|
APPLICANT |
NAME:
First, Middle Initial, Last (Suffix)
|
DATE OF
BIRTH
|
SOCIAL
SECURITY NUMBER
|
HOME
PHONE NUMBER (Including area code)
|
|
Email:
|
# OF DEPENDENTS (Fill in
age of each)
#1
#2
#3
#4
#5
|
|
MARITAL STATUS
|
|
CO-APPLICANT |
NAME:
First, Middle Initial, Last (Suffix)
|
DATE OF
BIRTH
|
SOCIAL
SECURITY NUMBER
|
HOME
PHONE NUMBER (Including area code)
|
|
MARITAL STATUS
|
# OF DEPENDENTS (Fill in
age of each)
#1
#2
#3
#4
#5
|
|
APPLICANT |
PRESENT STREET ADDRESS
|
CITY
|
STATE
|
ZIP
|
Monthly
Payment
|
HOW LONG AT PRESENT
ADDRESS
Years
Months
|
STATUS OF CURRENT
RESIDENCE
|
LANDLORD/MORTGAGE HOLDER
PRESENT STREET ADDRESS
|
CITY
|
STATE
|
ZIP
|
PREVIOUS STREET ADDRESS
|
CITY
|
STATE
|
ZIP
|
Monthly
Payment
|
HOW LONG AT PREVIOUS
ADDRESS
Years
Months
|
STATUS OF PREVIOUS
RESIDENCE
|
LANDLORD/MORTGAGE HOLDER
PRESENT STREET ADDRESS
|
CITY
|
STATE
|
ZIP
|
|
CO-APPLICANT |
PRESENT STREET ADDRESS
|
CITY
|
STATE
|
ZIP
|
Monthly
Payment
|
HOW LONG AT PRESENT
ADDRESS
Years
Months
|
STATUS OF CURRENT
RESIDENCE
|
LANDLORD/MORTGAGE HOLDER
PRESENT STREET ADDRESS
|
CITY
|
STATE
|
ZIP
|
PREVIOUS STREET ADDRESS
|
CITY
|
STATE
|
ZIP
|
Monthly
Payment
|
HOW LONG AT PREVIOUS
ADDRESS
Years
Months
|
STATUS OF PREVIOUS
RESIDENCE
|
LANDLORD/MORTGAGE HOLDER
PRESENT STREET ADDRESS
|
CITY
|
STATE
|
ZIP
|
|
APPLICANT
EMPLOYMENT (2 Year History Required) |
EMPLOYER
|
CITY
|
STATE
|
ZIP
|
PHONE
NUMBER
|
JOB TITLE
|
HIRE DATE
|
GROSS MONTHLY SALARY (Base)
|
SELF EMPLOYED? Yes/No
|
OVERTIME
$
|
BONUS
$
|
COMMISSION
$
|
PREVIOUS EMPLOYER (If
less than 2 years)
|
CITY
|
STATE
|
ZIP
|
PHONE
NUMBER
|
EMPLOYED FROM:
Years
Months
|
EMPLOYED TO:
Years
Months
|
|
CO-APPLICANT EMPLOYMENT (2 Year History Required) |
EMPLOYER
|
CITY
|
STATE
|
ZIP
|
PHONE
NUMBER
|
JOB TITLE
|
HIRE DATE
|
GROSS MONTHLY SALARY (Base)
|
SELF EMPLOYED? Yes/No
|
OVERTIME
$
|
BONUS
$
|
COMMISSION
$
|
PREVIOUS EMPLOYER (If
less than 2 years)
|
CITY
|
STATE
|
ZIP
|
PHONE
NUMBER
|
EMPLOYED FROM:
Years
Months
|
EMPLOYED TO:
Years
Months
|
|
APPLICANT'S
OTHER INCOME |
|
Note:
Alimony, Child Support, or separate maintenance
income
need not be revealed unless you want them considered
as a basis for repaying this loan. |
SOURCE
|
COURT ORDERED
|
MONTHLY AMOUNT
$
|
SOURCE
|
COURT ORDERED
|
MONTHLY AMOUNT
$
|
|
CO-APPLICANT'S OTHER INCOME |
|
Note:
Alimony, Child Support, or separate maintenance
income
need not be revealed unless you want them considered
as a basis for repaying this loan. |
SOURCE
|
COURT ORDERED
|
MONTHLY AMOUNT
$
|
SOURCE
|
COURT ORDERED
|
MONTHLY AMOUNT
$
|
|
APPLICANT'S
BANKING & ASSET INFORMATION |
CHECKING
ACCOUNT WITH?
|
ACCOUNT NUMBER
|
BALANCE
$
|
SAVINGS
ACCOUNT WITH?
