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
If you are the primary borrower please fill complete the section below. If you are the co-borrower skip to the next section.
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
If you are the co-borrower please fill complete the section below.
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