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Borrower Name: First:	Middle: Last:
Co-Borrower Name: First:	Middle: Last:
Street Address:
City:	State: Zip:
Contact Information
Borrower Email:
Co-Borrower Email:
Phone Numbers
Day:	Evening: Fax:
How would you like to be contacted? (Select all that apply)
Email: Day Phone: Evening Phone:

Has a home already been found?		Yes No
If yes: What is the scheduled closing date?
Do you have an idea on what price range you would like to pursue?
What type of property are you looking for?
Is there a maximum monthly payment threshold you do not want to exceed?
How much of a down payment do you wish to work with?
Do you plan on being in the home longer than 5 years from now?		Yes No Not Sure
What is the combined gross household income (monthly or annually)?
Is anyone applying for this loan self employed?		Yes No
What is the current minimum monthly debt obligation for all consumer debt (aside from existing mortgages) including car loans, student loans, credit cards, etc.?
How is your credit history rating?
Do you have a loan officer that you would like to work with?

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3212 NW Byron Street, Suite # 103
Silverdale, WA 98383
360-692-3534 - Office / 360-692-8466 - Fax