This form will allow you to completemortgage application on-line for the purpose ofhome purchase, refinance, or pre-qualification and send the file, by e-mail to Treg and begin your loan application process.

REMEMBER:This form is unsecured.

Its purpose is intended to expedite your loan process.

Uniform Residential Loan Application (FNMA 1003)

This application is designed to be completed by the applicant(s) . Co-Borrower information must also be provided (and the appropriate box selected below) when:

the income or assets ofperson other than the "Borrower" (including the Borrowers spouse) will be used asbasis for loan qualification or
the income or assets of the Borrowers spouse will not be used asbasis for loan qualification, but his or her liabilities must be considered because the Borrower resides incommunity property state, or the security property is located incommunity property state, or the Borrower is relying on other property located incommunity property state asbasis for repayment of the loan.

The name of the person completing this form is :

Your e-mail address is :

I. TYPE OF MORTGAGE AND TERMS OF LOAN

Amount: $ No. of Months: Amortization Type:

II. PROPERTY INFORMATION AND PURPOSE OF LOAN

Property Address:

Street:

City:

ST.:

ZIP:

No. of Units:

Year Built:

Purpose of Loan:

Property will be:

Complete this line if this isrefinance loan.

Year
Acquired

Original Cost

Existing Liens

Purpose of Refinance

$

$

III. BORROWER INFORMATION

Borrower

Co-Borrower

Name (include Jr. or Sr. if applicable)

Name (include Jr. or Sr. if applicable)

Social Sec. No.

Home Phone

Social Sec. No.

Home Phone

Age

Yrs. of School

Age

Yrs. of School

Marital Status

Married
Unmarried
Separated

Dependents

No.
Ages

Marital Status

Married
Unmarried
Separated

Addl. Dependents

No.
Ages

Present Address:

Present Address:

Street

City

Street

City

State

Zip

State

Zip

Own Rent

No. Yrs.

Own Rent

No. Yrs.

IF AT PRESENT ADDRESS LESS THAN TWO YEARS ...

Former Address:

Former Address:

Street

City

Street

City

State

Zip

State

Zip

Own Rent

No. Yrs.

Own Rent

No. Yrs.

IV. EMPLOYMENT INFORMATION

Borrower

Co-Borrower

Name of Employer:

Name of Employer:

Attn.:

Attn.:

Address:

Address:

City:

City:

State:

Zip:

State:

Zip:

Self-employed
Yes No

Years on this job:

Self-employed
Yes No

Years on this job:

Yrs. in current profession:

Yrs. in current profession:

Position/Title/Type of Bus:

Position/Title/Type of Bus:

Business Phone:

Business Phone:

IF EMPLOYED IN CURRENT POSITION FOR LESS THAN TWO YEARS...

Name of Employer:

Name of Employer:

Attn.:

Attn.:

Address:

Address:

City:

City:

State:

Zip:

State:

Zip:

Self-employed
Yes No

From - To:

Self-employed
Yes No

From - To:

Monthly Income:

$

Monthly Income:

$

Position/Title/Type of Bus:

Position/Title/Type of Bus:

Business Phone:

Business Phone:

V. MONTHLY INCOME AND COMBINED HOUSING EXPENSE INFORMATION

Gross
Monthly
Income

Borrower

Co-Borrower

Base Empl,
Income*

Overtime

Bonuses

Commissions

Dividends/
Interest

Net Rental
Income

Other

*Self Employed Borrowers(s) may be required to provide additional documentation such as tax returns and financial statements.

Combined
Mthly Exp.
(Housing)

Present

Proposed

Rent

First
Mortgage

Other
Financing

Hazard
Insurance

Real Estate
Taxes

Mortgage
Insurance

Homeowner Assn. Dues

Other

VI. ASSETS AND LIABILITIES

ASSETS

Completed

Jointly Not Jointly

Cash deposit held by: (for purchase only)

Amount:
$

Checking/Savings Accounts

Name of Bank/S&L/Credit Union:

Address:

City:

State: Zip:
A/C No.:
Balance:

Name of Bank/S&L/Credit Union:

Address:

City:

State: Zip:
A/C No.:
Balance:

Name of Bank/S&L/Credit Union:

Address:

City:

State: Zip:

Name of Bank/S&L/Credit Union:

Address:

City:

State: Zip:
A/C No.:
Balance:

Name of Bank/S&L/Credit Union:

Address:

City:

State: Zip:
A/C No.:
Balance:

Stocks and Bonds:
Company name/number & description:

Amount:

Company name/number & description:

Amount:

Company name/number & description:

Amount:

