Online Mortgage Application

* Indicates Required Fields
What Kind of Loan Are You Looking For?
Type of Loan  
Residence Type:
Property Type:
Number of Units:
Type of loan desired?
Sales Price or Home-Value if Refi:
Estimated Loan Amount ($) *:
   
 
Please Tell Us About Yourself
Applicant Name *, Middle In.

Applicant Last Name *

Home Phone *
( ) -
Work Phone
( ) -
 		 Social Sec. Number:
- -
Birth Date:
 Years of Schooling

Email *
     
Co-Applicant Name, Middle In.

Co-Applicant Last Name

Home Phone
( ) -
Work Phone
( ) -
 		 Social Sec. Number:
- -
Birth Date:
 Years of Schooling

Email
     
Current Address

City

 		 State

Zip
- 		Length of time at address
 Years    Months
Mailing Address (Same Address as above )
Address

City

 		 State

Zip
-
 		  
     
Employment Information

1.		 Applicant Employer

Position
 Years on Job

Years in same field
 Monthly Income ($)

2.		 Co-Applicant Employer

Position

 		 Years on Job

Years in same field
 Monthly Income ($)
3. Other Income Applicant
 Monthly Income ($)
  
4. Other Income Co-Applicant
 Monthly Income ($)
  
       
Total Gross Monthly Income ($):  
     
Your Assets
1. Cash Deposit (Account Type)
 Amount ($)
  
2.  
       
1. Checking and Savings Accounts
Financial Institution
 Amount ($)
 Account Number
2. Financial Institution
 Amount ($)
 Account Number
       
1. Stocks & Bonds (Description)
 Amount ($)
  
2.  
3.  
       
1. Life Insurance
 Face Amount ($)
  
       
1. Automobile Type
 Est. Value ($)
  
2.  
3.  
       
1. Other Assets (Description)
 Amount ($)
  
2.  
3.  
4.  
       
Please Describe Your Housing Expenses
  Monthly Pmt ($)   Monthly Pmt ($)
1st Mortgage 2nd Mortgage
Property Taxes Home Owners Ins.
Mortgage Insurance    
Total Current Housing Expenses:
       
Aprx. 1stMtg Balance ($): Aprx. 2ndMtg Balance ($):
Max Line of Credit ($): Aprx. Home Value ($):
Home is to be:    
       
Please list your Monthly Debts
  Type of Liability
 		 Account Number
 		 Cur. Bal. ($)
 		 Monthly Pmt. ($)
1.
2.
3.
4.
5.
 
Borrower Declarations
1. Are there any judgments against you? Yes No
2. Have you declared bankruptcy in the past 7 years? Yes No
3. Have you had a property foreclosed upon or given a deed in lieu of foreclosure in the past 7 years? Yes No
4. Are you party to a lawsuit? Yes No
5. Have you directly or indirectly been obligated on any loan which resulted in foreclosure, transfer of title in lieu or foreclosure of judgment ?
(This would include such loans as home mortgage loans, SBA loans, home improvement loans, educational loans, manufactured (mobile) home loans, any mortgages, financial obligation, bond, or loan guarantees.)		 Yes No
6. Are you presently delinquent on any Federal debt or any other loan, mortgage, financial obligation, bond, or loan guarantee? Yes No
7. Are you obligated to pay alimony, child support, or separate maintenance? Yes No
8. Is or will any part of the down payment borrowed? Yes No
9. Are you a co-maker or endorser on any other person's obligation (s)?
(This question does not apply to your spouse if he/she is to be a co-borrower on the subject transaction)		 Yes No
10. Do you intend to occupy this subject property as your primary residence? Yes No
11.If yes, have you had an ownership interest in a property in the past 3 years? Yes No
12.If yes, what type or property did you own?
13. How is the title held on your previous property?
14. What is your citizenship?
Borrower Government Monitoring
The following information is requested by the Federal Government for certain types of loans relating 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 Regulation, this Lender is required to note race and sex based on visual observation or surname.
Do you wish to provide information regarding your race, national origin, or sex?
What is your sex?
What is your National Origin?
Co-Borrower Declarations
1. Are there any judgments against you? Yes No
2. Have you declared bankruptcy in the past 7 years? Yes No
3. Have you had a property foreclosed upon or given a deed in lieu of foreclosure in the past 7 years? Yes No
4. Are you party to a lawsuit? Yes No
5. Have you directly or indirectly been obligated on any loan which resulted in foreclosure, transfer of title in lieu or foreclosure of judgment ?
(This would include such loans as home mortgage loans, SBA loans, home improvement loans, educational loans, manufactured (mobile) home loans, any mortgages, financial obligation, bond, or loan guarantees.)		 Yes No
6. Are you presently delinquent on any Federal debt or any other loan, mortgage, financial obligation, bond, or loan guarantee? Yes No
7. Are you obligated to pay alimony, child support, or separate maintenance? Yes No
8. Is or will any part of the down payment borrowed? Yes No
9. Are you a co-maker or endorser on any other person's obligation(s)?
(This question does not apply to your spouse if he/she is to be a co-borrower on the subject transaction)		 Yes No
10. Do you intend to occupy this subject property as your primary residence? Yes No
11.If yes, have you had an ownership interest in a property in the past 3 years? Yes No
12.If yes, what type or property did you own?
13. How is the title held on your previous property?
14. What is your citizenship?
Co-Borrower Government Monitoring
The following information is requested by the Federal Government for certain types of loans relating 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 Regulation, this Lender is required to note race and sex based on visual observation or surname.
Do you wish to provide information regarding your race, national origin, or sex?
What is your sex?
What is your National Origin?
If Other, Please specify?
If Other, Please specify?

 
 
Projected date of closing & Comments
Projected date of closing  
would be: