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Prudential Realty 7300 Healdsburg Ave Sebastopol CA 95472 P: (707) 328-6193 F: (707) 829-5028

Agent of the Year
Prudential
2006

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2004 - 2005 - 2006

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Please fill out the form below so you can be pre-approved for a home. If you would rather give your information over the phone please call (707) 328-6193.

Your Info

Name *
Phone Number*
Address*
City*
State*
Zip*
Fax Number
E-mail Address *
Best Time To Reach You*

If there is someone else applying with you, please enter their name below:
Their full name:

Status:
This loan is for a: *
Your ownership status: *

Estimate your loan:
Purchase price of the property?
How much do you want to borrow?*
Length of years for mortgage:
Annual interest rate:	%
Annual property tax: (if known)
Annual property insurance: (if known)

Employment and expenses:
Employment status: *
Co-borrower's employment status:

What is your occupation or type of business? *


How many months? *
How many months have you been working for your currentemployer? (If self-employed, how long have you had your own business?)	months

What is your total monthly income? *
Please include the income of anyone applying with you.

Your current monthly housing costs.
(Please include the housing costs of anyone applying with you.)
Rent:	monthly
First Mortgage:	monthly
Second Mortgage:	monthly
Taxes:	monthly
Homeowner's insurance:	monthly
Homeowner's dues:	monthly

Other payments:
How much do you pay each month on other debts such as car loans and credit cards? Please include the debts of anyone applying with you.	monthly

Additional information you think we should know:
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