Customer Profile

CUSTOMER PROFILE

Let Our Experience

be Your Guide

Client Profile

Primary Home Information

First name

Last name

Primary Phone

Secondary Phone

Credit Score

Estimated Home Value

Total Checking & Savings

Retirement Savings

Retirement type (401k, IRA, TSP, etc.)

Amount

Monthly Retirement Contribution

Your sources of income

Description/Occupation

Monthly Net Income

Monthly Gross Income

Real Estate Owned

Address (REAL ESTATE OWNED)

Rental Income

Association Fees

Maintenance Fees

Value

I/ Primary Home Mortgage

Original Loan Amount

Loan Origin Date

Loan Term

Lender (part I)

Balance

% Rate

P&I Payment

Escrow

Total Monthly Payment

II/ Additional Mortgages

# Years Remaining

Lender (part II)

Balance

% Rate

P&I Payment

Escrow

Total Monthly Payment

III/ Credit Cards and Car Loans

Lender (part III)

Credit Limit

% Rate

Balance

Minimum Payment

Lender (part III)

Credit Limit

% Rate

Balance

Minimum Payment

Lender (part III)

Credit Limit

% Rate

Balance

Minimum Payment

IV/ Loans or Lines of Credit

Lender (part IV)

Type of Loan or Line of Credit

Credit Limit

Balance

% Rate

Minimum Payment

Years Left

Taxes & Insurance

Description

Annual Cost

Description

Annual Cost

Living Expenses

Groceries/Dining Out/Household Goods

Electricity/Gas

Cable/Internet/Landline Phone/Cell Phone

Water/Waste (Sewer Bill)

Gasoline/Automobile Insurance

Miscellaneous (Vacation, etc.)

Any additional information

Questions, concerns, best time to contact you, etc.

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Office: (888) 338-8980

BrunikFinancial@gmail.com

CUSTOMER PROFILE

Client Profile

Questions, concerns, best time to contact you, etc.