Application Credit Information: If this is an INDIVIDUAL application, complete section A. If this is a joint application, complete section A and B. Note: If married, the spouse is not required to be the joint applicant.
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APPLICATION'S EMPLOYMENT HISTORY (Minimum Three Year, attach supplement if needed)
What is your base pay rate excluding commission, bonuses, and overtime:
Please Provide an explanation for any job gaps greater than 30 days.
APPLICANT'S OTHER INCOME
CO-APPLICANT'S OTHER INCOME
Income for SSI, Retirement, disability, alimony, child support or seprate maintenance agreement need not be disclosed if you do not wish to have it considered as a basic for undertaking or repaying this debt.
Assets and Credit Information
Are you a co-maker or guarantor on a note?
(A) Applicant - Debts / Obligations
(B) CO-Applicant - Debts / Obligations
List any Government Assitance Payments to you that help offset household expenses, such as WIC, TANF or SNAP. You are not required to disclose these amounts If you do not wish to have them considered as a basis in analyzing your ability to undertake or repay this dept.
If the answer is "yes" to any of the questions(1-5), exxplain on attached sheet. Enter Y(yes) or N(no) for the Borrower and/or Co-Borrower
3. Have you declared bankruptcy within the last 10 years?
If yes, when did you file?
California: An applicant, if married, may apply for a separate account. It is illegal to discriminate in the provision of availablity of financial assistance for the purpose of the purchase, construction, rehabilitation of any one to four unit family residence occupied by the owner and for the purpose of the house improvement of any one to four unit family residence by considering:
- Trends, characteristics or conditions in the neighborhood or geographic area surrounding a housing accommodation, unless the financial institution can demonstrate in the particular case that such consideration is required to avoid an unsafe and unsound business practice; or
- Race, color, religion, sex, marital status, national origin or anscestry.
It is illegal to consider the racial, ethnic, religious or national origin composition of aa neighborhood or geographic area surrounding a housing accommodation or whether or not such composition is undergoing change, or is expected to undergo change, in appraising a housing accommodation or in determining whether or not or under what terms and conditions, to provide financial assistance. If you have questions about your rights, or if you wish to file a complaint, contact the Lender or the California Department of Corporations at: 320 West 4St, Ste 750, Los Angeles, CA 90013, or 1390 Market St, Ste 810 San Francisco, CA 94102
New York and Vermont: In connection with your application for credit, a consumer report may be requested in connection with such application, Upon request, you will be informed whether a consumer report was requested, and if such report was requested, informed of the name and address of the consumer reporting agency that furnished the report. If your application is granted, subsequent consumer reports may be requested or utilized in connection with any updates, renewal or extension of the credit for which application was made for any other legitimate purpose associated with the account.
Ohio: The Ohio laws against discrimination requires that all creditors make credit equally available to all creditworthy customers and that credit reporting maintain separate credit histories on each individual upon request. The Ohio Civil Rights Commission administers compliance with this law.
Wisconsin: No provision of a marital property agreement, a unilateral statement under Wisc. Stat. 766.59 or a court decree under Wisc. Stat. 766.70 adversely affects the interest of the creditor unless the creditor, prior to the time the credit is granted, is furnished a copy of the agreement, statement, or decree of has actual knowledge of the adverse provision when the obligation to the creditor is incurred.
NON-APPLICANT SPOUSE WAIVER OF NOTICE: I agree to waive notice of any extension of credit in connection with this application:
Non-applicant Spouse: Date
Additional disclosures may be required for the following states: Texas, New York, Ohio, Oregon.
These documents are separate from this application and must be submitted with the application for the lender to process your request.
Each of the undersigned specifically represents to Lender and to Lender's actual or potential agents, brokers, processors, attorneys, insurers, successors and assigns and agrees and acknowledges that: (1) the information provided in this application is true and correct as of the date set forth opposite my signature and that any intentional or negligent misrepresentation of the information contained in the application may result in civil liability, including monetary damages, to any person who may suffer any loss due to reliance upon any misrepresentation that I have made on this application, and/or in criminal penalties including, but not limited to, fine or imprisonment or both under the provision of Title 18, United States Code, Sec. 1001, et seq.; (2) the loan requested pursuant to the application (the "Loan") will be secured by a mortgage of deed of trust on the property described herein;(3) the property will not be used for any illegal or prohibited purpose or use; (4) all statements made in the application are made for the purpose of obtaining a residential mortgage loan; (5) the property will be occupied as indicated herein; (6) any owner or servicer of the Loan may verify or re-verify any information contained in the application from any source named in the application, and Lender, its successors or assigns may retain the original and/or electronic record of the application, even if the Loan in not approved; (7) the Lenders and its agents, brokers, insurers, servicers, successors, and assigns may continuously rely on the information contained in the application, and I am obligated to amend and/or supplement the information provided in the application if any of the material facts that I have represented herein should change prior to the closing of the Loan; (8) in the event my payments on the Loan become delinquent, the owner or servicer of the Loan may, in addition to any other rights and remedies that it may have relating to such delinquency, report my name and account information to one or more consumer credit reporting agencies; (9) ownership of the Loan and/or administration of the Loan account may be transferred with such notice as may be required by law; (10) neigther Lender nor its agents, brokers, insurers,servicers, successors, or assigns has made any representation or warranty, expressed or implied, to me regarding the property or the condition or value of the property; and (11) my transmission of the application as an "electronic record" containing my "electronic signature" as those terms are defined in the applicable federal and/or state laws (excluding audio and video recordings), or my facsimile transmission of the application containing a facsimile of my signature, shall be as effective, enforceable and valid as if a paper version of the application were delivered containing my original signature. I give permission to Lender to investigate my credit and employment history and authorize my employer, landlord, depository institution, and credit company to release information about me. I acknowledge that my dealer is neigher a broker nor a credit grantor. This application may be considered withdrawn if I do not inquire about its status within 30 days of the date of this notice.
Demographic Information Of Applicant and Co-Applicant
The purpose of collecting this information is to help ensure that all applicants are treated fairly and that the housing needs of communites and neighborhoods are being fulfilled. For residential mortgage lending, Federal law requires that we ask applicants for their demographic information (ethnicity, race and sex) in order to monitor our compliance with equal credit opportunity, fair housing, and home mortgage disclosure laws. You are not required to provide this information, but are encouraged to do so. You may select one or more designations for "Ethnicity" and one or more designations for "Race". The law provides that we may not descriminate on the basis of this information, or on whether you choose to provide it. However if you choose not to provide the information and you have made this application in person, Federal regulations require us to note your ethnicity, race and sex on the basis of visual observation or surname. If you do not wish to provide some or all of this information, please check below.
The Demographic Information was Provided Through
IF YES HOW MUCH?