Good, Bad, or Ugly Credit OK! Whether you have good, bad, or ugly credit, you are approved! We have easy to own programs that does not require bank qualification. You can forget the banks because we have a home for you if you can afford a reasonable down payment and monthly payments. Fill in the following form as completely as possible and we will contact you when a home becomes available that meets your criteria. All information provided will be kept strictly confidential. If you are having troubles submitting this form, please click here to email us or call (402) 926-HOME.

*Items marked with a red asterisk are required. If you are unable to answer a required question, give us your best guess or enter a "?", "NA", "0", "don't know", etc. Your Contact Information *First Name *Day Phone *Last Name *Evening Phone *Address Cellular/Pager *City Email *State AL AK AZ AR CA CO CT DC DE FL GA HI ID IL IN IA KS KY LA ME MA MD MI MN MS MO MT NE NV NC NH NJ NM NY ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY *Zip *Best Time to Call Any Morning Afternoon Evening Weekend Your Property Needs What's the most you can afford to pay monthly for your new home? $250 $300 $350 $400 $450 $500 $550 $600 $650 $700 $750 $800 $850 $900 $950 $1,000 $1,100 $1,200 $1,300 $1,400 $1,500 $1,600 $1,700 $1,800 $1,900 $2,000 $2,250 $2,500 $2,750 $3,000 $3,250 $3,500 $3,750 $4,000 $4,250 $4,500 $4,750 $5,000+ What's the most you can afford to put down on your home? $0 $500 $1,000 $1,500 $2,000 $2,500 $3,000 $3,500 $4,000 $4,500 $5,000 $5,500 $6,000 $6,500 $7,000 $7,500 $8,000 $8,500 $9,000 $9,500 $10,000 $12,500 $15,000 $17,500 $20,000 $25,000 $30,000 $35,000 $40,000 $45,000 $50,000 $60,000 $70,000 $80,000 $90,000 $100,000+ What price range house are you looking for? $1,000 $5,000 $10,000 $20,000 $30,000 $40,000 $50,000 $60,000 $70,000 $80,000 $90,000 $100,000 $125,000 $150,000 $175,000 $200,000 $225,000 $250,000 $275,000 $300,000 $325,000 $350,000 $375,000 $400,000 $425,000 $450,000 $475,000 $500,000 $550,000 $600,000 $650,000 $700,000 $750,000 $800,000 $850,000 $900,000 $950,000   $5,000 $10,000 $20,000 $30,000 $40,000 $50,000 $60,000 $70,000 $80,000 $90,000 $100,000 $125,000 $150,000 $175,000 $200,000 $225,000 $250,000 $275,000 $300,000 $325,000 $350,000 $375,000 $400,000 $425,000 $450,000 $475,000 $500,000 $550,000 $600,000 $650,000 $700,000 $750,000 $800,000 $850,000 $900,000 $950,000 $1,000,000+ How is your credit? Ugly is OK! Excellent Good Fair Poor Ugly No Credit How soon are you looking to purchase your next home? ASAP 1 month 2 months 3 months 4 months 5 months 6 months 7 months 8 months 9 months 10 months 11 months 12 months + In which area(s) do you wish to purchase your home? How many bedrooms do you require? 1 2 3 4+ How many bathrooms do you require? 1 2 3 4+ How many finished square feet do you require? 500 sq ft or more 600 sq ft or more 700 sq ft or more 800 sq ft or more 900 sq ft or more 1000 sq ft or more 1250 sq ft or more 1500 sq ft or more 1750 sq ft or more 2000 sq ft or more 2250 sq ft or more 2500 sq ft or more 2750 sq ft or more 3000 sq ft or more 3250 sq ft or more 3500 sq ft or more 3750 sq ft or more 4000 sq ft or more Do you require a garage? None Car Port 1 Car 2 Car 3+ Car Do you require a basement? None Unfinished Partially Finished Finished Do you have any other special requirements? How did you hear about us? Business Card Car Sign Flyers Mail Omaha World Hearld Thrifty Nickle Search Engine Signs Word of Mouth Other Do you have any additional questions or comments?