Colby-Stanley Homes, Inc.
              (817-267-6822); fax: 817-803-6422)
HOUSE being considered:______________________________         date  ___________
Who do we CALL  with results (name)________________________________________
Phone #  day: __________     night: ____________ email:_______________________

YOUR FULL NAME: ____________________________________________________                
Social Security: _______________________ date of birth ___________________
Co-applicant (spouse, parent, etc): ___________________________________________
Social Security: _______________________  date of birth ___________________

Current Address:___________________________City______________ZIP_______ How long____  Rent per month? ____________    Landlord 's name  ___________________________ Landlord's Phone #  _________________
Prior Address: _____________________________City_____________ ZIP_______ How long____

Your Job (company & position): ______________________________________________ Hourly rate of pay (before taxes taken out) $_______ or Weekly rate of pay $_______ 
How long on job_________

Co-Applicant (company & position): __________________________________________
 Hourly rate of pay $_______ or Weekly rate of pay $_______  How long on job_________

Are taxes taken out of paychecks?__Yes__No. 
List source of any other income________________ Amount monthly $________

YOUR DEBT PAYMENTS (Fill in who owed and minimum amount required to paid monthly):          
 (Car payment) $ ______mo  ( Charge cards) $ _______mo.    
(Other)____________________  $ _______mo.
(Other)____________________  $ _______mo.

Ever had student loan?____ Paid off?____
If paying, how much/mo?______                        

Marital Status: __Married  __Separated  __Unmarried __Prev. Married       
Pay child support?____ How much/mo? $_______
The undesigned hereby authorizes a third party mortgage company to order an "In-File" credit report for the purpose of verifying the information provided. The undersigned is aware that a copy of the credit report can not be received by us, and that specific contents of the credit report cannot be revealed  by  the lender--this must come directly from the credit agency.

_____________________________  ________                 ________________________________   ________
Signature                                Date                Signature                                Date

Colby-Stanley Homes, Inc.      511 S. Main, Euless, Tx   76040
Office: 817-267-6822     Fax: 817-803-6422