I. Type of Mortgage and Terms of Loan
II. Property Information and Purpose of Loan
III. Borrower Information
IV. Employment Information
V. Monthly Income and Combined Housing Expense Information
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 this
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
Schedule of Real Estate Owned (if additional properties are owned,
use continuation sheet.)
VII. Details of Transaction
If you answer "yes" to any questions a through
i, please use continuation sheet for explanation.
Alterations, improvements, repairs
Land (if acquired separately)
Are there any outstanding judgments against you?
Refinance (incl. debts to be paid off)
Have you been declared bankrupt within the past 7 years?
Estimated prepaid items
Have you ever had property foreclosed upon or given
title or deed in lieu thereof
in the last 7 years?
Estimated closing costs
Are you a party to a lawsuit?
PMI, MIP, Funding Fee
Have you directly or indirectly
been obligated on any loan which resulted in foreclosure,
transfer of 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.)
Discount (if Borrower will pay)
Total costs (add items a through h)
Borrower's closing costs paid by Seller
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 previous question.
Other Credits (explain):
Are you obligated to pay alimony, child support, or
Is any part of the down payment borrowed?
Are you a co-maker or endorser on a note?
Are you a U.S. citizen?
Loan amount (exclude PMI, MIP, Funding Fee Financed)
Are you a permanent resident alien?
PMI, MIP, Funding Fee financed
Do you intend to occupy the property as your
primary residence?If "Yes," complete question m below.
Loan amount (add m & n)
Have you had an ownership interest in a property in the
last three years?
Cash from/to Borrower
(subtract j, k, l & o from i) $
(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
IX. 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 this 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 servicers, 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.
Right to Receive Copy of Appraisal. I/We
have the right to a copy of the appraisal report used in
connection with this application for credit. To obtain a
copy, I/we must send Lender a written request at the mailing
address Lender has provided. Lender must hear from me/us
no later than 90 days after Lender notifies me/us about the
action taken on this application, or I/we withdraw this
Acknowledgment. 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. X. 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 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 or 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.)
Continuation Section/Residential Loan Application
Use box below if you need more space to complete the Residential Loan Application. Mark B for Borrower or C for Co-Borrower Disclosures
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OBTAINING CREDIT
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 obtains credit.
What this means for you: When you obtain credit, 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
NOTICE: We may report information about your account
to credit bureaus. Late payments, missed payments, or
other defaults on your account may be reflected in your credit
NOTICE TO MARRIED APPLICANTS: No provision of any
material property agreement, unilateral statement under §766.59,
Wis. Stats., or court decree under §766.70 adversely affects the
interest of the creditor unless the creditor, prior to the time
the credit is granted or an open-end credit plan is entered
into, is furnished a copy of the agreement, statement or decree
or has actual knowledge of the adverse provision.