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Re-Finance Loan Application
Which Loan Officer is Assisting You?
Jacob Michaud
Rich Huizar
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Borrower
*
First
Last
Co-Borrower
First
Last
Are you the Borrower or Co-Borrower?
*
Borrower
Co-Borrower
I. Mortgage and Terms of Loan
Term Applied For
*
6 Months
12 Months
18 Months
24 Months
Loan Amount Requested
*
II. Property Information and Purpose of Loan
Subject Property Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Number of Units
*
Legal Description of Subject Property
Year Built
*
Purpose of Loan
*
New Construction
Rehab
Cash Out
Buy More RE
Other
If Other, please explain:
Property will be
*
Primary Residence
Secondary Residence
Investment
Complete this section if this is a construction or construction-permanent loan.
Year Lot Required
Original Cost (Dollars)
Amount Existing Liens (Dollars)
Present Value of Lot (Dollars)
Cost of Improvements (Dollars)
Complete this section if this is a refinance loan.
Year Lot Required
Original Cost (Dollars)
Amount Existing Liens (Dollars)
Purpose of Refinance
Describe Improvements Made
Describe Improvements to be Made
List the name(s) the title will be held in
*
III. Borrower Information
Borrower's Full Name (include Jr. or Sr. if applicable)
*
First
Middle
Last
Suffix
Phone
*
Date of Birth (MM/DD/YYYY)
*
MM slash DD slash YYYY
Years of School
Marital Status
Married
Separated
Unmarried (single, divorced, widowed)
Number of Dependents (not listed by Co-Borrower)
*
Ages of Dependents
Present Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Own or Rent?
*
Own
Rent
Rent - Number of Years
IV. Employment Information
Self Employed?
*
Yes
No
Name of Employer
Phone
Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Position / Title
Gross Monthly Income (Dollars)
Years at this Job
Years employed in this line of work/profession
V. Monthly Income and Combined Housing Expense Information
Gross Monthly Income (Dollars)
*
Commissions (Dollars)
Dividends/Interest (Dollars)
Net Rental Income (Dollars)
Other Income (Dollars)
Combined Monthly Housing Expense
Present Rent (Dollars)
*
Present Mortgage (Dollars)
Other Financing (Dollars)
Describe Other Income
Borrower or Co-Borrower
Borrower
Co-Borrower
Income Source
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 is completed about a non-applicant spouse or other person, this Statement and supporting schedules must be completed about that spouse or other person also.
How are you completing this section?
Jointly
Not Jointly
Assets - Description
Cash or Market Value (Dollars)
Checking & Savings Accounts
Name of Bank, S&L, or Credit Union
Account Number
Value (Dollars)
Stocks and Bonds
Company
Number
Description
Life Insurance Net Cash Value (Dollars)
Vested Interest in Retirement Fund (Dollars)
Net Worth of Businesses Owned (Dollars
Automobiles Owned
Make & Model
Year
Value (Dollars)
Make & Model
Year
Value (Dollars)
Schedule of Real Estate Owned
Property Address
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Type of Property
Current Market Value (Dollars)
Amount of Mortgages and Liens (Dollars)
Mortgage Payments (Dollars)
Insurance, Maintenance, Taxes, and Misc. (Dollars)
Net Rental Income (Dollars)
Address
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Additional Real Estate Owned
VII. Details of Transaction
Original Purchase Price
*
List Alterations Improvements, Repairs Made
What is the Estimated Current Value?
*
If the Property is Being Repaired, Please estimate the After Repair Value
How is Your Credit?
*
Excellent
Good
Fair
Poor
VIII. Declarations
Answer the following. If you answer "Yes" to any questions, please explain below.
Have you been declared bankrupt within the past 7 years?
*
Yes
No
Have you had property foreclosed upon or given title or deed in lieu thereof in the last 7 years?
*
Yes
No
Are you a party to a lawsuit?
*
Yes
No
Have you directly or indirectly been obligated on any loan of 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.)
*
Yes
No
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.
*
Yes
No
Are you obligated to pay alimony, child support, or separate maintenance?
*
Yes
No
Is any part of the down payment borrowed?
*
Yes
No
If you answered "Yes" to any of the preceding questions, please explain below
Answer the following.
Are you a U.S. citizen?
*
Yes
No
Are you a permanent resident alien?
Yes
No
Do you intend to occupy the property as your primary residence? If "Yes," complete the two questions below.
*
Yes
No
IX. Acknowlegement and Agreement
Each of the undersigned specifically represents to Lender and to Lender's actual or potential agents, brokers, processors, attorneys, insurers, servicers, successors and assigns and agrees and acknowledges that: (1) the information provided in this application is true and correct as of the date set forth opposite my signature and that any intentional or negligent misrepresentation of this information contained in this application may result in civil liability, including monetary damages, to any person who may suffer any loss due to reliance upon any misrepresentation that I have made on this application, and/or in criminal penalties including, but not limited to, fine or imprisonment or both under the provisions of Title 18, United States Code, Sec. 1001, et seq.; (2) the loan requested pursuant to this application (the "Loan") will be secured by a mortgage or deed of trust on the property described in this application; (3) the property will not be used for any illegal or prohibited purpose or use; (4) all statements made in this application are made for the purpose of obtaining a residential mortgage loan; (5) the property will be occupied as indicated in this application; (6) the Lender, its servicers, successors or assigns may retain the original and/or an electronic record of this application, whether or not the Loan is approved; (7) the Lender and its agents, brokers, insurers, servicers, successors, and assigns may continuously rely on the information contained in the application, and I am obligated to amend and/or supplement the information provided in this application if any of the material facts that I have represented herein should change prior to closing of the Loan; (8) in the event that my payments on the Loan become delinquent, the Lender, its servicers, successors or assigns may, in addition to any other rights and remedies that it may have relating to such delinquency, report my name and account information to one or more consumer reporting agencies; (9) ownership of the Loan and/or administration of the Loan account may be transferred with such notice as may be required by law; (10) neither Lender nor its agents, brokers, insurers, servicers, successors or assigns has made any representation or warranty, express or implied, to me regarding the property or the condition or value of the property; and (11) my transmission of this application as an "electronic record" containing my "electronic signature," as those terms are defined in applicable federal and/or state laws (excluding audio and video recordings), or my facsimile transmission of this application containing a facsimile of my signature, shall be as effective, enforceable and valid as if a paper version of this application were delivered containing my original written signature.
Acknowledgement.
Each of the undersigned hereby acknowledges that any owner of the Loan, its servicers, successors and assigns, may verify or reverify any information contained in this application or obtain any information or data relating to the Loan, for any legitimate business purpose through any source, including a source named in this application or a consumer reporting agency.
Borrower's Name
*
Date
*
MM slash DD slash YYYY
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