Mortgage Application

I. TYPE OF MORTGAGE AND TERMS OF LOAN
Please choose one of the following:
I am applying for individual credit in my own name and I am relying on my own income and assets and not the income or assets of another person.
I am applying for individual credit and I am relying on my own income or assets, as well as income or assets from other sources.
We are applying for joint credit.
Amount $


II. PROPERTY INFORMATION AND PURPOSE OF LOAN
Subject Property Address (street, city, state, ZIP)
No. of Units
Legal Description of Subject Property (Tax Township/Lot/Block)
Year Built:
Purpose of Loan:

Property is:   Primary Residence  Secondary Residence Investment

Contact Us for information on Constructions loans.
Complete this line if this is a refinance loan.
Year
Acquired
Original Cost
Amount Existing Loans
Purpose of Refinance
Describe Improvements:   made to be made Cost :$
Title is held in what Name (s):
Manner in which title is held:
(Individual/Joint/Joint-Survivorship)
Estate is held in:
Fee Simple
Leasehold (show Expiration Date)

 
III. BORROWER INFORMATION CO-BORROWER
Borrower’s Name (include Jr. or Sr. if applicable)
Co-Borrower’s Name (include Jr. or Sr. if applicable)
Social Security Number
Home Phone
(w/ area code)
DOB (MM/DD/YYYY)

Yrs. School

Social Security Number
Home Phone
(w/ area code)

DOB (MM/DD/YYYY)

Yrs. School

Married  Separated  
Unmarried (Include Single, Divorced, Widowed ) 

Dependents (not listed by
Co-Borrower)
Married Separated  
Unmarried (Include Single, Divorced, Widowed ) 
Dependents (not listed by
Co-Borrower)
No: Ages: No: Ages:
Present Address (street, city, state, ZIP)OwnRent  No Yrs.
Present Address (street, city, state, ZIP)OwnRent   No. Yrs.
Mailing Address, if different from Present Address
Mailing Address, if different from Present Address
If residing at present address for less than two years, complete the following:
Former Address (street, city, state, ZIP)Own Rent   No Yrs.
Former Address (street, city, state, ZIP) Rent No Yrs.
IV. BORROWER INFORMATION CO-BORROWER INFORMATION
Name & Address of Employer  Self Employed

Yrs. on this job
Name & Address of Employer  Self Employed

Yrs. on this job
Yrs. employed in this
line of work/profession
Yrs. employed in this
line of work/profession

Position/Title/Type of Business

Business Phone (w/ area code)

Position/Title/Type of Business
Business Phone (w/ area code)

If employed in current position for less than two years or if currently employed in more than one position, complete the following:

Name & Address of Employer     Self Employed

Dates (from – to)
 Name & Address of Employer   Self Employed

Dates (from – to)
Monthly Income
$
Monthly Income
$

Position/Title/Type of Business

Business Phone (w/ area code)

 Position/Title/Type of Business

Business Phone (w/ area code)

Name & Address of Employer     Self Employed

Dates (from – to)
 Name & Address of Employer   Self Employed

Dates (from – to)
Monthly Income
$
Monthly Income
$

Position/Title/Type of Business

Business Phone (w/ area code)

Position/Title/Type of Business

Business Phone (w/ area code)

V. MONTHLY INCOME AND COMBINED HOUSING EXPENSE INFORMATION
Gross Monthly Income Borrower Co-Borrower Total Combined Monthly
Housing Expense
Present Proposed
Base Empl. Income* $ $ $ Rent $
Overtime First Mortgage (P&I) $
Bonuses Other Financing (P&I)
Commissions Hazard Insurance
Dividends/Interest Real Estate Taxes
Net Rental Income Mortgage Insurance
Other (before, completing, see the notice in "describe other income," below) Homeowner Assn. Dues
Other:
Total $ $ $ Total $ $

* Self Employed Borrower(s) may be required to provide additional documentation such as tax returns and financial statements.

Describe Other Income Notice: Alimony, child support, or separate maintenance income need not be revealed if the Borrower (B) or Co-Borrower (C) does not choose to have it considered for repaying this loan.

