Don Leske - The Leske Team

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Please fill out our mini application below. We will call you with your approval within 24-48 hours. Your application is confidential and will not be sold to a third party.

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APPLICANT
Name (First, Middle Initial, Last)*			Birth Date (MM/DD/YYYY)
Social Security Number	Married Single Widowed Separated
Present Street Address
City, State, Zip , ,		Apt#	Home Phone*
Duration	Monthly Rent $		Cell Phone
Previous Address (if < 2 yrs)	Duration	Currently: Renting Owns Other

EMPLOYMENT
Employer	Self-Employed	City, State ,
Phone Number	Job Title	Years & Months
Gross Salary per Mo. $	Hourly Rate $	Hours per Week
Previous Employer (2yr Hist.)	City, State ,	Years & Months
Previous Employer (2yr Hist.)	City, State ,	Years & Months

OTHER INCOME
SSI, Disablility, Child Support, Pension, etc	Monthly Amount $

CASH ASSETS
Money in the Bank	$
401K - CD's - Mutual Fund - Stocks - IRA - etc	$

OTHER INFORMATION
Do you have V.A. Eligibility?	Yes No
Are you a first time Home Buyer?	Yes No
How much money do you have for a downpayment?	$
Notes

BUYER'S CRITERIA

A: When do you plan on moving?

B: What areas interest you?

C: How many bedrooms and bathrooms needed?

D: What is the most you can pay/mo for the right home?

E: Do you have a home to sell?

F: How did you hear about us?

G: Who is the agent you are working with?

Email Address*

CO-APPLICANT
Name (First, Middle Initial, Last)			Birth Date (MM/DD/YYYY)
Social Security Number	Married Single Widowed Separated
Present Street Address
City, State, Zip , ,		Apt#	Home Phone
Duration	Monthly Rent $		Cell Phone
Previous Address (if < 2 yrs)	Duration	Currently: Renting Owns Other

EMPLOYMENT
Employer	Self-Employed	City, State ,
Phone Number	Job Title	Years & Months
Gross Salary per Mo. $	Hourly Rate $	Hours per Week
Previous Employer (2yr Hist.)	City, State ,	Years & Months
Previous Employer (2yr Hist.)	City, State ,	Years & Months

OTHER INCOME
SSI, Disablility, Child Support, Pension, etc	Monthly Amount $

CASH ASSETS
Money in the Bank	$
401K - CD's - Mutual Fund - Stocks - IRA - etc	$

OTHER INFORMATION
Do you have V.A. Eligibility?	Yes No
Are you a first time Home Buyer?	Yes No
How much money do you have for a downpayment?	$
Notes

NOTICE: Out of respect for other Realtors if you plan to use a specific agent to negotiate an offer for you, please contact that agent to help with your real estate needs.

REALTOR NOTICE: We are sorry but we are unable to honor requests from other real estate agents at this time.

DISCLOSURE:
This website is not intended to solicit properties already listed for sale.

By filling out our online application and providing your telephone number you authorize any member of the Leske team to contact you by telephone to solicit our services.

Confidentiality Guaranteed: Your personal information will not be sold or shared with any 3rd party.