Name
*
First Name
Last Name
Have you ever owned a home before?
*
Yes
No
What type of mortgage did you have?
*
How long do you plan to live in this house?
*
1-3 years
3-5 years
5-7 years
7-10 years
10-15+years
Do you plan to make additional principal reduction payments in addition to your scheduled monthly mortgage payments?
*
Yes
No
Names and ages of children?
Do you foresee incurring other financial obligations within the next 5 years such as:
*
A new baby
A new car
Change in work time
College Expense
Of the following financial goals, which would you say is a top priority?
*
(Select all that apply)
Improve monthly cash flow
Maximize retirement savings
Building your net worth
Moving to a larger home
Saving money to send kids to college
Maximize investment contributions
Create a 6-12 month cash reserve account
Having your mortgage paid off when you retire
Achieving financial freedom
Create a comprehensive financial plan
Other
Which of the following is most important regarding your mortgage financing?
*
Determine maximum purchase price and loan amount I can qualify for
Determine purchase price and loan amount appropriate for my income and lifestyle
Obtain a targeted monthly mortgage payment amount
Purchase a home within a specific budget down payment and closing costs
Ability to sell home, pay down, pay off, or refinance home without penalty
Maximize tax benefits
Include improvements to home in financing
Quality for new home prior to, or without sale of existing home
Consolidate my loans
Renovate my home
Other
What mortgage payment do you feel comfortable making?
How would you describe your financial philosophy?
Conservative
Moderate Risk Taker
Risk Taker
Do you work with a financial planner?
*
Option One
Option Two
How would you rate him/her?
Excellent
Good
Average
Do you work with a stockbroker?
*
Yes
No
How would you rate him/her?
Excellent
Good
Average
Do you work with a life insurance agent?
*
Yes
No
How would you rate him/her?
Excellent
Good
Average
Do you have an RRSP or a Pension plan at work?
Yes
No
Do you participate in that plan?
Yes
No
If so, do you maximize your contribution?
Yes
No
Have you put a will in place or established a living trust to protect your family's assets in the event of something happening to you?
Yes
No
If so, how would you rate your attorney?
Excellent
Good
Average
If we can show you ways of building wealth faster or becoming debt free more quickly, would you be interested?
*
Yes
No
Do you want us to refer you to a trustworthy, professional, ethical, and experienced realtor?
Yes
No
Who should my team and I consider as the primary contact throughout the loan process?
*
Yourself
Your Spouse
Both
Other
We have found that the most efficient means of routine communication with you during the loan process is via e-mail. If there is a need for urgent communication, we call. If for any reason e-mail is not a convenient means of communication, please specify your preference.