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This is our Full 1003 Mortgage Application

(Uniform Residential Loan Application):
This Application will take about 15 to 20 Minutes to complete.
At the End you can hit the submit button and the completed application will be sent to us.

I. TYPE OF MORTGAGE AND TERMS OF LOAN :
This application is designed to be completed by the applicant(s) with the lender's assistance. 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 or assets of a person other than the "Borrower" (including the Borrower's spouse) will be used as a basis for loan qualification
OR
the income or assets 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.
 
Mortgage Applied For
If Other, Describe
Amount $
Interest Rate %
Number of Months
Amortization Type
If Other, Describe
 

II. PROPERTY INFORMATION AND PURPOSE OF LOAN :
Subject Property Address
(Street, City, State, Zip)
Number of Units
Year Built
Purpose of Loan
Property will be
 
Complete this section if construction or construction-permanent loan.
Year Lot Acquired
Original Cost $
Amount Existing Liens $
(a) Present Value of Lot $
(b) Cost of Improvements $
(c) Total (a + b) $
 
Complete this section if this is a refinance loan.
Year Acquired
Original Cost $
Amount Existing Liens $
Purpose of Refinance
Improvements
Describe Improvements
Cost of Improvements $
 
Title will be held in what name(s)?
Source of Down Payment,
Settlement Changes and/or
Subordinate Financing

III. BORROWER INFORMATION :
BORROWER
 
Name
Social Security Number
Home Phone (incl. Area Code)
Date of Birth (MM/DD/YYYY)
Years of School
Marital Status
Number of Dependents
(not listed by Co-Borrower)
Age of Dependents
(separate by commas)
Present Address
(Street, City, State, Zip)
Number of Years
 
If residing at present address for less than two years, complete the following:
Former Address
(Street, City, State, Zip)
Number of Years
Former Address
(Street, City, State, Zip)
Number of Years
 
CO-BORROWER
 
Name
Social Security Number
Home Phone (incl. Area Code)
Date of Birth (MM/DD/YYYY)
Years of School
Marital Status
Number of Dependents
(not listed by Borrower)
Age of Dependents
(separate by commas)
Present Address
(Street, City, State, Zip)
Number of Years
 
If residing at present address for less than two years, complete the following:
Former Address
(Street, City, State, Zip)
Number of Years
Former Address
(Street, City, State, Zip)
Number of Years

IV. EMPLOYMENT INFORMATION :
BORROWER
 
Self Employed?
Name of Employer
Employer Address
(Street, City, State, Zip)
How Long on This Job
(Date From - Date To) 		(MM/DD/YYYY)
Years in This Line of Work
Position / Title / Type of Business
Business Phone (incl. Area Code)
 
If employed in current position for less than two years or if currently in more than one position, complete the following:
Dates (from - to) (MM/DD/YYYY)
Monthly Income $
Self Employed?
Name of Employer
Employer Address
(Street, City, State, Zip)
Position / Title / Type of Business
Business Phone (incl. Area Code)
 
Dates (from - to) (MM/DD/YYYY)
Monthly Income $
Self Employed?
Name of Employer
Employer Address
(Street, City, State, Zip)
Position / Title / Type of Business
Business Phone (incl. Area Code)
 
CO-BORROWER
 
Self Employed?
Name of Employer
Employer Address
(Street, City, State, Zip)
How Long on This Job
(Date From - Date To) 		(MM/DD/YYYY)
Years in This Line of Work
Position / Title / Type of Business
Business Phone (incl. Area Code)
 
If employed in current position for less than two years or if currently in more than one position, complete the following:
Dates (from - to) (MM/DD/YYYY)
Monthly Income $
Self Employed?
Name of Employer
Employer Address
(Street, City, State, Zip)
Position / Title / Type of Business
Business Phone (incl. Area Code)
 
Dates (from - to) (MM/DD/YYYY)
Monthly Income $
Self Employed?
Name of Employer
Employer Address
(Street, City, State, Zip)
Position / Title / Type of Business
Business Phone (incl. Area Code)

V. MONTHLY INCOME AND COMBINED HOUSING EXPENSE :
Borrower Co-Borrower Total
Base Employment Income $ $ $
Overtime $ $ $
Bonuses $ $ $
Commissions $ $ $
Dividends / Interest $ $ $
Net Rental Income $ $ $
Other (see notice in "describe other income") $ $ $
$ $ $
Total $ $ $
 
Combined Monthly Housing Expense Present Proposed
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
Notice: Alimony, child support, or separate maintenance income need not be revealed if the Borrower or Co-Borrower does not choose to have it considered for repaying this loan.
 

