Washington State Bank Mortgage Information Form

City of Property Purchase *

Individual or Joint *

Individual Joint

Primary Applicant

Full Name *

DOB *

SS# *

Home Phone #

Mobile Phone #

Email Address

Marital Status *

Present Street Address

City *

State *

Zip *

Start Date *

Own / Rent *

Present Employer

Position or Title

Start Date

Employer Street Address

Employer City

Employer State

Employer Zip

Employer Phone #

Income *

Per *

Hours per week, if hourly

Co-Applicant (CA)

CA Full Name *

CA DOB *

CA SS# *

CA Home Phone #

CA Mobile Phone #

CA Email Address

CA Marital Status *

CA Present Street Address

CA City *

CA State *

CA Zip *

CA Start Date *

CA Own / Rent *

CA Present Employer

CA Position or Title

CA Start Date

CA Employer Street Address

CA Employer City

CA Employer State

CA Employer Zip

CA Employer Phone #

CA Income *

CA Per *

CA Hours per week, if hourly

Assets

Checking ($)

Savings ($)

Other Funds Available ($)

Purpose of Loan Desired *

Purchase Refinance

Loan Information

Loan Amount Requested *

Signatures

Everything that I've stated on this form is correct to the best of my knowledge. I understand that you will retain this form whether or not it is approved. You are authorized to check my credit and employment history and to answer questions about your credit experience with me.

Signature *

Signature Date *

Best Contact #

Best Time to Contact

Notes

How Did You Hear About Us?

* Required

Thank you for your submission! All provided information will be kept safe and confidential. One of our lenders will be in touch with you as soon as possible.

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City of Property Purchase *

Individual or Joint *

Primary Applicant

Co-Applicant (CA)

Assets

Purpose of Loan Desired *

Loan Information

Subject Property Information

If Purchase

Signatures

Stocks

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