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This application is designed to be completed by the applicant(s) with the lender's assistance. Applicants should complete this form as "Borrower" or "Co-Borrower", as applicable. Co-Borrower information must also be provided (and the appropriate box checked) when
the income or assets of a person other than the "Borrower" (including the Borrower's spouse) will be used as a basis for loan qualification or
the income or assets of the Borrower's spouse will not be used as a basis for loan qualification, but his or her liabilities must be considered because the Borrower resides in a community property state, the security property is located in a community property state, or the Borrower is relying on other property located in a community property state as a basis for repayment of the loan.
| I. TYPE OF MORTGAGE AND TERMS OF LOAN | ||||
| Mortgage
V.A.
Conventional Other: Applied for: FHA FmHA |
Agency Case # |
Lender Case # |
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| Amount $ |
Interest Rate % |
No. of Months |
Amortization
Fixed Rate
Other (explain): Type: GPM ARM(type): |
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| II. PROPERTY INFORMATION AND PURPOSE OF LOAN | |||||||
| Subject Property
Address (street , city, state,ZIP) |
No. of Units |
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| Legal Description of
Subject Property (attach description if necessary) |
Year Built | ||||||
| Purpose of Loan
Purchase
Construction
Other (explain): Refinance Construction-Permanent |
Property will be: Primary Residence Secondary Residence Investment |
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| Complete this line if construction or construction-permanent loan. | |||||||
| Year Lot Acquired |
Original Cost $ |
Amount Existing Liens $ |
(a) Present Value of Lot $ |
(b) Cost of Improvements $ |
Total (a+b) $ |
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| Complete this line if this is a refinance loan. | |||||||
| Year Acquired |
Original Cost $ |
Amount Existing Liens $ |
Purpose of Refinance |
Describe Improvements
made to
be made Cost $ |
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| Borrower III. BORROWER INFORMATION ; Co-Borrower | |||||||
| Borrower's Name (include Jr. or
Sr. if applicable) |
Co-Borrower's Name (include Jr. or
Sr. if applicable |
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| Social Security # |
Home Phone (incl. area code) |
Age |
Yrs. School |
Social Security # |
Home Phone (incl. area code) |
Age |
Yrs. School |
| Married Unmarried (include single divorced, widowed) Separated |
Dependents (not listed by Co- Borrower) no. 
ages |
Married Unmarried (include single divorced, widowed) Separated |
Dependents (not listed by Borrower) no.
ages |
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| If residing at present address for less than two years, complete the following: | |||||||
| Previous Address (street, city,
state, ZIP) Own
Rent ____No. Yrs. |
Previous Address (street, city,
state, ZIP) Own
Rent ____No. Yrs. |
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| Previous Address (street, city,
state, ZIP) Own
Rent ____No. Yrs. |
Previous Address (street, city,
state, ZIP) Own
Rent ____No. Yrs.. |
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| Borrower IV. EMPLOYMENT INFORMATION Co-Borrower | |||||||
| Name and
Address of Employer Self Employed |
Yrs. on this job |
Name and
Address of Employer Self Employed |
Yrs. on this job |
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| Yrs. employed in this line of work/profession |
Yrs. employed in this line of work/profession |
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| Position/Title/Type of Business | Business Phone (incl. area code) | Position/Title/Type of Business | Business Phone (incl. area code) | ||||
| If employed in current position for less than two years or if currently employed in more than one position, complete the following: | |||||||
| Name and
Address of Employer Self Employed |
Dates(from-to) |
Name and
Address of Employer Self Employed |
Dates(from-to) |
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| Monthly Income $ |
Monthly Income $ |
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| Position/Title/Type of Business | Business Phone (incl. area code) | Position/Title/Type of Business | Business Phone (incl. area code) | ||||
| Name and
Address of Employer Self Employed |
Dates(from-to) |
Name and
Address of Employer Self Employed |
Dates(from-to) |
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| Monthly Income $ |
Monthly Income $ |
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| Position/Title/Type of Business | Business Phone (incl. area code) | Position/Title/Type of Business | Business Phone (incl. area code) | ||||
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