Josh Talayka Josh Talayka Prequalification Form NameFirstLastPhoneEmailAddressStreet AddressAddress Line 2CityState / Province / RegionZip / Postal CodeAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongoCosta RicaCôte d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayNorthern Mariana IslandsOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbia and MontenegroSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabweCountryCan you comfortably invest $8,000 to $11,000 today to join our Lease to Own Program? (Includes- Lease to Own Fee/ Escrow set up/ 1st Month's Rent/ Security Deposit)YesNoIf yes, what are the sources of those funds?What is your total household take-home pay per month?What type of property and location are you interested in for your home?Do you own your own home today?YesNoIf yes, please explain the status of this house. If no, have you owned your own home in the past? How long ago?Have you had a short sale, foreclosure or a bankruptcy?YesNoIf yes, please give details:Have you spoken with a broker about getting financing today?YesNoIf yes, what were the details that he/she gave you for not being able to get mortgage financing? Are you renting right now?YesNoIf yes, how much is your monthly rent and when does your lease end?What is your timeline to be in your new home?Immediately3 months6 monthsHave you participated in a Lease to Own before?YesNoIf yes, what was the outcome?Have you discussed the Lease to Own Program in detail with your Realtor?YesNoDo you need more information on it?YesNoWhat are your top three reasons for wanting to join our Lease to Own Program?Do you understand if you qualify to become a member in our Lease to Own Program, you will be matched with an investor for the purchase of your home?YesNo