To be completed by the lender
Lender Loan No / Universal Loan Identifier
Agency Case No.
Application Overview
JSR Residential Loan Application
Verify and complete the information on this application. If you are applying for this loan with others, each additional Borrower must provide information as directed by your Lender.
Section 1: Borrower Information
This section asks about your personal information and your income fromemployment and other sources, such as retirement, that you want considered to qualify for this loan.
Borrower type
Primary Borrower
Co-Borrower
Typer of Credit
Please Select
Individual Credit
Joint Credit
Total Number of Borrowers
Please Select
1
2
3
4
Each Borrower intends to apply for joint credit. Your initials:
List Names of Other Borrowers Applying for this Loan
First, Middle, Last, Suffix - Use a separator between names
Borrower 1 Information
Borrower Name
*
First Name
Middle Name
Last Name
Alternate Names
List any other names by which you are known
Social Security Number / ITIN
*
Date of Birth
-
Month
-
Day
Year
Date
Citizenship
*
Please Select
U.S. Citizen
Permanent Resident Alien
Non-Permanent Resident Alien
Other
Marital Status
*
Please Select
Married
Separated
Unmarried - single, divorced, widower, civil union, domestic partnership, registered reciprocal beneficiary relationship
Dependent Count (not listed by another Borrower)
Please Select
0
1
2
3
4
5
6+
Ages of Dependents (not listed by another Borrower)
Home Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Cell Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Work Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Work Phone Number - Extension
Email Address
example@example.com
Current Street Address
*
Unit Number
City
*
State
*
Please Select
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
DC
Other
ZIP Code
*
Country
Years at Current Address
Months at Current Address
Current Housing Type
Please Select
Own
Rent
No primary housing expense
Current Monthly Rent/Mortgage Payment
If at Current Address for less than 2 years, list Former Address
Does not apply
Former Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Time at Former Address
Years
Time at Former Address
Months
Former Housing Status
Please Select
Own
Rent
No primary housing expense
Former Monthly Rent/Mortgage
Back
Next
Mailing Address Same as Current Address?
Yes
No
Mailing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Borrower 1 Employment & Income
Check if you are the Business Owner or Self-Employed
Yes
If yes
I have an ownership share of less than 25%
I have an ownership share of 25% or more
Employer / Business Name
Employer Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Employer Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Country
Position / Title
Employment Start Date
-
Month
-
Day
Year
Date
Years in this Line of Work
Months in this Line of Work
Check if this Statement Applies
I am employed by a family member, property seller, real estate agent, or other party to the transaction.
Gross Monthly Income - base ($ / mo.)
Gross Monthly Income - overtime ($ / mo.)
Gross Monthly Income - bonus ($ / mo.)
Gross Monthly Income - commission ($ / mo.)
Gross Monthly Income - Military Entitlements ($ / month)
Gross Monthly Income - Other Income ($ / month)
Total Gross Monthly Income
Have additional Employment / Self-Employment and Income to complete?
Yes
No
Employer / Business Name
Employer Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Employer Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Country
Position / Title
Employment Start Date
-
Month
-
Day
Year
Date
Years in this Line of Work
Months in this Line of Work
Check if this Statement Applies
I am employed by a family member,property seller, real estate agent, or otherparty to the transaction.
Gross Monthly Income - base ($ / mo.)
Gross Monthly Income - overtime ($ / mo.)
Gross Monthly Income - bonus ($ / mo.)
Gross Monthly Income - commission ($ / mo.)
Gross Monthly Income - Military Entitlements ($ / month)
Gross Monthly Income - Other Income ($ / month)
Total Gross Monthly Income
Have additional Employment / Self-Employment and Income to complete?
Yes
No
Employer / Business Name
Employer Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Employer Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Country
Position / Title
Employment Start Date
-
Month
-
Day
Year
Date
Years in this Line of Work
Months in this Line of Work
Check if this Statement Applies
I am employed by a family member, property seller, real estate agent, or other party to the transaction.
Gross Monthly Income - base ($ / mo.)
Gross Monthly Income - overtime ($ / mo.)
Gross Monthly Income - bonus ($ / mo.)
Gross Monthly Income - commission ($ / mo.)
Gross Monthly Income - Military Entitlements ($ / month)
Gross Monthly Income - Other Income ($ / month)
Total Gross Monthly Income
Have you been at your current employer for less than 2 years?
Yes
No
Previous Employer or Business Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Country
Previous Position / Title
Previous Start Date
-
Month
-
Day
Year
Date
Previous End Date
-
Month
-
Day
Year
Date
Were you the Business Owner or Self-Employed?
Yes
No
Previous Gross Monthly Income ($)
Income from Other Sources
Include income from other sources below. Under Income Source, choose from the sources listed here: •Alimony •Automobile Allowance •Boarder Income •Capital Gains •Child Support •Disability •Foster Care •Housing or Parsonage •Interest and Dividends •Mortgage Credit Certificate •Mortgage Differential Payments •Notes Receivable •Public Assistance •Retirement (e.g., Pension, IRA) •Royalty Payments •Separate Maintenance •Social Security •Trust •Unemployment Benefits •VA Compensation •Other | NOTE: Reveal alimony, child support, separate maintenance, or other income ONLY IF you want it considered in determining your qualification for this loan.
Rows
Not Satisfied
Monthly Income
Income Source - use list above
Income Source - use list above
Income Source - use list above
Income Source - use list above
*Provide total monthly amount here
Back
Next
Section 2 - Financial Information - Assets and Liabilities
This section asks about things you own that are worth money and that you want considered to qualify for this loan. It then asks about your liabilities (or debts) that you pay each month, such as credit cards, alimony, or other expenses.
Education Level
Please Select
High School
Associate Degree
Bachelor's Degree
Graduate Degree
Other
Language Preference
Please Select
English
Spanish
Chinese
Other
Ethnicity
Please Select
Hispanic or Latino
Not Hispanic or Latino
Declined to Answer
Other
Race
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Other
Primary Language
Please Select
English
Spanish
French
Chinese
Other
Preferred Contact Method
Please Select
Home Phone
Cell Phone
Work Phone
Email
Mail
Years at Current Employer
Months at Current Employer
Additional Borrower Identification Notes
Current Residence and Housing
Does the monthly payment include property taxes?
Please Select
Yes
No
Unknown
Does the monthly payment include homeowners insurance?
Please Select
Yes
No
Unknown
Does the monthly payment include association dues?
Please Select
Yes
No
Unknown
Association Dues Amount
Residence Type
Please Select
Single-family home
Condominium
Townhouse
Apartment
Mobile home
Other
Occupancy Basis
Please Select
Primary residence
Second home
Investment property
Other
Will the property be a primary residence?
Please Select
Yes
No
Unknown
Will you own this property?
Please Select
Yes
No
Unknown
Landlord or Mortgage Holder Name
Landlord or Mortgage Holder Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Landlord or Mortgage Holder Street Address
Landlord or Mortgage Holder City
Landlord or Mortgage Holder State
Please Select
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
DC
Other
Landlord or Mortgage Holder ZIP Code
Housing Payment Frequency
Please Select
Monthly
Quarterly
Annually
Other
Gross Monthly Rent
Months Remaining on Lease
Living Arrangement
Please Select
With spouse/partner
With family
With roommates
Alone
Other
Mailing Address Same as Current Address?
Please Select
Yes
No
Mailing Street Address
Mailing City
Mailing State
Please Select
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
DC
Other
Mailing ZIP Code
Additional Housing History Details
Employment and Income
Employer Name
Employer Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Employer Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Position/Title
Years Employed
Months Employed
Base Monthly Income
Overtime
Bonuses
Commissions
Dividends/Interest
Net Rental Income
Other Income
Other Income Description
Employer Name
Employer Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Employer Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Position/Title
Years Employed
Months Employed
Base Monthly Income
Overtime
Bonuses
Commissions
Dividends/Interest
Net Rental Income
Other Income
Other Income Description
Employer Name
Employer Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Employer Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Position/Title
Years Employed
Months Employed
Base Monthly Income
Overtime
Bonuses
Commissions
Dividends/Interest
Net Rental Income
Other Income
Other Income Description
Employer Name
Employer Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Employer Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Position/Title
Years Employed
Months Employed
Base Monthly Income
Overtime
Bonuses
Commissions
Dividends/Interest
Net Rental Income
Other Income
Other Income Description
Employer Name
Employer Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Employer Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Position/Title
Years Employed
Months Employed
Base Monthly Income
Overtime
Bonuses
Commissions
Dividends/Interest
Net Rental Income
Other Income
Other Income Description
Back
Next
Assets and Liabilities
Type of asset
Please Select
Depository account
Cash value life insurance
Vested retirement funds
Other
Financial institution name
Account number
Current value
Joint asset?
Yes
Joint owner name
First Name
Middle Name
Last Name
Relationship to borrower
Type of asset
Please Select
Certificates of deposit
Stocks
Bonds
Mutual funds
Retirement account
Other
Financial institution name
Account number
Current value
Joint asset?
Yes
Joint owner name
First Name
Middle Name
Last Name
Relationship to borrower
Type of asset
Please Select
Real estate owned
Personal property
Other
Description of asset
Location of asset
Current value
Joint asset?
Yes
Joint owner name
First Name
Last Name
Relationship to borrower
Name of depository or institution
Account holder name
Account number
Cash or market value
Joint account?
Yes
Joint account holder name
First Name
Last Name
Relationship to borrower
Type of liability
Please Select
Mortgage loan
Home equity loan
Installment loan
Auto loan
Student loan
Credit line
Other
Creditor name
Account number
Unpaid balance
Monthly payment
Months left to pay
Is this debt paid through the real estate transaction?
Yes
Type of liability
Please Select
Installment debt
Revolving debt
Lease obligation
Alimony
Child support
Separate maintenance
Tax lien
Judgment
Other
Creditor or recipient name
Account or case number
Monthly amount
Months remaining
Is this obligation paid through the real estate transaction?
Yes
Type of obligation
Please Select
Co-signed debt
Guaranty
Lease
Other
Borrower's responsibility amount
Payee name
Monthly payment
Months remaining
Is this obligation paid through the real estate transaction?
Yes
Other monthly obligations
Monthly amount
Assets included in reserve calculation
Please Select
Checking account
Savings account
Money market account
Stocks
Bonds
Retirement funds
Other
Total assets amount
Additional assets description
Additional liabilities description
Total liabilities amount
Explanation of large deposits or unusual liabilities
Back
Next
Loan and Property Details
Loan Amount Requested
*
Loan Purpose
*
Please Select
Purchase
Refinance
Construction
Home Equity
Other
Subject Property Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Occupancy
*
Please Select
Primary Residence
Second Home
Investment Property
Other
Property Type
Please Select
Single-Family
Condominium
Townhouse
Multi-Family
Manufactured Home
Other
Number of Units
Please Select
1
2
3
4
More than 4
Property Use
Please Select
Existing
New Construction
To Be Built
Under Construction
Other
Title Will Be Held In
Please Select
One Borrower
Joint Tenants
Tenants in Common
Community Property
Other
Loan Features Requested
Fixed Rate
Adjustable Rate
Interest Only
Balloon Payment
Other
Amortization Type
Please Select
Fully Amortizing
Interest Only
Negative Amortization
Other
Loan Term (Years)
Interest Rate Type
Please Select
Fixed
Adjustable
Temporary Buydown
Other
Prepayment Penalty
Please Select
Yes
No
Unknown
Escrow Account
Please Select
Yes
No
Unknown
Mortgage Insurance
Please Select
Yes
No
Unknown
Down Payment Amount
Down Payment Percentage
Down Payment Source
Please Select
Borrower Savings
Gift
Sale of Asset
Retirement Funds
Other
Property Rights To Be Acquired
Please Select
Fee Simple
Leasehold
Other
Existing Property Held
Please Select
Sale Pending
Not Yet Listed
Currently Listed
No Existing Property
Other
Existing Property Disposition
Property Condition
Please Select
Existing
Proposed
New Construction
Other
Construction Method
Please Select
Site-Built
Manufactured
Modular
Other
Energy Efficient Features
Please Select
Solar
Geothermal
Insulation Upgrade
Energy Star Appliances
None
Other
Will the Property Be Used as a Rental
Please Select
Yes
No
Unknown
Monthly Rental Income
Estimated Property Value
Please Select
Not Yet Determined
Estimated
Appraised
Purchase Price
Other
Purchase Price
Appraised Value
Source of Funds for Closing
Please Select
Savings
Checking
Gift
Retirement
Proceeds from Sale
Other
Occupancy Status at Closing
Please Select
Owner Occupied
Tenant Occupied
Vacant
Unknown
Refinance Type
Please Select
Rate and Term
Cash-Out
Streamline
No Cash-Out
Other
Loan-to-Value Ratio
Combined Loan-to-Value Ratio
Special Property Hazards
Please Select
Flood
Earthquake
Wildfire
Other
None
Back
Next
Declarations and Agreements
A. Will you occupy the property as your primary residence?
*
Yes
No
B. If this is a joint application, is the co-borrower required to occupy the property as a primary residence?
*
Yes
No
N/A
C. Are there any outstanding judgments against you?
*
Yes
No
D. Have you declared bankruptcy within the past 7 years?
*
Yes
No
E. Are you a party to a lawsuit?
*
Yes
No
F. Have you directly or indirectly been obligated on any loan that resulted in foreclosure, transfer of title in lieu of foreclosure, or judgment?
*
Yes
No
G. Are you presently delinquent or in default on any federal debt?
*
Yes
No
H. Are you obligated to pay alimony, child support, or separate maintenance?
*
Yes
No
I. Is any part of the down payment borrowed?
*
Yes
No
J. Are you a co-signer or guarantor on any debt or loan not listed on this application?
*
Yes
No
K. Are there any outstanding liens against your property?
*
Yes
No
L. Do you own or have you owned any property in the past 3 years?
*
Yes
No
M. Have you had property foreclosed upon in the last 3 years?
*
Yes
No
N. Have you conveyed title to a property in lieu of foreclosure in the last 3 years?
*
Yes
No
O. Do you have any financial interests in the property or loan transaction other than as disclosed?
*
Yes
No
P. Is the property subject to any liens or claims not disclosed on this application?
*
Yes
No
Q. Will the proceeds of this loan be used for business purposes?
*
Yes
No
R. Are you a U.S. citizen?
*
Yes
No
S. Are you a permanent resident alien?
*
Yes
No
T. Are you a nonpermanent resident alien?
*
Yes
No
U. I authorize the lender to verify the information provided in this application.
*
I agree
V. I authorize the lender to obtain a consumer report and verify employment, income, assets, and liabilities.
*
I agree
W. I acknowledge receipt of the disclosures required by applicable law.
*
I acknowledge
X. I understand that false statements may result in federal penalties.
*
I understand
Y. I agree to provide additional documentation if requested.
*
I agree
Z. I certify that the information provided is true and complete to the best of my knowledge.
*
I certify
AA. Have you ever had an ownership interest in a property that was financed through a mortgage loan?
*
Yes
No
BB. Have you had ownership interest in any property in the last 3 years that was financed with a mortgage or deed of trust?
*
Yes
No
CC. Do you intend to occupy the property as your primary residence within 60 days of closing?
*
Yes
No
DD. Are there any other declarations, agreements, or disclosures that apply to your application?
Yes
No
Back
Next
Military Service and Demographics
Are you a veteran?
Yes
No
Are you currently serving on active duty?
Yes
No
Are you a member of the National Guard?
Yes
No
Are you a reserve member?
Yes
No
Have you ever served in the U.S. military?
Yes
No
Branch of service
Please Select
Army
Navy
Air Force
Marine Corps
Coast Guard
Space Force
Other
Service status
Please Select
Active Duty
Reserve
National Guard
Retired
Separated
Other
Military service start date
Military service end date
Years of military service
Ethnicity
Hispanic or Latino
Not Hispanic or Latino
Prefer not to answer
Other
Race
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Prefer not to answer
Other
Sex
Male
Female
Prefer not to answer
Marital status
Please Select
Married
Separated
Unmarried
Other
Do you plan to occupy the property as your primary residence?
Yes
No
Will any borrower be a co-borrower?
Yes
No
Is there a non-occupant co-borrower?
Yes
No
Household size
Number of dependents
Age of youngest dependent
Do you receive military benefits?
Yes
No
Type of military benefits
Please Select
Disability compensation
Pension
Education benefits
Housing allowance
Other
Are you eligible for VA benefits?
Yes
No
VA entitlement amount
Additional demographic information
Back
Next
Loan Originator Information
Loan Originator Name
*
NMLS ID
Company Name
*
Company Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Loan Originator Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Loan Originator Email
example@example.com
Company Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Loan Officer Fax
Loan Originator License Number
Signatures and Dates
Borrower Signature
*
Borrower Signature Date
*
-
Month
-
Day
Year
Date
Co-Borrower Signature
Co-Borrower Signature Date
-
Month
-
Day
Year
Date
Date Signed
-
Month
-
Day
Year
Date
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