Capital Mortgage Services - The Mortgage Banking Professionals

E-mail Address

Amount of Loan
$

Property Address
Street	City	State	Zip

No. of Units

Year Built

Loan Purpose

Property To Be

Refinance Loans
Year Acquired	Original Cost $	Existing Leans $	Purpose of Refinance

Borrower Information
Borrower		Co-Borrower
Name (Including Jr. or Sr. if applicable)		Name (Including Jr. or Sr. if applicable)
Social Security Number	Home Phone	Social Security Number	Home Phone
Age	Years of School Completed	Age	Years of School Completed
Marital Status	Dependants No.Ages	Marital Status	Dependants No.Ages

Present Address
Street	City	Street	City
State	Zip	State	Zip
Own Rent	Number of Years at Current Residence	Own Rent	Number of Years at Current Residence
If At Present Address Less Than 2 Years Former Address
Street	City	Street	City
State	Zip	State	Zip
Own Rent	Number of Years at Residence	Own Rent	Number of Years at Residence

Employment Information
Borrower		Co-Borrower
Name of Employer		Name of Employer
Attn		Attn
Address	City	Address	City
State	Zip	State	Zip
Self Employed Yes No	Years on Job	Self Employed Yes No	Years on Job
Years of Current Profession		Years of Current Profession
Position/Title/Type of Business		Position/Title/Type of Business
Business Phone		Business Phone

If Employed in Current Position Less Than 2 Years
Name of Previous Employer		Name of Previous Employer
Attn		Attn
Address	City	Address	City
State	Zip	State	Zip
Self Employed Yes No	From - To	Self Employed Yes No	From - To
Monthly Income $		Monthly Income $
Position/Title/Type of Business		Position/Title/Type of Business
Business Phone		Business Phone

Monthly Income & Combined Housing Expense Information

Gross Monthly Income	Borrower	Co-Borrower	Combined Mnth. Housing Expense	Present	Proposed
Base Empl. Income*	$	$	Rent	$	$
Overtime	$	$	First Mortgage	$	$
Bonuses	$	$	Other Financing	$	$
Commissions	$	$	Hazard Insurance	$	$
Dividends / Interest	$	$	Real Estate Taxes	$	$
Net Rental Income	$	$	Mortgage Insurance	$	$
Other	$	$	Homeowner Assn. Dues	$	$
*Self Employed Borrower(s) may be required to provide additional documentation such as tax returns and financial statements.			Other	$	$

Assets
Completed Jointly Not Jointly	Cash Deposit Held By (for purchase only)	Amount $

Checking / Savings Accounts
Name of Bank/S&L/Credit Union		Name of Bank/S&L/Credit Union
Address	City	Address	City
State	Zip	State	Zip
Account #	Balance $	Account #	Balance $
Name of Bank/S&L/Credit Union		Name of Bank/S&L/Credit Union
Address	City	Address	City
State	Zip	State	Zip
Account #	Balance $	Account #	Balance $
Stocks & Bonds
Company Name/Number/Description		Company Name/Number/Description
Amount $		Amount $
Company Name/Number/Description		Company Name/Number/Description
Amount $		Amount $
Vested Interest in Retirement Fund $
Automobiles
Year & Make	Value $	Year & Make	Value $
Other Assets (e.g. Furniture, Jewelry, Household Goods, Personal Property, etc.) $

Liabilities
Enter only if this is a refinance loan (details of 1st mortgage on subject property)		Second Mortgage Creditor (details of second mortgage on subject property)
First Mortgage Creditor		Second Mortgage Creditor
Name		Name
Loan #		Loan #
Address	City	Address	City
State	Zip	State	Zip
Monthly Pmt $	Balance $	Monthly Pmt $	Balance $

All Other Monthly Liabilities (Include credit card dept, auto loans, student loans, installment loans etc.) You may estimate; We will obtain details from your credit report.
Monthly Payment $	Balance $

All Real Estate Owned
Market Value	Amount of Liens	Gross Income
Mortgage Payment	Tax/Insurance Maint.	Net Rental Inc.

Declarations
Items	Borrower	Co-Borrower
a. Are there any outstanding judgements against you?	Yes No	Yes No
b. Have you been declared bankrupt within the last 7 years?	Yes No	Yes No
c. Have you had property foreclosed upon in the last 7 years?	Yes No	Yes No
d. Are you a party to a lawsuit?	Yes No	Yes No
e. Have you directly or indirectly been obligated on any loan which resulted in foreclosure, transfer of title in lieu of foreclosure, or judgement?	Yes No	Yes No
f. Are you presently delinquent or in default on any Federal debt or any other loan, mortgage, financial obligation, bond or loan guarantee?	Yes No	Yes No
g. Are you obligated to pay alimony child support or separate maintenance?	Yes No	Yes No
h. Is any part of the down payment borrowed?	Yes No	Yes No
i. Are you the co-maker or endorser on a note?	Yes No	Yes No
j. Are you a U.S. citizen?	Yes No	Yes No
k.Are you a permanent resident alien?	Yes No	Yes No
l. Do you intend to occupy the property as your primary residence?	Yes No	Yes No
m. Have you had an ownership interest in a property in the last 3 years?	Yes No	Yes No

If m is "Yes"	Borrower	Co-Borrower
1. What type of property did you own?	Principal Residence Second Home Investment Property	Principal Residence Second Home Investment Property
2. How did you hold title to the home?	Solely by Yourself Jointly with Spouse Jointly with Another Person	Solely by Yourself Jointly with Spouse Jointly with Another Person

This information is optional
Borrower	Co-Borrower
I do not wish to furnish this information	I do not wish to furnish this information
Race/National Origin	Race/National Origin
Sex Male Female	Sex Male Female
Please use the following space to describe in more detail what you are seeking by filling out this form (refinance, purchase, qualify etc.):

Certification

I/We certify that the information provided in this application is true and correct as of this date and acknowledge my/our understanding that any intentional or negligent misrepresentation(s) of the information contained in this application may result in civic liability and/or criminal penalties including, but not limited to, fine or imprisonment or both under the provisions of Title 18, United States Code, Section 1001, et seq, and liability for monetary damages to the Lender, its agents, successors and assigns, insurers and any other person or entity who may suffer any loss due to reliance upon any misrepresentation which I/We have made on this application.

I/We further authorize Capital Mortgage Services and/or its assigns to pull my/our Credit Reports for the purpose of this application. I/We further authorize our employer(s), banking institutions, landlords, or any other third party, whether an individual or entity, to release all necessary information needed to process the application for financing.

By submitting this application, I/We certify the above declarations even though my/our actual signatures may not be present on this application. Further, I/We authorize any third parties to release any necessary information even though my/our actual signatures may not be present on this form.