I. TYPE OF MORTGAGE AND TERM OF LOANS
II. PROPERTY INFORMATION AND PURPOSE OF LOAN
Complete this line if construction or construction-permanent loan.
Complete this line if this is a refinance loan.
Estate will be held in
(Show expiration date)
III. BORROWER INFORMATION
If Residing at Present Address for less than 2 years, complete the following
IV. EMPLOYMENT INFORMATION
If employed in current position for less than 2 years or if currently employed in more than one position, complete the following
V. MONTHLY INCOME AND COMBINED HOUSING EXPENSE INFORMATION
Gross Monthly Income
Combined Monthly Housing Expense
* Self Employed Borrower(s) may be required to provide additional documentation such as tax returns and financial statements.
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.
Describe Other Income
VI. ASSETS & 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 non-applicant spouse or other person, this Statement and supporting schedules must be completed about that spouse or other person also.
CASH OR MARKET VALUE
List Checking and Savings Account Below
VII. DETAILS OF TRANSACTION
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 State Owned
Total Present Market Value
Total Amount of Mortgages & Liens
Total Gross Rental Income
Total Mortgage Payments
Total Insurance, Maintenance, Taxes & Misc
Total Net Rental Income
If you answer "Yes" to any questions a though i, please use continuation sheet for explanation.
A. Are there any outstanding judgment 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 judgement?
(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.)
F. Are you presently deliquent 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 separate maintenance?
H. Is any part of the down payment borrowed?
I. Are you a 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 - 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 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 business purpose 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 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 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 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 related to such delinquency, report my name and account information to one or more consumer 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 servicers, successors and assigns, may verify 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. GOVERNMENT MONITORING INFORMATION
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.