All information obtained will remain in the strictest of confidence. We value your privacy and will never sell, share, lend, rent or otherwise transfer this information to any person outside of our company with the exception of obtaining a loan for your home.
Name:
Joint name (if any)
EMail:
Mailing Address:
2nd line of address:
City, State, Zip:
Phone:
Years at current address	Less than 6 months 6 months to 1 year 1 year to 2 years 2 to 5 years 5 to 6 years
Employer:
Title:
Employer address:
Employer city, state and zip code:
Employer Phone:
Yearly income:
Social Security Number:	--
Years at current job:	Less than 6 months 6 months to 1 year 1 year to 2 years 2 to 5 years 5 to 6 years
Have you ever filed bankruptcy:	Never Less then 2 years ago Less than 7 years ago Less than 10 years ago Over 10 years ago
Comments:
By submitting this form, you are giving Santiam Homes permission to check your credit report and verify other information here obtained for the sole reason of obtaining a home from Santiam Homes.