How do I create a form to put this information on it as a fillable document?

INFORMATION FORM

Your first name: _____________________

Your middle initial: ____________________

Your last name: ______________________

Your phone number: _____-_____-________

Your email:______________________@_______________.

Your home address: ________________________

                             ________________________

How long you have been at this address: __years, __months

How long at your previous address: ___years, ___months

Your Social Security Number: _____-_____-______

Your date of birth: ___/___/_____

Your employer: _____________________________

Your employers' address: _____________________

                                 _____________________

Your employers phone number: ____-____-_______

How long you have been employed by this employer: __years, __months

Previous employer: (if less than 2 years):_______________

Your employers' address: _____________________

                                     _____________________

Your employers phone number: _____-_____-______

How long you have been employed by this employer: __years, __months

If less than 2 years or gaps of employment, please explain why: _____________________________________________________________________________

How much money you make per month: $_________

Your equitable tangible assets: (please include the year, make, model, mileage, and balance owed if any)______________________,______________________,______________________

Your liquid assets: (cash on hand, in accounts, and in vaults total) $___________

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Have you had a Bankruptcy, Foreclosure, or Short-sale in the last 2 years? ___Y, ___N

If so, can you document a loss in income due to hardship? ___Y, ___N

Lease agreement expiration date: ___/___/_____

Lease agreement break fee: $________

​

Your goals: (mark an x on as many as you want) __ HOUSE, __ AUTO, __ JEWELRY, __ HIGHER CREDIT SCORES, __ TO MAKE MORE MONEY, __ BETTER HEALTH, __VACATION.

I have created a simple form with the information mentioned above. You can clone my test form here http://form.jotformpro.com/form/42505055970958.

I simply used some basic fields type in my sample form:

Text box
E-mail
Phone field
Address
Checkbox
Radio buttons
Added masking to text boxes

You can also check out our simple one page lease agreement if you like. 

Let us know if you have questions.