FIDELITY HOMES

Home Address

Name

Email

How would you prefer to be contacted? How would you prefer to be contacted? Call Text Email

Phone

What are the primary reasons for building a new home? (check all that apply) What are the primary reasons for building a new home? (check all that apply) Downsizing Investment/Dream Home Need More Space Relocation Other

How did you hear about Fidelity Homes?

How many family members (including yourself)?

How many adults?

How many teenagers?

Children

How many are elderly?

Do you have any pets that are a part of your home life? Do they need any special space?

Do any of these occupants have special needs or requirements, or would you like to plan for any in the future?

What is your financing approval status & approval amount? (Once approved, we will need a copy of your financing approval letter)

What is your approximate budget range for your new home?

Will the construction loan be taken out by you or Fidelity? (If lot is owned by Homeowner and loan is taken out by Fidelity, the lot will need to be deeded to Fidelity during construction and will be deeded back at closing)

What are you comfortable with for a down payment amount?

When would you prefer to start?

Would you like to use one of our floor plans or make changes to one? If so, which plan and what changes would you like to make?

What architectural style/design would you like? Check all that apply and / or describe. Please send pictures. What architectural style/design would you like? Check all that apply and / or describe. Please send pictures. Colonial Dutch Colonial French Colonial Spanish Colonial Georgian Colonial Adam Colonial Early Classic Revival Modern Prairie Craftsman/Bungalow Modern/Art Deco International / Contemporary Other Unsure N/A

What approximate square footage do you have in mind for your home?

Would you like a: Would you like a: Basement Slab on grade Crawlspace Unsure

Would you like a: Would you like a: Bungalow 2-Storey Split-Level Multi-Level Unsure

Do you already own a lot? Do you already own a lot? Yes No

If a lot needs to be purchased, are there any certain specs or locations you prefer (flat, walkout, daylight, etc.)? Which direction do you want the house to face?

If you already own a lot or plan to purchase one, we will need a site plan (which shows easements and building setback lines), a plot map and an address.

If you are interested in a Fidelity Lot, please indicate which one(s). Lot Location (Address, City & Directions)

Is the lot included in your budget? Is the lot included in your budget? Yes No Unsure

Are there any architectural control restrictions which govern your property? (If so, we will need a copy of the covenants for review and the name of the architectural review board)

City water/sewer? City water/sewer? Yes No Unsure N/A

For Rural Lots: Propane? For Rural Lots: Propane? Yes No Unsure N/A

For Rural Lots: Private Septic System? For Rural Lots: Private Septic System? Yes No Unsure N/A

For Rural Lots: Private Rural Water? For Rural Lots: Private Rural Water? Yes No Unsure N/A

For Rural Lots: Entrance Required? For Rural Lots: Entrance Required? Yes No Unsure N/A

For Rural Lots: Natural Gas? For Rural Lots: Natural Gas? Yes No Unsure N/A

For Rural Lots: Community Septic? For Rural Lots: Community Septic? Yes No Unsure N/A

For Rural Lots: Well? For Rural Lots: Well? Yes No Unsure N/A

What is the depth of well?

Approximate distance of house from utilities (electricity, water):

Additional utilities allowance (used to bring utilities up to the property)