Mortgage Applied
for:
V.A. Conventional FHA Other Amortization Type: Fixed Rate
Other GPM ARM
PROPERTY
INFORMATION AND PURPOSE OF LOAN
Subject Property Address (street,
city, state, zip)
County
No. of Units
Legal Description of
Subject Property (attach description if necessary)
Year Built
Purpose of Loan: Purchase
Refinance
Construction Construction Permanent Other
Property will be:
Primary Residence Secondary
Residence
Investment
Borrower
BORROWER
INFORMATION
Co-Borrower
Borrower's Name:
EMail:
Co Borrower's
Name:
EMail:
Social Sec #
Home Phone
Age
School
Social Sec #
Home Phone
Age
School
Married Separated
Unmarried
Dependents No. Ages
Married Separated
Unmarried
Dependents No. Ages
Present Address
(street, city, state, zip)
Own
Rent
No.
Yrs.
Present Address
(street, city, state, zip)
Own
Rent
No.
Yrs.
Borrower
EMPLOYMENT
INFORMATION
Co-Borrower
Name and Address of
Employer
Yrs. on Job
Yrs in this line of profession: Self Employed
Name and Address of
Employer
Yrs. on Job
Yrs in this line of profession:
Self Employed
Position/Title/Type of
Business
Business Phone
Position/Title/Type of
Business
Business Phone
If employed for
less than two years or if employed in more than one position,
complete the following:
Name and Address of
Employer
From To
Monthly Income $ Self Employed
Name and Address of
Employer
From To
Monthly Income $ Self Employed
Position/Title/Type of
Business
Business Phone
Position/Title/Type of
Business
Business Phone
MONTHLY INCOME AND COMBINED HOUSING EXPENSE
INFORMATION
Gross Monthly Income
Borrower
Co-Borrower
Total
Housing Expenses
Present
Proposed
Base
Employ. 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
$
$
$
Homeowner Assn.
Dues
$
$
$
$
$
Other
$
$
Total
$
$
$
Total
$
$
*Self employed
borrower(s) may be required to provide additional
documentation such as tax returns & financial
statements.
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 seperate statements and schedules are required. If
the co-borrower section was completed about a spouse, this
statement and supporting schedules must be completed about the
spouse also.
ASSETS
Cash or Market Value
Liability and Pledged Assets. List the
creditors name, address and account # for all outstanding
debts,including auto loans, revolving charge accounts, real
estate loans, alimony, child support, stock predges,
etc.
Cash Deposit Purchase Held by:
Amount: $
LIABILITIES
Monthly
Pmt/ Unpaid Balance
Name and
address of Bank, SL or Credit Union
Name and
address of Company
Payment: $ Balance: $
Acct. no.
Balance $
Acct. no.
Name and
address of Bank, SL or Credit Union
Name and address of
Company
Payment: $ Balance: $
Acct. no.
Balance $
Acct. no.
Name and address of Bank, SL or Credit Union
Name and
address of Company
Payment: $ Balance: $
Acct. no.
Balance
$
Acct. no.
Stocks and
Bonds $ $ $
$
Name and address of Company
Payment: $ Balance: $
Life
insurance net cash value Face amount $
Balance
$
Acct. no.
Subtotal
Liquid Assets
$
Name and address of Company
Payment: $ Balance: $
Retirement Fund
$
Real
Estate Owned:
$
Acct. no.
Automobiles Owned:
$
$ $
Name and address of Company
Payment: $ Balance: $
Net Worth
of business(es):
$
Acct. no.
Other Assets:
$ $ $
Alimony/Child Support/Seperate Maintenance:
$
Job Related Expense:
$
Total
Monthly Payments
$
Total Assets
$
Total
Liabilities
$
DECLARATIONS
Borrower
Co-Borrower
Yes
No
Yes
No
a. Are
there any outstanding judgments against you?
b. Have
you been declared bankrupt within the past 7 years
c. Have
you had property foreclosed upon or given title or deed in
lieu thereof in the last 7 years?
d. Are you
a party to a lawsuit?
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
home loans, any mortgage, financial obligation. bond, or loan
guarantee.)
f. Are you
presently delinquent or in default on any Federal debt or any
other loan, mortgage, financial obligation, bond or loan
guarantee?.
g. Are you
obligated to pay alimony, child support, or seperate
maintenance?
h. Is any
part of the down payment borrowed?
i. Are you
the co-maker or endorser on a note?
j. Are you
a U.S. citizen?
k. Are you
a permanent resident alien?
l. Do you
intend to occupy the property as your primary
residence?
m. Have
you had an ownership interest in a property in the last three
years?
(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)?
ACKNOWLEDGMENT AND AGREEMENT
The
undersigned specifically acknowledge(s) and agree(s) that:(1)
The loan requested by this application will be secured by
a
first mortgage or deed of trust on the property. Described
herein; (2) the property will not be used for any illegal
or
prohibited purpose or use; (3) all statements made in this
application are made for the purpose of obtaining the loan
indicated herein; (4) occupation of the property will be
as
indicated above; (5) verification or re-verification of any
information contained in the application may be made at any
time by the lender, it's agents, successors and assigns,
either directly or through a credit reporting agent, from
any source named in this application, and the original copy
of
this application will be retained by the lender, even if
the loan is not approved; (6) the lender, it's agents, successors
and assigns will rely on the information contained in the
application and I/we have a continuing obligation to amend
and/or supplement the information provided in this application
if any of the material facts which I/we have represented
herein should change prior to closing; (7) in the event my/our
payments on the loan indicated in this application become
delinquent, the lender, it's agents, successors and assigns,
may, in addition to all their other rights and remedies,
report my/our name(s) and account information to a credit
reporting agency; (8) ownership of the loan may be transferred
to successor or assign of the lender without notice to me
and/or the administration of the loan account may be
transferred to an agent, successor or assign of the lender
with prior notice to me; (9) the lender, it's agents,
successors and assigns make no representations or warranties,
expressed or implied, to the borrower(s) regarding the
property, the condition of the property, or the value of
the property.
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 form me/us no later than 90
days after Lender notifies me/us about the action taken on
this application, or I/We withdraw this application.
Certification: I/we certify that the information
provided in this application is true and correct as of the
date set forth opposite my/our sygnature(s) on this
application and acknowledge my/our understanding that my
intentional or negligent misrepresentation(s) of the
information contained in this application may result in cival
liability and/or criminal penalties including, but not limited
to, fine or imprisonment or both under the provisions of title
18, United States Code, Section 1001, et seq. and liability
for monitary damages to the lender, it's agents, successors
and assigns, insurers and any other person who may suffer any
loss due to the reliance upon any misrepresentation which I/we
have made on this application.
