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Loan Application Form
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Assessed you another
Name
*
First
Last
Date of Birth
Phone
Email
*
Marital Status
Married
Unmarried
Seperated
Street Address
Street Address Line 2
City
State
Postal / Zip Code
Housing
Own
Rent
No Primary Housing Expenses
Is your mailing address the same as your current address?
Yes
No
What is your current working status?
Full Time
Part Time
Freelancer
Retired
Business Name
Check if you are the Business Owner or Self-Employed
Check if you are the Business Owner or Self-Employed
Start Date
Position or Title
Business Phone
Monthly Income
Business Office Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Base Employment Income
Overtime
Bonuses
Commissions
Dividends/Interest
Net Rental Income
Other
1) Will you occupy the property as your primary residence?
Yes
No
Third Choice
2) If this is a Purchase Transaction: Do you have a family relationship or business affiliation with the seller of the property?
Yes
No
3) Are you borrowing any money for this real estate transaction (e.g., money for your closing costs or down payment) or obtaining any money from another party, such as the seller or realtor, that you have not disclosed on this loan application?
Yes
No
4) 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?
Yes
No
5) 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?
Yes
No
6) 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)?
Yes
No
Ethnicity
Hispanic or Latino
Not Hispanic or Latino
I do not wish to provide this information
Sex
Male
Female
I do not wish to provide this information
Race
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
I do not wish to provide this information
Date
Submit
