Please print and complete this form and mail or fax it to us at the address and numbers on our contact page.

LOAN APPLICATION

This is the basic information requested on a traditional uniform residential loan application, reformatted for ease of use on an Internet application. The information provided here will be used for qualifying purposes only. Data received will be reviewed by lending institutions for the purpose of making a mortgage loan only. Personal data is in no way otherwise disseminated by use of mailing list or any other such media by this service. With respect to an individuals right to privacy, any fields may be left blank at the users discretion, however the more complete the application is, the better quality the loan approval will be. Please provide enough information to render a good loan decision. Completion of this form in no way obligates the user of this service to accept any loan offered or provide any moneys to obtain a loan approval. Please take a few moments to fill out the following form.

Are you applying as and individual borrower or will you have a co-borrower? Individual___ Joint___ Not Sure_____

What is the purpose of your loan? Purchase_____ Refinance _____ Construction ______ Other_________

Do you want the property title held jointly? Yes____ No_____ Not Sure____

BORROWER INFORMATION

Borrowers Name (include Jr. or Sr. if applicable)

(First)________________________ (Last) ____________________________ (M)___________________

Social Security # ______-_____-_________

Home Phone (include area code) (____) ________-______________

Age _____

Years School ______

Married_____ Unmarried (includes single, divorced, widowed)_____ Separated _______

Number of Dependents _______

HOUSING HISTORY (Note: lenders are requesting a total minimum combined 2-year housing history, the primary focus is on provable stability)

Present Address:

Street_______________________________________________________________ Apt__________

City____________________________________________

State:________________________Zip:______________________

Own______ Rent______ Number of years_______


If residing at present address less than 2 years complete the following.

Former Address:

Street_______________________________________________________________ Apt__________

City_________________________________________

State:_______________Zip:______________________

Own______ Rent______ Number of years_______

Use continuation sheet if more space is required for additional residences

EMPLOYMENT INFORMATION (Note, a primary focus on employment is job stability. Education as it relates to the career field is generally considered employment, if desired substitution of generic employer names for privacy concerns are acceptable at this time, although the actual employer may need to be contacted at a later date for loan verification purposes with applicants approval)

Name and address of current employer. (Generic substitute OK if desired such as office, clerical, manufacturing, General Labor, Proffessional, Medical, Construction, Sales, etc.)

Employer__________________________________________________________________

Address____________________________________________________________________

City_______________________________________

State __________________ Zip_______________________

Self employed Yes________ No________

Business Phone: (____) ________-____________________ ext._______________

Title or position: _________________________________________________________

Type of work: ____________________________________________________________

Number of years on this job? __________Number of years employed in this line of work. _______
If you have been employed less than two years or if currently employed in more than one position complete the following:
Name and address of employer: From ______________ / To ___________________ /

Employer___________________________________________________________________

Address____________________________________________________________________

City_______________________________________ ST. ____ Zip_______________________

Self employed Yes________ No________ Monthly income _____________________

Business Phone: (____) ________-____________________ ext._______________

Title or position: _________________________________________________________

Type of work: ____________________________________________________________

Number of years on this job? __________Number of years employed in this line of work. _______

Use continuation sheet if more space is required for additional employment



INCOME
(Note: lenders will qualify income as stated (unprovable) or as fully documented (w-2's and or tax returns) under different guidelines.
How should your income be considered? Fully Documented_________ Stated________ Not Sure_______

Base Employment Income _____________ Choose one: Annual_____ Monthly _____ Weekly____
Hourly Rate_____________

Overtime______________ (lenders will use a 2 year average)

Bonuses _____________ (lenders will use 2 year average)

Commissions______________ (lenders will use 2 year average)

Dividends/Interest_______________ (lenders will use 2 year average)

Net Rental Income__________(after PITI. Lenders will use their own internal maintenance factor)

Other Income ____________ Choose one: Annual_______ Monthly _______ Weekly _________ (note any alimony, separate maintenance or child support income need not be revealed if Borrower or CO-Borrower chooses not to have it considered as a basis for repaying this loan)

Please use continuation page for any additional information regarding income



HOUSING EXPENSE

Rent____________ Choose one: Annual_____ Monthly _______ Weekly ___________

First mortgage _______________ (Show as monthly Principle, interest, taxes and insurance)

Other financing ____________(Principle and interest)

