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Borrower

DOB Month:

How Long at Current Address1 year2 years3 years4 years5 years6 years7 years8 years9 years10 years11 years12 years13 years14 years15 years16 years17 years18 years19 years

Living Status at AddressOwnRentLiving rent Free

Loan Officer

Please Sele Your Loan OfficerI do not have one yetChris DaddarioChristina VerduzcoJason GonzellJason SantangeloMike HungerfordNate BryantTom Neal

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.

Source of Additional IncomeAccessory Unit IncomeAlimonyAutomobile AllowanceBoarder IncomeBonusCapital GainsChild SupportCommissionsDefined Contribution PlanDisabilityDividends InterestEmployment Related AccountFoster CareHousing AllowanceHousing Choice Voucher ProgramMortgage Credit CertificateMortgage DifferentialNon Borrower Houshold IncomeNotes Receivable InstallmentOtherOvertimePensionPublic AssistanceRoyaltiesSeperate MaintenanceSocial SecurityTemporary LeaveTip IncomeTrustUnemploymentVA Benefits NonEducational

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Employment Section

Employment StatusEmployedSelf Employed

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Assets

Additional Real Estate Owned

Do You Own Additional Real Estate?YesNo

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Additional Details

Marital StatusMarriedUnmarriedSeparated

Do You Pay Child Support Or Alimony?YesNo

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Is This a Purchase Or Refinance?YesNo

Are You A Veteran?YesNo

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First Time Home Buyer?YesNo

Co-Borrower

Do You Have a Co-Borrower?YesNo

[group Yes-selected]

DOB Month:

How Long at Current Address1 year2 years3 years4 years5 years6 years7 years8 years9 years10 years11 years12 years13 years14 years15 years16 years17 years18 years19 years

Living Status at AddressOwnRentLiving rent Free

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I understand that by submitting this online application, I am authorizing a credit check and to make whatever inquiries necessary in connection with this request.

How Did You Hear About Us?

How Did You Hear About Us?InternetOtherFriendRealtorBuilder

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[group Howdid-u-hear-Realtor]

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[group Howdid-u-hear-Builder]

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Info For Government

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 Not Discriminate Either On The Basis Of This Information, Or On Whether You Choose To Furnish It. If You Furnish The Information, Please Provide Both Ethnicity And Race. For Race, You May Check More Than One Designation. If You Do Not Furnish Ethnicity, Race, Or Sex, Under Federal Regulations, This Lender Is Required To Note The Information On The Basis Of Visual Observation And Surname If You Have Made This Application In Person. If You Do Not Wish To Furnish The Information, Please Check The Box Below.