BORROWER'S NAME *

FIRST

LAST

CO-BORROWER'S NAME

FIRST

LAST

Property Information and Purpose of the Loan

LOAN AMOUNT BEING REQUESTED *

PRESENT MARKET VALUE

AMOUNT OF MORTGAGES & LIENS

GROSS RENTAL INCOME

MORTGAGE PAYMENTS

INSURANCE, MAINTENANCE, TAXES & MISC.

SUBJECT PROPERTY ADDRESS *

LINE 1

LINE 2

City

State

Zip Code

Country

NUMBER OF UNITS

PURPOSE OF THE LOAN PURPOSE OF THE LOAN Purchase Refinance Refinance (Cash-Out) Construction Construction-Permanent

SUBJECT PROPERTY WILL BE: SUBJECT PROPERTY WILL BE: Primary Residence Secondary Residence Investment

TITLE WILL BE HELD IN WHAT NAME(S)

MANNER IN WHICH TITLE WILL BE HELD

SOURCE OF DOWN PAYMENT, SETTLEMENT CHARGES AND/OR SUBORDINATE FINANCING (EXPLAIN)

Refinance Loans

Only complete this section if you are refinancing

YEAR ACQUIRED

ORIGINAL COST OF THE PROPERTY

AMOUNT EXISTING LIENS

Borrower's Information

BORROWER'S NAME (INCLUDE JR. OR SR. IF APPLICABLE)

First

Last

EMAIL *

PHONE NUMBER (INCLUDE AREA CODE) *

SOCIAL SECURITY NUMBER *

DATE OF BIRTH *

PRESENT ADDRESS *

LINE 1

LINE 2

City

State

Zip Code

Country

YEARS AT THIS ADDRESS

**IF LESS THAN 2 YEARS, PLEASE PROVIDE PREVIOUS ADDRESS

LINE 1

LINE 2

City

State

Zip Code

Country

MARITAL STATUS * MARITAL STATUS * Married (includes registered domestic partners) Unmarried (includes single, divorced, widowed) Separated

Co-Borrower's Information

Only fill out if applicable

CO-BORROWER'S NAME (INCLUDE JR. OR SR. IF APPLICABLE)

First

Last

EMAIL

PHONE NUMBER (INCL. AREA CODE)

SOCIAL SECURITY NUMBER

DATE OF BIRTH

PRESENT ADDRESS

LINE 1

LINE 2

City

State

Zip Code

Country

YEARS AT THIS ADDRESS

**IF LESS THAN 2 YEARS, PLEASE PROVIDE PREVIOUS ADDRESS

LINE 1

LINE 2

City

State

Zip Code

Country

MARITAL STATUS MARITAL STATUS Married (includes registered domestic partners) Unmarried (includes single, divorced, widowed) Separated

Information About Other Properties Owned

Please skip this section do you DO NOT own any other properties

HOW MANY OTHER PROPERTIES DO YOU OWN?

Property #1 (if applicable)

TYPE OF PROPERTY TYPE OF PROPERTY Primary Residence Secondary Residence Investment Property

AMOUNT PAID MONTHLY (INCLUDE TAXES + INSURANCE)

IS THERE A MORTGAGE ON THIS PROPERTY? IS THERE A MORTGAGE ON THIS PROPERTY? Yes No

NAME OF LENDER

ADDRESS OF PROPERTY #1

Line 1

Line 2

City

State

Zip Code

Country

Property #2 (if applicable)

TYPE OF PROPERTY TYPE OF PROPERTY Primary Residence Secondary Residence Investment Property

AMOUNT PAID MONTHLY (INCLUDE TAXES + INSURANCE)

IS THERE A MORTGAGE ON THIS PROPERTY? IS THERE A MORTGAGE ON THIS PROPERTY? Yes No

NAME OF LENDER

ADDRESS OF PROPERTY #2

Line 1

Line 2

City

State

Zip Code

Country

Property #3(if applicable)

TYPE OF PROPERTY TYPE OF PROPERTY Primary Residence Secondary Residence Investment Property

AMOUNT PAID MONTHLY (INCLUDE TAXES + INSURANCE)

TYPE OF PROPERTY TYPE OF PROPERTY Yes No

NAME OF LENDER

ADDRESS OF PROPERTY #3

Line 1

Line 2

City

State

Zip Code

Country

Property #4(if applicable)

TYPE OF PROPERTY TYPE OF PROPERTY Primary Residence Secondary Residence Investment Property

AMOUNT PAID MONTHLY (INCLUDE TAXES + INSURANCE)

IS THERE A MORTGAGE ON THIS PROPERTY? IS THERE A MORTGAGE ON THIS PROPERTY? Primary Residence Secondary Residence Investment Property

NAME OF LENDER

ADDRESS OF PROPERTY #4

Line 1

Line 2

City

State

Zip Code

Country

Property #5(if applicable)

