This form will allow you to complete a mortgage application on-line for a home purchase, refinance, or pre-qualification.  Help Icons questionicon3.gif (1036 bytes) are located throughout the application.
Your name (the contact for the application): 
Your e-mail address is :
Name of Loan Officer:

 

I. TYPE OF MORTGAGE AND TERMS OF LOAN

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Amount: $ No. of Months: Amortization Type:

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2. PROPERTY INFORMATION AND PURPOSE OF LOAN

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Street: City: ST.: ZIP:
Number of Units: Year Built:
Purpose of Loan:
 Property will be:
Type of loan:
 Estimated Property Value or Sale Price$:

Complete this line if this is a refinance loan.

Year
Acquired 		Original Cost Existing Liens Purpose of Refinance
$ $

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3. BORROWER INFORMATION

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Borrower Co-Borrower
First Name 
Middle Initial
Last Name   		First Name 
Middle Initial
Last Name  
Social Sec. No.

(no spaces or dashes)		 Home Phone

(no spaces or dashes)		 Social Sec. No.

(no spaces or dashes)		 Home Phone

(no spaces or dashes)
Date of Birth
Month   Day     Year
 Yrs. of School
 Date of Birth
Month   Day     Year
 Yrs. of School
Marital Status Dependents
Number
Ages		 Marital Status
 Addtl Dependents
Number
Ages

Present Address:

Present Address:

Street
 City
 Street
 City
State
 Zip
 State
 Zip
At this address I...

Own Rent

 No. Yrs. 

No. Mos.

 At this address I...

Own Rent

 No. Yrs. 

No. Mos.

IF YOU HAVE BEEN AT YOUR PRESENT ADDRESS LESS THAN TWO YEARS ...

Former Address:

Former Address:

Street
 City
 Street
 City
State
 Zip
 State
 Zip
At this address I..

Owned Rented

No. Yrs. 

No. Mos.

 At this Address I..

Owned Rented

No. Yrs. 

No. Mos.

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4. EMPLOYMENT INFORMATION

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Borrower Co-Borrower
Name of Current Employer:
 Name of Current Employer:
Attn.:
Attn.:
Address:
Address:
City:
City:
State: Zip: State: Zip:
Employment Type No. Yrs.
No. Mos.		 Employment Type No. Yrs.
No. Mos.
Years in current profession: Years in current profession:
Position/Title/Type of Bus:
 Position/Title/Type of Bus:
Business Phone: Business Phone:
IF EMPLOYED IN CURRENT POSITION FOR LESS THAN TWO YEARS...
Name of Previous Employer:
 Name of Previous Employer:
Attn.:
Attn.:
Address:
Address:
City:
City:
State: Zip: State:  Zip:
Employment Type No. Yrs.

No. Mos.

Employment Type No. Yrs.

No. Mos.
Previous Monthly Income: $ Previous Monthly Income: $
Position/Title/Type of Bus:
 Position/Title/Type of Bus:
Business Phone: Business Phone:

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5. MONTHLY INCOME AND COMBINED HOUSING EXPENSE INFORMATION

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in this section please use only whole dollar amounts.  For example $416.23 = 416
Gross
Monthly
Income 		Borrower Co-Borrower

Combined
Mthly Exp.
(Housing)

Present Proposed
Base Employment
Income		   Rent  
Overtime   First
Mortgage
Bonuses   Other
Financing
Commissions   Hazard
Insurance
Dividends/
Interest 		  Real Estate
Taxes
Other **   Mortgage
Insurance
        Homeowner Assn. Dues
**Alimony, child support, or separate maintenance income need not be revealed if the borrower or Co-borrower does not wish to have it considered for repaying this loan.   Other

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6. ASSETS AND LIABILITIES

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ASSETS
Cash deposit held by: (for purchase only) Amount:
$

Deposit Accounts and Other Assets
Name of Bank/S&L/Credit Union:

Acct. No.:
Balance: 		Name of Bank/S&L/Credit Union:

Acct. No.:
Balance:
Name of Bank/S&L/Credit Union:

Acct. No.:
Balance: 		Name of Bank/S&L/Credit Union:

Acct. No.:
Balance:
Name of Bank/S&L/Credit Union:

Acct. No.:
Balance: 		Stocks and Bonds Mutual Funds:
Company name/number & description:

Value:

Company name/number & description:

Value:

Company name/number & description:

Value:
Vested Interest in Retirement Fund:
$

Automobiles:
Year & Make: Value: $
Year & Make: Value: $

Other Assets: (e.g. Furniture, Jewelry, Household Goods, Personal Property, etc.)
$ 		Gifts For Down Payment

Gift Amount$:($4,000.00 = 4000)
Liabilities
Enter only if this is a refinance loan (details of first mortgage on subject property):

First Mortgage Creditor:
Name:
Loan Number:
Monthly payment: Balance:
Details of second mortgage on subject property (if any):

Second Mortgage Creditor:
Name:
Loan Number:
Monthly Payment: Balance:
All other monthly liabilities:
(Include credit card debt, auto loans, student loans, installment loans etc.) You may use an estimate; we will obtain details from your credit report.

