| 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 |
Page 3 of 4 |