Initial Client Information
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| First Name : |
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| Last Name : |
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Contact Information
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| Home Phone : |
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| Cell Phone : |
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Work Phone
(will not call unless you ask us to) : |
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| Email : |
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Gross Monthly Income (before taxes) :
*Include: Child Support, SSI, Disability, Social Security
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Total Amount of Monthly Installment Debt :
Add Monthly: Credit Cards, Loans, Furniture Accts., Car Loan
Do Not Include: Utilities, Cell phone, Rent
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| Employers in last 24 Months & Dates Employed : |
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| W2 Employee : |
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| 1099 Employee : |
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Housing Interest
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Did you see and have interest in one of our properties?
If so, which one? : |
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| Area of Interest : |
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| Bedrooms Preference : |
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| Current Housing Detail |
(incl. all residences in last 24 mo.) |
Current Monthly Housing Expense
(rent or mortgage payment) : |
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| Do you Own your home : |
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| Do you Rent your home : |
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| How do you pay? : |
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| Landlord Type : |
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| Your Current Address (Street): |
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| City : |
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| State : |
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| Zip Code : |
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| If you lived there less than 2 years, previous address : |
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| Banking & Reserves |
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| Bank Account Status : |
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| Current Reserves (savings in account) : |
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| Current Credit Information |
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| Bankruptcy History (Yes/No/Status/Date Finished) : |
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| What do you think is your current credit score? : |
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| Are there Credit issues you think you have? : |
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| Have you Applied for mortgage in last 2 years? : |
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| What was lender's response/outcome? : |
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| How did you hear about us? : |
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Comments and
Other information : |
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| Who referred you to The Parrish Group, Inc.? : |
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Thank you for your interest,
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