Monthly pmt. Balance

OTHER REAL ESTATE OWNED (Enter total for all properties not including subject property for a refinance)

Market Value
 Amt. of Liens
 Gross Rent Inc
 Mortgage Pmt
 Tax/Ins. Maint.
 Net Rental Inc

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8. DECLARATIONS
If you answer yes any question, then provide details in the comment section at the end of the application.

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Items Borrower Co-Borrower
a. Are there any outstanding judgments against you? Yes No Yes No
b. Have you been declared bankrupt within the last 7 years? Yes No Yes No
c. Have you had property foreclosed upon in the last 7 years? Yes No Yes No
d. Are you a party to a lawsuit? Yes No Yes No
e. Have you directly or indirectly been obligated on any loan which resulted in foreclosure, transfer of title in lieu of foreclosure, or judgment? Yes No Yes No
f. Are you presently delinquent or in default on any Federal debt or any other loan, mortgage, financial obligation, bond or loan guarantee? Yes No Yes No
g. Are you obligated to pay alimony child support or separate maintenance? Yes No Yes No
h. Is any part of the down payment borrowed? Yes No Yes No
i. Are you the co-maker or endorser on a note? Yes No Yes No
j. Are you a U.S. citizen? Yes No Yes No
k. Are you a permanent resident alien? Yes No Yes No
l. Do you intend to occupy the property as your primary residence? Yes No Yes No
m. Have you had an ownership interest in a property in the last 3 years? Yes No Yes No

If the answer to m above is "yes":

  Borrower Co-Borrower
1. What type of property did you own? Principal residence
Second home
Investment Property 		Principal residence
Second home
Investment Property
2. 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

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9. ACKNOWLEDGMENT AND AGREEMENT

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The undersigned specifically acknowledge(s) and agree(s) that: (1) the loan requested by this application will be secured by a first mortgage or deed of trust on the property described herein: (2) the property will not be used for any illegal or prohibited purpose or use: (3) all statements made in this application are made for the purpose of obtaining the loan indicated herein: (4) occupation of the property will be as indicated above: (5) verification or re-verification of any information contained in this application may be made at any time by the Lender, its agents, successors and assigns, either directly or through a credit reporting agency, from any source named in this application, and the original copy of this application will be retained by the Lender, even if the loan is not approved: (6) the Lender, its agents, successors and assigns will rely on the information contained in the application and I/we have a continuing obligation to amend and/or supplement the information provided in this application if any of the material facts which I/we have represented herein have changed prior to closing: (7) in the event my/our payments on the loan indicated in this application become delinquent, the Lender, its agents, successors and assigns, may, in addition to all their other rights and remedies, report my/our name(s) and account information to a credit reporting agency: (8) ownership of the loan may be transferred to an agent, successor or assign of the Lender with prior notice to me: (9) the Lender, its agents, successors and assigns make no representations or warranties, express or implied, to the Borrower(s) regarding the property, the condition of the property, or the value of the property.

Certification: I/We certify that the information provided in this application is true and correct as of the date set forth opposite my/our signature (acknowledgment indicated below) on this application and acknowledge my/our understanding that any intentional or negligent misrepresentation(s) of the information contained in this application may result in civil liability and/or criminal penalties including, but not limited to, fine or imprisonment or both under the provisions of title 18, United States Code, Section 1001, et seq. and liability for monetary damages to the Lender, its agents, successors and assigns, insurers and any other person who may suffer any loss due to reliance upon any misrepresentation which I/we made on this application.

This application is designed to be completed by the applicant(s) . Co-Borrower information must also be provided (and the appropriate box selected below) when:

the income or assets of a person other than the "Borrower" (including the Borrowers spouse) will be used as a basis for loan qualification or
the income or assets of the Borrowers spouse will not be used as a basis for loan qualification, but his or her liabilities must be considered because the Borrower resides in a community property state, or the security property is located in a community property state, or the Borrower is relying on other property located in a community property state as a basis for repayment of the loan.

By submitting this application you acknowledge the above

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10. INFORMATION FOR GOVERNMENT MONITORING PURPOSES

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This information is entirely optional.

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

Any Additional information you wish to send may be typed in the space below to assist us in processing your loan request (preferred loan programs, special requirements regarding your purchase, refinance, pre-qualification, etc.)  be sure to enter anything that may clarify any information provided in the application:

The Hard part is over!  Push the Submit button below and your application will be forwarded to one of our loan officers.  We will contact you about your loan by the next business day. Thank You .

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Copyright © 1998-2004 Metro Mortgage Corporation. All rights reserved.
Revised: May 04, 2007.