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Home Equity Line of Credit Application

Type of Mortgage and Terms of Loan

Are you applying for joint credit? Yes No

Total Loan Amount

Property Information & Purpose of Loan

Name of Title Holder Manner in Which Title is Held

What is the estate held in? Fee Simple Leasehold

Leasehold Expiration Date Subject Property Address City State Zip Code Legal Description of Property Year Built Number of Units Purpose of Loan

What will the property be used for? Primary Residence Secondary Residence Investment

Contact Us for information on Construction loans.

Is this a refinance? Yes No

Purpose of Refinance Year Acquired Original Cost Remaining Loan Amount

Will this be used for improvements? Yes No

Improvements have already been made. Describe Improvements Total Cost of Improvements

Borrower Information

First Name Middle Initial Last Name Suffix Social Security Number Birth Date Mother's Maiden Name Home Phone Number E-mail Address Please do NOT email me important news and updates.

Marital Status Single Married Separated Divorced Widowed

Number of Dependents (Not Listed by Co-Borrower) List Dependent's Ages

Housing

Home Address City State Zip Code Mailing address is different than street address.

Mailing Address City State Zip Code

Do you own or rent this property? Own Rent Other

Explain Residency Start Date Monthly Mortgage or Rent Payment

Have you lived here for two or more years? Yes No

Previous Home Address City State Zip Code

Did you own or rent this property? Own Rent Other

Explain Residency Start Date Monthly Mortgage or Rent Payment

Co-Borrower Information

First Name Middle Initial Last Name Suffix Social Security Number Birth Date Mother's Maiden Name Home Phone Number E-mail Address Please do NOT email me important news and updates. Highest Level of Education Completed

Marital Status Single Married Separated Divorced Widowed

Number of Dependents (Not Listed by Co-Borrower) List Dependent's Ages

Housing

Home Address City State Zip Code Mailing address is different than street address.

Mailing Address City State Zip Code

Do you own or rent this property? Own Rent Other

Explain Residency Start Date Monthly Mortgage or Rent Payment

Have you lived here for two or more years? Yes No

Previous Home Address City State Zip Code

Did you own or rent this property? Own Rent Other

Explain Residency Start Date Monthly Mortgage or Rent Payment

Borrower Employment Information

Is the borrower employed? Employed Not Employed

Employment Start Date Position or Title Gross Monthly Income Name of Employer Employer's Address City State Zip Code Employer's Phone Number

Have you worked here for more than two years? (No if unemployed) Yes No

Previous Employer 1

Employment Start Date Position or Title Gross Monthly Income Name of Employer Employer's Address City State Zip Code Employer's Phone Number

Previous Employer 2

Employment Start Date Position or Title Gross Monthly Income Name of Employer Employer's Address City State Zip Code Employer's Phone Number

Co-Borrower Employment Information

Is the borrower employed? Employed Not Employed

Employment Start Date Position or Title Gross Monthly Income Name of Employer Employer's Address City State Zip Code Employer's Phone Number

Have you worked here for more than two years? (No if unemployed) Yes No

Previous Employer 1

Employment Start Date Position or Title Gross Monthly Income Name of Employer Employer's Address City State Zip Code Employer's Phone Number

Previous Employer 2

Employment Start Date Position or Title Gross Monthly Income Name of Employer Employer's Address City State Zip Code Employer's Phone Number

Monthly Income and Combined Housing Expense Information

Monthly Income Source	Borrower	Co-Borrower	Line Total
Base Employment Income	Base Employment Income	Co-Borrower Base Employment Income	Total Base Employment Income
Overtime	Overtime	Co-Borrower Overtime	Total Overtime
Bonuses	Bonuses	Co-Borrower Bonuses	Total Bonuses
Commissions	Commissions	Co-Borrower Commissions	Total Commissions
Dividends/Interest	Dividends/Interest	Co-Borrower Dividends/Interest	Total Dividends/Interest
Net Rental Income	Net Rental Income	Co-Borrower Net Rental Income	Total Net Rental Income
Other Income	Other Income	Co-Borrower Other Income	Total Other Income
before completing, see the notice in "describe other income" below
	Income Total	Co-Borrower Income Total	Combined Income Total

Other Income

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.

