Refinancing a Home Application

Step 1 of 7

Property Information

Occupancy

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Estimated Value

Borrower Information

Borrower

Individual

Joint

Borrower's Name(Required)

First Middle Last

Email(Required)

Home Phone(Required)

Date of Birth

Month

Day

Year

Marital Status

Married

Separated

Unmarried (includes single, divorced, widowed)

Co-Borrower's Name

First Last

Home Phone

Date of Birth

Month

Day

Year

Marital Status

Married

Separated

Unmarried (includes single, divorced, widowed)

Borrower Information cont.

Number of Dependents

Ages of Dependents

Present Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Type

Own

Rent

Number of Years

Borrower Present Employer Information

Self-Employed?

Yes

Employer Name

Position

Years on this Job

Months

Business Phone

Yrs. in this line of work/profession

Months

Co-Borrower Present Employer Information

Self-Employed?

Yes

Employer Name

Position

Years on this Job

Months

Business Phone

Yrs. in this line of work/profession

Months

Income

Before Tax Monthly Income

Current Monthly Housing Payment

Do You Rent or Own Your Current House?

Rent

Own

Co-Borrower Income

Before Tax Monthly Income

Current Monthly Housing Payment

Do You Rent or Own Your Current House?

Rent

Own

Declarations

Are there any outstanding judgments against you?

Yes

Have you been declared bankrupt within the past 7 years?

Yes

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

Yes

Are you a party to a lawsuit?

Yes

Have you directly or indirectly been obligated on any loan which resulted in foreclosure, transfer of title in lieu of foreclosure, or judgment? (This would include such loans as home mortgage loans, SBA loans, home improvement loans, educational loans, manufactured (mobile) home loans, any mortgage, financial obligation, bond, or loan guarantee.)

Yes

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

Yes

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

Yes

Is any part of the down payment borrowed?

Yes

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

Yes

Are you a U.S. citizen?

Yes

Are you a permanent resident alien?

Yes

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

Yes

Have you had ownership interest in a property in the last three years? If "Yes," complete question m.1 and m.2 below.

Yes

What type of property did you own -- principal residence (PR), second home (SH), or investment property (IP)?

How did you hold title to the home -- solely by yourself (S), jointly with your spouse (SP), or jointly with another person (O)?

Co-Borrower Declarations

Are there any outstanding judgments against you?

Yes

Have you been declared bankrupt within the past 7 years?

Yes

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

Yes

Are you a party to a lawsuit?

Yes

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

Yes

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

Yes

Is any part of the down payment borrowed?

Yes

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

Yes

Are you a U.S. citizen?

Yes

Are you a permanent resident alien?

Yes

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

Yes

Have you had ownership interest in a property in the last three years? If "Yes," complete question m.1 and m.2 below.

Yes

What type of property did you own -- principal residence (PR), second home (SH), or investment property (IP)?

How did you hold title to the home -- solely by yourself (S), jointly with your spouse (SP), or jointly with another person (O)?

Contact Information

Contact (If other than primary applicant)

Best Time to Call

Best Day to Call

Phone if other than primary contact

Comments

Acknowledgement and Agreement

By checking a radio button below, you attest that the information provided is true and accurate.

The information I have provided is true and accurate.(Required)

Yes

INFORMATION FOR GOVERNMENT MONITORING PURPOSES

The following information is requested by the Federal Government for certain types of loans related to a dwelling, in order to monitor the Lender's compliance with equal credit opportunity, fair housing and home mortgage disclosure laws. You are not required to furnish this information, but are encouraged to do so. The law provides that a Lender may neither discriminate on the basis of this information, nor whether you choose to furnish it. However, if you choose not to furnish it, under Federal regulations this Lender is required to note race and sex on the basis of visual observation or surname. If you do not wish to furnish the above information, please check the box below. (Lender must review the above material to assure that the disclosure satisfies all requirements to which the Lender is subject under applicable state law for the particular type of loan applied for.)

Borrower race/national origin

If other, please specify

Borrower sex

CoBorrower race/national origin

If other, please specify

CoBorrower sex

Referral Type

If other, please specify

This field is for validation purposes and should be left unchanged.

Property Information

Borrower Information

Borrower Information cont.

Borrower Present Employer Information

Co-Borrower Present Employer Information

Income

Co-Borrower Income

Declarations

Co-Borrower Declarations

Contact Information

Acknowledgement and Agreement

INFORMATION FOR GOVERNMENT MONITORING PURPOSES

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