B/C  

Monthly Amount

$  
VI. ASSETS AND LIABILITIES

This Statement and any applicable supporting schedules may be completed jointly by both married and unmarried Co-Borrowers if their assets and liabilities are sufficiently joined so that the Statement can be meaningfully and fairly presented on a combined basis; otherwise, separate Statements and Schedules are required. If the Co-Borrower section was completed about a non-applicant spouse or other person, this Statement and supporting schedules must be completed about that spouse or other person also.

Completed: Jointly Not Jointly

ASSETS

Description

                Cash or Market Value

Cash deposit toward purchase held by:

$
List checking and savings accounts below
Name and address of Bank, S&L, or Credit Union
Acct. no. $
Name and address of Bank, S&L, or Credit Union
Acct. no. $
Name and address of Bank, S&L, or Credit Union
Acct. no. $
Name and address of Bank, S&L, or Credit Union
Acct. no. $
Stocks & Bonds (Company name/number & description)

$
Life insurance net cash value
Face amount: $

$
Subtotal Liquid Assets $
Real estate owned (enter market value from schedule of real estate owned) $
Vested interest in retirement fund $
Net Worth of business(es) owned (attach financial statement) $
Automobiles owned (make and year)

$
Other Assts (itemize)

$

Total Assets a.

$
Liabilities and Pledged Assets. List the creditor's name, address and account number for all outstanding debts, including automobile loans, revolving charge accounts, real estate loans, alimony, child support, stock pledges, etc. Use continuation sheet, if necessary. Indicate by (*) those liabilities which will be satisfied upon sale of real estate owned or upon refinancing of the subject property.

LIABILITIES

Monthly Payment Unpaid Balance
Name and address of Company


$


$
Acct. no.
Name and address of Company


$


$
Acct. no.
Name and address of Company


$


$
Acct. no.
Name and address of Company


$


$
Acct. no.
Name and address of Company


$


$
Acct. no.
Name and address of Company


$


$
Acct. no.
Name and address of Company


$


$
Acct. no.
Alimony/Child Support/Separate Maintenance Payments Owed to:

$

 
Job-Related Expense (child care, union dues, etc.)

$

Total Monthly Payments

$

Net Worth
(a minus b)
$ Total Liabilities b. $

Schedule of Real Estate Owned (If additional properties are owned, use continuation sheet.)

Property Address (enter S if sold, PS if pending sale or R if rental being held for income) Type of Property Present Market Value Amount of Mortgages & Liens Gross Rental Income Mortgage Payments Insurance, Maintenance, Taxes & Misc. Net Rental Income

$ $ $ $ $ $

 

 

Totals

$ $ $ $ $ $
List any additional names under which credit has previously been received and indicate appropriate creditor name(s) and account number(s):
Alternate Name
Creditor Name
Account Number
VII. DECLARATIONS
If you answer "Yes" to any questions a through i, please use continuation sheet for explanation. Borrower Co-Borrower
    Yes No Yes No
a. Are there any outstanding judgments against you?
b. Have you been declared bankrupt within the past 7 years?
c. Have you had property foreclosed upon or given title or deed in lieu thereof in the last 7 years?
d. Are you a party to a lawsuit?
e. Have you directly or indirectly been obligated on any loan which resulted in foreclosure, transfer or title in lieu of foreclosure, or judgment?
(This would include such loans as home mortgage loans, SBA loans, home improvement loans, educational loans, manufactured (mobile) home loans, any mortgage, financial obligation, bond, or loan guarantee. If "Yes" provide details, including date, name and address of Lender, FHA or VA case number, if any, and reasons for the action.)
f. Are you presently delinquent or in default on any Federal debt or any other loan, mortgage, financial obligation, bond, or loan guarantee?
If "Yes", give details as described in the preceding question.
g. Are you obligated to pay alimony, child support, or separate maintenance?
h. Is any part of the down payment borrowed?
i. Are you a co-maker or endorser on a note?
       
j. Are you a U.S. citizen?
k. Are you a permanent resident alien?
l. Do you intend to occupy the property as your primary residence?
If "Yes", complete question m below.
m. Have you had an ownership interest in a property in the last three years?
  (1) What type of property did you own-principal residence (PR), second home (SH), or investment property (IP)?
  (2) How did you hold title to the home-solely by yourself (S), jointly with your spouse (SP), or jointly with another person (o)?
VIII. ACKNOWLEDGMENT AND AGREEMENT

