Loan Application Final 1003

LOAN APPLICATION - FINAL 1003

SECTION I — TYPE OF MORTGAGE AND TERMS OF LOAN

Loan Amount:   Interest Rate:   Loan Term (Years):

Type of Mortgage: Conventional FHA VA USDA Other

Purpose of Loan: Purchase Refinance Construction Other

SECTION II — PROPERTY INFORMATION AND PURPOSE OF LOAN

Year Built:   Units:   Estimated Value:

Occupancy: Primary Residence Secondary Residence Investment Property

SECTION III — BORROWER

Social Security No.:   Date of Birth:   Home Phone:

Years at Current Address:   Monthly Housing Payment:

Employer Address:

Position:   Years on Job:   Gross Monthly Income:

SECTION IV — CO-BORROWER

Social Security No.:   Date of Birth:   Home Phone:

Position:   Years on Job:   Gross Monthly Income:

SECTION V — ASSETS AND LIABILITIES

Enter asset amounts or account information. Attach supporting documentation for all accounts and assets listed where requested.

SECTION VI — DECLARATIONS

The undersigned represents and warrants the following (check Yes or No and provide explanations as required). A checked Yes indicates the existence of the condition described.

SECTION VII — ACKNOWLEDGMENT AND AGREEMENT / CERTIFICATION

I/We certify that the information contained in this application is true and correct to the best of my/our knowledge and belief. I/We understand that any intentional or negligent misrepresentation of the information contained in this application may result in civil liability, including monetary damages to the lender, and/or criminal penalties under applicable law.

I/We authorize the lender to verify my/our credit, employment, assets, and any other information necessary to process this application and to share information with third parties as necessary to close the loan. I/We consent to the lender obtaining consumer credit reports in connection with this application. I/We also authorize employers and other third parties to release employment and income information for verification purposes.

Borrower understands that additional documentation may be required to evidence information provided in this application and that final underwriting approval is conditioned upon verification of all information provided, appraisal of the property, and compliance with applicable lending program requirements.

CERTIFICATION AND CONSENT

By signing below, I/We certify under penalty of perjury that the foregoing statements and the information provided in any attachment to this application are true and accurate. I/We acknowledge receipt of a copy of this application and understand that lender may rely on this application and any supporting documentation to make credit decisions.

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