Mortgage Loan Application

Section 1. Borrower's Information

Borrower's Name *

First

Middle

Last

Borrower's SSN *

Borrower's Home Phone *

Borrower's Date of Birth *

Borrower's Years of School *

Borrower's Marital Status *

Married
Separated
Unmarried

Number of Dependents *

Dependents Ages

Borrower's Address *

Address Line 1

Address Line 2

City

State

Zip Code

Mailing Address (if different from above)

Address Line 1

Address Line 2

City

State

Zip Code

How long have you resided at this address? *

If less than 2 years at current address, please list previous address

Address Line 1

Address Line 2

City

State

Zip Code

Email *

Section 2. Co-Borrower's Information

Co-Borrower's Name

First

Middle

Last

Co-Borrower's SSN

Co-Borrower's Home Phone

Co-Borrower's Date of Birth

Co-Borrower's Years of School

Co-Borrower's Marital Status

Married
Separated
Unmarried

Co-Borrower's Number of Dependents and Ages

Co-Borrower's Address

Address Line 1

Address Line 2

City

State

Zip Code

How long have you lived at this address?

Co-Borrower's Mailing Address (if different from above)

Address Line 1

Address Line 2

City

State

Zip Code

Co-Borrower's Email

Section 3. Borrower's Employment Information

Name of Employer *

Business Phone *

Employer Address *

Address Line 1

Address Line 2

City

State

Zip Code

Years on this job *

Start Date (mm/yy)

If less than 2 years at current employer, please list previous employment

Employer Name

Employer Address

Address Line 1

Address Line 2

City

State

Zip Code

Start Date (mm/yy)

End Date (mm/yy)

Years in this line of work *

Position Title *

Type of Industry

Monthly Gross Income (Gross is before taxes) *

Section 4. Co-Borrower's Employment Information

Name of Co-Borrower's Employer

Co-Borrower's Business Phone

Co-Borrower's Employer Address

Address Line 1

Address Line 2

City

State

Zip Code

Co-Borrower's year's on this job

Start Date (mm/yy)

If less than 2 years at current employer, please list previous employment

Employer Name

Employer Address

Address Line 1

Address Line 2

City

State

Zip Code

Start Date (mm/yy)

End Date (mm/yy)

Co-Borrower's years in this line of work

Co-Borrower's Position Title

Co-Borrower's Type of Industry

Co-Borrower's Monthly Gross Income (Gross is before taxes)

Section 5. Loan Information

Requested Mortgage Loan Amount *

Type of Loan Product *

Fixed
Adjustable
Interest Only

Transaction Type *

Purchase
Refinance

If Purchase, How much money do you have to put towards a down payment & closing costs

Account Type

Financial Institution

Account Number

Available Funds

Account Type

Financial Institution

Account Number

Available Funds

If Refinance, What company is your mortgage currently with

What is your current Principal Balance and Interest Rate

Current Monthly Payment

Does this amount include escrow

Do you have a second mortgage *

If Yes, Interest Rate

What Company is it with

Current Balance

If Refinance, Purpose

Shorten Term
Cash Out
Home Improvement
Lower Rate
Debt Consolidation

Address of Property

Address Line 1

Address Line 2

City

State

Zip Code

Property Type

Primary
Secondary
Vacation
Rental

Estimated Value of Property

If you own other real estate please list address below

Address Line 1

Address Line 2

City

State

Zip Code

Property Type

Primary
Secondary
Vacation
Rental

Estimated Value of Property

Section 6. General Questions

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 forecloser, 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 reason for the action.) *

E (1) - If Yes, provide details below

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 you primary residence? If "Yes," complete question M below. *

M - Have you had an ownership interest in a property in the last three years? *

M (1) - What type of property did you own?

M (2) - How did you hold title to the home?

Section 7. Signatures

Borrower Signature *

Date *

Co-Borrower Signature

Date

Home Mortgage Application

Section 1. Borrower's Information

Section 2. Co-Borrower's Information

Section 3. Borrower's Employment Information

Section 4. Co-Borrower's Employment Information

Section 5. Loan Information

Section 6. General Questions

Section 7. Signatures