Refinance Application

First Name *

Last Name *

Property is * —Primary residenceSecondary residenceInvestment

Preference for Closing Costs * —Lender to PayPay in CashAdd into New Loan

Home Phone *

D.O.B. *

Years in School

Marital Status * —MarriedUnmarriedSeparated

Any Dependents? * —YesNo

If so, ages?

How long have you lived at your present address? *

Position/Title *

Years employed *

Line of work *

Business Phone *

Any other Real Estate owned? —YesNo

If so: Address

Amount of outstanding mortgages

Mortgage payment

Are there any outstanding judgments against you? * —YesNo

Have you been declared bankrupt in the past 7 years? * —YesNo

Have you had property foreclosed upon or given title or deed in lieu thereof in the last 7 years? * —YesNo

Are you a party to a lawsuit? * —YesNo

Have you been obligated on any loan resulted in foreclosure, transfer of title in lieu of foreclosure, or judgment? * —YesNo

Are you presently delinquent or in default on any Federal debt or any otherloan, mortgage, financial obligation, bond or loan guarantee? * —YesNo

Are you obligated to pay alimony, child support or separate maintenance? * —YesNo

Is any part of the down payment borrowed? * —YesNo

Are you a co-maker or endorser on a note? * —YesNo

Are you a U.S. Citizen? * —YesNo

Are you a permanent resident alien? * —YesNo

Do you intend to occupy the property as your primary residence? * —YesNo

Have you had an ownership interest in a property in the last three years? * —YesNo

What type of property did you own? Primary ResidenceSecond HomeInvestment Property

How did you hold title to the property? Sole OwnershipJoint with SpouseJoint with other than spouse

Are there any outstanding judgments against you? —YesNo

Have you been declared bankrupt in the past 7 years? —YesNo

Have you had property foreclosed upon or given title or deed in lieu thereof in the last 7 years? —YesNo

Are you a party to a lawsuit? —YesNo

Have you been obligated on any loan resulted in foreclosure, transfer of title in lieu of foreclosure, or judgment? —YesNo

Are you presently delinquent or in default on any Federal debt or any otherloan, mortgage, financial obligation, bond or loan guarantee? —YesNo

Are you obligated to pay alimony, child support or separate maintenance? —YesNo

Is any part of the down payment borrowed? —YesNo

Are you a co-maker or endorser on a note? —YesNo

Are you a U.S. Citizen? —YesNo

Are you a permanent resident alien? —YesNo

Do you intend to occupy the property as your primary residence? —YesNo

Have you had an ownership interest in a property in the last three years? —YesNo

What type of property did you own? Primary ResidenceSecond HomeInvestment Property

How did you hold title to the property? Sole OwnershipJoint with SpouseJoint with other than spouse