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13400 Sutton Park Dr S, Ste 1001, Jacksonville, FL 32224

Application

First Name

Last Name

Address

Street Address

City

State

Country

Postal 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

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?

What is the sales price or what do you expect it to be?

What is your estimated down payment?

What is the desired loan term?

Will you receive any gifts or grants to help with this purchase?

Yes

No

Please add all gifts or grants you will receive below:

How much will you receive?

What is the source of the gift or grant?

What is your current address?

Same as first screen

Do you rent or own this property?

Rent

Own

How much is your monthly payment?

When did you begin living there?

What is your Social Security Number or Taxpayer Identification Number? *

What is your date of birth? *

What is your citizenship? *

What is your marital status? *

Do you have any dependents?

Yes

No

How Many Dependents?

What are their ages?

Are you self-employed or a business owner?

Yes

No

What is your ownership share?

Is this employment for applicant or co-applicant?

Applicant

Co-Applicant

Where are your Currently employed ?

Address

Street Address

Address Line

City

State

ZIP Code

What is your position or title ?

What is your monthly income ?

When did your employment begin ?

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 ?

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 Information

What is the name and email of the person applying for the loan with you?

First

Middle

Last

Suffix

Joint Applicant Email

Joint Applicant Phone

What is their Social Security Number or Taxpayer Identification Number? *

What is their date of birth?

What is their relationship to you?

What is their current address?

Same as me

Street Address

Address Line

City

State

ZIP Code

When did they begin living there?

Joint Applicant Consent *

I agree.

Are they self-employed or a business owner?

Yes

No

What is their ownership share?

Is this employment for applicant or co-applicant ? *

Applicant

Co-Applicant

Where are your Currently employed ?

Street Address

Address Line

City

ZIP Code

State

What is your position or title ?

What is your monthly income ?

When did your employment begin ?

Your Asset Information

Institution Name

Type of asset

Balance or Value

Do you have other monthly expenses?

Yes

No

Other Monthly Expenses

What is other monthly expense

What is your monthly payment ?

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?

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

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

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

What is your race? Select all that apply.

Consent

I do not want to provide this information at this time.

What is the name of principal tribe?

Select all that apply .

Native Hawaiian

Samoan

Guamanian or Chamorro

Other

What is your other race?

What is your other race ?

Signature *

Clear

I agree to terms & conditions provided by the company. By providing my phone number, I agree to receive text messages from the business.

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Quick Info

13400 Sutton Park Drive South Ste #1001

Jacksonville, FL 32224

[email protected]

(904) 389-4635

NMLS #378379

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Nelcor, Inc. DBA North Florida Mortgage NMLS 378379 is a licensed mortgage loan originator representing Florida Capitla Bank and UWM Lending. Licensed in FL.