Income Proprietor	Description	Monthly Amount
Income Proprietor	Description	Monthly Amount

Combined Monthly Housing Expenses

Monthly Expense Source	Present	Proposed
Rent	Rent
First Mortgage (P&I)	First Mortgage (P&I)	Proposed First Mortgage (P&I)
Other Financing (P&I)	Other Financing (P&I)	Proposed Other Financing (P&I)
Hazard Insurance	Hazard Insurance	Proposed Hazard Insurance
Real Estate Taxes	Real Estate Taxes	Proposed Real Estate Taxes
Mortgage Insurance	Mortgage Insurance	Proposed Mortgage Insurance
Homeowner Association Dues	Homeowner Association Dues	Proposed Homeowner Association Dues
Other	Other	Proposed Other
	Total	Proposed Total

Assets

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.

Liquid Assets	Person or Institution	Cash or Market Value
Cash deposit toward purchase	Cash deposit toward purchase	Cash Deposit Value
Life Insurance	Life Insurance	Life Insurance Cash Value

Checking or Savings Accounts

Account Number	Institution	Cash or Market Value
Account Number	Institution Name	Total Value

Stocks and Bonds

Description	Company	Cash or Market Value
Description	Company Name	Total Value
		Subtotal Liquid Assets

Investments

Assets	Cash or Market Value
Real estate owned (enter market value from schedule of real estate owned)	Real estate owned (enter market value from schedule of real estate owned)
Vested interest in retirement fund	Vested interest in retirement fund
Net Worth of business(es) owned (attach financial statement)	Net Worth of business(es) owned (attach financial statement)

Automobiles owned

Make	Model	Year	Cash or Market Value
Make	Model	Year	Total Value

Other Assets (itemize)

Asset Description	Cash or Market Value
Asset Description	Total Value

Assets Total

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.

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.

Liability

Account Number Unpaid Balance Monthly Payment Name of Liability Owner Liability Owner's Address City State Zip Code

Alimony/Child Support/Separate Maintenance

Expense	Total Owed	Monthly Payment
Alimony	Total Owed	Monthly Payment
Child Support	Total Owed	Monthly Payment
Job-Related Expenses (child care, union dues, etc.)		Monthly Payment
	Total Liabilities	Total Monthly Payments

Net Worth

Net Worth (Assets minus Liabilities)

Schedule of Real Estate Owned

Real Estate

Property Address City State Zip Code Type of Property Present Market Value Amount of Mortgages & Liens

Monthly Mortgage Payments Monthly Insurance, Maintenance, Taxes & Misc. Monthly Gross Rental Income Monthly Net Rental Income

Totals

Real Estate Market Value Mortgages & Liens

Monthly Totals

Mortgage Payments Insurance, Maintenance, Taxes & Misc. Gross Rental Income Net Rental Income

Borrower Declarations

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
Alternate Name	Creditor Name	Account Number

Are there any outstanding judgments against you? Yes No

Explain

Have you been declared bankrupt within the past 7 years? Yes No

Explain

Have you had property foreclosed upon or given title or deed in lieu thereof in the last 7 years? Yes No

Explain

Are you a party to a lawsuit? Yes No

Explain

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.) Yes No

Explain

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. Yes No

Explain

Are you obligated to pay alimony, child support, or separate maintenance? Yes No

Explain

Is any part of the down payment borrowed? Yes No

Explain

Are you a co-maker or endorser on a note? Yes No

Explain

Are you a U.S. citizen? Yes No

Are you a permanent resident alien? Yes No

Explain

Do you intend to occupy the property as your primary residence? Yes No

Have you had an ownership interest in a property in the last three years? Yes No

What type of property did you own? How did you hold the title to the home?

Co-Borrower Declarations

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
Alternate Name	Creditor Name	Account Number

Are there any outstanding judgments against you? Yes No

Explain

Have you been declared bankrupt within the past 7 years? Yes No

Explain

Have you had property foreclosed upon or given title or deed in lieu thereof in the last 7 years? Yes No

Explain

Are you a party to a lawsuit? Yes No

Explain

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.) Yes No

Explain

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. Yes No

Explain

Are you obligated to pay alimony, child support, or separate maintenance? Yes No

Explain

Is any part of the down payment borrowed? Yes No

Explain

Are you a co-maker or endorser on a note? Yes No

Explain

Are you a U.S. citizen? Yes No

Are you a permanent resident alien? Yes No

Explain

Do you intend to occupy the property as your primary residence? Yes No

Have you had an ownership interest in a property in the last three years? Yes No

What type of property did you own? How did you hold the title to the home?

Acknowledgement & 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.

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

Type the numbers you see above:

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