Mortgage Loan Application

Important Information About Procedures For Opening a New Account

To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify and record information that identifies each person who opens an account.

What this means for you: When you open an account, we will ask for your name, address, date of birth and other information that will allow us to identify you. We may also ask to see your driver's license or other identifying documents and use third party identifiers such as chex systems and/or credit bureau reports.

Required Field

Loan Information

Are you applying for joint credit?

What type of mortgage are you applying for?

Purpose of Loan

Is this application for pre-qualification?

Property Information

Refinance

Will this be used for improvements?

Borrower Information

Housing

Do you own or rent this property?

Have you lived here for two or more years?

Did you own or rent this property?

Marital Status

Employment Information

Is the borrower employed?

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

Previous Employer

Co-Borrower Information

Housing

Do you own or rent this property?

Have you lived here for two or more years?

Did you own or rent this property?

Marital Status

Employment Information

Is the co-borrower employed?

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

Previous Employer

Financial Information

Please note: Alimony, child support or separate maintenance income need not be revealed if the Borrower or Co-Borrower does not choose to have it considered for repaying this loan. Also self employed borrowers may be required to provide additional documentation such as tax returns and financial statements. (before taxes)

Borrower's Gross Monthly Income

Co-Borrower's Gross Monthly Income

Current Monthly Housing Expenses

Checking or Savings

Please list all checking and savings accounts.

Account

Add Another Account

Stocks & Bonds

Life Insurance

Real Estate

Property

Add Another Property

Miscellaneous Assets

Automobile

Add Another Automobile

Other Assets

  • Description

Current Monthly Payments (Liabilities)

  • Name of Company

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

Borrower

Are there any outstanding judgments against you?

Have you been declared bankrupt within the past 7 years?

Have you had property foreclosed upon or given title or deed in lieu thereof in the last 7 years?

Are you a party to a lawsuit?

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.)

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.

Are you obligated to pay alimony, child support, or separate maintenance?

Is any part of the down payment borrowed?

Are you a co-maker or endorser on a note?

Are you a U.S. citizen?

Are you a permanent resident alien?

Do you intend to occupy the property as your primary residence?

Have you had an ownership interest in a property in the last three years?

Co-Borrower

Are there any outstanding judgments against you?

Have you been declared bankrupt within the past 7 years?

Have you had property foreclosed upon or given title or deed in lieu thereof in the last 7 years?

Are you a party to a lawsuit?

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.)

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.

Are you obligated to pay alimony, child support, or separate maintenance?

Is any part of the down payment borrowed?

Are you a co-maker or endorser on a note?

Are you a U.S. citizen?

Are you a permanent resident alien?

Do you intend to occupy the property as your primary residence?

Have you had an ownership interest in a property in the last three years?

Information 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 discriminate neither on the basis of this information, nor 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 or surname. If you do not wish to furnish that information, please check the box below. (Lender must review the above material to assure that he 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

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.