Loan Application

Name*

Last Name:*

Email:*

Home Phone:-*

Cell Phone:-*

Work Phone:-Ext.*

Marital Status:--Select Status--MarriedUnmarriedSeparated*

Are you a U.S. citizen?--Select Citizen--YesNo*

Date of Birth:*

Social Security or Tax ID #:-*

Credit Check Authorization:--Select Credit Check--I AgreeI Do Not Agree*

Years of School:*

Number of Dependents:*

Dependent Age(s):*

Loan Officer:--Select Loan Officer--No PreferenceKen ThayerCraig CalentinoMichael McClareBob Howe Dean ThayerGlenn Barry Tod Merkwan  *

Current Address

Street Address:*

City:*

State:--Select State-- ALABAMAALASKAARIZONAARKANSASCALIFORNIACOLORADOCONNECTICUTDELAWAREDISTRICT OF COLUMBIAFLORIDAGEORGIAGUAMHAWAIIIDAHOILLINOISINDIANAIOWAKANSASKENTUCKYLOUISIANAMAINEMARYLANDMASSACHUSETTSMICHIGANMINNESOTAMISSISSIPPIMISSOURIMONTANANEBRASKANEVADANEW HAMPSHIRENEW JERSEYNEW MEXICONEW YORKNORTH CAROLINANORTH DAKOTAOHIOOKLAHOMAOREGONPENNSYLVANIAPUERTO RICORHODE ISLANDSOUTH CAROLINASOUTH DAKOTATENNESSEETEXASUTAHVERMONTVIRGIN ISLANDSVIRGINIAWASHINGTONWEST VIRGINIAWISCONSINWYOMING*

Zip:-*

Years at this Address:YearsMonths*

Rent or Own:--Select rent Or Own--RentOwn*

Previous Address

Street Address:*

City:*

State:--Select Previous State-- ALABAMAALASKAARIZONAARKANSASCALIFORNIACOLORADOCONNECTICUTDELAWAREDISTRICT OF COLUMBIAFLORIDAGEORGIAGUAMHAWAIIIDAHOILLINOISINDIANAIOWAKANSASKENTUCKYLOUISIANAMAINEMARYLANDMASSACHUSETTSMICHIGANMINNESOTAMISSISSIPPIMISSOURIMONTANANEBRASKANEVADANEW HAMPSHIRENEW JERSEYNEW MEXICONEW YORKNORTH CAROLINANORTH DAKOTAOHIOOKLAHOMAOREGONPENNSYLVANIAPUERTO RICORHODE ISLANDSOUTH CAROLINASOUTH DAKOTATENNESSEETEXASUTAHVERMONTVIRGIN ISLANDSVIRGINIAWASHINGTONWEST VIRGINIAWISCONSINWYOMING*

Zip:-*

Years at this Address:YearsMonths*

Rent or Own:--Select Type--RentOwn*

Subject Property

Purpose of Loan:--Select Loan--PurchaseConstruction - PermConstructionNo Cash-Out RefiCash-Out RefiOther

Property Usage:--Select Usage--Primary ResidenceSecond HomeInvestment*

Loan Amount:$*

Purchase Price:$*

Number of Units:

Year Built:

Subject Property Address:

City:

State:--Select State--CALIFORNIAWe only accept applications for the states listed.

Zip:-*

Monthly Income

Submitting income from alimony, child support, or separate maintenance income is optional if you do not want to use that income for qualification purposes.

Base Income:$*

Bonuses:$*

Commission:$*

Other Income:$*

Assets

Checking:$*

Savings:$*

Retirement Funds:$*

Mutual Funds:$*

Other:$*

Information for Government Monitoring Purposes

The following information is requested by the federal government for certain types of loans related to a dwelling in order to monitor the lender's compliance with equal credit opportunity, fair housing, and home mortgage disclosure laws. You are not required to furnish this information, but are encouraged to do so. You may select one or more designations for "Race." The law provides that a lender may not discriminate on the basis of this information, or on whether you choose to furnish it. However, if you choose not to furnish the information and you have made this application in person, under federal regulations the lender is required to note ethnicity, race, and sex on the basis of visual observation or surname. If you do not wish to furnish the information, please check below.

Other:I do not wish to furnish this information

Sex:Male

 Female

Ethnicity:Hispanic or Latino

 Not Hispanic or Latino

Race:I do not wish to furnish this information

 Asian

 Black or African American

 Native Hawaiian or Other Pacific Islander

 White

Privacy Policy:*

 I accept the terms of the privacy policy

Co-Borrower

Do you have a co-borrower?YesNo