CORE1, LLC. Foreclosure Prevention Specialists in the Kansas and Missouri area.

Please let us know what type of home you are looking for by filling out the following information as completely as possible. All information provided will be kept strictly confidential.

First Applicant Information:

First Name*
Middle Name*
Last Name*
Date of Birth*
Social Security Number *
Home Phone*
Cell Phone*
Business Phone*
Email *
Address *
City*
State*
Zip Code*

Employment Information:

Employers Name
How Long Employed?
Position Held
Gross Monthly Salary (US dollars)
Misc Income
Ever have a Bankruptcy ?
Been in Foreclosure?
Current on your bills?
In Credit Counseling?

Financial Information:

Are wanting to Buy or Lease To Own?
What purchase price are you interested in?	to
What area(s) of town are you interested in?
What is the maximum monthly payment you can afford?
How much cash do you have available for up front acquisition costs?
Have you already talked with a lender?
How soon are you looking to move?
Number of bedrooms?
Number of baths?
Size of garage?
Do you have any other preferences?

Do you have any additional questions or comments?

How did you hear about us?

Joint Application Information

First Name*
Middle Name*
Last Name*
Date of Birth*
Social Security Number *
Home Phone*
Cell Phone*
Business Phone*
Email *
Address *
City*
State*
Zip Code*

Joint Applicant Employment Information:

Employers Name
How Long Employed?
Position Held
Gross Monthly Salary (US dollars)
Misc Income
Ever have a Bankruptcy ?
Been in Foreclosure?
Current on your bills?
In Credit Counseling?

Signatures
Applicant A*
Date	07/24/08
Applicant B
Date	07/24/08

***By clicking on the "Submit" button you are granting CORE 1, LLC permission to run a credit report based on the information you have provided. We understand that your privacy is crucial. Your information is 100% private and will never be shared with anyone without your permission.