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Residential Loan Application
Purpose of Loan
Please Select
*
Purchase
Refinance
Construction
Other: Please explain purpose of loan
Please complete these items if this is a refinance loan.
Year Accquired
Originial Cost
Amount Existing Liens
Describe Improvements
Do you have a second mortgage?
Yes
No
Balance due:
Reason for the Refianance
Lower Payment
Cash Out/ Consolidate Debt
Home Improvements
Other
If other, please explain:
Borrower Information
Borrower's Name (include Jr. or Sr. if applicable)
*
Home Phone
*
DOB (mm/dd/yy)
*
Yrs. School
Married
Separated
Unmarried (include single - divorced - widowed)
Dependents (not listed by Co-Borrower) No. & Ages
Present Address (street, city, state, zip)
Own
Rent
Mail Address, if different from Present Address
Have you lived at your present address for less than 2 years?
Yes
No
If residing at present address for less than 2 years, complete the following:
Former Address (street, city, state, zip)
Own
Rent
Employment Information
Name and Address of Employer
Self Employed
Years employed in this line of work/profession.
Position/Title/Type of Business
Business Phone (include area code)
How long have you been in this position/job?
< 2 Years
2 - 5 years
> 5 years
If employed in current position for less than two years, complete the following:
Self Employed
Name and Address of Employer
Dates (from - to)
Monthly Income
Position/Title/Type of Business
Business Phone
Do you have another postion/job?
Yes
No
Name and Address of Employer
Self Employed
Monthly Income
Dates (from - to)
Position/Title/Type of Business
Business Phone
Do you have any other income you would like to include?
Yes
No
If yes, please explain
Is there a Co-Borrower for this loan?
Yes
No
Co-Borrower Information
Co-Borrower's Name (include Jr. or Sr. if applicable)
Home Phone
DOB (mm/dd/yy)
Yrs. School
Married
Separated
Unmarried (include single - divorced - widowed)
Dependents (not listed by Borrower) No. & Ages
Present Address (street, city, state, zip)
Own
Rent
Number of Years?
Mailing Address, if different from Present Address
Mailing Address
If residing at present address for less than 2 year, complete the following:
Former Address (street, city, state, zip)
Own
Rent
Co-Borrower Employment Information
Name and Address of Employer
Self Employed
Years on this job
Years employed in this line of work/profession.
Position/Title/Type of Business
Business Phone (include area code)
If employed in current position for less than two years, or if currently employed n more than one position, complete the following:
Name and Address of Employer
Self Employed
Dates (from - to)
Monthly Income
Position/Title/Type of Business
Business Phone
Name and Address of Employer
Self Employed
Dates (from - to)
Monthly Income
Position/Title/Type of Business
Business Phone
Monthly Income
Please gather your information concerning your
Gross Monthly Income
.
Notice:
Alimony, child support or separate maintenance income need to not be revealed if the Borrower (B) or Co-Borrower(C) does not choose to have it considered for repaying this loan.
Borrower Base Empl. Income
Borrower Overtime
Borrower Bonuses
Borrower Commissions
Borrower Dividends/Interest
Borrower Net Rental Income
Borrower - Other Income
Co-Borrower Base Empl. Income
Co-Borrower Overtime
Co-Borrower Bonuses
Co-Borrower Commissions
Co-Borrower Dividends/Interest
Co-Borrower Net Rental Income
Co-Borrower - Other Income
Assets
Description
Cash or Market Value
Asset
Cash or Market Value
Cash deposit toward purchase held by:
Name and Address of Bank, S&L, or Credit Union
Account Number
$ Value
Name and Address of Bank, S&L, or Credit Union
Account No.
$ Value
Name and Address of Bank, S&L, or Credit Union
Account No.
$ Value
Do you have additional Real Estate?
Yes
No
Schedule of Real Estate Owned
