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RESIDENTIAL
LOAN APPLICATION
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| SECTION I - Borrower Information |
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Borrower's Name
(Includ Jr or Sr if applicable): |
Married
Separated
Unmarried (includes single, divorced, widowed) |
| Social Security Number: |
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| Date of Birth: |
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| Presnet Address: |
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Rent
Own
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| Home Phone Number: |
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| Mobile Phone Number: |
Please check if wish this to make your Mobile the
primary contact number |
| Work Phone Number: |
Please check if wish this to make Work your primary
contact number |
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| SECTION II - Co-Borrower Information |
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Co-Borrower's Name
(Includ Jr or Sr if applicable): |
Married
Separated
Unmarried (includes single, divorced, widowed) |
| Social Security Number: |
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| Date of Birth: |
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| Presnet Address: |
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Rent
Own
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| Home Phone Number: |
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| Mobile Phone Number: |
Please check if wish this to make your Mobile the primary contact number
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| Work Phone Number: |
Please check if wish this to make Work your primary contact number |
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| SECTION III - Borrower Employment Information |
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| Name & Address of Employer: |
Self Employed
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| Business Phone (include area code): |
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| Position/Title/Type of Business: |
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| Years on this Job: |
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| If employed in current position for less than
two years or if currently employed in more than one position, complet
the following: |
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| Name & Address of Employer: |
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| Business Phone (include area code): |
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| Position/Title/Type of Business: |
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| Years on this Job: |
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| SECTION IV - Co-Borrower Employment
Information |
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| Name & Address of Employer: |
Self Employed?
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| Business Phone (include area code): |
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| Position/Title/Type of Business: |
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| Years on this Job: |
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| SECTION V - Montly Income and Conbined
Housing Expense Information |
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| SECTION VI - Assets |
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| SECTION VII - Select Liabilities and Declarations |
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| Do you pay Allomony, Child Support, or Separate
Maintenance Payments? |
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| Owed To: |
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| Amount: |
$
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| Do you currently own other property?
Yes |
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If yes
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Second Home |
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Rental Property |
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| Are there any outstanding judgments against you? |
Yes |
No
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| Have you been declared bankrupt within the past 7
years? |
Yes |
No
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| Have you had property foreclosed upon or given title
or deed in lieu thereof in the last 7 years? |
Yes |
No
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| Are you a party to a lawsuit? |
Yes |
No
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| 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 imporovement loans, education loans,
manufactured home loans, any mortgage, financial obligation, bond,
or loan guarantee.) |
Yes |
No
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| Are you presoently delinquent or in default on any
Federal debt or any other loan, mortgage, financial obligation,
bond, or loan gurantee? |
Yes |
No
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| Are you obligated to pay alimony, child support, or
separate maintenance? |
Yes |
No
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| Is any part of the down payment borrowed? |
Yes |
No
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| Are you a co-maker or endorser on a note? |
Yes |
No
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| Are you a U.S.citizen? |
Yes |
No
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| Are you a permanet resident alien? |
Yes |
No
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| Do you intent to occupy the property as your primary
residence? |
Yes |
No
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| Section VIII - Acknowledgment and Agreement |
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| 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 reverification
of any information contained in this application may be made at any time
by the Lender, its agents, successors and assigns, either directly or
through a credit reporting agency, 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, its agents, successors
and assigns will rely on the information continued 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, its 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, its agents, successors
and assigns make no representations or warranties, express 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 from me/us no later than 90 days after Lender notified 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 name below on this application and acknowledge
my/our understanding that any intentional or negligent misrepresentation(s)
of the information contained in this application may result in civil
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 monetary damages to the
Lender, its agents, successors and assigns, insurers and any other person
who may suffer any loss due to reliance upon any misrepresentation which
I/we have made on this application.
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