Borrower

 $

Borrower

 $

Borrower

 $

Co-Borrower

 $

Co-Borrower

 $

Co-Borrower

 $

VI. ASSETS AND LIABILITIES :
This statement and any applicable supporting schedules may be completed jointly by both married and unmarried Co-borrowers if their assets and liabilities are sufficiently joined so that the Statement can be meaningfully and fairly presented on a combined basis; otherwise separate Statements and Schedules are required. If the Co-Borrower section was completed about a spouse, this Statement and supporting schedules must be completed about that spouse also.
 
ASSETS Completed:

Cash deposit toward purchase held by

$ 		Cash or Market Value

Cash deposit toward purchase held by

$ 		Cash or Market Value
Name of Bank
 Account Number
$ 		Cash or Market Value
Name of Bank
 Account Number
$ 		Cash or Market Value
Name of Bank
 Account Number
$ 		Cash or Market Value
Name of Bank
 Account Number
$ 		Cash or Market Value
Stocks & Bonds
(Company name / number & description) 		Description
$ 		Cash or Market Value
Stocks & Bonds
(Company name / number & description) 		Description
$ 		Cash or Market Value
Stocks & Bonds
(Company name / number & description) 		Description
$ 		Cash or Market Value
Life insurance net cash value
$ 		Face Amount
$ 		Cash or Market Value
Subtotal Liquid Assets $
Real estate owned (enter market value from schedule of real estate owned) $
Vested interest in retirement fund $
Net worth of business(es) owned $
Automobile owned (make and year) / value $
Automobile owned (make and year) / value $
Automobile owned (make and year) / value $
Other Assets $
Other Assets $
Other Assets $
Total Assets a. $
 
LIABILITIES
 
Liabilities and Pledged Assets. List the creditor's name, address and account number for all outstanding debts, including automobile loans, revolving charge accounts, real estate loans, alimony, child support, stock pledges, etc. Use continuation sheet, if necessary. Indicate by (*) those liabilities which will be satisfied upon sale of real estate owned or upon refinancing of the subject property.
Name of Company
 Acct. No.
$ 		Mo. Payt.
 Mo. Left
$ 		Balance
Name of Company
 Acct. No.
$ 		Mo. Payt.
 Mo. Left
$ 		Balance
Name of Company
 Acct. No.
$ 		Mo. Payt.
 Mo. Left
$ 		Balance
Name of Company
 Acct. No.
$ 		Mo. Payt.
 Mo. Left
$ 		Balance
Name of Company
 Acct. No.
$ 		Mo. Payt.
 Mo. Left
$ 		Balance
Name of Company
 Acct. No.
$ 		Mo. Payt.
 Mo. Left
$ 		Balance
Name of Company
 Acct. No.
$ 		Mo. Payt.
 Mo. Left
$ 		Balance
 
Alimony / Child Support /
Separate Maintenance 		Owed To
$ 		Mo. Payt.
Job Related Expense
(child care, union dues, etc.) 		Owed To
$ 		Mo. Payt.
Job Related Expense
(child care, union dues, etc.) 		Owed To
$ 		Mo. Payt.
Total Monthly Payments $
Total Liabilities b. $
Net Worth (a - b) $
 
SCHEDULE OF REAL ESTATE OWNED
 
Please detail other property you currently own.
Status (S - Sold, PS - Pending Sale, R - Rental Property)
 
Present
Market
Value 		Amount of
Mortgages
& Liens 		Gross
Rental
Income 		Mortgage
Payments 		Insurance,
Maint.,
Taxes
& Misc 		Net Rental
Income
Status / Type of Property

Street

City, State, Zip
$ 
$ 
$ 
$ 
$ 
$ 
 
Status / Type of Property

Street

City, State, Zip
$ 
$ 
$ 
$ 
$ 
$ 
 
Status / Type of Property

Street

City, State, Zip
$ 
$ 
$ 
$ 
$ 
$ 
 
Totals $  $  $  $  $  $ 

VII. DETAILS OF TRANSACTION :
a. Purchase price $
b. Alterations, improvements, repairs $
c. Land (if acquired separately) $
d. Refinance (incl. 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) $
Other Credits (explain) $
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) $

:: VIII. DECLARATIONS ::
Borrower Co-Borrower
a. Are there any outstanding judgments against you?
b. Have you been declared bankrupt within the past 7 years?
c. Have you had property foreclosed upon or given title or deed in lieu thereof 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, 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.
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.
g. Are you obligated to pay alimony, child support, or separate maintenance?
h. Is any part of the down payment borrowed?
i. Are you a 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? If "Yes," complete question m below.
m. Have you had an ownership interest in a property in the last three years?
(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)?

IX. ACKNOWLEDGEMENT AND AGREEMENT :
The undersigned specifically acknowledge(s) and agree(s) that:

(1) the loan requested by this application will be secured by a first mortgage or deed of trust on the property described herein;

(2) the property will not be used for any illegal or prohibited purpose or use;

(3) all statements made in this application are made for the purpose of obtaining the loan indicated herein;

(4) occupation of the property will be as indicated above;

(5) verification or reverification of any information contained in the application may be made at any time by the Lender, its agents, successors and assigns, either directly or through a credit reporting agency, from any source named in this application, and the original copy of this application will be retained by the Lender, even if the loan is not approved;

(6) the Lender, its agents, successors and assigns will rely on the information contained in the application and I/we have a continuing obligation to amend and/or supplement the information provided in this application if any of the material facts which I/we have represented herein should change prior to closing;

(7) in the event my/our payments on the loan indicated in this application become delinquent, the Lender, its agents, successors and assigns, may, in addition to all their other rights and remedies, report my/our name(s) and account information to a credit reporting agency;

(8) ownership of the loan may be transferred to successor or assign of the Lender without notice to me and/or the administration of the loan account may be transferred to an agent, successor or assign of the Lender with prior notice to me;

(9) the Lender, its agents, successors and assigns make no representations or warranties, express or implied, to the Borrower(s) regarding the property, the condition of the property, or the value of the property.

Certification: I/We certify that the information provided in this application is true and correct as of the date set forth opposite my/our signature(s) on this application and acknowledge my/our understanding that any intentional or negligent misrepresentation(s) of the information contained in this application may result in civil liability and/or criminal penalties including, but not limited to, fine or imprisonment or both under the provisions of Title 18, United States Code, Section 1001, et seq. and liability for monetary damages to the Lender, its agents, successors and assigns, insurers and any other person who may suffer any loss due to reliance upon any misrepresentation which I/we have made on this application.

X. INFORMATION FOR GOVERNMENT MONITORING PURPOSES :
The following information is requested by the Federal Government for certain types of loans related to a dwelling, in order to monitor the Lender's compliance with equal credit opportunity, fair housing and home mortgage disclosure laws. You are not required to furnish this information, but are encouraged to do so. The law provides that a Lender may neither discriminate on the basis of this information, nor on whether you choose to furnish it. However, if you choose not to furnish it, under Federal regulations this Lender is required to note race and sex on the basis of visual observation or surname. If you do not wish to furnish the above information, please check the box below. (Lender must review the above material to assure that the disclosure satisfy all requirements to which the Lender is subject under applicable state law for the particular type of loan applied for.)
 
Borrower Race / National Origin:
Borrower Sex
 
Co-Borrower Race / National Origin:
Co-Borrower Sex