Application Application 1Borrower Information2Loan Type Information3New Home Location4Down Payment5Current Housing6Personal Info7Dependents8Employment9Other Income10Joint Applicant?11Joint - Personal Info12Joint - Employment13Assets14Expenses15Own Other Real Estate16Declarations17Demographics18Signature Your Name First Middle Last Suffix PhoneAddress Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Do you own a home? Yes, I own a home No, I am thinking about buying a new home Why are you looking for a mortgage? I want to buy a new property I want to refinance my home I want to use a Home Equity Line of Credit I want to get a second mortgage Have you found a new home yet? Yes No New home address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code What is the purpose of the new property? It will be my primary residence. It will be my secondary or vacation residence. I will use it as a rental or investment property. What type of property is it?Single-Family HomeCondominiumTownhomeManufactured HomeMulti-Family HomeCooperativePUDWhat is the sales price or what do you expect it to be? What is your estimated down payment?What is the desired loan term?10 Years15 Years20 Years25 Years30 YearsWill you receive any gifts or grants to help with this purchase? Yes No Please add all gifts or grants you will receive below: What is the source of the gift or grant? How much will you receive? Actions Edit Delete There are no GIfts/Grants. Add Gift/Grant Maximum number of gifts/grants reached. What is your current address? Same as first screen Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Do you rent or own this property? Rent Own How much is your monthly payment?When did you begin living there? MM slash DD slash YYYY What is your Social Security Number or Taxpayer Identification Number?* What is your date of birth? MM slash DD slash YYYY What is your citizenship?US CitizenPermanent Resident AlienNon-Permanent Resident AlienWhat is your marital status?MarriedSeparatedUnmarried (Single, Divorced, Widowed, Civil Union, Domestic Partnership)Consent* I agreeI authorize North Florida Mortgage to obtain a consumer credit report on {Your Name (First):1.3} {Your Name (Last):1.6}. Do you have any dependents? Yes No How Many? What are their ages? For example: 1, 4, 7 Are you self-employed or a business owner? Yes No What is your ownership share?Less than 25%25% or morePlease add your employment here. Is this employment for applicant or co-applicant? Where are you currently employed? When did your employment begin? Actions Edit Delete There are no Jobs. Add Job Maximum number of jobs reached. Include a minimum of 2 years. NOTE: Reveal alimony, child support, separate maintenance, or other income ONLY IF you want it considered in determining your qualification.Do you receive any income other than from your employment? Yes No What type of other income do you receive? How much do you receive monthly? Actions Edit Delete There are no Entries. Add Entry Maximum number of entries reached. Is anyone else applying for this loan with you? Yes No If you are applying for joint credit, each applicant must agree that he or she intends to apply for joint credit.Joint Applicant InformationWhat is the name and email of the person applying for the loan with you? First Middle Last Suffix Joint Applicant Email Joint Applicant Phone Joint Applicant InformationWhat is their Social Security Number or Taxpayer Identification Number?* What is their date of birth? MM slash DD slash YYYY What is their relationship to you?SpouseBrotherFatherMotherSisterSonDaughterGrandparentGrandchildOther RelativeNot RelatedWhat is their current address? Same as me Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code When did they begin living there? MM slash DD slash YYYY Joint Applicant Consent* I agree.I authorize North Florida Mortgage to obtain a consumer credit report on {What is the name and email of the person applying for the loan with you? (First):58.3} {What is the name and email of the person applying for the loan with you? (Last):58.6}. Joint Applicant EmplomentAre they self-employed or a business owner? Yes No What is their ownership share?Less than 25%25% or morePlease add employment here. Is this employment for applicant or co-applicant? Where are you currently employed? When did your employment begin? Actions Edit Delete There are no Jobs. Add Job Maximum number of jobs reached. Include a minimum or 2 years.Do they receive any income other than from their employment? Yes No What type of other income do you receive? How much do you receive monthly? Actions Edit Delete There are no Entries. Add Entry Maximum number of entries reached. Your Asset Information Institution Name Type of asset Balance or Value Actions Edit Delete There are no Entries. Add Entry Maximum number of entries reached. HiddenYour Asset InformationInstitution NameType of AssetBalance or Value CheckingSavingsMoney MarketCertificates of DepositMutual FundsStockStock OptionsBondsRetirementBridge Loan ProceedsIndividual Development AccountTrust AccountLife Insurance Do you have other monthly expenses? Yes No Other Monthly Expenses What is this other monthly expense? What is your monthly payment? Actions Edit Delete There are no Entries. Add Entry Maximum number of entries reached. HiddenWhat is this other monthly expense?What is your monthly payment? AlimonyChild SupportSeparate MaintenanceJob Related ExpensesOther Do you currently own any real estate (excluding the property in this transaction)? Yes No What is the monthly rental income received from this property?Does this property have an outstanding mortgage lien? Yes No What’s the mortgage amount of this property? a. Are there any outstanding judgments against you?* Yes No b. Have you declared bankruptcy within the past 7 years?* Yes No c. Have you had property foreclosed upon or given title or deed in lieu thereof in the last 7 years?* Yes No d. Are you a party to a lawsuit?* 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? (This would include any mortgage loans, SBA loans, home improvement loans, student loans, manufactured (mobile) home loans, financial obligations, bonds or loan guarantees.)* 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 g. Are you obligated to pay alimony, child support, or separate maintenance?* Yes No h. Is, or will, any part of the down payment be borrowed?* Yes No i. Are you a co-maker or endorser on a note?* Yes No j. Are you a U. S. citizen?* Yes No k. Are you a permanent resident alien?* Yes No l. Do you intend to occupy the property as your primary residence?* Yes No m. Have you had an ownership interest in a property in the last three years?* Yes No Answering the following questions is optional. We are required to ask them to comply with Federal Law. 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, 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 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, race, and sex 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.What is your sex?Consent I do not want to provide this information at this time. Male Female What is your ethnicity?Consent I do not want to provide this information at this time.Ethnicity Hispanic or Latino Non Hispanic or Latino Select all that apply Mexican Cuban Puerto Rican Other What is your ethnicity? For example: Argentinean, Colombian, Dominican, Nicaraguan, Salvadoran, Spaniard, and so on.What is your race? Select all that apply.Consent I do not want to provide this information at this time. American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White What is the name of principal tribe? Select all that apply. Asian Indian Filipino Korean Chinese Japanese Vietnamese Other What is your other race? Select all that apply. Native Hawaiian Samoan Guamanian or Chamorro Other What is your other race? DisclaimerBy submitting your information you agree to our Terms of Use and Security and Privacy Policies. You also expressly consent to being contacted by a representative of our company to complete this information.Consent* I accept the terms stated aboveSignature*{all_fields}
