| *
required fields |
New
Loan Information |
| *
Purpose of loan: |
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| * Property
value, $: |
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| *
Loan amount applying for, $: |
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| *
Is there a co-borrower: |
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| *
What state do you need a loan: |
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| *
Do you own any real estate: |
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| * How is your
credit: |
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New
User Contact Information |
| * First name: |
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| * Middle name: |
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| * Last name: |
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| * Home phone
number: |
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| Work phone
number: |
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| Cell phone
number: |
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| * Best time
to call: |
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| * Email address: |
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Property
Information |
| * Street address: |
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| * City: |
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| * State: |
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| * Zip: |
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| * Property
type: |
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| * Year built: |
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| * Year acquired: |
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| * Original
cost, $: |
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| Amount existing
liens: |
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| * Title will
be held in what name: |
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| Manner in
which title will be held: |
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| * Borrower's
name: |
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| * Date of
birth: |
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| * Years in
school: |
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| * Number of
dependents: |
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| * Marital
status: |
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| * Current
address: |
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| * Current
city: |
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| * Current
state: |
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| * Current
zip: |
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| * Rent or
Own: |
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| * How long:
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| * Borrower's
current employer: |
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| * Borrower's
position: |
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| * Borrower's
employer address: |
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| * Borrower's
employer city: |
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| * Borrower's
employer state: |
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| * Borrower's
employer zip: |
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| * Length of
employment: |
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| * Borrower
self employed: |
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| * Employed
from (dates): |
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| * Monthly
income, $: |
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Borrower
Gross Monthly Income |
| * Base employee
income, $: |
|
| Commissions,
$: |
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| Overtime,
$: |
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| Dividends/Interest,
$: |
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| Bonuses, $: |
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| Net rental
income, $: |
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| Other, $: |
|
Rent |
| First mortgage
(P & I): |
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| Second mortgage
(P & I): |
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| Hazard insurance: |
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| Real estate
taxes: |
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| Mortgage insurance
(PMI): |
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| Other: |
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Liability
and Pledged Assets |
1st
Mortgage |
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| Name of creditor: |
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| Monthly payment,
$: |
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| Unpaid balance,
$: |
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| Type of liability: |
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| Will this
debt be paid off: |
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2nd
Mortgage |
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| Name of creditor 2: |
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| Monthly payment 2, $:
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| Unpaid balance 2, $: |
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| Type of liability 2: |
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| Will this debt be paid
off 2: |
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Other
Payments |
| Alimony payments,
$: |
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| Child support
payment, $: |
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| Separate maintenance
payment, $: |
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Job related
expense, $:
(child care, union dues, etc.) |
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| * Amount of
mortgage, $: |
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| Liens, $: |
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| Gross rental
income, $: |
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| * Mortgage
payments, $: |
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| Insurance
maint., taxes & misc, $: |
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| * Are you
going to be documenting your income: |
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| * Does the
property have more than 5 acres: |
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Home
Equity Transaction Information |
*
What city would you prefer to sign loan documents: |
|
*
Are you currently in the process of remodeling, making
additions, or any other construction on this property: |
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*
Balance on your current first mortgage, $: |
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*
Do you have a home equity, line of credit or a second
mortgage: |
|
Yes,
I have a home equity line/second in the amont of, $: |
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*
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 below: |
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If
yes: |
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*
Are you obligated to pay alimony, child support, or
separate maintenance: |
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*
Is any part of the down payment borrowed: |
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*
Are you a co-maker or endorser on a note: |
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*
Are you a U.S. citizen: |
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*
Are you a permanent residential alien: |
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*
Do you intend to occupy the property as your primary
residence? |
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*
Have you had ownership interest in a property in the
last three years? |
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What type of property did you own: |
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How
did you hold title to the home-soley by yourself (S),
jointly with your spouse (SP), or jointly with another
person (O): |
|
|
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:
- 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.;
- 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;
- The property will not be used for any illegal
or prohibited purpose or use;
- All statements made in this application are made
for the purpose of obtaining a residential mortgage
loan;
- The property will be occupied as indicated in
this application;
- 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;
- 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;
- 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 reporting agencies;
- Ownership of the Loan and/or administration of
the Loan account may be transferred with such notice
as may be required by law;
- 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
- 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
Required: 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.) |
| * I don't
want to furnish this information: |
|
| Ethnicity: |
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| Race/National
Origin: |
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| Gender: |
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| Additional Information: Please
enter any comments that could be helpful in processing
your application: |
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