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Loan Application

 

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BORROWER INFORMATION
Loan Amount: Property Type (select):
$
Address of Property:  
 


Borrower
Co-Borrower
Borrower's Name (include Jr. or Sr. if applicable) Co-Borrower's Name (include Jr. or Sr. if applicable)
Date of Birth 00/00/00 Social Security #
Date of Birth 00/00/00 Social Security #
Home Phone Age Yrs. School
Home Phone Age Yrs. School
Married Single Unmarried (Includes single, divorced, widowed) Married Single Unmarried (Includes single, divorced, widowed)
Present Address (street, city, state, zip) Present Address (street, city, state, zip)
Own Rent
No. Years
Own Rent
No. Years
If residing at present address for less than two years, complete the following:
Former Address (street, city, state, zip) Former Address (street, city, state, zip)
Own Rent
No. Years
Own Rent
No. Years
Former Address (street, city, state, zip) Former Address (street, city, state, zip)
Own Rent
No. Years
Own Rent
No. Years
Employment Information
Name and address of Employer Name and address of Employer

Position
Self Employed
Yrs. on this job
Yrs. employed at this line of work profession
Business Phone (incl. area code)

Position
Self Employed
Yrs. on this job
Yrs. employed at this line of work profession
Business Phone (incl. area code)

 

Monthly Income and combined Housing Expense Information
Gross Monthly Income
Borrower
Co-Borrower
Total
Combined Monthly Housing Expense
Present
Proposed
Base Empl. Income*
$
$
$
Rent
$
$
Overtime
First Mortgage (P& I)
Bonuses
Other Financing (P & I)
Commissions
Hazard Insurance
Dividends/Interest
Real Estate Taxes
Net Rental Income
Mortgage Insurance
 Other
Homeowner Assn. Dues
      Other
Total
$
$
$
Total
$
$
*Self Employed Borrower(s) may be required to provide additional documentation such as tax returns and financial statements.

 

Assets and Liabilities

The 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 meaningful and fairly presented on a combined basis; otherwise separate Statements and Schedules are required. If the co-borrower section was completed about a spouse, this Statement and supporting schedules must be completed about that spouse also.

Completed Jointly Not Jointly

Assets
Cash or Market Value
Description
$
 
Cash Deposit toward purchase held by:
List Checking and Savings Accounts Below
Name and address of Bank, S&L, or Credit Union
Account Number $
Name and address of Bank, S&L, or Credit Union
Account Number $
Name and address of Bank, S&L, or Credit Union
Account Number $

Stocks & Bonds (Company Name/ number and description)

$

Life Insurance net cash value

Face Value $

$
Subtotal Liquid Assets $
Real Estate Owned (enter market value from schedule or real estate owned) $
Vested interest in retirement fund $
Net worth of business(es) owned (send financial statement $
Automobiles owned (make and year)
$
Other Assets (itemize)
$
Total Assets a.
$
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 (8) those liabilities which will be satisfied upon sale of real-estate owned or upon refinancing of the subject property.
Liabilities
Name and Address of Company
Monthly Payt. & Mos. Left to Pay
Unpaid Balance
$
Payt./Mos.
$
Account Number:
Name and Address of Company
Monthly Payt. & Mos. Left to Pay
Unpaid Balance
$
Payt./Mos.
$
Account Number:
Name and Address of Company
Monthly Payt. & Mos. Left to Pay
Unpaid Balance
$
Payt./Mos.
$
Account Number:
Name and Address of Company
Monthly Payt. & Mos. Left to Pay
Unpaid Balance
$
Payt./Mos.
$
Account Number:
Name and Address of Company
Monthly Payt. & Mos. Left to Pay
Unpaid Balance
$
Payt./Mos.
$
Account Number:
Name and Address of Company
Monthly Payt. & Mos. Left to Pay
Unpaid Balance
$
Payt./Mos.
$
Account Number:
Name and Address of Company
Monthly Payt. & Mos. Left to Pay
Unpaid Balance
$
Payt./Mos.
$
Account Number:
Alimony/child Support/Separate Maintenance Payments Owed to:
$
 
Job Related Expense (child care, union dues, etc.)
$
Total Monthly Payments $
Net Worth (a-b) $ Total
Liabilities b.
$

 

Assets and Liabilities
Schedule of Real Estate Owned (if additional properties are owned, submit continuation sheet)
Property Address (enter S if sold, PS is pending sale, or R if rental being held for income)
Type of Property
Present Market Value
Amount of Mortgage & Liens
Gross Rental Income
Mortgage Payments
Insurance Maintenance Taxes & Misc.
Net Rental Income
$ $ $ $ $ $
$ $ $ $ $ $
$ $ $ $ $ $
Totals
$ $ $ $ $ $

 

By submitting this form I/We specifically acknowledge(s) and agree(s) that: (1) the loan a requested by this application will be secured by 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 reverfication of any information contained in the 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 contained 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 of 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.

Certification: I/We certify that the information provided in this application is true and correct as of the date set forth opposite my/our signature(s) 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 misrepresentation which I/we have made on this application.

NLMLS 327623 / Florida License MBR799 / Virginia License MC5955 / West Virginia License MB34228

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