Vested Interest in Retirement Fund:
$

Automobiles:
Year & Make: Value: $
Year & Make: Value: $

Other Assets: (e.g. Furniture, Jewelry, Household Goods, Personal Property, etc.)
$

Liabilities

Enter only if this isrefinance loan (details of first mortgage on subject property):

First Mortgage Creditor:
Name
Loan Number
Address
City
State Zip Monthly pmt. Balance

Details of second mortgage on subject property (if any):

Second Mortgage Creditor:
Name
Loan Number
Address
City
State Zip Monthly pmt. Balance

All other monthly liabilities:
(Include credit card debt, auto loans, student loans, installment loans etc.) You may use an estimate; we will obtain details from your credit report.

Monthly pmt. Balance

OTHER REAL ESTATE OWNED (Enter total for all properties not including subject property)

Market Value

Amt. of Liens

Gross Income

Mortgage Pmt

Tax/Ins. Maint.

Net Rental Inc

VIII. DECLARATIONS

Items

Borrower

Co-Borrower

a. Are there any outstanding judgments against you?

Yes No

Yes No

b. Have you been declared bankrupt within the last 7 years?

Yes No

Yes No

e. Have you directly or indirectly been obligated on any loan which resulted in foreclosure, transfer of title in lieu of foreclosure, or judgment?

Yes No

Yes No

d. Are youparty tolawsuit?

Yes No

Yes No

e. Have you directly or indirectly been obligated on any loan which resulted in foreclosure, transfer of title in lieu of foreclosure, or judgment?

Yes No

Yes No

f. Are you presently delinquent or in default on any Federal debt or any other loan, mortgage, financial obligation, bond or loan guarantee?

Yes No

Yes No

g. Are you obligated to pay alimony child support or separate maintenance?

Yes No

Yes No

h. Is any part of the down payment borrowed?

Yes No

Yes No

i. Are you the co-maker or endorser onnote?

Yes No

Yes No

j. Are youU.S. citizen?

Yes No

Yes No

k. Are youpermanent resident alien?

Yes No

Yes No

l. Do you intend to occupy the property as your primary residence?

Yes No

Yes No

m. Have you had an ownership interest inproperty in the last 3 years?

Yes No

Yes No

If the answer to (m.) above is "yes":

1. What type of property did you own?

Principal residence
Second home
Investment Property

Principal residence
Second home
Investment Property

2. How did you hold title to the home?

Solely by yourself
Jointly with spouse
Jointly with another person

Solely by yourself
Jointly with spouse
Jointly with another person

IX. ACKNOWLEDGMENT AND AGREEMENT

The undersigned specifically acknowledge(s) and agree(s) that: (1) the loan requested by this application will be secured byfirst mortgage or deed of trust on the property described herein: (2) the property will not be used for any illegal or prohibited purpose or use: (3) all statements made in this application are made for the purpose of obtaining the loan indicated herein: (4) occupation of the property will be as indicated above: (5) verification or re-verification of any information contained in this application may be made at any time by the Lender, its agents, successors and assigns, either directly or throughcredit reporting agency, from any source named in this application, and the original copy of this application will be retained by the Lender, even if the loan is not approved: (6) the Lender, its agents, successors and assigns will rely on the information contained in the application and I/we have a continuing obligation to amend and/or supplement the information provided in this application if any of the material facts which I/we have represented herein have changed prior to closing: (7) in the event my/our payments on the loan indicated in this application become delinquent, the Lender, its agents, successors and assigns, may, in addition to all their other rights and remedies, report my/our name(s) and account information to a credit reporting agency: (8) ownership of the loan may be transferred to an agent, successor or assign of the Lender with prior notice to me: (9) the Lender, its agents, successors and assigns make no representations or warranties, express or implied, to the Borrower(s) regarding the property, the condition of the property, or the value of the property.

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 (acknowledgment indicated below) 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, its agents, successors and assigns, insurers and any other person who may suffer any loss due to reliance upon any misrepresentation which I/we made on this application.

Borrower's Acknowledgment Co-Borrowers Acknowledgment

X. INFORMATION FOR GOVERNMENT MONITORING PURPOSES

This information is entirely optional:

Sex: Female Male

Additional information you require may be typed in the space provided below to assist us in processing your loan request (preferred loan programs, special requirements regarding your purchase, refinance, pre-qualification, etc.):

Security Code * (enter in the textfield below)


You're done! Congratulations. Push theSubmit button below and Treg will quickly contact you about your loan. Thank You

 

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Copyright © April, 2002 TREG
Last modified: August 27, 2002