V.
MONTHLY INCOME AND COMBINED HOUSING EXPENSE INFORMATION
Gross Monthly Income
Borrower
Co-Borrower
Total
Combined
Monthly Housing Expense
Present
Proposed
Base Empl. Income*
$
$
$
Rent
$
$
Overtime
$
$
$
First Mortgage (P&I)
$
$
Bonuses
$
$
$
Other Financing (P&I)
$
$
Commissions
$
$
$
Hazard Insurance
$
$
Dividends/Interest
$
$
$
Real Estate Taxes
$
$
Net Rental Income
$
$
$
Mortgage Insurance
$
$
Other (see Þ below)
$
$
$
Homeowner Assn. Dues
$
$
$
$
$
Other:
$
$
Total
$
$
$
Total
$
$
*Self Employed Borrower(s) may be required to provide
additional documentation such as tax returns and financial statements.
Þ Describe Other Income Notice: Alimony, child support, or
separate maintenance income need not be revealed if the Borrower(B) or
Co- Borrower(C) does not choose to have it considered for repaying this
loan.
B/C
.
Monthly Amount
.
.
$
.
.
$
VI.
ASSETS AND 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.
Completed
Jointly Not Jointly
ASSETS
Cash or Market
Value
Liabilites and Pledged Assets.
List the creditor's name, address and account number for all
outstanding debts, including automobile loans, revolving charge
accounts, real estate loans, alimony, child support, stock pledges,
etc. Use continuation sheet, if necessary. Indicate by (*) those
liabilities which will be satisfied upon sale of real estate owned
or upon refinancing of the subject property.
Cash deposit toward purchase held by:
$
LIABILITES
Monthly Pmt. &
Mos. Left to Pay
Unpaid
Balance
List checking and savings
accounts below
Name & Address of Bank, S&L,
or Credit Union
Name & Address of Company
$ Pat/Mos.
:
$
-
Acct. no.
$
Acct. no.
Name & Address of Bank, S&L,
or Credit Union
:
Name & Address of Company
$ Payt./Mos.
:
$
-
Acct. no.
$
Acct. no.
Name & Address of Bank, S&L,
or Credit Union
Name & Address of Company
$ Payt./Mos.
$
Acct. no.
$
Acct. no.
Name & Address of Bank, S&L,
or Credit Union
Name & Address of Company
$ Payt./Mos.
$
-
Acct. no.
$
Acct. no.
Stocks & Bonds(Company name/
number & description)
$
Name & Address of
Company
$ Payt./Mos.
$
Acct. no.
$
Acct. no.
Life insurance net cash value
.
Name & Address of Company
$ Payt./Mos.
$
-
Face amount $
$
Acct. no.
Subtotal Liquid Assets
$
Name & Address of
Company
$ Payt./Mos.
$
Real Estate owned enter market value from
schedule or real estate owned, (page 3.)
$
Acct. no.
Vested interest in retirement
fund
$
Name & Address of
Company
$ Payt./Mos.
$
Net worth of business(es) owned (attach
financial statement)