Borrower/Guarantor Information for Individuals

Borrower/Guarantor #1

Name (include Jr. or Sr., if applicable)

Age

Yrs School

Home Phone Number (include area code)

Married              Unmarried        Separated

Social Security Number
(use format xxx-xx-xxxx )

Present Address

previous address if residence has
changed in previous 24 months:

Rent Own
No Years

Date of Birth

//

 

Name and address of employer            
Self Employed

Yrs on this job

Yrs employed in this line of work/profession

Position/Title/Type of business

Business Phone Number

Borrower/Guarantor #2 (if spouse, else use another form)

Name (include Jr. or Sr., if applicable)

Age

Yrs School

Home Phone Number (include area code)

Married              Unmarried
Separated

Social Security Number
(use format xxx-xx-xxxx )

Present Address

previous address if residence has
changed in previous 24 months:

Rent Own

No Years

Date of Birth

//

 

Name and address of employer           
  Self Employed

Yrs on this job

Yrs employed in this line of work/profession

Position/Title/Type of business

Business Phone Number

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

Yrs on this job

Yrs employed in this line of work/profession

Position/Title/Type of business

Business Phone Number

Name and address of employer   
  Self Employed

Yrs on this job

Yrs employed in this line of work/profession

Position/Title/Type of business
  

Business Phone Number

 

 

 

If you answer "yes" to any of the questions a through g, provide an explanation to right or on a continuation sheet.

Borrower/

Guarantor #1

 Borrower/

 Guarantor #2

Explanations. Use continuation sheets as necessary
Yes No Yes No

a. Are there outstanding judgments against you?

b. Have you been declared bankrupt in the past seven years?

c. Have you had property foreclosed upon or given title or deed in lieu thereof in the last seven (7) years?

d. Are you party to a lawsuit?
e. Have you directly or indirectly been obligated on any loan which resulted in foreclosure, transfer of title in lieu of foreclosure, or judgment? (This would include such loans as home mortgage loans, SBA loans, home improvements loans, educational loans, manufactured (mobile) home loans, any mortgage, financial obligation, bond, or loan guarantee. If "Yes," provide details, including date, name and address of  Lender, FHA or VA case number, if any, and reasons for the action.
f. Are you presently delinquent or in default on any Federal debt or any other loan, mortgage, financial obligation, bond, or loan guarantee? If "Yes," give details as  described in the preceding question.

g. Is any part of the down payment borrowed?

h. Are you a U.S. citizen?

i. Are you a permanent resident alien?

 

 

 

  Monthly Income

Gross Monthly Income

Borrower #1

Borrower #2

Total

Describe sources of other income below

Base Empl. Income

 $ $

$

Overtime

 $ $

$

Bonuses

 $ $

$

Commissions

 $ $

$

Dividends/Interest

 $ $

$

Net Rental Income (Total is calculated on the Real Estate Schedule)

$

Business Income

 $ $

$

Other Income

 $ $

$

Total

$

$

$

Acknowledgement and Agreement
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(s) 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, it agents, successors and assigns, insurers and any other person who may suffer any loss due to reliance upon any misrepresentation which I/we have made in the application.

Borrower/Guarantor's #1
Click inside the checkbox to signalize your agreement: 

Date    //

Borrower/Guarantor's #2
Click inside the checkbox to signalize your agreement:

Date    //

 

 

 

Statement of Assets and Liabilities for Individuals

Borrower/Guarantor #1

Borrower/Guarantor #2 (if spouse, else use another form)

Name

Name

Assets

Liabilities & Net Worth

Cash on Hand in Banks (List accounts below)

 

Notes Payable to Bank

$

$

Notes Payable to Relatives

$

$

Notes Payable to Others

$

$

Accounts Payable (i.e. credit cards)

$

$

Liens on Real Estate (from schedule below)

$

Cash currently on deposit or in escrow  with seller $

Other Liabilities (List Below)

 

U.S. Government Securities

$

$

Accounts, Loans and Notes Receivable

$

$

Cash Surrender Value Life Insurance

$

$

Stocks & Bonds

$

$

Total Liquid Assets (Verifiable at closing)

$

$

Real Estate Owned (Complete schedule below)

$

$

Net Worth of Business Owned

$

$

Vested Interest in Retirement Fund

$

$

Automobiles Owned

$

$

Other Assets (List Below)

 

 $
$ $
$ $
$ $
$ $
$

Total Liabilities

$

 

Total Assets 

$

Net Worth (Assets - Liabilities)

$

 

 

 

Schedule of Real Estate

Property Address

Type of Property

Percentage owned

Present Market Value*

Amount of Mortgages & Liens*

Annual Gross Rental Income*

Annual Operating Expenses*

Annual Net Income

%

$
%

$
%

$
%

$
%

$
%

$
%

$
%

$
%

$
%

$

Totals

 

  

$

$

$

$

$
*-Enter Either the 100% present market value, 100% amount of mortgages & liens, 100% annual gross rental income, 100% annual operating expenses and 100% annual net income