Home Loan Application

HOME LOAN APPLICATION

Loan Request

Loan Amount Requested:   Loan Purpose: Purchase Refinance Construction

Property Type: Single-family Condominium Multi-family   Occupancy: Primary Secondary Investment

Property Information

Borrower Information

Date of Birth:   Social Security Number:

Years at Address:   Phone:   Email:

Co-Borrower Information (if applicable)

Date of Birth:   Social Security Number:

Employment and Income — Borrower

Position/Title:   Years on Job:   Gross Monthly Income:

Employment and Income — Co-Borrower

Position/Title:   Years on Job:   Gross Monthly Income:

Assets and Liabilities

Declarations

For each question below, check Yes or No. If Yes, provide details in the space provided.

1. Have you had a bankruptcy in the past 7 years?    Yes    No

2. Are there outstanding judgments against you?    Yes    No

Acknowledgment, Authorization and Certification

By signing below, the undersigned applicant(s) certify under penalty of perjury that the information contained in this application is true and complete to the best of their knowledge. The undersigned authorize the lender, its agents, servicers, and any assignees to obtain and verify credit history, employment records, bank and other financial records, and any other information necessary to process this application. The undersigned further authorize any person or consumer reporting agency to disclose credit information to the lender.

The undersigned understand that incomplete or false statements may constitute a criminal offense under applicable federal and state law and may be subject to civil or criminal penalties. The lender may retain this application whether or not the loan is approved.

The undersigned consent to receive disclosures and communications in electronic form to the contact information provided in this form. Consent may be withdrawn by written notice to the lender, but such withdrawal will not affect the legal validity of any prior electronic communications.

Fair Lending Notice

The lender evaluates mortgage applications without regard to race, color, religion, national origin, sex, marital status, age, or the receipt of income from public assistance programs. Information requested on this form is for the purpose of determining eligibility for credit and complying with applicable fair lending requirements.

Ethnicity:   Race:   Sex:

Declarations — Applicant Affirmations

The undersigned affirm that they have read and understand the terms of this application and certify that the statements made are true, complete and accurate. The undersigned agree to provide additional documentation upon request to verify the statements made herein.

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