Please click here to view Equal Credit Opportunity Act information before completing this application.

For a printable version of this application click here
 

This application is designed to be completed by the applicant(s) with the lender's assistance. Applicants should complete this form as "Borrower" or "Co-Borrower" as applicable. Co-Borrower information must also be provided (and the appropriate box checked) when
the income or assets of a person other than the "Borrower" (including the Borrower's spouse) will be used as a basis for loan qualification or
the income or assets of the Borrower's spouse or other person who has community property rights pursuant to state law will not be used as a basis for loan qualification, but his or her liabilities must be considered because the spouse or other person has community property rights pursuant to applicable law and the Borrower resides in a community property state, the security property is located in a community property state, or the Borrower is relying on other property located in a community property state as a basis for repayment of the loan.
If you are interested in applying for an adjustable rate mortgage (ARM), please view the Consumer Handbook on Adjustable Rate Mortgages by clicking here.
I. TYPE OF MORTGAGE AND TERMS OF LOAN
     
Mortgage Applied for:
 		    
V.A. Conventional FHA
USDA/Rural Housing Service
Other:		   Agency Case Number
Lender Case No.
Amount*   Interest Rate     No. of Months* Amortization Type:*
$   %  

Fixed Rate ARM (type):
 GPM Other (explain):
 
II. PROPERTY INFORMATION AND PURPOSE OF LOAN
  No. of Units
Subject Property Address (street , city, state, & ZIP)*
Legal Description of Subject Property (attach description if necessary)
Year Built
   
Purpose of Loan:* Property will be:*
Purchase Construction  
 Refinance Construction-Permanent
Other (explain): 		Primary Residence
Secondary Residence
Investment
 
Complete this line if construction or construction-permanent loan.

Year Lot   Acquired     

Original Cost

$		 Amount Existing Liens
$ 		  (a) Present Value of Lot
$		   (b) Cost of Improvements
$		 Total (a+b)
$		  
 
Complete this line if this is a refinance loan.
Year Acquired Original Cost Amount Existing Liens   Purpose of Refinance Describe Improvements
$ $   made to be made
Cost $
   
 Title will be in what Names(s)
 		Manner in which Title will be held
 Estate will be held in:
Fee Simple
Leasehold
Source of Down Payment, Settlement, Charges and/or Subordinate Financing (explain)
 		 
 
        III. BORROWER INFORMATION

Borrower 

Co-Borrower

Borrower's Name (include Jr. or Sr. if applicable)*

 

  Co-Borrower's Name (include Jr. or Sr. if applicable)
   
 
Social Security #*
 DOB* (MM/DD/YYYY)
 		  Yrs. School
 		    Social Security #
    		DOB (MM/DD/YYYY)
 		Yrs.
School
   
Home Phone (incl. area code)*
()-		    Home Phone (incl. area code)
   ()-
       
Married
 Unmarried (include single divorced, widowed)
 Separated

Dependents
(not listed by Co- Borrower)
no. ages 		  Married
 Unmarried (include single divorced, widowed)
 Separated

 

Dependents
(not listed by Borrower)
no. ages
   
Present Address (street, city, state, ZIP) *

 Own Rent No. Yrs.
 
 Present Address (street, city, state, ZIP)

   Own Rent 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)
Own Rent No. Yrs.
 
 
IV. EMPLOYMENT INFORMATION
Borrower                                                                                             Co-Borrower
 
Name and Address of*
Employer

Self Employed 

Yrs. on this job*

    Name and 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*
 
()-		 Position/Title/Type of Business
Business Phone

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

                  Borrower                                                                 Co-Borrower
Name and Address of
Employer

Self Employed  

  Dates(from-to)
 

  Name and Address of Employer

Self Employed 

  Dates(from-to)
 
Monthly Income
$ 		  Monthly Income
$
       
Position/Title/Type of Business
  Business Phone

()-		 Position/Title/Type of Business
Business Phone

()-

                  Borrower                                                                 Co-Borrower
Name and Address of
Employer

Self Employed 

  Dates(from-to)
 

  Name and Address of Employer

Self Employed 

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

                                    

   
Position/Title/Type of Business
Business Phone

()-		 Position/Title/Type of Business
Business Phone

()-
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 complete,
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 Description Monthly Amount
1   $
2   $
3      $
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 spouse, this Statement and supporting schedules must be completed about that spouse also.
Completed *
 Jointly Not Jointly
  
