First Name:
Last Name:
City:
County:
State:
Zip Code:
Day Phone:
Night Phone:
E-Mail:
Re-type:
1)
Are you subject to any IRS Notice of Lien?
Yes
No
2)
Any judgments against you?
Yes
No
3)
Any mechanics liens on the property?
Yes
No
4)
Any State Tax liens on your property?
Yes
No
5)
Any HOA dues unpaid?
Yes
No
6)
Any encumbrances on the property beyond your mortgage(s)?
Yes
No
7)
Are there any legal suits pending against you or other signor on note or owner of property?
Yes
No
8)
Are you divorced or separated and if so is former spouse on the deed and on the note?
Yes
No
Comments:
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