1003 Application

First Lenders Mortgage Loan Application

I. TYPE OF MORTGAGE AND TERMS OF LOAN

Amount		Interest Rate	Number of Years	Amortization Type:
$		%		Fixed Rate	ARM (Type):

II. PROPERTY INFORMATION AND PURPOSE OF LOAN

Subject Property Address:			City:	State:	Zip:	No. of Units

Purpose of Loan	Purchase	Refinance		Property will be: (check all that apply)
	FHA	Cash Out		Primary Residence Secondary Residence		Condo/Townhouse Investment
Complete this line if this is a refinance loan.
Year Acquired	Original Cost	Amount Existing Liens		Title will be held in what name(s)		Year Built
	$	$

III. Borrower Information

Borrower’s First Name*		Borrower’s Last Name*

Social Security Number		Date of Birth	Yrs. School

Home Phone*		Cell Phone



Married	Single	Dependents
Seperated		No	Ages

Present Address	Own	Rent	No. Yrs.



If residing at present address for less than two years, complete below:
Former Address	Own	Rent	No. Yrs.

Co-Borrower’s First Name		Co-Borrower’s Last Name

Social Security Number		Date of Birth	Yrs. School

Home Phone		Cell Phone



Married	Single	Dependents
Seperated		No	Ages

Present Address	Own	Rent	No. Yrs.



If residing at present address for less than two years, complete below:
Former Address	Own	Rent	No. Yrs.

IV. Employer Information

Name & Address of Employer	Self Employed	Years

		Yrs. in profession

Position/Title	Business Phone


If employed in current position for less than two years or if currently employed in more than one position, complete the following:
Name & Address of Employer		Dates (from-to)

		Monthly Income
		$

Name & Address of Employer	Self Employed	Years

		Yrs. in profession

Position/Title	Business Phone


If employed in current position for less than two years or if currently employed in more than one position, complete the following:
Name & Address of Employer		Dates (from-to)

		Monthly Income
		$

V. MONTHLY INCOME AND COMBINED HOUSING EXPENSE INFORMATION
Gross Monthly Income	Borrower	Co-Borrower	Total	Combined Housing Monthly Expenses	Present	Proposed
Base Empl. Income*				Rent		NA
Overtime				First Mortgage (P&I)
Bonuses				Other Financing (P&I)
Commissions				Hazard Insurance
				Real Estate Taxes
				Mortgage Insurance
				Homeowner Assn. Dues

VI. ASSETS AND LIABILITIES

Schedule of Real Estate Owned (If additional properties are owned, use continuation sheet.)
Property Address (*enter S if sold, P if pending sale or R if rental being held for income)	*	Type of Property	Present Market Value	Amount of Mortgages & Liens	Gross Rental Income	Mortgage Payments	Insurance, Maintenance, Taxes & Misc.	Net Rental Income

VII. DECLARATIONS

If your answer is "Yes" to any questions a through i, please use continuation sheet for explanation.	Borrower		Co-Borrower
	Yes	No	Yes	No
a. Are there any outstanding judgments against you?
b. Any gaps in employment or any unemployment compensation since 2009?
c. Are you obligated to pay alimony, child support, or separate maintenance?
d. Do you have more than ONE W2 for YOUR type of employment?

e. Are you a U.S. citizen?
f. Are you a permanent resident alien?
g. Do you intend to occupy the property as your primary residence?
h. Are you presently doing any renovations/remodeling to the home that would affect the appraisal?
i. Do you own any other properties/land? ( even if there is no mortgage on the property)*
j. Do you have any second mortgage or home equity loan on the property?*
k. Are you looking to escrow for taxes and insurance?*
l. Has your home been listed for sale in the past 6 months?*
m. Do you show any "other" income on your tax returns?*
n. Do you have any "open permits" on the subject property?*
o. Have you refinanced in the past 6 months?*
p. Did you file a tax extension for your taxes?*
q. Are you planning on rolling closing costs and/or new escrows into your new loan amount?*

VIII. OTHER INFORMATION

Explanations or Notes:

Borrowers' Email Address:*		Name and Address of Interviewer's Employer First Lenders Mortgage 6 Leonardville Road Middletown, New Jersey, 07748 NMLS# 274724 Phone: 732-233-1128 Fax: 732-957-9666 loans@firstlendersmortgage.com
Co-Borrowers' Email Address:
How did you hear about us?:*
What is the value of the home being mortgaged?:*
* Required fields (if not filled out - you will have to fill out the form again.)