Borrower
Co-Borrower
Amount
Subject Property Address
Purpose of Loan
Borrower's Name (include Jr. or Sr. if applicable)
Social Security Number
Home Phone (incl. area code)
DOB (mm/dd/yyyy)
Years School
Marital status
Dependents (not listed by Co-Borrower)
No.
Ages
(Present Address (street, city, state, ZIP/ country)
If residing at present address for less than two years, complete the following:
(Former Address (street, city, state, ZIP/ country)
Name & Address of Employer
Yrs. on this job
Yrs. employed in this line of work/profession
Position/Title/Type of Business
Business Phone (incl. area code)
If employed in current position for less than two years or if currently employed in more than one position, complete the following:
If you answer "Yes" to any questions a through i, please use continuation sheet for explanation.
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?
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 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-solely by yourself (S), jointly with your spouse (SP), or jointly with another person (O)?
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