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Property Information
If you have not selected your new home yet, please skip the address information.

Street Address:

City:

Zip:

Number of Units:

Occupancy:

Down Payment Information

Amount

Source of Down Payment

Explanation

Type of Mortgage
If you do not know which type of mortgage is best for you, complete what you can and leave the rest blank.

Sales Price:

Desired Loan Amount:

Number of Years:

Loan Type:
How many years do you plan to own this property?:
Will anything significantly change in your financial situation over the next few years (tuition, inheritance, business needs, etc.)?:

If yes to above, please describe:

Personal Information

Borrower

Co-Borrower

First Name:

First Name:

MI:

MI:
Last Name: Last Name:
Email: Email:
Generation: Generation:
Birth (mm/dd/yyyy): Birth (mm/dd/yyyy):
Home Phone: Home Phone:
Work Phone: Work Phone:
Cell Phone: Cell Phone:
Home Fax: Home Fax:

Residency - (2 Year History Needed)

Borrower

Co-Borrower
Street Address:

Street Address:
City:   City:
State:   State:

Zip:

   Zip:   Same as Borrower

Previous Address

Borrower

Co-Borrower
Street Address:

Street Address:
City:   City:
State:   State:

Zip:

   Zip:   Same as Borrower
From Date:   From Date:
To Date:   To Date:

Employment - (2 Year History Needed)

Borrower

Co-Borrower
Self Employed:   Self Employed:
Employer:   Employer:
Street Address:

Street Address:
City:   City:
State:   State:

Zip:

   Zip:
Phone: ext.   Phone: ext.
Fax:   Fax:
From Date:   From Date:

Previous / Part-Time Employment

Borrower

Co-Borrower
Self Employed: Self Employed:
Employer:   Employer:
From Date:   From Date:
To Date:   To Date:

Monthly Income

Borrower

Co-Borrower
Base Income: Base Income:
Overtime:   Overtime:
Bonuses:   Bonuses:
Commissions:   Commissions:
Dividends/Interest:   Dividends/Interest:
Other:   Other:
Net Rental:   Net Rental:
Total:   Total:

Residential Properties Owned

Borrower

Co-Borrower
Number of Properties: Number of Properties:

Description of Other Income

Borrower

Co-Borrower

Description

Amount

Description

Amount

Existing Monthly Housing Expense

Borrower

Co-Borrower
Rent: Rent:
First Mortgage (P&I):   First Mortgage (P&I):
Other Financing (P&I):   Other Financing (P&I):
Hazard Insurance:   Hazard Insurance:
Real Estate Taxes:   Real Estate Taxes:
Mortgage Insurance:   Mortgage Insurance:
Homeowner Assn. Dues   Homeowner Assn. Dues:
Other:   Other:
Total:   Total:
Please check this box if you want to pay your property taxes and homeowners insurance separately from your mortgage.

Assets

Borrower

Co-Borrower

Assets

Cash Value

Assets

Cash Value

Liabilities

Borrower

Co-Borrower

Type

Payment

Type

Payment

Declarations
Please check the appropriate box if yes or true.

 

  

B

CB

a.

 Are there any outstanding judgments against you?
b. Have you declared bankruptcy within the last 7 years?
c. Have you had property foreclosed upon 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, deed in lieu or judgment?
f. Are you presently delinquent or in default on any federal debt, obligation 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 the 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 your primary residence?
m. Have you had an ownership interest in a property in the last 3 years?

Realtor Information
Please provide the following information.
Are currently working with a realtor?  Yes  No

Realtor Name:

Phone:
If you are not currently working with a realtor, would you like me to refer you to one?  Yes  No

Additional Comments