Quick Inquiry Fill out the form below and submit to be contacted by someone from The Carriker Team. **This is not an application for a mortgage loan.** Borrower – Full Legal Name****Must match Driver’s License.*** First Middle Initial Last Suffix (Jr, Sr, etc…) Home Phone*Work PhoneCell PhoneBorrower Email* Co-Borrower – Full Legal Name***Must match Driver’s License.*** First Middle Initial Last Suffix (Jr, Sr, etc…) Home PhoneWork PhoneCell PhoneCo-Borrower EmailNeeds to be different than borrower’s email for compliance purposes. Borrower's Current Mailing Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Co-Borrower's Current Mailing Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code County*Please put down the county your home resides in. CountyPlease put down the county your home resides in. Combined Monthly Income* Purpose of Loan*PurchaseRefinanceLoan Amount* Property Value* State Property Resides In* Does anyone in the household receive child support or alimony?* Yes No Have you owned any real estate in the last 3 years?* Yes No Is either borrower or co-borrower a veteran?* Borrower Co-Borrower Both Not a veteran Best Time To Call Loan Officer*Please choose the loan officer you have spoken with or were referred too.Choose OneDon CarrikerAlex CarrikerUnknownHow Did You Hear About Us?*Choose OneKSGF 104.1 FM/1260 AMI Am A Previous ClientRealtor ReferralReferred By…SunshadeInternet SearchOtherIf Referral, Realtor or Other, Please Explain (How or Who)