| 1. Type of Mortgage and Terms of Loan [HELP] |
Mortgage Applied for:
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Loan Amount:
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Interest Rate %:
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No. of Months:
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Amortization Type:
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*If Adjustable Rate, Choose Type:
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| 2. Subject Property Info and Purpose of Loan [HELP] |
Property Address:
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City:
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Purpose of Loan:
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Property Will Be:
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Vesting Of Title:
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Property Price:
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Payment Source:
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Down Payment Amount:
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| Complete the items below if this is a construction, construction-permanent, or refinance loan: |
Year Acquired
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Original Cost
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Existing Liens: (Amount)
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Purpose of Refinance:
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| 3. Borrower Information [HELP] |
| Borrower |
Co-borrower |
First Name: *
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First Name: *
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Middle Name:
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Middle Name:
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Last Name: *
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Last Name: *
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Generation Suffix(such as, Jr., Sr., or II)
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Generation Suffix(such as, Jr., Sr., or II)
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Social Security Number:
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Social Security Number:
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Date of Birth:
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Date of Birth:
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Years Of School:
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Years Of School:
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Marital Status:
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Marital Status:
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Dependents Number:
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Dependents Number:
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Email:
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Email:
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Phone:
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Phone:
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| Present Address |
Address:
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Address:
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City:
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City:
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Rent or Own?
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Rent or Own?
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How Long at This Address:
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How Long at Address:
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| Complete the following if at present address less than 2 years: |
| Former Address |
Street:
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Street:
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City:
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City:
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Rent or Own?
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Rent or Own?
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How Long at This Address:
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How Long at Address:
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| 4. Employment Information [HELP] |
| Current Employer |
| Borrower |
Co-borrower |
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| Previous Employment: If employed in current position less than 2 years or if currently employed in more than 1 position, complete the following: |
| Borrower |
Co-borrower |
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| 5. Monthly Income and Combined Housing Expense Information [HELP] |
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| 6. Assets [HELP] |
| 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 *. If the co-borrower section was completed about a spouse, this statement and supporting schedules must be completed about the spouse also.
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| Cash Deposit on Sales Contract Held By Escrow. |
| Deposit In Escrow: |
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| List assets, including checking and savings accounts below. |
Asset Type:
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Bank Name:
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Account Number:
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Balance:
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Asset Type:
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Bank Name:
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Account Number:
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Balance:
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Asset Type:
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Bank Name:
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Account Number:
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Balance:
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Asset Type:
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Bank Name:
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Account Number:
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Balance:
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| Real Estate Owned |
| Property # 1 |
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Property Street:
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Property City:
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Property State:
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Property ZIP Code
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Loan Amount
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Loan Monthly Payment
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Gross Rental Income:
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Insurance, HOA & Taxes
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| Property # 2 |
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Property Street:
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Property City:
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Property State:
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Property ZIP Code:
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Loan Amount
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Loan Monthly Payment
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Gross Rental Income:
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Insurance,HOA & Taxes Fee:
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| Property # 3 |
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Property Street:
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Property City:
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Property State:
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Property ZIP Code:
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Loan Amount
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Loan Monthly Payment:
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Gross Rental Income:
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Insurance,HOA & Taxes Fee:
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| 7. Declarations [HELP] |
| Items |
Borrower |
Co- borrower |
| a. Are there any outstanding judgments against you? |
Yes
No |
Yes
No |
| b. Have you been declared bankrupt within the last seven years? |
Yes
No |
Yes
No |
| c. Have you had property foreclosed upon or given title or deed in lieu thereof in the last seven years? |
Yes
No |
Yes
No |
| d. Are you a party to a lawsuit? |
Yes
No |
Yes
No |
| 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.) |
Yes
No |
Yes
No |
| f. Are you presently delinquent or in default on any federal debt or any other loan, mortgage, financial obligation, bond, or loan guarantee? |
Yes
No |
Yes
No |
| g. Are you obligated to pay alimony, child support, or separate maintenance? |
Yes
No |
Yes
No |
| h. Is any part of the down payment borrowed? |
Yes
No |
Yes
No |
| i. Are you a co-maker or endorser on a note? |
Yes
No |
Yes
No |
| j. Are you a U.S. citizen? |
Yes
No |
Yes
No |
| k. Are you a permanent resident alien? |
Yes
No |
Yes
No |
| l. Do you intend to occupy the property as your primary residence? |
Yes
No |
Yes
No |
| m. Have you had an ownership interest in a property in the last three years? (If you answered Yes, complete questions 1 and 2 below.) |
Yes
No |
Yes
No |
| 1. What type of property did you own? |
| Borrower |
Co-borrower |
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| 2. How did you hold title to the home? |
| Borrower |
Co-borrower |
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| If you answered yes to any questions A through I above, explain in the box below. |
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| 8. Information for Government Monitoring Purposes [HELP] |
| The following information is requested by the federal government for certain
types of loans related to a dwelling to monitor the lender's compliance with equal credit opportunity, fair housing, and home mortgage
disclosure laws. You are not * to furnish this information, but are encouraged to do so. The law provides that a lender may not discriminate on
the basis of this information, nor on whether you choose to furnish it. If you do not want to furnish this information, select the box below.
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| Borrower |
Co-borrower |
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I do not wish to furnish this information
Ethnicity:
Race:
Sex:
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I do not wish to furnish this information
Ethnicity:
Race:
Sex:
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