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Residental Mortgage Application
Submitter Information (Required)
First Name
(required)
Last Name
(required)
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Resolve the errors marked in red before submitting again.
Important Notices

Applicants must reside in Missouri.

Important Information to Applicant(s).To help the government fight the funding of terrorism and money laundering activities, federal law requires all financial institutions to obtain, verify, and record information that identifies each person who applies for a loan or opens an account.  What this means for you: When you apply for a loan or open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver's license or other identifying documents. In some instances, we may use outside sources to confirm the information. The information you provide is protected by our privacy policy and federal law.

False Statements. By completing this application, I/we fully understand that it is a federal crime punishable by fine or imprisonment, or both, to knowingly make any false statements concerning any of the above facts as applicable under the provisions of Title 18, United States Code, Section 1001, et seq.

Security Notice: ONLY fill out this loan application on-line if you are using a browser with the latest security enhancements. If you do not have the latest version, download it now. This form is NOT cached (saved in your computer's memory) when you QUIT your browser.

Right to Receive a Copy of Appraisal Report.  We may order an appraisal to determine the property's value and charge you for this appraisal.  We will promptly give you a copy of an appraisal, even if your loan does not close.  You can pay for an additional appraisal for your own use at your own cost.

Click here to access Adjustable Rate Mortgage (ARM) Disclosures.

Instructions:

  • Print this form and gather the information you'll need.
  • Complete this form on-line and click "Submit Application". Upon receipt, we will contact you to discuss your application within three business days and we will send you the proper required disclosures. Receipt of these disclosures does not constitue loan approval.
  • To safeguard your privacy, please QUIT your browser and restart it again after submitting this form.

This Residential Loan Application is for personal loans and is NOT intended for Business use.

This application is designed to be completed by the applicant(s). Applicants should complete this form as "Borrower" or "Co-Borrower", as applicable. Co-Borrower information must also be provided (and the appropriate box checked) when the income of a person other than the "Borrower" (including Borrower's spouse) will be used as a basis for loan qualification or the income of the Borrower's spouse will not be used as a basis for loan qualification, but his or her liabilities must be considered because the Borrower resides in a community property state, the security property is located in a community property state, or the Borrower is relying on other property located in a community property state as a basis for repayment of the loan.

Type of Loan Application
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)
 
I. TYPE OF MORTGAGE AND TERMS OF LOAN
Amount Applying For $No. of MonthsInterest Rate

 
Amortization Type:
II. PROPERTY INFORMATION AND PURPOSE OF LOAN
Purpose of Loan:
Property will be:
Property Address
Estimated Value of Property (required)
III. BORROWER INFORMATION
Borrower
Borrower's Name (include Jr. or Sr. if applicable)Social Security No.Phone (incl. area code)Date of BirthEmail Address

 
Present Address (required)
Co-Borrower
Co-Borrower's Name (include Jr. or Sr. if applicable)Social Security No.Phone (incl. area code)Date of BirthEmail Address

 
Present Address
IV. EMPLOYMENT INFORMATION
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
 
V. MONTHLY INCOME INFORMATION
Gross Monthly Income
BorrowerCo Borrower
Gross Monthly Income
 
VIII. DECLARATIONS
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)
X. INFORMATION FOR GOVERNMENT MONITORING PURPOSES

Demographic Information: This section asks about your ethnicity, sex, and race.

The purpose of collecting this information is to help ensure that all applicants are treated fairly and that the housing needs of communities and neighborhoods are being fulfilled.  For residential mortgage lending, federal law requires that we ask applicants for their demographic information (ethnicity, sex, and race) in order to monitor our compliance with equal credit opportunity, fair housing, and home mortgage disclosure laws.  You are not required to provide this information, but are encouraged to do so.  The law provides that we may not discriminate on the basis of this information, or on whether you choose to provide it.  However, if you choose not to provide the information and you have made this application in person, federal regulations require us to note your ethnicity, sex, and race on the basis of visual observation or surname.  The law also provides that we many not discriminate on the basis of age or marital status information you provide in this application.  Instructions.  You may select one or more "Hispanic or Latino" origins and one or more designations for "Race." If you do not wish to provide some or all of this information, select this applicable check box.

Demographic Information
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.
IX. ACKNOWLEDGMENT AND AGREEMENT

Each of the undersigned specifically represents to Lender and to Lender's actual or potential agents, brokers, processors, attorneys, insurers, servicers, successors and assigns and agrees and acknowledges that:(1) the information provided in this application is true and correct as of the date set forth opposite my signature and that any intentional or negligent misrepresentation of this information contained in this application may result in civil liability, including monetary damages, to any person who may suffer any loss due to reliance upon any misrepresentation that I have made on this application, and/or in criminal penalties including, but not limited to, fine or imprisonment or both under the provisions of Title 18, United States Code, Sec. 1001, et seq.;(2) the loan requested pursuant to this application (the "Loan") will be secured by a mortgage or deed of trust on the property described in this application;(3) the property will not be used for any illegal or prohibited purpose or use;(4) all statements made in this application are made for the purpose of obtaining a residential mortgage loan;(5) the property will be occupied as indicated herein;(6) the Lender, its servicers, successors or assigns may retain the original and/or an electronic record of this application, whether or not the Loan is approved.  (7) the Lender and its agents, brokers, insurers, servicers, successors and assigns may continuously rely on the information contained in the application, and I am obligated to amend and/or supplement the information provided in this application if any of the material facts that I have represented herein should change prior to closing of the Loan;(8) in the event that my payments on the Loan become delinquent, the owner or servicer of the Loan may, in addition to any other rights and remedies that it may have relating to such delinquency, report my name and account information to one or more consumer credit reporting agencies;(9) ownership of the Loan and/or administration of the Loan account may be transferred with such notice as may be required by law;(10) neither Lender nor its agents, brokers, insurers, servicers, successors or assigns has made any representation or warranty, express or implied, to me regarding the property or the condition or value of the property; and (11) my transmission of this application as an "electronic record" containing my "electronic signature," as those terms are defined in applicable federal and/or state laws (excluding audio and video recordings), or my facsimile transmission of this application containing a fascimile of my signature, shall be as effective, enforceable and valid as if a paper version of this application were delivered containing my original written signature.

Consent. You authorize us to contact you using any of the telephone numbers listed on this Credit Application or that you subsequently provide us in connection with your credit account - regardless whether the number we use is assigned to a paging service, cellular telephone service, specialized mobile radio service or other radio common carrier service or any other service for which you may be charged for hte call.  You further authorize us to contact you through the use of voice, text and email and through the use of pre-recorded/artificial voice messages or an automated dialing device.

Acknowledgement. Each of the applicants hereby acknowledges that any owner of the Loan, its servicers, successors and assigns, may verify or reverify any information contained in this application or obtain any information or data relating to the Loan, for any legitimate business purpose through any source, including a source named in this application for a consumer reporting agency.

Borrower's NameDateCO-Borrower's NameDate

 
Driver's License Upload
Driver's License Upload
Please upload a copy of the Front of the Borrower & Co-Borrower Driver Licenses
To be completed by Bank Employee (if applicable)
Interviewer's NameInterviewer's Phone Number (incl. area code)Name and address of Interviewer's EmployerMLO#NMLS#

 
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