Equal Housing Lender | Member FDIC
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Mortgage Application
Submitter Information
First Name (required)
Last Name (required)
Resolve the errors marked in red before submitting again.
APPLICANTS MUST RESIDE IN ONE OF THE FOLLOWING COUNTIES. In which of the following counties do you currently reside? (required)
Mortgage Applied for:
Agency Case No.Lender Case No.Amount $Interest Rate %No. of Months

 
Amortization Type:
Subject Property Address (street, city state & ZIP)No. of Units

 
Legal Description of Subject Property (attach description if necessary)Year Built

 
Purpose of Loan:
Property will be:
Complete these lines if construction or construction-permanent loan:
Year Lot AcquiredOriginal Cost $Amount Existing Liens $

 
(a) Present Value of Lot(b) Cost of Improvements $ Total (a+b) $

 
Complete these lines if this is a refinance loan.
Year AcquiredOriginal Cost $Amount Existing Liens $Purpose of Refinance

 
Describe Improvements
Describe ImprovementsCost $

 
Title will be held in what Names(s)Manner in which Title will be held:Source of Down Payment, Settlement Changes and/or Subordinate Financing (explain)

 
Estate will be held in:
Borrower
Borrower's Name (include Jr. or Sr. if applicable)Social Security No.Home Phone (incl. area code)Date of BirthYrs. School

 
Dependents (not listed by Co-Borrower)
no.ages

 
Present Address
No. Yrs.
Former Address
If residing at present address for less than two years, complete the following:
No. of yrs.
Former Address
No. of yrs.
Co-Borrower
Co-Borrower's Name (include Jr. or Sr. if applicable)Social Security No.Home Phone (incl. area code)Date of BirthYrs. School

 
Dependents (not listed by Borrower)
no.ages

 
Present Address
No. Yrs.
Former Address
If residing at present address for less than two years, complete the following:
No. of yrs.
Former Address
No. of yrs.
Borrower
Borrower
Name & Address of Employer Years on this jobYrs. employed in this line of work/profession:Position/Title/Type of BusinessBusiness Phone (include area code)

 
Name & Address of EmployerDates (from-to)Monthly income: $Position/Title/Type of BusinessBusiness Phone (incl. area code)

 
Name & Address of EmployerDates (from-to)Monthly income: $ Position/Title/Type of BusinessBusiness Phone (incl. area code)

 
Co-Borrower
Co-Borrower
Name & Address of EmployerYears on this jobYears employed in this line of work/profession:Position/Title/Type of BusinessBusiness Phone (incl. area code)

 
Name & Address of EmployerDates: from-to:Monthly income: $Position/Title/ Type of BusinessBusiness Phone (inc. area code)

 
Name & Address of EmployerDates: from-to:Monthly income: $Position/Title/ Type of BusinessBusiness Phone (inc. area code)

 
Gross Monthly Income
BorrowerCo BorrowerTotal
Base Empl. Income *
 
Overtime
 
Bonuses
 
Commissions
 
Dividends/Interest
 
Net Rental Income
 
Other (before completing, see the notice in "describe other income" below)
 
Total
 
Combined Monthly Housing Expense
PresentProposed
Rent
 
First Mortgage (P & I)
 
Other Financing(P & I)
 
Hazard Insurance
 
Real Estate Taxes
 
Mortgage Insurance
 
Homeowner Assn. Dues
 
Other
 
Total
 
* Self Employed Borrower(s) may be required to provide additional documentation such as tax returns and financial statements.
Describe Other Income B/CNotice: Alimony, child support, or separate maintenance income need not be revealed if the Borrower (B) or co-Borrower(C) does not choose to have it considered for repaying this loan.Monthly Amount
B/C
 
B/C
 
B/C
 
Completed
ASSETS Description
Cash deposit toward purchase held by:S DescriptionCash or Market Value

 
List checking and savings accounts below
Name and address of Bank, S & L, or Credit Union Acct. no.Cash or Market Value

 

 

 

 

 
Stock & Bonds (Company name/number & descriptionCash or Market Value

 
Life Insurance net cash value Face amount: $ Market Value

 
Real estate owned (enter market value from schedule of real estate owned)
Subtotal Liquid Assets
Real estate owned (enter market value from schedule of real estate owned)
Vested interest in retirement
Net worth of business(es) owned (attach financial statement)
Automobiles owned (make and year)Cash or Market Value

 
Other Assets (itemized)Cash or Market Value

 
Cash or Market Value
Total Assets (a)
 
Liabilities
Name and Address of CompanyMonthly Payt. & Mos. Left to PayUnpaid BalanceAcct. No.

