Use this form to
submit your Residential Loan Application electronically
& pre-qualify
Please complete
accurately...
Privacy Policy:
We respect private information and operate with the highest business
ethics. Any details you supply to us will not be disclosed to any other
party without your prior consent.
Borrower &
Co-Borrower Information:
BORROWER DETAILS:
Borrower First Name
Borrower Last Name
Present Address
City State Zip
Owner
Rented
(Please select One)
No. Years at this address
If you have been at this address
less than 2 years please use the
box below to provide address, whether you owned or rented, and
how long you were at your former address:
SSN
(Social Sec. No.)
E-Mail
Home Phone
Work Phone
Date of Birth
Age
Years at School
Marital Status
No. of Dependents
Ages
CO-BORROWER DETAILS:
Co-Borrower First Name
Co-Borrower Last Name
Present Address
City State Zip
Owner
Rented
(Please select One)
No. Years at this address
If you have been at this address
less than 2 years please use the
box below to provide address, whether you owned or rented, and
how long you were at your former address:
SSN (Social
Sec. No.)
E-Mail
Home Phone
Work Phone
Date of Birth
Age
Years at School
Marital Status
Only complete the following if
not given by Borrower:
No. of Dependents
Ages
Employment
Information:
BORROWER EMPLOYMENT
DETAILS:
Name & Address of Employer (for Borrower)
Position
Employer Tel. No.
Monthly Income Amt.$
No. of Years on this Job
Please provide
details below of previous Employer if you have been in your
current job less than 2 years
Years in same field/profession
Self Employed? (Check
this box if you are)
PREVIOUS EMPLOYER
COMPLETE THIS SECTION IF YOU HAVE
BEEN IN YOUR CURRENT EMPLOYMENT LESS THAN 2 YEARS
Name & Address of Previous Employer (for Borrower)
Position
Employer Tel. No.
Monthly Income Amt.$
Dates on this Job
(date from - to leaving
date)
Years in same field/profession
Were you Self Employed?
(Check this box if you were)
BORROWER EMPLOYMENT
DETAILS:
Name & Address of Employer
(for Co-Borrower)
Position
Employer Tel. No.
Monthly Income Amt.$
No. of Years on this Job
Please provide
details below of previous Employer if you have been in your
current job less than 2 years
Years in same field/profession
Self Employed? (Check
this box if you are)
PREVIOUS EMPLOYER
COMPLETE THIS SECTION IF YOU HAVE
BEEN IN YOUR CURRENT EMPLOYMENT LESS THAN 2 YEARS
Name & Address of Previous Employer
(for Co-Borrower)
Position
Employer Tel. No.
Monthly Income Amt.$
Dates on this Job
(date from - to leaving
date)
Years in same field/profession
Were you Self Employed?
(Check this box if you were)
Total Gross Monthly Income: $
Assets & Liabilities
List Checking and
Savings Accounts
1. Name & Addr. of Bank, S&L, or Credit Union
Amount $
Account
Number
2. Name & Addr. of Bank, S&L, or
Credit Union
Amount $
Account
Number
1.
Stocks and Bonds
(Please Describe)
Amount
$
2.
$
3.
$
1.
Life
Insurance
Face Amount
$
1.
Automobile
Type
Est. Value $
2.
$
3.
$
1.
Other
Assets (Please Describe)
Amount $
2.
$
3.
$
4.
$
Schedule of Real Estate Owned:
Property Address
Present Market Value ($)
Current Status
Amount of Mortgages & Liens
($)
Monthly Mortgage Payments ($)
1.
2.
3.
Type of Loan Requested:
Price of Property purchasing (US$)
Downpayment/Deposit
(select one)
20%,
25%,
30%,
More
than 35%,
Loan Type:
Residence
Type:
Property
Type:
Loan
Type:
Estimated
Loan Amount ($):
DECLARATIONS:
BORROWER
CO-BORROWER
a.
Are
there any outstanding judgements 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 therof in the last 7 years?
d.
Are
you party to a lawsuit?
e.
Have
you directly or indirectly been obliged on any loan
which resulted in foreclosure, transfer of title in
lieu of foreclosure, or judgement?
f.
Are
you presently delinquent or in default on any Federal
debt or any other loan, mortgage, or loan guarantee?
g.
Are
you obliged to pay alimony, child support, or seperate
maintenance?
h.
Is
any part of the down payment borrowed?
i.
Are
you a co-maker or endorser on a note?
j.
Are
you a U.S. Citizen?
k.
Are
you a permanent resident alien in the U.S.A?
l.
Do
you intend to occupy the property as your primary
residence? If 'yes' complete question 'm' below.
m.
Have you had ownership interest in a
property in the last three years?
1. What type of property did you own?
2. How did you hold title to the home?
If you answered
'YES' to any question a. through i. above, please use the box
below to explain. Also use this box to provide us with any
other information that you feel is important.
* "I authorize U.S.
Holidays Mortgages.net LLC. and/or assigns to obtain my/our credit
report for the purpose of determining credit worthiness. The
information that is obtained is strictly confidential. By
submitting this electronically, this is to be deemed to be the
equivalent of an original Uniform Residential Loan Application
Form 1003."
PLEASE
CLICK ON THE SUBMIT BUTTON AND WAIT FOR CONFIRMATION THAT WE HAVE RECEIVED YOUR
DETAILS (THIS CAN TAKE UP TO A MINUTE AT BUSY TIMES)