Section 2. Property Information and Purpose of Loan
Property Address:
Street:
City, State, ZIP:
,
# of Units:
(for Multi-Family)
Residency:
Property will be:
Purpose of Loan is:
If Refinance:
Year Lot Acquired:
Original Cost:
$
Existing Liens:
$
Purpose:
Improvements:
Cost:
$
Description:
These are:
Title:
Names on Title:
Manner:
Section 3a. Borrower Information
First Name:
Middle Name:
Last Name:
Social Security Number:
--
Birth Date:
Age in Years:
Years in School:
Marital Status:
Dependents:
Number: Ages:
eMail Address:
Home Phone Number:
--
Current Address:
# of Years Occupied:
Street Address:
City:
State:
ZIP Code:
Mailing Address: if different
Street Address:
City:
State:
ZIP Code:
Former Address: if Current Address is less than 2 years
Street Address:
City:
State:
ZIP Code:
Section 3b. Co-Borrower Information
First Name:
Middle Name:
Last Name:
Social Security Number:
--
Birth Date:
Age in Years:
Years in School:
Marital Status:
Dependents:
Number:
Ages:
eMail Address:
Home Phone Number:
--
Fax Number:
--
Current Address:
# of Years Occupied:
Street Address:
City:
State:
ZIP Code:
Mailing Address: if different
Street Address:
City:
State:
ZIP Code:
Former Address: if Current Address is less than 2 years
Street Address:
City:
State:
ZIP Code:
Section 4a. Borrower Employment Information
Name of Employer:
Employer Address:
Street Address:
City:
State:
ZIP Code:
Business Phone Number:
--
Years on Job:
Years,
Months
Years in Profession:
If Borrower was on current job less than 2 years, please complete the following:
Former Employer:
Employer Address:
Street Address:
City:
State:
ZIP Code:
Business Phone Number:
--
Years on Job:
Years,
Months
Section 4b. Co-Borrower Employment Information
Name of Employer:
Employer Address:
Street Address:
City:
State:
ZIP Code:
Business Phone Number:
--
Years on Job:
Years,
Months
Years in Profession:
If Co-Borrower was on current job less than 2 years, please complete the following:
Former Employer:
Employer Address:
Street Address:
City:
State:
ZIP Code:
Business Phone Number:
--
Years on Job:
Years,
Months
Section 5. Monthly Income and Expenses
Section 5a. Income
Borrower
Co-Borrower
Combined
Base Income:
$
$
$
Overtime:
$
$
$
Bonus:
$
$
$
Commission:
$
$
$
Dividends/Interest:
$
$
$
Rental Income:
$
$
$
Other:
$
$
$
Totals:
$
$
$
Section 5b. Combined Monthly Housing Expenses
Monthly Cost
Rent:
$
First Mortgage:
$
Other Financing:
$
Hazard Insurance:
$
Taxes:
$
Mortgage Insurance:
$
Association Dues:
$
Other:
$ describe:
Section 6. Assets & 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
Cash Deposits
1.
$
held
by
2.
$
held
by
Bank Holdings
Amount
Bank/Institution Name
Type
Account #
1.
$
2.
$
3.
$
Stocks & Bonds
Market Value
Broker/Description
Value: $
Life Insurance
Face Amount
$
Market Value
$
amount that would be received if
sold today
Automobile(s)
Make/Model/Year
Market Value
1.
$
2.
$
3.
$
Other Assets
Description
Amount
1.
$
2.
$
3.
$
4.
$
Liabilities
Include any outstanding debts with monthly payments (i.e., Credit Cards, Auto Loans, Taxes, Other Mortgages, Home Equity Line, etc.)
Description
Type
Balance
Monthly Payment
Liability:
$
$
Liability:
$
$
Liability:
$
$
Liability:
$
$
Liability:
$
$
Alimony & Child Support
Monthly Amount
Paid to
$
Job-related Expenses
Monthly Amount
Purpose
$
Child care, Union dues, etc.
Schedule of Real Estate Owned
Property Address
Status
Present Market Value
Amount of Mortgage & Liens
Gross Rental Income
Mortgage Payments
Insurance, Maintenance, Taxes & Misc.
Net Rental Income
Section 7. Declarations
Check to indicate a YES answer to the declarations below. If the answer is NO, leave the box blank.
Question
Borrower
Co-Borrower
a.
Are there any outstanding judgments against you?
b.
Have you been bankrupt within the last 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 a loan which resulted in foreclosure, transfer of title in lieu of foreclosure, or judgment?
f.
Are you presently delinquent or in default on any Federal debt or any other loan, mortgage, financial obligation, bond 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 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?
m.
Have you had an ownership interest in a property in the last three years?
