Loan Application

This application is designed to be completed by the applicant(s) with the Lender’s assistance. Applicants should complete this form as “Borrower” or “Co-Borrower,” as applicable. Co-Borrower information must also be provided. You may also download a PDF version of this form to print and manually turn in to your lender.

Will the income or assets of a person other than the Borrower (including the Borrower’s spouse) be used as a basis for loan qualification?
YesNoUnknown

If the income or assets of the Borrower’s spouse or other person who has community property rights pursuant to state law will not be used as a basis for loan qualification, must his or her liabilities be considered because:

• the spouse or other person has community property rights pursuant to applicable law and Borrower resides in a community property state
• the security property is located in a community property state
• the Borrower is relying on other property located in a community property state as a basis for repayment of the loan

YesNoUnknown

Borrower Full Name

Co-Borrower Full Name

Mortgage Applying for:
VAFHAConventionalUSDA / Rural Housing ServiceOther

Mortgage Amount

Amortization Type:
Fixed RateGPMOtherARM

Subject Property Address

Purpose of Loan
PurchaseRefinanceConstructionConstruction-PermanentOther

Property will be:
Primary ResidenceSecondary ResidenceInvestment

Title will be held under what name(s)?

What is the Borrowers full name?

Social Security Number

Phone Number

Date of Birth

Years of School

Borrower's marital status:
Married (includes registered domestic partners)Unmarried (includes, single, divorced, widowed)Separated

Borrower's dependents (that will not be listed by Co-Borrower)

Borrower's dependents age(s) (separate with commas)

Borrower's present address:

Different mailing address?
YesNo

Own or Rent?
OwnRent

Number of years?

What is the Co-Borrowers full name?

Social Security Number

Phone Number

Date of Birth

Years of School

Co-Borrower's marital status:
Married (includes registered domestic partners)Unmarried (includes, single, divorced, widowed)Separated

Co-Borrower's dependents (that will not be listed by Borrower)

Co-Borrower's dependents age(s) (separate with commas)

Co-Borrower's present address:

Different mailing address?
YesNo

Own or Rent?
OwnRent

Number of years?

Name of Borrower's Employer

Address of Borrower's Employer

Self-Employed?
Yes

Years with Employer

Years working in profession

Position/Title/Type of Business

Business Phone

Name of Co-Borrower's Employer

Address of Co-Borrower's Employer

Self-Employed?
Yes

Years with Employer

Years working in profession

Position/Title/Type of Business

Business Phone

Describe other income

Notice: Alimony, child support, or separate maintenance income need not be revealed if the Borrower or Co-Borrower does not choose to have it considered for repaying this loan.

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 was completed about a non-applicant spouse or other person, this Statement and supporting schedules must be completed by that spouse or other person also.

Completed
JointlyNot Jointly

Checking and Savings Accounts

List each Checking and Savings account you wish to be used when considering your loan application. Click the "Add Another" button to add addition Checking and Savings accounts as needed.

Stocks and Bonds

List all Stocks and Bonds you wish to be considered with your loan application. Click the "Add another" button to add another Stock or Bond as needed.

Vested interest in retirement fund $

Liabilities and Pledged Assets

List the creditor's name, address and account number for all outstanding debts, including automobile loans, revolving charge accounts, real estate loans, alimony, child support, stock pledges, etc.