Application Type *

Choose an option below

Purchase

Refinance

Home Equity

Date of Birth *

MM

DD

YYYY

Do you currently own or rent? *

Own

Rent

Live Rent Free

Marital Status *

Married

Unmarried

Separated

Work Phone *

(###)

###

####

Start Date *

MM

DD

YYYY

Is there a Co-Applicant? *

Yes

No

Have you declared bankruptcy in the last 5 years? *

Yes

No

What is your ethnicity? *

The purpose of collecting this information is to help ensure that all applicants are treated fairly and that the housing needs of communities and neighborhoods are being fulfilled. For residential mortgage lending, federal law requires that we ask applicants for their demographic information (ethnicity, sex, and race) 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 discriminate 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, sex, and race on the basis of visual observation or surname. The law also provides that we may not discriminate on the basis of age or marital status information you provide in this application. If you do not wish to provide some or all of this information, please check below.

Hispanic or Latino

Not Hispanic or Latino

I do not wish to provide this information

What is your race? *

American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White

I do not wish to provide this information

Applicant Citizenship Status *

U.S. Citizen

Resident Alien

Other

Will you occupy the property as your primary residence?

Yes

No

Do you own any other properties?

yes

No

If this is a Purchase Transaction: Do you have a family relationship or business affiliation with the seller of the property?

Yes

No

Have you or will you be applying for any other mortgage loan on another property before closing this transaction?

Yes

No

Are you a co-signer or guarantor on any debt or loan that is not disclosed on this application?

Yes

No

Are there any outstanding judgments against you?

Yes

No

Are you currently delinquent or in default on a federal debt?

Yes

No

Are you in a party lawsuit in which you potentially have any personal financial liability?

Yes

No

With in the last 7 years have you done a foreclosure or short sale?

Yes

No

Have you declared bankruptcy within the past 7 years?

Yes

No