ASSETS Cash or Market
Value		  

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.
Description:
Cash deposit toward purchase held by

:
 

 

   LIABILITIES

 

 Monthly Pmt. &
Mos. Left to Pay		 Unpaid
Balance
List checking and savings accounts below
Name & Address of Bank, S&L, or Credit Union*

   

  Name & Address of Company
 $ Pmt./Months
 		$
Acct. no.* $*       Acct. no.
Name & Address of Bank, S&L, or Credit Union
  Name & Address of Company
 $ Pmt./Months
 		$
Acct. no. $      Acct. no.
Name & Address of Bank, S&L, or Credit Union

  Name & Address of Company
 $ Pmt./Months
 		$
Acct. no. $     Acct. no.
Name & Address of Bank, S&L, or Credit Union
  Name & Address of Company
 		$ Pmt./Months
 		$
Acct. no. $     Acct. no.
Stocks & Bonds(Company name/ number & description)
 		$   Name & Address of Company
 $ Pmt./Months
 		$
       Acct. no.
Life insurance net cash value

$   Name & Address of Company
 		$ Pmt./Months
 $
Face amount $ $     Acct. no.
Subtotal Liquid Assets $   Name & Address of Company
 		$ Pmt./Months
 		$
Real Estate owned (enter market value from schedule or real estate owned)
 $

    Acct. no.

 
Vested interest in retirement fund $   Name & Address of Company
 $ Pmt./Months
$
Net worth of business(es) owned (attach financial statement) $ Acct. no.
Automobiles owned (make and year) $ Alimony/Child Support/Separate Maintenance Payments $
Other Assets (itemize)
$
Job Related Expense (child care, union dues, etc. ) $

Total Monthly Payments $

Total Assets a.

$

Net Worth
(a minus b)

$ Total Liabilities b. $  
 
Schedule of Real Estate Owned*

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 Mortgage & 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. DETAILS OF TRANSACTION VIII. DECLARATIONS*
a. Purchase Price $   If you answer "yes" to any questions a through i, please use continuation sheet for explanation. Borrower Co-
Borrower
b. Alterations, improvements, repairs $     Yes No   Yes No
c. Land (if acquired separately) $   a. Are there any outstanding judgments against you?  
d. Refinance (incl. debts to be paid off) $   b. Have you been declared bankruptcy within the past 7 years?  
e. Estimated prepaid items $   c. Have you had property foreclosed upon or given title or deed in lieu thereof in the last 7 years?  
f. Estimated closing costs $   d. Are you a party to a lawsuit?  
g. PMI, MIP, Funding Fee $   e. 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 .)  
h. Discount (if Borrower will pay) $   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.  
i. Total costs (add items a through h) $   g. Are you obligated to pay alimony, child support, or separate maintenance?  
j. Subordinate financing $   h. Is any part of the down payment borrowed?  
k. Borrower's closing costs paid by seller $   i. Are you a co-maker or endorser on a note?  
l. Other Credits (explain) $   j. Are you a U.S. citizen?  
m. Loan amount (exclude PMI, MIP, Funding Fee financed ) $   k. Are you a permanent resident alien?  
n. PMI, MIP, Funding Fee financed $   l. Do you intend to occupy the property as your primary residence?
If "Yes," complete question m below		  
o. Loan amount (add m & n) $   m. Have you had an ownership interest in a property in the last 3 years?  
p. 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? Soley by yourself (S), jointly with your spouse (SP), or jointly with another person (O)?
 
IX. ACKNOWLEDGEMENT 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 herein; (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 herein; (6) any owner or servicer of the Loan may verify or reverify any information contained in the application from any source named in this application, and Lender, its successors or assigns may retain the original and/or an electronic record of this application, even if the Loan is not 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 owner or servicer of the Loan 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 services, successors and assigns, may verify or reverify any information contained in this application or obtain any information of data to the Loan, for any legitimate purpose through any source, including a source named in this application or a consumer reporting agency.
       
Borrower*
I Agree		   Co-Borrower
I Agree		  
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 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 wish to 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 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* I do not wish to furnish this information

CO-BORROWER   I do not wish to furnish this information
Ethnicity
Hispanic or Latino Not Hispanic or Latino
Ethnicity
Hispanic or Latino   Not Hispanic or Latino


Race
 
American Indian or Alaska Native
Asian
Black or African American
     
Native Hawaiian or Other Pacific Islander
White
  


Race