Loan Application

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* Select which best describes you

* Email Address to be used to check the status of this application

Personal Information

* First Name

M.I.

* Last Name

Suffix

* Social Security #

* Date of Birth

* Citizenship

Type of Credit

* Marital Status

Number of Dependents

Age of Dependents

* Home Phone #

* Cell Phone #

Office Phone #

* Email Address

Current Address

* Address

Unit #

* City

* State

* Zip Code

* Country

How Long at Current Address?

* Years

* Months

* Housing

Street

Unit #

City

State

Zip Code

Country

How Long at Former Address?

Years

Months

Housing

Mailing Address

Check if the same as Current Address

Street

Unit #

City

State

Zip Code

Country

Current Employment/Self Employment Information and Income

* Employer or Business Name

* Phone

* Street

* City

* State

* Zip Code

* Position or Title

* Start Date

* Years

* Months

Check if you are the Business Owner or Self-Employed

Ownership Share

* Monthly Income (or Loss)

Check if this statement applies:

I am employed by a family member, property seller, real estate agent, or other party to the transaction

Gross Monthly Income

* Base

Overtime

Bonus

Commission

Military Entitlements

Other

Total

Employer or Business Name

Phone

Street

City

State

Zip Code

Position or Title

Start Date

Years

Months

Check if you are the Business Owner or Self-Employed

Ownership Share

Monthly Income (or Loss)

Check if this statement applies:

I am employed by a family member, property seller, real estate agent, or other party to the transaction

Gross Monthly Income

Base

Overtime

Bonus

Commission

Military Entitlements

Other

Total

Employer or Business Name

Street

City

State

Zip Code

Position or Title

Start Date

End Date

Check if you are the Business Owner or Self-Employed

Previous Gross Monthly Income

Income From Other Sources

NOTE: Reveal alimony, child support, separate maintenance, or other income ONLY IF you want it considered in determining your qualification for this loan.

Alimony

Child Support

Interest and Dividends

Notes Receivable

Royalty Payments

Unemployment

Automobile Allowance

Disability

Mortgage Credit Certificate

Public Assistance

Separate Maintenance

Benefits

Border Income

Foster Care

Mortgage Differential

Retirement (e.g., Pension, IRA)

Social Security

VA Compensation

Capital Gains

Housing or Parsonage

Payments

Trust

Other

Income Source - use list above

Monthly income

Total:

Assets and Liabilities

Assets - Bank Accounts, Retirement, and Other Accounts You Have

Include all accounts below. Under Account Type, choose from the types listed here:

Checking

Certificate of Deposit

Stock Options

Bridge Loan Proceeds

Trust Account

Savings

Mutual Fund

Bonds

Individual Development Account

Cash Value of Life Insurance (used for the transaction)

Money Market

Stocks

Retirement(e.g, 401k, IRA)

Account Type

Financial Institution

Account Number

Cash or Market Value

Total:

Other Assets and Credits You Have

Include all other assets below. Under Asset Type, choose from the types listed here:

Earnest Money

Proceeds from Real Estate Property to be sold on or before closing

Employer Assistance

Trade Equity

Proceeds from Sale of Non-Real Estate Asset

Rent Credit

Unsecured Borrowed Funds

Sweat Equity

Secured Borrower Funds

Other

Asset Type

Cash or Market Value

Total:

Other Liabilities and Expenses

Include all other liabilities and expenses NOT ON CREDIT REPORT below. Choose from the types listed here:

Alimony

Child Support

Separate Maintenance

Job Related Expenses

Other

Expense Type

Monthly Payment

Subject Property and Loan Information

Loan Amount

Loan Purpose

Address

Unit #

City

State

Zip Code

Country

Number of Units

Property Value

Occupancy

Mixed Use Property If you will occupy the property, will you set aside space within the property to operate your own business? (e.g., daycare facility, medical office, beauty/barber shop)

Manufactured Home Is the property a manufactured home? (e.g., a factory built dwelling built on a permanent chassis)

Declarations

About This Property and Your Money for This Loan

* A. Will you occupy the property as your primary residence?

* B. If this is a Purchase Transaction: Do you have a family relationship or business affiliation with the seller of the property?

* C. Are you borrowing any money for this real estate transaction (e.g., money for your closing costs or down payment) or before closing this transaction that is not disclosed on this loan application?

