Print out this Financial Qualifier Form to use as
a worksheet and speak with a Landmark, REALTOR®
at any of our 5 office locations to find the best financial options for your needs.

For the security of your information, please do not e-mail this form.

Address_______________________________________________________________

Home Phone__________________________Work Phone_______________________

Employment
(1)a Place__________________________(2)a Place____________________________
b Length of Service______________ b Length of Service________________
c Gross Monthly Income___________ c Gross Monthly Income_____________
Gross monthly income is calculated by taking weekly
income x 4.3. Do not include overtime hours, unless
guaranteed.

Income Combined(Gross Monthly Income) A.$_________________________________

B.$_________________________________
Other Income(i.e. Child Support,
Social Security, etc.) C.$_________________________________

Add A, B, C for Total Gross Income $_________________________________

Money Available for Home Purchase $_________________________________

Debts Monthly Payments Balance Owed Term
1 Car loan(s) ________________ ____________ ____________
2 Personal loans ________________ ____________ ____________
3 Charge cards ________________ ____________ ____________
4 Child support/Alimony ________________ ____________ ____________
5 Other ________________ ____________ ____________
(i.e. school loans, etc.)

Total Monthly Debts $_______________

Are you or Co-Buyer(if any) an Active Duty Veteran or Military Reservist
with at least 6 years of service? ________

Have you owned a home in the last 3 years? ________

Do you have a family member that would be willing to assist you with money
to buy a home, if needed? ________ If yes, how much money do you feel they
would supply? $___________________

Permission is granted to pull a recent credit report? Yes ______ No ______
If yes, please supply Social Security numbers and date of birth of all
Buyers.

Social Security Number Buyer A _________________ Buyer B _________________
Date of Birth Buyer A _________________ Buyer B _________________

_________________________________ _________________________________________
Signature Buyer A Signature Buyer B