| VI. ASSESTS AND
LIABIILTES (cont.) |
Schedule of Real Estate Owned (if
additional properties are owned, use continuation sheet.)
|
| Property Address (enter S if
sold, PS if pending sale or R if rental being held for income) |
Type of Property |
Present Market Value |
Amount of Mortgage & Liens |
Gross Rental Income |
Mortgage Payments |
Insurance, Maintenance, Taxes
& Misc . |
Net Rental Income |
| . |
. |
. |
$ |
$ |
$ |
$ |
$ |
$ |
| . |
. |
. |
$ |
$ |
$ |
$ |
$ |
$ |
| . |
. |
. |
$ |
$ |
$ |
$ |
$ |
$ |
| . |
Totals |
$ |
$ |
$ |
$ |
$ |
$ |
List any additional names under which credit has
previously been received and indicate appropriate creditor name(s) and
account number(s):
| Alternate Name |
Creditor Name |
Account Number |
|
|
|
|
|
|
| VII. DETAILS
OF TRANSACTION |
VIII. DECLARATIONS |
| a. Purchase Price |
$ |
If you answer "yes" to any questions a
through i, please use continuation sheet for explanation. |
Borrower |
Co-Borrower |
| b. Alterations, improvements, repairs |
$ |
. |
Yes |
No |
Yes |
No |
| c. Land (if acquired separately) |
$ |
a. Are there any outstanding judgments against
you? |
 |
|
|
|
| d. Refinance (incl. debts to be paid off) |
$ |
b. Have you been declared bankruptcy within
the past 7 years? |
|
|
|
|
| e. Estimated prepaid items |
$ |
c. Have you had property foreclosed upon
or given title or deed in lieu thereof in the last 7 years? |
|
|
|
|
| f. Estimated closing costs |
$ |
d. Are you a party to a lawsuit? |
|
|
|
|
| g. PMI, MIP, Funding Fee |
$ |
e. Have you directly or indirectly been obligated
on any loan which resulted in foreclosure, transfer of title in lieu of
foreclosure, or judgment? (This would include such loans as home mortgage
loans, SBA loans, home improvement loans, educational loans, manufactured
(mobile) home loans, any mortgage, financial obligation, bond, or loan
guarantee. If "Yes," provide details, including date, name and address
of Lender, FHA or VA case number, if any, and reasons for the action .) |
|
|
|
|
| h. Discount (if Borrower will pay) |
$ |
f. Are you presently delinquent or in default
on any federal debt or any other loan, mortgage, financial obligation bond,
or loan guarantee? If "Yes," give details as described in the preceding
question. |
|
|
|
|
| i. Total costs (add items a through h) |
$ |
g. Are you obligated to pay alimony, child
support, or separate maintenance? |
|
|
|
|
| j. Subordinate financing |
$ |
h. Is any part of the down payment borrowed? |
|
|
|
|
| k. Borrower's closing costs paid by seller |
$ |
i. Are you a co-maker or endorser on a note?
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|
|
|
|
| l. Other Credits (explain)
-
- |
$ |
j. Are you a U.S. citizen? |
|
|
|
|
| m. Loan amount (exclude PMI, MIP, Funding Fee financed
) |
$ |
k. Are you a permanent resident alien? |
|
|
|
|
| n. PMI, MIP, Funding Fee financed |
$ |
l. Do you intend to occupy the property as
your primary residence?
If "Yes," complete question m below |
|
|
|
|
| o. Loan amount (add m & n) |
$ |
m. Have you had an ownership interest in
a property in the last 3 years? |
|
|
|
|
| p. Cash from/to Borrower (subtract j, k, l & o from
i) |
$ |
(1) What type of property did you own-principal
residence (PR), second home (SH), or investment property (IP)? |
______ |
______ |
| |
|
(2) How did you hold title to the home? Soley
by yourself (S), jointly with your spouse (SP), or jointly with another
person (O)? |
______ |
______ |
| IX. ACKNOWLEDGMENT
AND AGREEMENT |
| The undersigned specifically acknowledge(s)
and agree(s) that: (1) the loan requested by this application will be secured
by a first mortgage or deed of trust on the property described herein;
(2) the property will not be used for any illegal or prohibited purpose
or use; (3) all statements made in this application are made for the purpose
of obtaining the loan indicated herein; (4) occupation of the property
will be as indicated above; (5) verification or reverification of any information
contained in the application may be made at any time by the Lender, its
agents, successors and assigns, either directly or through a credit reporting
agency, from any source named in this application, and the original copy
of this application will be retained by the Lender, even if the loan is
not approved; (6) the Lender, its agents, successors and assigns will rely
on the information contained in the application and I/we have a continuing
obligation to amend and/or supplement the information provided in this
application if any of the material facts which I/we have represented herein
should change prior to closing; (7) in the event my/our payments on the
loan indicated in this application become delinquent, the Lender, its agents,
successors and assigns, may in addition to all their other rights and remedies,
report my/our name(s) and account information to a credit reporting agency;
(8) be transferred to an agent, successor or assign of the Lender with
prior notice to me; (9) the Lender, its agents, successors and assigns
make no representation or warranties, express or implied, to the Borrower(s)
regarding the property, the condition of the property, or the value of
the property.
Certification: I/We certify that the information
provide in this application is true and correct as of the date set forth
opposite my/our signature(s) on this application and acknowledge my/our
understanding that any intentional or negligent misrepresentation(s) of
the information contained in this application may result in civil liability
and/or criminal penalties including, but not limited to, fine or imprisonment
or both under the provisions of Title 18, United States Code, Section 1001,
et seq. and liability for monetary damages to the Lender, its agents, successors
and assigns, insurers and any other person may suffer any loss due to reliance
upon any misrepresentation which I/we have made on this application. |
| Borrower's Signature
X |
Date |
Co-Borrower's Signature
X |
Date |
| X. INFORMATION
FOR GOVERNMENT MONITORING PURPOSES |
| The following information is requested by
the Federal Government for certain types of loans related 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 regulations this Lender is required to note race
and sex on the basis of visual observation or surname. If you do not wish
to furnish the above information, please check the box below. Lender must
review the above material to assure that the disclosure satisfy all requirements
to which the Lender is subject under applicable state law for the particular
type of loan applied for. |
| BORROWER |
CO-BORROWER |
Race/National
Origin: |
I do not wish to furnish this information
American Indian or Alaskan Native
Asian or Pacific Islander
Black, not of Hispanic origin
Hispanic
White, not of Hispanic origin
Other (specify) _________________ |
Race/National
Origin: |
I do not wish to furnish this information
American Indian or Alaskan Native
Asian or Pacific Islander
Black, not of Hispanic origin
Hispanic
White, not of Hispanic origin
Other (specify) _________________ |
| Sex: |
Female Male |
Sex: |
Female Male |
To be Completed by Interviewer
This application was taken by:
face-to-face interview
by mail
by telephone |
Interviewer's Name (print or
type)
__________________________________________
Interviewer's Signature / Date
__________________________________________
Interviewer's Phone Number (incl. area code)
__________________________________________ |
Name and Address Interviewer's Employer |
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