TYPE OF PROPERTY TYPE OF PROPERTY Primary Residence Secondary Residence Investment Property

AMOUNT PAID MONTHLY (INCLUDE TAXES + INSURANCE)

IS THERE A MORTGAGE ON THIS PROPERTY? IS THERE A MORTGAGE ON THIS PROPERTY? Yes No

NAME OF LENDER

ADDRESS OF PROPERTY #5

Line 1

Line 2

City

State

Zip Code

Country

Assets

NAME AND ADDRESS OF BANK, S&L, OR CREDIT UNION #1

CURRENT BALANCE #1

NAME AND ADDRESS OF BANK, S&L, OR CREDIT UNION #2

CURRENT BALANCE #2

NAME AND ADDRESS OF BANK, S&L, OR CREDIT UNION #3

CURRENT BALANCE #3

NAME AND ADDRESS OF BANK, S&L, OR CREDIT UNION #4

CURRENT BALANCE #4

Declarations

ARE THERE ANY OUTSTANDING JUDGMENTS AGAINST YOU? ARE THERE ANY OUTSTANDING JUDGMENTS AGAINST YOU? Yes No

HAVE YOU BEEN DECLARED BANKRUPT WITHIN THE PAST 7 YEARS? HAVE YOU BEEN DECLARED BANKRUPT WITHIN THE PAST 7 YEARS? Yes No

ARE YOU A PARTY TO A LAWSUIT? ARE YOU A PARTY TO A LAWSUIT? Yes No

HAVE YOU HAD PROPERTY FORECLOSED UPON OR GIVEN TITLE OR DEED IN LIEU THEREOF IN THE LAST 7 YEARS? HAVE YOU HAD PROPERTY FORECLOSED UPON OR GIVEN TITLE OR DEED IN LIEU THEREOF IN THE LAST 7 YEARS? Yes No

HAVE YOU DIRECTLY OR INDIRECTLY BEEN OBLIGATED ON ANY LOAN WHICH RESULTED IN FORECLOSURE, TRANSFER OF TITLE IN LIEU OF FORECLOSURE, OR JUDGMENT? 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

ARE YOU PRESENTLY DELINQUENT OR IN DEFAULT ON ANY FEDERAL DEBT OR ANY OTHER LOAN, MORTGAGE, FINANCIAL OBLIGATION, BOND, OR LOAN GUARANTEE? ARE YOU PRESENTLY DELINQUENT OR IN DEFAULT ON ANY FEDERAL DEBT OR ANY OTHER LOAN, MORTGAGE, FINANCIAL OBLIGATION, BOND, OR LOAN GUARANTEE? Yes No

ARE YOU OBLIGATED TO PAY ALIMONY, CHILD SUPPORT, OR SEPARATE MAINTENANCE? ARE YOU OBLIGATED TO PAY ALIMONY, CHILD SUPPORT, OR SEPARATE MAINTENANCE? Yes No

IS ANY PART OF THE DOWN PAYMENT BORROWED? IS ANY PART OF THE DOWN PAYMENT BORROWED? Yes No

ARE YOU A CO-MAKER OR ENDORSER ON A NOTE? ARE YOU A CO-MAKER OR ENDORSER ON A NOTE? Yes No

ARE YOU A U. S. CITIZEN? ARE YOU A U. S. CITIZEN? Yes No

ARE YOU A PERMANENT RESIDENT ALIEN? ARE YOU A PERMANENT RESIDENT ALIEN? Yes No

DO YOU INTEND TO OCCUPY THE PROPERTY AS YOUR PRIMARY RESIDENCE? DO YOU INTEND TO OCCUPY THE PROPERTY AS YOUR PRIMARY RESIDENCE? Yes No

HAVE YOU HAD AN OWNERSHIP INTEREST IN A PROPERTY IN THE LAST THREE YEARS? HAVE YOU HAD AN OWNERSHIP INTEREST IN A PROPERTY IN THE LAST THREE YEARS? Yes No

WHAT TYPE OF PROPERTY DID YOU OWN? WHAT TYPE OF PROPERTY DID YOU OWN? Principal Residence (PR) Second Home (SH) Investment Property (IP)

HOW DID YOU HOLD TITLE TO THE HOME? HOW DID YOU HOLD TITLE TO THE HOME? Solely by yourself (S) Jointly with your spouse (SP) Jointly with another person (O)

Demographic Information

Borrower

ETHNICITY ETHNICITY Hispanic or Latino Not Hispanic or Latino

RACE RACE American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White

SEX SEX Male Female

Co-Borrower

ETHNICITY ETHNICITY Hispanic or Latino Not Hispanic or Latino

RACE RACE American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White

SEX SEX Male Female

Sign and Date

BORROWER'S SIGNATURE

DATE

CO-BORROWER'S SIGNATURE

DATE