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E: SSN: Birth Date (Applicant): Birth Date (Co-Applicant): Current Address: Home phone: Cell (1): Cell (2): Email: Race: ( ) White ( ) Black ( ) Asian ( ) American Indian or ( ) Native Hawaiian ( ) Multiple Alaska Native & Pacific Islander Races Ethnicity: Sex: ( ) Hispanic ( ) Non Hispanic ( ) Other ( ) Female ( ) Male Family Size: Household Income: $ Home Purchase within ( ) 3 Months ( ) 6 Months ( ) 1 Year ( ) 3 Years and more Working with Realtor: ( ) Yes ( ) No Working with Lender: ( ) Yes.
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