| Complete this line
if this is a refinance loan. |
| Year
Acquired |
Original
Cost |
Amount
Existing Liens |
Purpose of
Refinance |
Describe
Improvements made to be made |
|
$ |
$ |
|
Cost $
|
| Title will
be held in what name(s) |
Manner in which Title will be held |
| Source of Down Payment, Settlement Charges and/or
Subordinate Financing(explain) |
Estate will be held in:
Fee Simple
Leasehold (show expiration
date) |
|
Borrower
III. BORROWER INFORMATION
Co-Borrower
|
| Borrower's
Name (include Jr. or Sr. if applicable) |
Co-Borrower's Name (include Jr. or Sr. if
applicable) |
Social
Security Number
|
Home Phone
(incl. area code) |
Age |
Yrs.
School |
Social
Security Number |
Home Phone
(incl. area code) |
Age |
Yrs.
School |
Married
Unmarried
(Single; divorced, widowed)
Separated |
Dependents
(not listed by Co-Borrower) no. ages:
|
Married
Unmarried
(Single, divorced, widowed)
Separated |
Dependents
(not listed by co-Borrower) no. ages:
|
Present
Address (street, city, state & zip) Own Rent ___No. Yrs. |
Present
Address (street, city, state & zip) Own Rent ___No.
Yrs. |
| If residing at
present address for less than two years, complete the
following: |
Previous
Address (street., city, state & zip) Own Rent ___No. Yrs. |
Previous
Address (street., city, state & zip) Own Rent ___No.
Yrs. |
Previous
Address (street., city, state & zip) Own Rent ___No. Yrs. |
Previous
Address (street., city, state & zip) Own Rent ___No.
Yrs. |
|
Back
Next |
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Borrower. Initial _____ Co-Borrower. Initial _____
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