Client Questionaire
 
First Name
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Last Name
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Address
Town or City:
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State:
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Zip Code:
Telephone Number:
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Email Address:
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Matial Status:
How many children do you have living at home?
List Monthly Income From ALL Sources
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How much is your house worth at today's prices?
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How many mortgages do you have?
What is your balance on your first mortgage?
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What is the balance on your 2nd mortgage or home equity loan?
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What is the total of your credit card balances?
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What area do you wish more information?
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