Home Mortgage Loan Application

(Premier Lending --- John Shea)
(770) 740-9590 ..... (800) 830-8222

*** Approved for mortgage lending in GA, FL, TN, NC, & SC ***

 

Your Name ...........
E-mail address .....
Fax Number .........

I. TYPE OF MORTGAGE AND TERMS OF LOAN

(Purchase) Sales Price: ......................................
(Refinance) Estimate of Appraised Value: .......
(Refinance) Current Interest Rate %: .............
(Refinance) Current Mortgage Program: ........
(Refinance) Loan Balance (1st mortgage) .......
(Refinance) Loan Balance (2nd mortgage) ......
(Refinance) Yearly Tax Bill ..............................
(Refinance) Yearly Homeowners Insurance ....

Requested Loan Amount: ..................................
Mortgage Program (Fixed, Arm, VA, FHA): ....
When is your Closing Date: ...............................
If you are selling your current house, what will it sell for: ....

Escrow Account:
If your down payment is at least 20% (purchase), or if you have at least 20% equity in your house based on the appraised value (refinance), you have an option on whether or not to have an escrow account. If you choose to have an escrow account, which most people do, each month you will put 1/12 of your yearly tax bill & 1/12 of your yearly homeowners insurance bill into an escrow account managed by your lender. The lender will then pay these bills for you each year.

Do you want an escrow account?

II. PROPERTY INFORMATION AND PURPOSE OF LOAN

House Property Address:

Street: City: State: Zip:
County: No. of Units: Year Built:
Purpose of Loan:
 Property will be:


Complete the line below, if this is a refinance loan.

Year
Acquired		 Original Cost Purpose of Refinance

III. BORROWER INFORMATION

Borrower Co-Borrower
Name (include Jr. or Sr. if applicable)
 Name (include Jr. or Sr. if applicable)
Social Security #
 Home Phone
 Social Security #
 Home Phone
Age
 Years of School
 Age
 Years of School
Marital Status

Married
Unmarried
Separated

Dependents

No.
Ages

Marital Status

Married
Unmarried
Separated

Dependents

No.
Ages

Present Address: Present Address:
Street
 City
 Street
 City
State
 Zip Code
 State
 Zip Code
Own Rent # of Years Own Rent # of Years


IF AT PRESENT ADDRESS LESS THAN TWO YEARS

Former Address: Former Address:
Street
 City
 Street
 City
State
 Zip Code
 State
 Zip Code
Own Rent # of Years Own Rent # of Years

 

Former Address: Former Address:
Street
 City
 Street
 City
State
 Zip Code
 State
 Zip Code
Own Rent # of Years Own Rent # of Years

 

IV. EMPLOYMENT INFORMATION

Borrower Co-Borrower
Name of Employer:
 Name of Employer:
Address: Address:
City: City:
State: Zip Code: State: Zip Code:
Self-employed
Yes No		 Years on this job:
 Self-employed
Yes No		 Years on this job:
Yrs. in current profession: Yrs. in current profession:
Position Title:
 Position Title:
Business Phone: Business Phone:

 

IF EMPLOYED IN CURRENT POSITION FOR LESS THAN TWO YEARS...

Name of Employer:
 Name of Employer:
Address: Address:
City: City:
State: Zip Code: State: Zip Code:
Self-employed
Yes No		 From - To (month/year):
 Self-employed
Yes No		 From - To (month/year):
Monthly Income: $ Monthly Income: $
Position Title:
 Position Title:
Business Phone: Business Phone:

 

Name of Employer:
 Name of Employer:
Address: Address:
City: City:
State: Zip Code: State: Zip Code:
Self-employed
Yes No		 From - To (month/year):
 Self-employed
Yes No		 From - To (month/year):
Monthly Income: $ Monthly Income: $
Position Title:
 Position Title:
Business Phone: Business Phone:

 

V. MONTHLY INCOME &
COMBINED HOUSING EXPENSE INFORMATION

Gross
Monthly
Income

Borrower Co-Borrower
Base
Income
Overtime
Bonuses
Commissions
Other Income
Net Rental
Income
TOTAL
*** Self Employed Borrowers will be required to provide tax returns and financial statements.

