemed Reliable, But Not Guaranteed