This application is designed to be completed by the applicant(s).
Co-Borrower information must also be provided (and the appropriate box selected below) when

the income or assets of a person other than the "Borrower" (including the Borrowers spouse) will be used as a basis for loan qualification or
the income or assets of the Borrowers 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, or 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.

*Name of person
completing this application :
*Your e-mail address is :


*Do you authorize us to access your credit report(s)? :

I. TYPE OF MORTGAGE AND TERMS OF LOAN

Mortgage Applied For:
Conventional
VA FHA
USDA/Rural Housing
Other


Lien Position: Loan Amount: $ No. of Months:

Amortization Type: Fixed Rate Adjustable Rate

II. PROPERTY INFORMATION AND PURPOSE OF LOAN

Subject Property Address: (if available)

Street:

City:

ST:

ZIP:

Number of Units:

Year Built:

Purpose of Loan:
Purchase
Refinance
Construction
Construction-Permanent
Other

Use of Property:


Primary Residence
Secondary Residence
Investment

If Purchase:
Purchase Price: $ Seller Credit for Closing Costs: $

Complete this line if this is a refinance loan.

Year
Acquired

Original Cost

Existing Liens

Purpose of Refinance

$

$


III. BORROWER INFORMATION


Borrower

Co-Borrower

*First Middle
 *Last Suffix

First Middle

Last Suffix

Social Sec. No.
(no dashes)

*Home Phone
(no dashes)

Social Sec. No.
(no dashes)

Home Phone
(no dashes)

*Birth Date
YYYYMMDD

*Yrs. of School

Birth Date
YYYYMMDD

Yrs. of School

Marital Status:
Married
Separated
Unmarried (single,
divorced, widowed)

Dependents

No.
Ages

Marital Status:
Married
Separated
Unmarried (single,
divorced, widowed)

Addl. Dependents

No.
Ages



Present Address:

Present Address:

*Address: Address:
*City: City:
*State: *Zip: State: Zip:
Own Rent YrMo Own Rent YrMo
(Check if same as Borrower:

IF AT PRESENT ADDRESS LESS THAN TWO YEARS ...

Former Address:

Former Address:

Street

 Street
City State Zip

City State Zip

Own Rent

YrMo

 Own Rent

YrMo

IV. EMPLOYMENT INFORMATION


Borrower

Co-Borrower

*Employer:

Employer:

Address:

Address:

City:

City:

State:

Zip:

State:

Zip:

Self-employed

Years on this job:
Months:

Self-employed

Years on this job:
Months:

Years in
current profession:

Years in
current profession:

Job Title/Type of Business:

Job Title/Type of Business:

Business Phone: no dashes

Business Phone: no dashes

IF EMPLOYED IN CURRENT POSITION
FOR LESS THAN TWO YEARS...

Previous Employer:

Previous Employer:

Address:

Address:

City:

City:

State:

Zip:

State:

Zip:

Self-employed

From-To: YYYYMMDD

Self-employed

From-To: YYYYMMDD

Monthly Income:

$

Monthly Income:

$

Job Title/Type of Business:

Job Title/Type of Business:

Business Phone: no dashes

Business Phone: no dashes


V. MONTHLY INCOME AND COMBINED HOUSING EXPENSE INFORMATION


Gross
Monthly
Income

Borrower

Co-Borrower

*Base
Income

Overtime

Bonuses

Commissions

Dividends/
Interest

Other

*Self Employed Borrowers(s) may be required
to provide additional documentation such as
tax returns and financial statements.

Combined
Mthly Exp.
(Housing)

Present

Proposed

Rent

First
Mortgage

Other
Financing

Hazard
Insurance

Real Estate
Taxes

Mortgage
Insurance

HOA Dues

Other

VI. ASSETS AND LIABILITIES


ASSETS

Cash deposit held by:
(for purchase only)

Amount:


$

Checking/Savings Accounts

Bank/S&L/Credit Union:

 Address:

City:

State: Zip:
A/C No.:
Balance: $

Bank/S&L/Credit Union:

 Address:

City:

State: Zip:
A/C No.:
Balance: $

Bank/S&L/Credit Union:

 Address:

City:

