Residential Loan Application

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General Information

The following form is an abbreviated residential loan application designed to provide us with the basic information we may need to prequalify you for a home mortgage. Please provide all of the requested information. When you have completed the form, press the submit button to send your application. We will then contact you for pre-qualification and assist you with the process of obtaining a loan. The items marked with (*) are required fields.

Will you be applying for Individual or Joint Credit?

(If Joint, the co-applicant section has the same required fields as the primary applicant.)

Complete marital status if this loan is for: a. Joint or secured credit, or b. You reside in or rely on property located in a Community Property State. (AZ, CA, ID, LA, NM, NV, TX, WA, WI)

Marital Status

Primary Applicant

*
*
*
*
*

Home Address

*
*
*

Time at Current Residence

Residence Type

Previous Address *If at current residence less than 2 years

Time at Previous Residence

Residence Type

Present Employer

Employment Status

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.

Previous Employer *If at current employer less than 2 years

Employment Status

CoApplicant

Home Address

Time at Current Residence

Residence Type

Previous Address *If at current residence less than 2 years

Time at Previous Residence

Residence Type

Present Employer

Employment Status

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.

Previous Employer *If at current employer less than 2 years

Employment Status

Additional Real Estate Owned if applicable

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.

HMDA Primary Applicant

Ethnicity
Race
Sex

HMDA Co Applicant if applicable

Ethnicity
Race
Sex

Additional Information

How would you prefer to be contacted?