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Print All Four Pages and Mail or Fax to
4745 Nicholas Point Drive
Grove City, OH 43123
fax: 614-899-9190
Mortgage Broker Number: MB 802616 UI 219001
Please note that your printer's paper size must be set to Legal Paper (8 1/2" x 14")This application is designed to be completed by the applicant(s) with the lender's assistance. Applicants should complete this form as "Borrower" or "Co-Borrower", as applicable. Co-Borrower information must also be provided (and the appropriate box checked) when
the income or assets of a person
other than the "Borrower" (including the Borrower's spouse) will be used
as a basis for loan qualification or the income or assets of the
Borrower's 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, 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. | I. TYPE OF MORTGAGE AND TERMS OF LOAN | ||||
| Mortgage V.A. Conventional Other: Applied for: FHA FmHA
|
Agency Case # |
Lender Case # | ||
| Amount $ |
Interest Rate % |
No. of Months |
Amortization Fixed Rate Other
(explain): Type: GPM
ARM(type): | |
| II. PROPERTY INFORMATION AND PURPOSE OF LOAN | |||||||
| Subject Property Address
(street , city, state,ZIP) |
No. of Units | ||||||
| Legal Description of Subject
Property (attach description if necessary) |
Year Built | ||||||
| Purpose of Loan Purchase Construction Other (explain): Refinance
Construction-Permanent |
Property will be: Primary Residence Secondary Residence
Investment | ||||||
| Complete this line if construction or construction-permanent loan. | |||||||
| Year Lot Acquired |
Original Cost $ |
Amount Existing Liens $ |
(a) Present Value of Lot $ |
(b) Cost of Improvements $ |
Total (a+b) $ | ||
| Complete this line if this is a refinance loan. | |||||||
| Year Acquired |
Original Cost $ |
Amount Existing Liens $ |
Purpose of Refinance |
Describe Improvements made to be made Cost $ | |||
| Borrower III. BORROWER INFORMATION ; Co-Borrower | |||||||
| Borrower's Name (include Jr. or Sr. if
applicable) |
Co-Borrower's Name (include Jr. or Sr.
if applicable | ||||||
| Social Security # |
Home Phone (incl. area code)
|
Age |
Yrs. School |
Social Security # |
Home Phone (incl. area code)
|
Age |
Yrs. School |
| MarriedUnmarried (include single
divorced, widowed)Separated |
Dependents (not listed by Co- Borrower) no. |
MarriedUnmarried (include single
divorced, widowed)Separated |
Dependents (not listed by Borrower) no. | ||||
| If residing at present address for less than two years, complete the following: | |||||||
| Previous Address (street, city, state,
ZIP) Own Rent ____No.
Yrs. |
Previous Address (street, city, state,
ZIP) Own Rent ____No.
Yrs. | ||||||
| Previous Address (street, city, state,
ZIP) Own Rent ____No.
Yrs. |
Previous Address (street, city, state,
ZIP) Own Rent ____No.
Yrs.. | ||||||
| Borrower IV. EMPLOYMENT INFORMATION Co-Borrower | |||||||
| Name and Address of
Employer Self
Employed (check above box) |
Yrs. on this job |
Name and Address of
Employer Self
Employed (check above box) |
Yrs. on this job | ||||
| Yrs. employed in this line of work/profession |
Yrs. employed in this line of work/profession | ||||||
| Position/Title/Type of Business | Business Phone (incl. area code) | Position/Title/Type of Business | Business Phone (incl. area code) | ||||
| If employed in current position for less than two years or if currently employed in more than one position, complete the following: | |||||||
| Name and Address of
Employer Self
Employed (check above box) |
Dates(from-to) |
Name and Address of
Employer Self
Employed (check above box) |
Dates(from-to) | ||||
| Monthly Income $ |
Monthly Income $ | ||||||
| Position/Title/Type of Business | Business Phone (incl. area code) | Position/Title/Type of Business | Business Phone (incl. area code) | ||||
| Name and Address of
Employer Self
Employed (check above box) |
Dates(from-to) |
Name and Address of
Employer Self
Employed (check above box) |
Dates(from-to) | ||||
| Monthly Income $ |
Monthly Income $ | ||||||
| Position/Title/Type of Business | Business Phone (incl. area code) | Position/Title/Type of Business | Business Phone (incl. area code) | ||||
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