Applicant Information
Applicant Name:  (First M.I. Last)
Home Phone:	Business Phone:
Soc. Sec. Number:
Email Address:
Current Living Address
Address:
City:	State:   Zip:
Own or Rent This Property?:	Own   Rent           # of Years:   # of Months:
If residing at present address for less than two years, please complete the following section(s)
Former Address #1:
City:	State:   Zip:
Did you Own or  Rent This Property?:	Own   Rent           # of Years:   # of Months:
Former Address #2:
City:	State:   Zip:
Did you Own or  Rent This Property?:	Own   Rent           # of Years:   # of Months:

 

Co-Applicant Information
Co-Applicant Name:  (First M.I. Last)
Home Phone:	Business Phone:
Soc. Sec. Number:
Email Address:
Please type "SAME" if same as Applicant in following section(s)
Current Living Address
Address:
City:	State:   Zip:
Own or Rent This Property?:	Own   Rent           # of Years:   # of Months:
If residing at present address for less than two years, please complete the following section(s)
Former Address #1:
City:	State:   Zip:
Did you Own or  Rent This Property?:	Own   Rent           # of Years:   # of Months:
Former Address #2:
City:	State:   Zip:
Did you Own or  Rent This Property?:	Own   Rent           # of Years:   # of Months:

 

Property Information
Please provide information about the property for which you are applying for this loan
Property Address:
City:	State:   Zip:
Number of Units:	Year Built:
If this is a construction or construction-permanent loan please answer the following:
Year Lot Acquired:	Original Cost: $   Amt. Existing Liens: $
Present Value of Lot:	$   Cost of Improvements: $
If this is a refinance loan please answer the following:
Year Acquired:	Original Cost: $   Amt. Existing Liens: $
Purpose of Refinance:	-- Select One -- No Cash-Out Rate Term Limited Cash-Out Rate/Term Cash-Out/Home Improvement Cash-Out/Debt Consolidation Cash-Out/Other
Describe Improvements:	-- Select One -- Already Made To be Made In Progress           Cost: $

 

Title Information
Title will be held in what Name(s):	1.  2.
Manner In which Title will be held:	-- Select One -- Community Property Joint Tenants SingleMan SingleWoman Tenants in Common To be determined in Escrow Unmarried Man Unmarried Woman
The Estate will be held in:	-- Select One -- Fee Simple Leasehold
If "Leasehold" for above option,  please give expiration date:
Source of Down Payment, Settlement  Charges and/or Subordinate Financing:	-- Select One -- Bridge Loan Cash on Hand Checking/Savings Deposit on Sales Contract Equity from Pending Sale Equity from Subject Property Equity on Sold Property Gift Funds Life Insurance Cash Value Lot Equity Other Type of Down Payment Rent With Option to Purchase Retirement Funds Sale of Chattel Secured Borrowed Funds Stocks & Bonds Sweat Equity Trade Equity Trust Funds Unsecured Borrowed Funds

 

Applicant Employment Information
Applicant Current Employer:
Employment Address:
City:	State:   Zip:
Work Phone:	Work Fax:
Position/Title:	Self Employed: Yes   No
Monthly Income Amount:	$   Work Schedule: Full-Time Part-Time
Years on Job:	Years in same field:
If employed in current position less than two years or if currently employed in more than one position, please complete the following section:
Applicant Additional Employer:
Employment Address:
City:	State:   Zip:
Employer Phone:	Employer Fax:
Position/Title:	Self Employed: Yes   No
Monthly Income Amount:	$   Work Schedule: Full-Time Part-Time
Begin Date:	End Date:
OTHER additional employer in past 2 years:
Applicant Additional Employer:
Employment Address:
City:	State:   Zip:
Employer Phone:	Employer Fax:
Position/Title:	Self Employed: Yes   No
Monthly Income Amount:	$   Work Schedule: Full-Time Part-Time
Begin Date:	End Date:

 

Co-Applicant Employment Information
Co-Applicant Current Employer:
Employment Address:
City:	State:   Zip:
Work Phone:	Work Fax:
Position/Title:	Self Employed: Yes   No
Monthly Income Amount:	$   Work Schedule: Full-Time Part-Time
Years on Job:	Years in same field:
If employed in current position less than two years or if currently employed in more than one position, please complete the following section:
Co-Applicant Additional Employer:
Employment Address:
City:	State:   Zip:
Employer Phone:	Employer Fax:
Position/Title:	Self Employed: Yes   No
Monthly Income Amount:	$   Work Schedule: Full-Time Part-Time
Begin Date:	End Date:
OTHER additional employer in past 2 years:
Co-Applicant Additional Employer:
Employment Address:
City:	State:   Zip:
Employer Phone:	Employer Fax:
Position/Title:	Self Employed: Yes   No
Monthly Income Amount:	$   Work Schedule: Full-Time Part-Time
Begin Date:	End Date:

 