State Zip:
A/C No.:
Balance: $

Bank/S&L/Credit Union:

 Address:

City:

State: Zip:
A/C No.:
Balance: $

Bank/S&L/Credit Union:

 Address:

City:

State: Zip:
A/C No.:
Balance: $

Stocks and Bonds:
Company/No. shares/Amount:
$

Company/No. shares/Amount:
$

Company/No. shares/Amount:
$

Vested Interest in
Retirement Fund:$

Automobiles:
Make/Model:
Year: Value:$
Make/Model:
Year: Value:$
Make/Model:
Year: Value:$

Other Assets: (e.g. Furniture,
Jewelry,Household Goods, etc.)

Description/Value:
$
$
$
$

Liabilities

Enter only if this is a refinance loan
First mortgage on subject property:
Name:
Address:
City:
State: Zip:
Loan Number:
Monthly pmt.: $ Balance: $
Second mortgage on subject property (if any):
Name:
Address:
City:
State: Zip:
Loan Number:
Monthly pmt.: $ Balance: $

Alimony/Child Support
Separate Maintenance: $

Estimate of other monthly liabilities on credit report:
(Include credit card debt, auto loans, student loans,
installment loans and other creditors which you pay on
monthy. We will obtain details from your credit report.

Total Monthly pmts. $Total Balances $

Schedule of Real Estate Owned

Street Address

City, State, Zip

 Sold
Pending Sale
Rental Prop.

Market Value

Total Liens

Rental Income

Mortgage
Payment

Taxes
Insurance


Sold
Pending Sale
Rental Prop.







Sold
Pending Sale
Rental Prop.






VIII. DECLARATIONS


Items

Borrower

Co-Borrower

a. Are there any outstanding judgments against you?

Yes No

Yes No

b. Have you been declared bankrupt within the last 7 years?

Yes No

Yes No

c. Have you had property foreclosed upon in the last 7 years?

Yes No

Yes No

d. Are you a party to a lawsuit?

Yes No

Yes No

e. Have you directly or indirectly been obligated on any loan which resulted in
foreclosure, transfer of title in lieu of foreclosure, or judgment?

Yes No

Yes No

f. Are you presently delinquent or in default on any Federal debt
or any other loan, mortgage, financial obligation, bond or loan guarantee?

Yes No

Yes No

g. Are you obligated to pay alimony child support or separate maintenance?

Yes No

Yes No

h. Is any part of the down payment borrowed?

Yes No

Yes No

i. Are you the co-maker or endorser on a note?

Yes No

Yes No

j. Are you a U.S. citizen?

Yes No

Yes No

l. Do you intend to occupy the property as your primary residence?

Yes No

Yes No

m. Have you had an ownership interest in a property in the last 3 years?

Yes No

Yes No

If the answer to m above is "yes":

1. What type of property did you own?

Principal residence
Second home
Investment Property

Principal residence
Second home
Investment Property

2. How did you hold title to the home?

Solely by yourself
Jointly with spouse
Jointly with another person

Solely by yourself
Jointly with spouse
Jointly with another person



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 herein; (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) any owner or servicer of the Loan may verify or reverify any information contained in the application from any source named in this application, and Lender, its successors or assigns may retain the original and/or an electronic record of this application, even if the Loan is not 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 facsimile 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.


*Borrower's Acknowledgment Co-Borrowers Acknowledgment

X. INFORMATION FOR GOVERNMENT MONITORING PURPOSES

This information is optional.

Borrower

Co-Borrower

I do not wish to furnish this information

I do not wish to furnish this information

Ethnicity:
Hispanic or Latino
Not Hispanic or Latino

Ethnicity:
Hispanic or Latino
Not Hispanic or Latino

Race/National Origin:
American Indian/Alaskan Native
Native Hawaiian or Other Pacific Islander
Asian White Black or African American

Sex: Female Male

Race/National Origin:
American Indian/Alaskan Native
Native Hawaiian or Other Pacific Islander
Asian White Black or African American

Sex: Female Male

Additional information you require may be typed in the space provided below to assist us in processing your loan request (preferred loan programs, special requirements regarding your purchase, refinance, pre-qualification; your credit scores, etc.):



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