Real Estate Loan Application
First Bank Kansas – Real Estate Loan Application
*Are you inquiring about Individual or Joint Credit? Joint Individual (If Joint, the co-borrower section has the same required fields as the primary borrower.) *Marital Status: Unmarried Married Separated *Purpose of Loan
*Purchase Price or Appraised Value of Property$*Loan Amount Requested$Length of loan requested(months)$Subject Property Address*Property will be:
Primary Borrower |
|
| *Last Name | |
| *First Name | |
| Middle Name | |
| *Social Security Number (TIN) | – – |
| *Date of Birth | / / |
| Number of Dependents | |
| Ages of Dependents | |
| Home Phone Number | – – |
| Work Phone Number | – – ext. |
| *Cell Phone Number | – – |
| *Email Address | |
Home Address |
|
| *Address 1 | |
| Address 2 | |
| *City | |
| *State | |
| *Zip | – |
| Time at Current Residence | Years Months |
| Residence Type | Own Rent Other |
Mailing Address |
|
| *Address 1 | |
| Address 2 | |
| *City | |
| *State | |
| *Zip | – |
Previous Address (if within the last 2 years) |
|
| Address 1 | |
| Address 2 | |
| City | |
| State | |
| Zip | – |
| Time at Previous Residence | Years Months |
| Residence Type | Own Rent Other |
Present Employer |
|
| Name | |
| Phone Number | – – ext. |
| Employment Status | Full Time Part Time Temp Retired Other |
| Job Title | |
| Job Start Date | / / |
| Gross Salary | $Per |
| Alimony, child support, or separate maintenance need not be revealed if you do not wish to have it considered as a basis for repaying obligation. | |
| Other Income | $Per |
| Other Income Source | |
Previous Employer (if within the last 2 years) |
|
| Name | |
| Phone Number | – – ext. |
| Employment Status | Full Time Part Time Temp Retired Other |
| Job Title | |
| Job Start Date | / / |
| Job End Date | / / |
| Gross Salary | $Per |
Co-Borrower |
|
| *Marital Status: | |
| Unmarried Married Separated | |
| *Last Name | |
| *First Name | |
| Middle Name | |
| *Social Security Number (TIN) | – – |
| *Date of Birth | / / |
| Number of Dependents | |
| Ages of Dependents | |
| *Home Phone Number | – – |
| Work Phone Number | – – ext. |
| Cell Phone Number | – – |
| Email Address | |
Home Address |
|
| *Address 1 | |
| Address 2 | |
| *City | |
| *State | |
| *Zip | – |
| Time at Current Residence | Years Months |
| Residence Type | Own Rent Other |
| Monthly Payment | $ |
Mailing Address |
|
| *Address 1 | |
| Address 2 | |
| *City | |
| *State | |
| *Zip | – |
Previous Address (if within the last 2 years) |
|
| Address 1 | |
| Address 2 | |
| City | |
| State | |
| Zip | – |
| Time at Previous Residence | Years Months |
| Residence Type | Own Rent Other |
Present Employer |
|
| Name | |
| Phone Number | – – ext. |
| Employment Status | Full Time Part Time Temp Retired Other |
| Job Title | |
| Job Start Date | / / |
| Gross Salary | $Per |
| Alimony, child support, or separate maintenance need not be revealed if you do not wish to have it considered as a basis for repaying obligation. | |
| Other Income | $Per |
| Other Income Source | |
Previous Employer (if within the last 2 years) |
|
| Name | |
| Phone Number | – – ext. |
| Employment Status | Full Time Part Time Temp Retired Other |
| Job Title | |
| Job Start Date | / / |
| Job End Date | / / |
| Gross Salary | $Per |
Home Mortgage Disclosure Act (HMDA) |
|
| Please Note: 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. | |
Primary Borrower |
|
| I do not wish to furnish this information | |
| Ethnicity | Hispanic or Latino Not Hispanic or Latino |
| Race | American Indian, Alaskan Native Asian Black or African American Native Hawaiian or Other Pacific Islander White |
| Sex | Male Female |
Co-Borrower (if applicable) |
|
| I do not wish to furnish this information | |
| Ethnicity | Hispanic or Latino Not Hispanic or Latino |
| Race | American Indian, Alaskan Native Asian Black or African American Native Hawaiian or Other Pacific Islander White |
| Sex | Male Female |
Declarations
Place a check for any “Yes” answers. Leave blank for “No”. Please explain any “Yes” answers to questions a through i, in the space provided below.
| Borrower | Co-Borrower | |
| a. Are there any outstanding judgments against you? | ||
| b. Have you been declared bankrupt within the past 7 years? | ||
| c. Have you had property foreclosed upon or given title or deed in lieu thereof in the last 7 years? | ||
| d. Are you a party to a lawsuit? | ||
| e. Have you directly or indirectly been obligated on any loan which resulted in foreclosure, transfer of title in lieu of foreclosure, or judgment? (If “Yes”, provide details, including date, name and address of Lender, FHA or VA case number, if any, and reasons for the action.) | ||
| f./ Are you presently delinquent or in default on any Federal debt or any other loan, mortgage, financial obligation, bond, or loan guarantee? (If “Yes”, give details as described in the preceding question.) | ||
| g. Are you obligated to pay alimony, child support, or separate maintenance? | ||
| h. Is any part of the down payment borrowed? | ||
| i. Are you a co-maker or endorser on a note? | ||
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| j. Are you a U.S. citizen? | ||
| k. Are you a permanent resident alien? | ||
| Explain any “Yes” answers here | ||
Debts/Monthly Payments
List all other debts (for example, auto loans, credit cards, second mortgage, home assoc. dues, alimony, child support, child care, medical, utilities, auto insurance, IRS liabilities, etc.)
| Debts | Monthly Payments |
| $ | |
| $ | |
| $ | |
| $ | |
| $ | |
| $ | |
| $ | |
| $ | |
| $ | |
| $ |
Additional Information |
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| How would you prefer to be contacted? Home Phone Work Phone Cell Phone Email Address Other | |
| Name of Lender (if preference) | |
| Special Instructions/Comments | |
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Back to top of page | Jump to Submit Button Please note: Income verification is required; other information may be required. I certify that statements on this application are true and complete. I authorize any person, association, firm or corporation to furnish, on request of this financial institution, information concerning me or my affairs.(Sec. 1014, Title 18, U.S. Code makes it a Federal Crime to knowingly make a false statement on this application.) A lender will contact you to discuss your loan inquiry within 1-3 business days. We look forward to working with you! |
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