* D. 1. Have you or will you be applying for a mortgage loan on another property (not the property securing this loan) on or before closing this transaction that is not disclosed on this loan application?

* 2. Have you or will you be applying for any new credit(e.g., installment loan, credit card, etc.) on or before closing this loan that is not disclosed on this application?

* E. Will this property be subject to a lien that could take priority over the first mortgage lien, such as a clean energy lien paid through your property taxes (e.g., the Property Assessed Clean Energy Program)?

About Your Finances

* F. Are you a co-signer or guarantor on any debt or loan that is not disclosed on this application?

* G. Are there any outstanding judgments against you?

* H. Are you currently delinquent or in default on a federal debt?

* I. Are you a party to a lawsuit in which you potentially have any personal financial liability?

* J. Have you conveyed title to any property in lieu of foreclosure in the past 7 years?

* K. Within the past 7 years, have you completed a pre-foreclosure sale or short sale, whereby the property was sold to a third party and the Lender agreed to accept less than the outstanding mortgage balance due?

* L. Have you had the property foreclosed upon in the last 7 years?

* M. Have you declared bankruptcy within past 7 years?

If YES, identify the type(s) of bankruptcy

Chapter 7

Chapter 11

Chapter 12

Chapter 13

Demographic Information of Borrower

The purpose of collecting this information is to help ensure that all applicants are treated fairly and that the housing needs of communities and neighborhoods are being fullfilled. For residential mortgage lending, Federal law requires that we ask applicants for their demographic information (ethnicity, sex, and race) in order to monitor our compliance with equal credit opportunity, fair housing, and home mortgage disclosure laws. You are not required to provide this information, but are encouraged to do so. You may select one or more designations for "Ethnicity" and one or more designations for "Race:" The law provides that we may not discriminate on the basis of this information, or no whether you choose to provide it. However, if you choose not to provide the information and you have made this application in person, Federal regulations requires us to note your ethnicity, sex, and race on the basis of visual observation or surname. The law also prvodes that we may not discriminate on the basis of age or marital status information you provide in this application. If you do not wish to provide some or all of this information, please check below.

Acknowledgement & Agreement

DECLARATION OF NON-OWNER OCCUPANCY & BUSINESS USE OF PROCEEDS

* I ("Borrower") certify and represent to lender ("Originator") as follows: I hereby declare that I have no intention of making the property (subject property listed in my loan application) my principal residence. Additionally, I declare that I have no intention of utilizing the property as a second home and/or any surviving spouse or family member shall live in the property. I understand that this loan is a business purpose loan and not a household purpose loan. The loan proceeds are intended to be used and shall be used for business purpose only, not for personal use. I represent that I understand the difference between consumer loan for personal purposes and a commercial loan for business purposes. I represent that this loan is not a consumer loan and therefore is not subject to any laws relating to consumer loans under any state or federal laws such as Truth in Lending Act (15 U.S.C §§ 6802-8809). Secure and Fair Enforcement Mortgage Licensing Act (12 U.S.C. § 5101 et seq.), and Homeowners Protection Act (12 U.S.C. § 4901 at seq.). I realize the lender, broker, assignees,and successors rely upon this information. I confirm I have read and understand this document. I declare that under penalty of perjury the foregoing is true and correct.

AUTHORIZATION TO CONDUCT CREDIT & BACKGROUND CHECK

* By signing this form. I/we hereby authorize the lender to conduct a background and/or credit check. Additionally, the undersigned and each party to this loan, authorizes lender to disclose to any third party, employee, agent or assignee thereof information regarding my reported background and credit history. I understand that it is a federal crime punishable by fine or imprisonment, or both, to knowingly make any false statement when applying for this mortgage, as applicable under the provisions of title 18, united states code, 1014. I also understand that the lender intends to use the data obtained through the investigation for due diligence purposes only and shall not disclose such information to any other party.

A FACSIMILE, ELECTRONIC OR OTHER COPY OF THIS SIGNED AUTHORIZATION SHALL BE AS VALID AS THE ORIGINAL.

* Applicant 1 Signature (Type Initials)

* Applicant 1 Printed Name

* Date

Note: All questions marked with a red asterisk (*) are required to complete the application.