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LOAN APPLICATION FORM

Use this form to submit your Residential Loan Application electronically & pre-qualify

Please complete accurately...

Privacy Policy: We respect private information and operate with the highest business ethics. Any details you supply to us will not be disclosed to any other party without your prior consent.

  Borrower & Co-Borrower Information:
BORROWER DETAILS:

Borrower First Name
 
Borrower Last Name

Present Address

City
State  
Zip     

Owner Rented  (Please select One)

No. Years at this address

 

If you have been at this address less than 2 years please use the box below to provide address, whether you owned or rented, and how long you were at your former address:

 

SSN (Social Sec. No.)

 

E-Mail

 

Home Phone

 

Work Phone

Date of Birth

 

Age

 

Years at School

 

Marital Status

 

No. of Dependents

 

Ages

 
CO-BORROWER DETAILS:

Co-Borrower First Name

Co-Borrower Last Name

Present Address

City
State  
Zip     

Owner Rented  (Please select One)

No. Years at this address

 

If you have been at this address less than 2 years please use the box below to provide address, whether you owned or rented, and how long you were at your former address:

SSN (Social Sec. No.)

 

E-Mail

 

Home Phone

 

Work Phone

Date of Birth

 

Age

 

Years at School

 

Marital Status

 

Only complete the following if not given by Borrower:

 

No. of Dependents

 

Ages
  Employment Information:
BORROWER EMPLOYMENT DETAILS:

 

Name & Address of Employer (for Borrower)

Position

Employer Tel. No.

Monthly Income Amt. $

 

No. of Years on this Job 

Please provide details below of previous Employer if you have been in your current job less than 2 years


Years in same field/profession 

 

Self Employed?  (Check this box if you are)

PREVIOUS EMPLOYER

COMPLETE THIS SECTION IF YOU HAVE BEEN IN YOUR CURRENT EMPLOYMENT LESS THAN 2 YEARS
 

Name & Address of Previous Employer (for Borrower)
Position
Employer Tel. No.

Monthly Income Amt. $

 

Dates on this Job (date from - to leaving date)


Years in same field/profession 

 

Were you Self Employed?  

(Check this box if you were)

 
BORROWER EMPLOYMENT DETAILS:

Name & Address of Employer

(for Co-Borrower)

Position

Employer Tel. No.

Monthly Income Amt. $

 

No. of Years on this Job 

Please provide details below of previous Employer if you have been in your current job less than 2 years


Years in same field/profession 

 

Self Employed?  (Check this box if you are)

PREVIOUS EMPLOYER

COMPLETE THIS SECTION IF YOU HAVE BEEN IN YOUR CURRENT EMPLOYMENT LESS THAN 2 YEARS
 

Name & Address of Previous Employer

(for Co-Borrower)

Position

Employer Tel. No.

Monthly Income Amt. $

 

Dates on this Job (date from - to leaving date)


Years in same field/profession 

 

Were you Self Employed?  

(Check this box if you were)

Total Gross Monthly Income: $
   Assets & Liabilities
  List Checking and Savings Accounts
1. Name & Addr. of Bank, S&L, or Credit Union
 Amount
$
Account Number
  2. Name & Addr. of Bank, S&L, or Credit Union
 Amount
$
Account Number
1.

Stocks and Bonds  (Please Describe)

 Amount
$
2. $
3. $
1. Life Insurance
 Face Amount
$
1. Automobile Type
 		Est. Value
$
2. $
3. $
1.

Other Assets (Please Describe)

Amount
$
2. $
3. $
4. $
  Schedule of Real Estate Owned:
Property Address Present Market Value ($) Current Status Amount of Mortgages & Liens ($) Monthly Mortgage Payments ($)

1.

2.

3.

   Type of Loan Requested:
Price of Property purchasing (US$) 
Downpayment/Deposit (select one) 20%, 25%, 30%, More than 35%, 
Loan Type: 
Residence Type: 
Property Type: 
Loan Type: 
Estimated Loan Amount ($): 
  DECLARATIONS:
    BORROWER CO-BORROWER
a. Are there any outstanding judgements against you?
b. Have you been declared bankrupt within the past 7 years?
c. Have you had property foreclosed upon or given title or deed in lieu therof in the last 7 years?
d. Are you party to a lawsuit?
e. Have you directly or indirectly been obliged on any loan which resulted in foreclosure, transfer of title in lieu of foreclosure, or judgement?
f. Are you presently delinquent or in default on any Federal debt or any other loan, mortgage, or loan guarantee?
g. Are you obliged to pay alimony, child support, or seperate maintenance?
h. Is any part of the down payment borrowed?
i. Are you a co-maker or endorser on a note?
j. Are you a U.S. Citizen?
k. Are you a permanent resident alien in the U.S.A?
l. Do you intend to occupy the property as your primary residence? If 'yes' complete question 'm' below.
m. Have you had ownership interest in a property in the last three years?
  1. What type of property did you own?
  2. How did you hold title to the home?

If you answered 'YES' to any question a. through i. above, please use the box below to explian. Also use this box to provide us with any other information that you feel is important.

* "I authorize U.S. Holidays and/or assigns to obtain my/our credit report for the purpose of determining credit worthiness. The information that is obtained is strictly confidential. By submitting this electronically, this is to be deemed to be the equivalent of an original Uniform Residential Loan Application Form 1003."

 


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