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  • GENERAL INFORMATION
  • BORROWER INFORMATION
  • EMPLOYMENT INFORMATION
  • MONTHLY INCOME AND COMBINED HOUSING EXPENSE INFORMATION
  • ASSETS AND LIABILITIES
  • DECLARATIONS
  • CREATE ACCOUNT

Borrower

Co-Borrower

Amount

Subject Property Address

Purpose of Loan

Borrower

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)

Co-Borrower

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)

(Former Address (street, city, state, ZIP/ country)

Borrower

Name & Address of Employer

Self Employed ?

Yrs. on this job

Yrs. employed in this line of work/profession

Position/Title/Type of Business

Business Phone (incl. area code)

Co-Borrower

Name & Address of Employer

Self Employed ?

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:

Name & Address of Employer

Self Employed ?

Yrs. on this job

Yrs. employed in this line of work/profession

Position/Title/Type of Business

Business Phone (incl. area code)

Name & Address of Employer

Self Employed ?

Yrs. on this job

Yrs. employed in this line of work/profession

Position/Title/Type of Business

Business Phone (incl. area code)

Gross Monthly Income Borrower Co-Borrower Total
Base Empl. Income*
$
$
$
Overtime
$
$
$
Bonuses
$
$
$
Commissions
$
$
$
Dividends/Interest
$
$
$
Net Rental Income
$
$
$
Other
$
$
$
Total
$
$
$
Property Address (enter S if sold, PS if pending sale or R if rental being held for income) Type of Property Present Market Value Amount of Mortgages & Liens Gross Rental Income Mortgage Payments Insurance, Maintenance, Taxes & Misc Net Rental Income
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
Total
$
$
$
$
$
$

If you answer "Yes" to any questions a through i, please use continuation sheet for explanation.

Borrower

Co-Borrower

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 (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 delinquent or in default on any Federal debt or any other loan, mortgage, financial obligation, bond, or loan guarantee?

If "Yes," give details as described in the preceding question

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?

If "Yes," complete question m below.

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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