If you answer "Yes" to any questions a through i, please provide an explanation.
|
a. Are there any outstanding judgments against you? |
|
Explanation
|
b. Have you been declared bankrupt within the past seven years? |
|
Explanation
|
c. Have you had property foreclosed upon or given title or deed in lieu thereof
in the last seven years? |
|
Explanation
|
d. Are you a party to a lawsuit? |
|
Explanation
|
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 action. |
|
Explanation
|
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. |
|
Explanation
|
g. Are you obligated to pay alimony, child support or separate maintenance? |
|
Explanation
|
h. Is any part of the down payment borrowed? |
|
Explanation
|
i. Are you a co-maker or endorser on a note? |
|
Explanation
|
j. Citizenship? |
|
k. Have you had an ownership interest in a property in the last three years? |
|
1) What type of property did you own-- principal residence, second home or investment
property? |
|
2) How did you hold title to the home-- solely by yourself, jointly with your spouse
or jointly with another person? |
|
|
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 not discriminate either on the basis of this information, or on
whether you choose to furnish it. If you furnish the information, please provide
both ethnicity and race. For race, you may choose more than one designation. If
you do not furnish ethnicity, race or sex, under Federal regulations the lender
is required to note the information on the basis of visual observation and surname
if you have made this application in person. If you do not wish to furnish the information,
please indicate your choice by checking the box provided.
|
I do not wish to furnish
this information. |
|
l. Ethnicity |
|
m. Race |
|
Additional Race |
|
Additional Race |
|
Additional Race |
|
n. Sex |
|
If you answer "Yes" to any questions a through i, please provide an explanation.
|
a. Are there any outstanding judgments against you? |
|
Explanation
|
b. Have you been declared bankrupt within the past seven years? |
|
Explanation
|
c. Have you had property foreclosed upon or given title or deed in lieu thereof
in the last seven years? |
|
Explanation
|
d. Are you a party to a lawsuit? |
|
Explanation
|
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 action. |
|
Explanation
|
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. |
|
Explanation
|
g. Are you obligated to pay alimony, child support or separate maintenance? |
|
Explanation
|
h. Is any part of the down payment borrowed? |
|
Explanation
|
i. Are you a co-maker or endorser on a note? |
|
Explanation
|
j. Citizenship? |
|
k. Have you had an ownership interest in a property in the last three years? |
|
1) What type of property did you own-- principal residence, second home or investment
property? |
|
2) How did you hold title to the home-- solely by yourself, jointly with your spouse
or jointly with another person? |
|
|
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 not discriminate either on the basis of this information, or on
whether you choose to furnish it. If you furnish the information, please provide
both ethnicity and race. For race, you may choose more than one designation. If
you do not furnish ethnicity, race or sex, under Federal regulations the lender
is required to note the information on the basis of visual observation and surname
if you have made this application in person. If you do not wish to furnish the information,
please indicate your choice by checking the box provided. |
I do not wish to furnish
this information. |
|
l. Ethnicity |
|
m. Race |
|
Additional Race |
|
Additional Race |
|
Additional Race |
|
n. Sex |
|
ASSETS |
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 or other person, this Statement and supporting
schedules must be completed about that spouse or other person also.
|
ACCOUNT TYPE |
|
INSTITUTION (include banks, credit unions, S&Ls, etc.) |
|
ADDRESS |
|
CITY
STATE
ZIP |
,
|
ACCOUNT # |
BALANCE |
|
|
|
|
ACCOUNT TYPE |
|
INSTITUTION (include banks, credit unions, S&Ls, etc.) |
|
ADDRESS |
|
CITY
STATE
ZIP |
,
|
ACCOUNT # |
BALANCE |
|
|
I/We have applied for credit from the Lender. As part of the application process,
the Lender and any potential investor or insurer of this loan may verify the information
contained in my/our credit application and in other documents required in connection
with this loan.
I/We authorize you to provide to the Lender and to any potential investor or insurer
of this loan, any and all information and documentation requested. Such information
may include, but is not limited to: employment and income history, bank, money
market and similar account balances; credit history; and copies of income tax returns.
The source of the information may come from, but is not limited to: credit
bureaus; banks and other depository institutions; current and former employers;
federal or state records including State Employment Security Agency (SESA) records;
or other sources as required.
This authorization to access employment and income history from federal or state
records including SESA records, for this transaction continues in effect for one
(1) year unless limited by state law, in which case the authorization continues
in effect for the maximum period, not to exceed one (1) year, allowed by law.
Certification: I/We certify that the information provided in this application
is true and correct as of the date submitted by clicking "Submit Application" below.
I/we 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 who may suffer any loss due to reliance upon any misrepresentations
which I/We have made on this application.
|
|