Combined
Monthly Expense

Present Proposed
Rent
Monthly Mortgage Payment

  If "Other Income" is filled in above, please explain below:

VI. ASSETS AND LIABILITIES

ASSETS
Completed Jointly Not Jointly
Cash Deposit / Earnest Money Given To:

Amount of Cash Deposit / Earnest Money:
$
 
1. Name of Bank/S&L/Credit Union:

Acct. #:
Balance:
2. Name of Bank/S&L/Credit Union:

Acct. #:
Balance:

3. Name of Bank/S&L/Credit Union:

Acct. #:
Balance:

4. Name of Bank/S&L/Credit Union:

Acct. #:
Balance:

5. Name of Bank/S&L/Credit Union:

Acct. #:
Balance:

6. Name of Bank/S&L/Credit Union:

Acct. #:
Balance:

STOCKS / BONDS / 401-K

1. Name / Type:

Amount:


2. Name / Type:

Amount:
STOCKS / BONDS / 401-K:

3. Name / Type:

Amount:


4. Name / Type:

Amount:

Vested Interest in Retirement Fund:
$


Automobiles

Year & Make:
Market Value:

Year & Make:
Market Value:

Other Assets: (Furniture, Jewelry etc.)
$

 

Monthly Liabilities

Current Mortgage Company:
Name
Loan Number
Telephone #
Monthly payment Loan Balance

If you have a Second Mortgage on your current house:
Name
Loan Number
Telephone #
Monthly payment Loan Balance
Monthly Car Payment (1) ............ Monthly Car Payment (2)

Monthly Student Loan (1) ............ Monthly Student Loan (2)

Minimum Monthly Credit Card Payment (total of all cards)

Other

*** You may use estimates; we will obtain actual amounts from your credit report.


OTHER REAL ESTATE OWNED

Market Value
Mortgage Balance
Gross Monthly Revenue
Mortgage Payment
Market Value
Mortgage Balance
Gross Monthly Revenue
Mortgage Payment

 

VIII. DECLARATIONS

Items Borrower Co-Borrower
a. Are there any outstanding judgements against you?
No Yes
No Yes
b. Have you been declared bankrupt within the last 7 years?
No Yes
No Yes
c. Have you had property foreclosed upon in the last 7 years?
No Yes
No Yes
d. Are you a party to a lawsuit?
No Yes
No Yes
e. Have you directly or indirectly been obligated on any loan which resulted in foreclosure, transfer of title in lieu of foreclosure, or judgment?
No Yes
No Yes
f. Are you presently delinquent or in default on any Federal debt or any other loan, mortgage, financial obligation, bond or loan guarantee?
No Yes
No Yes
g. Are you obligated to pay alimony, child support, or separate maintenance?
No Yes
No Yes
h. Is any part of the down payment borrowed?
No Yes
No Yes
i. Are you the co-maker or endorser on a note?
No Yes
No Yes
j. Are you a U.S. citizen?
No Yes
No Yes
k. If the answer to Question J is No:
Are you a permanent resident alien?

What is your VISA Classification (non-U.S. citizens)?
Borrower:
Co-Borrower:


No Yes
No Yes
l. Do you intend to occupy the property as your primary residence?
No Yes
No Yes
m. Have you had an ownership interest in a property in the last 3 years?
No Yes
No Yes


*** If the answer to question m above is "yes," please complete the following:

 

Borrower

Co-Borrower
What type of property
did you own?		 Principal residence
Second home
Investment Property		 Principal residence
Second home
Investment Property
How did you hold title
to the home?		 Solely by yourself
Jointly with spouse
Jointly with another person		 Solely by yourself
Jointly with spouse
Jointly with another person

X. INFORMATION FOR GOVERNMENT
MONITORING PURPOSES

Borrower Co-Borrower
I do not wish to furnish this information

Race/National Origin:

Sex: Female Male

I do not wish to furnish this information

Race/National Origin:

Sex: Female Male


Please use the following space for comments
and/or
any additional information about your situation.

Congratulations & Thank You!
The on-line loan application is now complete.

..... Click the submit button to send
or
(print & fax to: 770-740-0995)

 

Last Modified: January 22, 1998
John Shea --- Mortgage Loan Officer --- (770) 740-9590