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Residental Mortgage Application
Submitter Information
First Name (required)
Last Name (required)
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Resolve the errors marked in red before submitting again.
To apply with Peoples Bank, you must be a resident of the State of Missouri or a current customer of Peoples Bank. Before proceeding, please confirm your eligibility. (required)
 
 
Choose 1 and initial Joint Intent (if applicable). Use another application if more than 2 applicants. (required)
Joint Credit Acknowledgement
ONLY complete if you chose, JOINT CREDIT above.
BorrowerCo-Borrower
Please initial (By initialing, you agree that each of us intend to apply for Joint Credit)
 
Amount Applying For $No. of MonthsInterest Rate

 
Amortization Type:
Purpose of Loan:
Property will be:
Property Address
Estimated Value of Property (required)
Borrower
Borrower
Name (include Jr. or Sr. if applicable)
 
Social Security No.
 
Phone (incl. area code)
 
Date of Birth
 
Email Address
 
Present Address (required)
Co-Borrower
Co-Borrower
Name (include Jr. or Sr. if applicable)
 
Social Security No.
 
Phone (incl. area code)
 
Date of Birth
 
Email Address
 
Present Address
Borrower
* Self Employed Borrower(s) may be required to provide additional documentation such as tax returns and financial statements.
Borrower
EmployerAdditional Employer
Employer Name
 
Employer Address
 
Years on Job (If less than 2 yrs, please fill out Additional Employer Information)
 
Years employed in this profession
 
Position/Title
 
Business Phone
 
Co-Borrower
* Self Employed Borrower(s) may be required to provide additional documentation such as tax returns and financial statements.
Co-Borrower
EmployerAdditional Employer
Name
 
Address
 
Years on Job (if less than 2 yrs, please fill out Additonal Employer Info.)
 
Years employed in this profession
 
Position/Title
 
Business Phone
 
Gross Monthly Income
BorrowerCo Borrower
Gross Monthly Income
 
A. Are there any outstanding judgments against the Borrower or Co-Borrower? (required)
B. Has the Borrower or Co-Borrower declared bankruptcy within the past 10 years? (required)
C. Has the Borrower or Co-Borrower had property foreclosed upon or given title or deed in lieu thereof in the last 7 years? (required)
D. Is the Borrower or Co-Borrower party to a lawsuit? (required)
E. Has the Borrower or Co-Borrower directly or indirectly been obligated on any loan which resulted in foreclosures, transfer of title in lieu of foreclosure, or judgment? (required)
F. Is the Borrower or Co-Borrower presently delinquent or in default on any Federal debt or any other loan, mortgage, financial obligation, bond, or loan guarantee? (required)
G. Is the Borrower or Co-Borrower obligated to pay alimony, child support, or separate maintenance? (required)
H. Is any part of the down payment borrowed? (required)
I. Is the Borrower or Co-Borrower a co-maker or endorser on a note? (required)
J. Is the Borrower and Co-Borrower U.S. citizens? (required)
K. Is the Borrower or Co-Borrower a permanent resident alien? (required)
L. Does the Borrower or Co-Borrower intend to occupy the property as their primary residence? (required)
M. As the Borrower or Co-Borrower had an ownership interest in a property in the last 3 years? (required)
M.1 What type of property did you own?
(Complete if the answer to question M is Yes)
M.2 How did you hold title to the home?
(Complete if the answer to question M is Yes)
N. Are there any other equity loans on the property? (required)
Borrower - Sex
Borrower - Ethnicity
Borrower - Ethnicity Con't (if Applicable)
Complete if Hispanic or Latio was chosen above
Borrower - Race
If American Indian or Alaska Native was chosen, please enter name of enrolled or principal tribe.
Borrower - Race con't (if Applicable)
if Asian, Native Hawaiian or Other Pacific Islander was selected please complete this section
 
 
If Other Asian or Other Pacific Islander was chosen above, please enter Race.
Co-Borrower - Sex
Co-Borrower - Ethnicity
Co-Borrower - Ethnicity con't (if Applicable)
Complete if Hispanic or Latio was chosen above
Co-Borrower - Race
If American Indian or Alaska native was chosen, please enter the name of enrolled or principal tribe.
Co-Borrower - Race con't (if Applicable)
if Asian, Native Hawaiian, or Other Pacific Islander was chosen above, please enter Race.
 
 
If Other Asian or Other Pacific Islander was chosen above, please enter Race.
Borrower's NameDateCO-Borrower's NameDate

 
Driver's License Upload
Please upload a copy of the Front of the Borrower & Co-Borrower Driver Licenses
Enter NameLoan Originator Identifier (MLO#)
Loan Originator's Name
 
Peoples Bank, PO Box H, Cuba MO 65453 NMLS#469800
Date Application Received
This application was taken by:
Was the ethnicity of the Borrower collected on the basis of visual observation or surname?
for in person application
Was the sex of the Borrower collected on the basis of visual observation or surname?
for in person application
Was the race of the Borrower collected on the basis of visual observation or surname?
for in person application
Was the ethnicity of the Co-Borrower collected on the basis of visual observation or surname?
for in person application
Was the sex of the Co-Borrower collected on the basis of visual observation or surname?
for in person application
Was the race of the Co-Borrower collected on the basis of visual observation or surname?
for in person application