Income Information
Please give answers based on GROSS MONTHLY INCOME
Base Employment Income:	Applicant: $   Co-Applicant: $
Overtime:	Applicant: $   Co-Applicant: $
Bonuses:	Applicant: $   Co-Applicant: $
Commissions:	Applicant: $   Co-Applicant: $
Dividends/Interest:	Applicant: $   Co-Applicant: $
Net Rental Income:	Applicant: $   Co-Applicant: $
Please describe any other income
:	Applicant: $   Co-Applicant: $
:	Applicant: $   Co-Applicant: $
:	Applicant: $   Co-Applicant: $
:	Applicant: $   Co-Applicant: $
:	Applicant: $   Co-Applicant: $

 

Combined (Current) Monthly Housing Expenses
Rent:	$
First Mortgage (Principle & Interest):	$
Other Financing (Principle & Interest):	$
Hazard Insurance:	$
Real Estate Taxes:	$
Mortgage Insurance:	$
Homeowner Assn. Dues:	$
Other:	$

 

Assets
Bank Accounts
Account Type:	Checking Savings Other     Current Balance: $
Financial Institution:	Acct. #:
Address:
City:	State:   Zip:
Bank Account #2
Account Type:	Checking Savings Other     Current Balance: $
Financial Institution:	Acct. #:
Address:
City:	State:   Zip:
Bank Account #3
Account Type:	Checking Savings Other     Current Balance: $
Financial Institution:	Acct. #:
Address:
City:	State:   Zip:
Bank Account #4
Account Type:	Checking Savings Other     Current Balance: $
Financial Institution:	Acct. #:
Address:
City:	State:   Zip:
Bank Account #5
Account Type:	Checking Savings Other     Current Balance: $
Financial Institution:	Acct. #:
Address:
City:	State:   Zip:
Stocks & Bonds
Please Describe:	Current Value: $
Please Describe:	Current Value: $
Please Describe:	Current Value: $
Please Describe:	Current Value: $
Please Describe:	Current Value: $
Other Assets
Life Insurance (Describe):	Face Amount: $
Life Insurance (Describe):	Face Amount: $
Retirement Acct. (Describe):	Current Value: $
Retirement Acct. (Describe):	Current Value: $
Business - Owned (Describe):	Net Worth:       $
Autos - Owned (Describe):	Est. Value:        $
Autos - Owned (Describe):	Est. Value:        $
Autos - Owned (Describe):	Est. Value:        $
Other Assets (Describe):	Value/Amount: $
Other Assets (Describe):	Value/Amount: $
Other Assets (Describe):	Value/Amount: $

 

Monthly Debts
Debt #1
Debt Description:
Current Balance:	$   Monthly Pymnt: $
Financial Institution:	Acct. #:
Address:
City:	State:   Zip:
Debt #2
Debt Description:
Current Balance:	$   Monthly Pymnt: $
Financial Institution:	Acct. #:
Address:
City:	State:   Zip:
Debt #3
Debt Description:
Current Balance:	$   Monthly Pymnt: $
Financial Institution:	Acct. #:
Address:
City:	State:   Zip:
Debt #4
Debt Description:
Current Balance:	$   Monthly Pymnt: $
Financial Institution:	Acct. #:
Address:
City:	State:   Zip:
Debt #5
Debt Description:
Current Balance:	$   Monthly Pymnt: $
Financial Institution:	Acct. #:
Address:
City:	State:   Zip:

 

Schedule of Real Estate Owned
Property #1
Property Address:
City:	State:   Zip:
Type of Property:	-- Select One -- Single Family Residence Condominium Town Home 2 - 4 Units Multi-family (Five + Units) CO OP Commercial-Residential Commercial-Non Residential Farm Land Mixed Use Property Mobile
Present Market Value:	$   Property Mortgage Liens: $
Gross Rental Income:	$   Mortgage Payments:         $
Insurance, Taxes & Maintenance:	$   Net Rental Income:             $
Property #2
Property Address:
City:	State:   Zip:
Type of Property:	-- Select One -- Single Family Residence Condominium Town Home 2 - 4 Units Multi-family (Five + Units) CO OP Commercial-Residential Commercial-Non Residential Farm Land Mixed Use Property Mobile
Present Market Value:	$   Property Mortgage Liens: $
Gross Rental Income:	$   Mortgage Payments:         $
Insurance, Taxes & Maintenance:	$   Net Rental Income:             $
Property #3
Property Address:
City:	State:   Zip:
Type of Property:	-- Select One -- Single Family Residence Condominium Town Home 2 - 4 Units Multi-family (Five + Units) CO OP Commercial-Residential Commercial-Non Residential Farm Land Mixed Use Property Mobile
Present Market Value:	$   Property Mortgage Liens: $
Gross Rental Income:	$   Mortgage Payments:         $
Insurance, Taxes & Maintenance:	$   Net Rental Income:             $

 

Authorization

Please CHECK the box below:

"I authorize this institution to obtain my/our credit report for the purpose of determining credit         worthiness. The information that is obtained is strictly confidential. By submitting this         electronically, this is to be deemed to be the equivalent of the original."

 

Additional Comments

Please give any additional comments you feel appropriate for this loan request. If you have additional information where there was not enough space, please enter them here.

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