* INDICATES REQUIRED FIELD 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 SUBMIT