 

 

 

 

 

 
Monthly Payt. & Mos. Left to Pay
Alimony/Child Support/Separate Maintenance Payments Owed to:
 
Monthly Payt. & Mos. Left to Pay
Job Related Expense (child care, union dues, etc.)
 
Monthly Payt. & Mos. Left to Pay
Total Monthly Payments
 
Monthly Payt. & Mos. Left to Pay
Net Worth (a minus b)
 
Monthly Payt. & Mos. Left to Pay
Total Liabilities(b)
 
Schedule of Real Estate Owned (if additional properties are owned use continuation sheet)
Property AddressS - sold, PS- pending sale or R - rental being held for incomeType of PropertyPresent Market ValueAmount of Mortgage & LiensGross Rental IncomeMortgage PaymentsInsurance Maintenance, Taxes & Misc.Net Rental Income

 

 

 
Total
 
List any additional names under which credit has previously been received and indicate appropriate creditor name(s) and account number(s):
Alternative NameCreditor Name Account Number

 
a. Purchase Price
b. Alterations, improvements, repairs
c. Land (if acquired separately)
d. Refinance (incl. in debts to be paid off)
e. Estimated prepaid items
f. Estimated closing costs
g. PMI, MIP, Funding Fee
h. Discount (if Borrower will pay)
i. Total costs (add items a through h)
j. Subordinate financing
k. Borrower's closing costs paid by Seller
l. Other Credits (explain)$

 
m. Loan amount (exclude PMI, MIP, Funding Fee financed)
n. PMI, MIP, Funding Fee financed
o. Loan amount (add m & n)
p. Cash from/to Borrower (subtract j, k, l & o from i)
a. Are there any outstanding judgments against you?
YesNo
Borrower
 
Co-Borrower
 
b. Have you been declared bankrupt within the past 7 years?
YesNo
Borrower
 
Co-Borrower
 
c. Have you had property foreclosed upon or given title or deed in lieu thereof in the last 7 years?
YesNo
Borrower
 
Co-Borrower
 
d. Are you a party to a lawsuit?
YesNo
Borrower
 
Co-Borrower
 
e. Have you directly or indirectly been obligated on any loan which resulted in foreclosure, transfer of title in lieu of foreclosure, 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 reasons for the action.)
YesNo
Borrower
 
Co-Borrower
 
f. Are you presently delinquent or in default on any Federal debt or any other loan, mortgage, financial obligation, bond, or loan guarantee? If "Yes," give details as described in the preceding question.
YesNo
Borrower
 
Co-Borrower
 
g. Are you obligated to pay alimony, child support or separate maintenance?
YesNo
Borrower
 
Co-Borrower
 
h. Is any part of the down payment borrowed?
YesNo
Borrower
 
Co-Borrower
 
i. Are you a co-maker or endorser on a note?
YesNo
Borrower
 
Co-Borrower
 
j. Are you a U.S. citizen?
YesNo
Borrower
 
Co-Borrower
 
k. Are you a permanent resident alien?
YesNo
Borrower
 
Co-Borrower
 
l. Do you intend to occupy the property as your primary residence? If "Yes," complete question below.
YesNo
Borrower
 
Co-Borrower
 
m. Have you had an ownership interest in a property in the last three years?
YesNo
Borrower
 
Co-Borrower
 
(1) What type of property did you own -- principal residence (PR), second home (SH), or Investment Property (IP)?
2) How did you hold title to the home -- solely by yourself (S), jointly with your spouse (SP), or jointly with another person (O)?
Borrower's NameDateCO-Borrower's NameDate

 
Borrower:
Ethnicity:
Race or National Origin:
Sex
Co-Borrower:
Ethnicity
Race or National Origin:
Sex
This application was taken by:
Interviewer's NameInterviewer's Phone Number (incl. area code)Name and address of Interviewer's Employer