Homeowner Dues___________ Annual _______ Monthly _____

Condominium Association Dues__________ Annual______ Monthly_____


ASSETS (note, the primary focus is available funds, verification of funds will be dependent on loan type. Traditional underwriting requires 60-90 days seasoning of funds. The use of generic names for financial institutions are acceptable for privacy concerns, balances can be averaged to the nearest 100 shown as an average daily balance if desired)


Cash on hand $___________

Cash deposit made toward purchase $_____________

Name and Address of Financial Institution. (A generic substitute such as Bank, S&L, Credit Union, Stocks, Bonds is acceptable if desired, account numbers and physical addresses will be used for verification purposes after a loan has been selected. They can be left blank for privacy concerns at this time if desired)

Name of Institution___________________________________________________________________

Address___________________________________________________________________

Street_______________________________________________________________ Suite__________

City____________________________________

State:_____Zip:______________________

Account number_________________________

Balance $__________

Name of Institution_____________________________________________________________________

Address___________________________________________________________________

Street_______________________________________________________________ Suite__________

City________________________________________

State:_____Zip:______________________

Account number_________________________

Balance $__________

Name of Institution____________________________________________________________________

Address___________________________________________________________________

Street_______________________________________________________________ Suite__________

City_______________________________________________

State:_____Zip:______________________

Account number_________________________

Balance $__________

Name of Institution_____________________________________________________________________

Address___________________________________________________________________

Street_______________________________________________________________ Suite__________

City___________________________________________

State:_____Zip:______________________

Account number_________________________

Balance $__________

Use continuation sheet if required for additional Banking institutions

LIABILITIES (the primary focus here is revolving and installment type debt. This would include debt such as automobile loans, credit cards, and real estate loans, alimony and child support. Regular household debt such as phone bills, electric bills, grocery bills should not be included. For revolving type debt use the minimum due even if a higher amount is generally paid. If the debt is going to be paid off upon the sale of real estate owned or upon refinancing of the subject property be sure and indicate this in the space provided .For privacy concerns a generic substitute is acceptable for verification at a later date)

Name and address of creditor (real estate loan, automobile loan, credit card, department store credit card, etc.)

Name of creditor___________________________________________________________________

Address_________________________________________________________________________


Street_______________________________________________________________ Suite__________

City_____________________________________________

State:_____Zip:______________________

Account number_______________________________Minimum monthly payment required ___________

Balance owed $____________________


Name of creditor______________________________________________________________________

Address______________________________________________________________________

Street_______________________________________________________________ Suite__________

City_____________________________________________

State:_____Zip:______________________

Account number_______________________________Minimum monthly payment required __________

Balance owed $____________________

Name of creditor___________________________________________________________________

Address______________________________________________________________________

Street_______________________________________________________________ Suite__________

City______________________________________________

State:_____Zip:______________________

Account number_______________________________Minimum monthly payment required ___________

Balance owed $____________________


Name of creditor____________________________________________________________________

Address______________________________________________________________________

Street_______________________________________________________________ Suite__________

City_______________________________________

State:_____Zip:______________________

Account number_______________________________Minimum monthly payment required ___________

Balance owed $____________________




Name of creditor______________________________________________________________________

Address______________________________________________________________________

Street_______________________________________________________________ Suite__________

City_______________________________________________

State:_____Zip:______________________

Account number_______________________________Minimum monthly payment required ___________

Balance owed $____________________

Use continuation sheet is required for additional creditors


Do you currently own a home ? Y_____ N_____

Address_______________________________________________________________________________

City______________________________________________

State_____ Zip code______________________

Market value__________________ Mortgages &Liens__________________ Mos. pmt.______________

Rental income ___________________ pending sale Y_____ N_____


Address_______________________________________________________________________________

City______________________________________________

St_____ Zip code______________________

Market value____________________ Mortgages &Liens_________________ Mos.pmt.______________

Rental income ___________________ pending sale Y_____ N_____


Use continuation sheet if required for additional properties owned


Are you a U.S citizen? Y____N______

Permanent Resident Alien Y____N_____

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



CO BORROWER

Simply reprint application and fill in applicable blanks


Use this page for any additional information as needed as well as any pertinent information that might be helpful in securing a loan.
Please print and complete this form and mail or fax it to us at the address and numbers on our contact page.

Brian Hays Home Finance & Real Estate Services
1-941-321-7772
Toll free 1-800 -329-2580
E Mail Brian Hays