| 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?
|
|
|
|
|
| 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
|
|