Each of the undersigned specifically represents to Lender and to Lender's actual or potential agents, brokers, processors, attorneys, insurers, servicers, successors and assigns and agrees and acknowledges that: (1) the information provided in this application is true and correct as of the date set forth opposite my signature and that any intentional or negligent misrepresentation of this information contained in this application may result in civil liability, including monetary damages, to any person who may suffer any loss due to reliance upon any misrepresentation that I have made on this application, and/or in criminal penalties including, but not limited to, fine or imprisonment or both under the provisions of Title 18, United States Code, Sec. 1001, et seq.; (2) the loan requested pursuant to this application (the "Loan") will be secured by a mortgage or deed of trust on the property described in this application; (3) the property will not be used for any illegal or prohibited purpose or use; (4) all statements made in this application are made for the purpose of obtaining a residential mortgage loan; (5) the property will be occupied as indicated in this application; (6) the Lender, its servicers, successors or assigns may retain the original and/or an electronic record of this application, whether or not the Loan is approved; (7) the Lender and its agents, brokers, insurers, servicers, successors and assigns may continuously rely on the information contained in the application, and I am obligated to amend and/or supplement the information provided in this application if any of the material facts that I have represented herein should change prior to closing of the Loan; (8) in the event that my payments on the Loan become delinquent, the Lender, its services, successors or assigns may, in addition to any other rights and remedies that it may have relating to such delinquency, report my name and account information to one or more consumer credit reporting agencies; (9) ownership of the Loan and/or administration of the Loan account may be transferred with such notice as may be required by law; (10) neither Lender nor its agents, brokers, insurers, servicers, successors or assigns has made any representation or warranty, express or implied, to me regarding the property or the condition or value of the property; and (11) my transmission of this application as an "electronic record" containing my "electronic signature," as those terms are defined in applicable federal and/or state laws (excluding audio and video recordings), or my facsimile transmission of this application containing a facsimile of my signature, shall be as effective, enforceable and valid as if a paper version of this application were delivered containing my original written signature.

Acknowledgement. Each of the undersigned hereby acknowledges that any owner of the Loan, its servicers, successors and assigns, may verify or reverify any information contained in this application or obtain any information or data relating to the Loan, for any legitimate business purpose through any source, including a source named in this application or a consumer reporting agency.

Borrower's Signature
Date
Co-Borrower's Signature
Date
INFORMATION USED FOR GOVERNMENT MONITORING PURPOSES

The following information is requested by the Federal Government for certain types of loans related to a dwelling in order to monitor the lender's compliance with equal credit opportunity, fair housing and home mortgage disclosure laws. You are not required to furnish this information, but are encouraged to do so. The law provides that a lender may not discriminate either on the basis of this information, or on whether you choose to furnish it. If you furnish the information, please provide both ethnicity and race. For race, you may check more than one designation. If you do not furnish ethnicity, race, or sex, under Federal regulations, this lender is required to note the information on the basis of visual observation and surname if you have made this application in person. If you do not wish to furnish the information, please check the box below. (Lender must review the above material to assure that the disclosures satisfy all requirements to which the lender is subject under applicable state law for the particular type of loan applied for.)

Borrower Co-Borrower
I do not wish to furnish this information I do not wish to furnish this information
Ethnicity Ethnicity
Hispanic or Latino
Not Hispanic or Latino
Hispanic or Latino
Not Hispanic or Latino
Race Race
American Indian
Asian
Black or African American
Alaska Native
Native Hawaiian or other Pacific Islander
White
American Indian
Asian
Black or African American
Alaska Native
Native Hawaiian or other Pacific Islander
White
Sex Sex
Male
Female
Male
Female


CONTINUATION SHEET/RESIDENTIAL LOAN APPLICATION
Use this continuation sheet if you need more space to complete the Residential Loan Application. Mark B for Borrower or C for Co-Borrower. Borrower: Agency Case Number:
Co-Borrower: Lender Case Number:

I/We fully understand that it is a Federal crime punishable by fine or imprisonment, or both, to knowingly make any false statements concerning any of the above facts as applicable under the provisions of Title 18, United States Code, Section 1001, et seq.
       
Type your name in the box below to represent your electronic signature  
Borrower's Signature
Date
Co-Borrower's Signature
Date