Pennsylvania Realtors and Buyers Representation
218 South Broad Street, Lansdale, Pennsylvania (PA) 19446
800-340-2444 · 215-393-1600
A Licensed Pennsylvania Real Estate Broker - #RB-019857A

Bux-Mont Home Buyers Program

For Real Estate Buyers and Purchases in Bucks and Montgomery County, Pennsylvania (PA)

Please fill out the form below and submit to get started on the path to homeownership!

Buyer's Full Name *REQUIRED
SSN
Co-Buyer's Full Name
SSN

Address
City
State
Zip Code
Phone Number *REQUIRED
Fax Number
Cell Phone
E-Mail Address *REQUIRED

Do you currently:
Own? - If so, Amount of Monthly Mortgage Payment
Rent? - If so, Amount of Monthly Rent Payment

If you own any commercial or rental properties, please indicate:
Amount of Monthly Mortgage Payment
Amount of Monthly Rental Income

Are you obligated to pay alimony or child support? How much on a monthly basis?

Have you in the last 7 years declared bankruptcy, suffered foreclosure, had an
account assigned for collection or had any legal action affecting your ability to finance?
YES
NO

Are there any outstanding judgements against you?
YES
NO

Are you aware of any liens against your current property?
YES
NO

Do you have any potential gift monies coming from a family member for the purchase of your home?
YES
NO

What would you like your monthly payment to be (approximate)?

What is the time frame for your purchase/move?

What areas are you interested in?
(Windows users hold down the Ctrl key to make multiple selections)

Montgomery County

Bucks County

Describe your dream home:

Do you wish to receive real estate listings via E-mail?
YES
NO

May we have permission to obtain an in-file credit report? (Buyers SSN needed above)
YES
NO


Thank you for taking the time to review and complete this form.
We believe it will be an excellent start in acquiring your
new home. Simply click on the "submit request" button below to continue.

Thank you.

Bux-Mont Home Buyers Program Info

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