|
ACCOUNT NUMBER
|
BALANCE
$
|
RETIREMENT ACCTS (401k,IRA/203B):
|
ACCOUNT NUMBER
|
BALANCE
$
|
OTHER
|
ACCOUNT NUMBER
|
BALANCE
$
|
|
CO-APPLICANT'S BANKING & ASSET INFORMATION |
CHECKING
ACCOUNT WITH?
|
ACCOUNT NUMBER
|
BALANCE
$
|
SAVINGS
ACCOUNT WITH?
|
ACCOUNT NUMBER
|
BALANCE
$
|
RETIREMENT ACCTS (401k,IRA/203B):
|
ACCOUNT NUMBER
|
BALANCE
$
|
OTHER
|
ACCOUNT NUMBER
|
BALANCE
$
|
|
APPLICANT'S
OTHER OBLIGATIONS |
ALIMONY/CHILD SUPPORT
|
MONTHLY AMOUNT
|
BALANCE
$
|
|
CO-APPLICANT'S OTHER OBLIGATIONS |
ALIMONY/CHILD SUPPORT
|
MONTHLY AMOUNT
|
BALANCE
$
|
|
SOURCE OF DOWN PAYMENT |
|
|
|
ALTERNATIVE CREDIT |
NAME AND ADDRESS OF CREDITOR
|
DATE OPENED
|
PAYMENT
$
|
ORIGINAL BALANCE
$
|
CURRENT BALANCE
$
|
NAME AND ADDRESS OF CREDITOR
|
DATE OPENED
|
PAYMENT
$
|
ORIGINAL BALANCE
$
|
CURRENT BALANCE
$
|
NAME AND ADDRESS OF CREDITOR
|
DATE OPENED
|
PAYMENT
$
|
ORIGINAL BALANCE
$
|
CURRENT BALANCE
$
|
NAME AND ADDRESS OF CREDITOR
|
DATE OPENED
|
PAYMENT
$
|
ORIGINAL BALANCE
$
|
CURRENT BALANCE
$
|
NAME AND ADDRESS OF CREDITOR
|
DATE OPENED
|
PAYMENT
$
|
ORIGINAL BALANCE
$
|
CURRENT BALANCE
$
|
NAME AND ADDRESS OF CREDITOR
|
DATE OPENED
|
PAYMENT
$
|
ORIGINAL BALANCE
$
|
CURRENT BALANCE
$
|
NAME AND ADDRESS OF CREDITOR
|
DATE OPENED
|
PAYMENT
$
|
ORIGINAL BALANCE
$
|
CURRENT BALANCE
$
|
|
MANUFACTURED HOME |
MANUFACTURER (Make)
|
MODEL
|
YEAR
|
NEW OR
USED?
|
WIDTH
|
LENGTH
|
FLOORPLAN
|
TYPE
|
|
LOAN INFORMATION |
LOAN TYPE
|
LOAN PURPOSE
|
TERM
mo. |
RATE
% |
CO-SIGNER
PROGRAM
|
CO-SIGNER
RELATED?
|
ESTIMATED ANNUAL
PROPERTY TAXES
$
|
ESTIMATED ANNUAL
HOMEOWNER'S
INSURANCE PREMIUM
$
|
|
PROPERTY INFORMATION |
PROPERTY ADDRESS WHERE
NEW HOME WILL BE LOCATED
|
CITY
|
STATE
|
ZIP
|
SIZE
|
If customer already has
land, how was the land acquired?
|
What was the date the
land was acquired?
|
|
AUTHORIZATIONS |
|
PRIVACY ACT NOTICE: This
information is to be used by the agency collecting
it or its assignees in determining whether you
qualify as a prospective mortgagor under its
program(s). It will not be disclosed outside the
agency except as required and permitted by law. You
do not have to provide this information, but if you
do not, your application for credit as a borrower
may be delayed or rejected.
Information is requested by the federal government
to monitor the creditors compliance with laws on
equal opportunity, fair housing and home mortgage
disclosure. You do not need to answer, but are
encouraged to do so. If you do not wish to answer
please indicate on the first line below. If you
choose not to fill in the information and you have
made this application in person, the creditor is
required to fill in race or national origin and sex
on the basis of visual observation or surname. |
|
|
|
1) Are there any
outstanding judgments against you? Yes
or No
2) Have you been
declared bankrupt in the last 7 years? Yes
or No
3) Are you obligated
to pay alimony, child support? Yes
or No
4) Is any part of the
down payment borrowed? Yes
or No
5) Are you a U.S.
citizen? Yes
or No
6) Are you a
permanent resident alien? Yes
or No
7) Will this property
be your primary residence? Yes
or No
8) Have you owned
property in the last three years? Yes
or No
9) Have you directly
or indirectly been obligated on any loan, which
resulted in foreclosure or judgment in the last 7
years? (If yes, provided details including date,
name and address of lender.) Yes
or No
|
