At any time, please contact us with questions via phone or email. We look forward to serving you!

317-472-1575
317-566-2398 [fax]
homesteadguarantees@yahoo.com

©2006
Homestead
Guarantees
New Home Builder  
Community
Prepared By
E-mail Address
Sales Agent
 Phone No.
 Cell No.
 Days Off
Has Contract Been Signed?
APPLICANT INFORMATION
Individual #1 Individual #2
Name
Home Phone No.
Business Phone No.
Fax No.
Cell Phone No.
E-mail Address
EXISTING HOME INFORMATION
Street Address City Zip
County Subdivision Lot #
No. of Years in Home Age of Home Builder
No. of Bedrooms No. of Baths Basement Garage
Estimated Current Value of Your Home
Homeowners Association Phone No.
Water Sewer Pets
List type of pets and number
Is the home in a flood plain? Do you pay flood insurance?
Directions to Home
First Mortgage Lender Account No. Phone No.
Original Loan Amount Current Loan Balance Type of Loan
Second Mortgage Lender Account No. Phone No.
Original Loan Amount Current Loan Balance
LISTING
Is Your Home Currently on the Market?
By REALTOR®
By Owner 		Listing Company
Last List Price List Date Expiration Date
NEW HOME INFORMATION
Are Your Represented By a REALTOR® New Home Sale Price
New Home Address
Lot # Anticipated Closing Date

Please call 317-566-2399 to follow up on your online application.