Mortgage Loan Application

Important Information About Procedures For Opening a New Account

To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify and record information that identifies each person who opens an account.

What this means for you: When you open an account, we will ask for your name, address, date of birth and other information that will allow us to identify you. We may also ask to see your driver’s license or other identifying documents and use third party identifiers such as chex systems and/or credit bureau reports.

Loan Information

Borrower Information

First Name

Middle Initial

Last Name

Suffix

Social Security Number

Birth Date

Mother’s Maiden Name

Home Phone Number

Driver's License #

State

Issue Date

Expiration Date

Email Address

Please do NOT email me important news and updates.

Housing

Home Address

City

State

ZIP Code

Mailing address is different than street address.

Mailing Address

City

State

ZIP Code

Do you own or rent this property?OwnRentOther

Explain

Residency Start Date

Monthly Mortgage or Rent Payment

Have you lived here for two or more years?YesNo

Previous Home Address

City

Select State

ZIP Code

Did you own or rent this property?OwnRentOther

Explain

Residency Start Date

($) Monthly Mortgage or Rent Payment

Number of Dependents (Not Listed by Co-Borrower)

List Dependents' Ages

Employment Information

Is the borrower employed?EmployedNot Employed

Employment Start Date

Position or Title

($) Gross Monthly Income

Name of Employer

Employer’s Address

City

Select State

ZIP Code

Employer’s Phone Number

Have you worked here for more than two years? (No if unemployed)YesNo

Previous Employer

Employment Start Date

Position or Title

($) Gross Monthly Income

Name of Employer

Employer’s Address

City

Select State

ZIP Code

Employer’s Phone Number

Co-Borrower Information

First Name

Middle Initial

Last Name

Suffix

Social Security Number

Birth Date

Mother’s Maiden Name

Home Phone Number

Email Address

Please do NOT email me important news and updates.

Housing

Home Address

City

State

ZIP Code

Mailing address is different than street address.

Mailing Address

City

State

ZIP Code

Do you own or rent this property?OwnRentOther

Explain

Residency Start Date

Monthly Mortgage or Rent Payment

Have you lived here for two or more years?YesNo

Previous Address

City

Select State

ZIP Code

Did you own or rent this property?OwnRentOther

Explain

Residency Start Date

($) Monthly Mortgage or Rent Payment

Marital StatusSingleMarriedSeparatedDivorcedWidowed

Number of Dependents (Not Listed by Co-Borrower)

List Dependents' Ages

Employment Information

Is the co-borrower employed?EmployedNot Employed

Employment Start Date

Position or Title

($) Gross Monthly Income

Name of Employer

Employer’s Address

City

Select State

ZIP Code

Employer’s Phone Number

Have you worked here for more than two years? (No if unemployed)YesNo

Previous Employer

Employment Start Date

Position or Title

($) Gross Monthly Income

Name of Employer

Employer’s Address

City

Select State

ZIP Code

Employer’s Phone Number

Financial Information

Please note: Alimony, child support or separate maintenance income need not be revealed if the Borrower or Co-Borrower does not choose to have it considered for repaying this loan. Also self employed borrowers may be required to provide additional documentation such as tax returns and financial statements. (before taxes)

Borrower’s Gross Monthly Income

($) Monthly Salary & Wages

($) Other Monthly Income (if any)

Income Type

Co-Borrower’s Gross Monthly Income

($) Monthly Salary & Wages

($) Other Monthly Income (if any)

Income Type

Current Monthly Housing Expenses

($) Rent

($) First Mortgage

($) Second Mortgage

($) Hazard Insurance

($) Property Taxes

($) Mortgage Insurance

($) Home Owners Association Dues

About this Property

If this is a Purchase Transaction: Do you have a family relationship or business affiliation with the seller of the property?YesNo

Have you or will you be applying for a mortgage loan on another property (not the property securing this loan) on or before closing this transaction that is not disclosed on this loan application?YesNo

Have you or will you be applying for any new credit (e.g., installment loan, credit card, etc.) on or before closing this loan that is not disclosed on this application?YesNo

Will this property be subject to a lien that could take priority over the first mortgage lien, such as a clean energy lien paid through your property taxes (e.g., the Property Assessed Clean Energy Program)?YesNo

Borrower

Select type of property owned

Select how the property was held

Co-Borrower

Select type of property owned

Select how the property was held

Military Service

Did you (or your deceased spouse) ever serve, or are you currently serving, in the United States Armed Forces?YesNo

*Check all that apply
Currently serving on active duty with projected expiration date of service/tour
Currently retired, discharged, or separated from service
Only period of service was a non-activated member of the Reserve or National Guard
Surviving Spouse

Demographic Information of Borrower

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, sex, and race) 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 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, sex, and race 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.

Ethnicity: Check one or more

Hispanic or Latino

Mexican
Puerto Rican
Cuban
Other Hispanic or Latino - Print origin:

other-hispanic-latino-print

Not Hispanic or Latino

I do not wish to provide this information

Sex:

Female

Male

I do not wish to provide this information

Race: Check one or more

American Indian or Alaska Native

american-indian-alaska-native-print

Asian

Asian Indian
Chinese
Filipino
Other Asian

other-asian-print

Black or African American

Native Hawaiian or Other Pacific Islander

Native Hawaiian
Guamanian or Chamorro
Samoan
Other Pacific Islander

other-pacific-islander-print

White

I do not wish to provide this information

Endorsement

Acknowledgement. Each of the undersigned hereby acknowledges that any owner of the Loan, its servicers, successors and assigns, may verify or reverify any information contained in this application or obtain any information or data relating to the Loan, for any legitimate business purpose through any source, including a source named in this application or a consumer reporting agency.

I/We fully understand that it is a Federal crime punishable by fine or imprisonment, or both, to knowingly make any false statements concerning any of the above facts as applicable under the provisions of Title 18, United States Code, Section 1001, et seq.

Type your name in the box below to represent your electronic signature.

Borrower's Signature

Date

Co-Borrower's Signature

Date

Mortgage Loan Application

Important Information About Procedures For Opening a New Account

Loan Information

Borrower Information

Housing

Employment Information

Previous Employer

Co-Borrower Information

Housing

Employment Information

Previous Employer

Financial Information

Borrower’s Gross Monthly Income

Co-Borrower’s Gross Monthly Income

Current Monthly Housing Expenses

About this Property

Borrower

Co-Borrower

Military Service

Demographic Information of Borrower

Endorsement

Quick Links

Main Office Location

Mortgage Loan Application

Important Information About Procedures For Opening a New Account

Loan Information

Borrower Information

Housing

Employment Information

Previous Employer

Co-Borrower Information

Housing

Employment Information

Previous Employer

Financial Information

Borrower’s Gross Monthly Income

Co-Borrower’s Gross Monthly Income

Current Monthly Housing Expenses

About this Property

Borrower

Co-Borrower

Military Service

Demographic Information of Borrower

Endorsement

Online Banking