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Home Exterior Loan Program Application - Owner Occupied - No Page Breaks

  1. Do you have the following digital documents ready to upload? If not, please compile all the documents listed and have them ready for a later step in the application process. *
  2. Will the be a Co-Applicant?*
  3. I own and occupy this home as my principal residence*
  4. Marital Status*
  5. Female head of household*
  6. Disabled*
  7. Household composition (List the head of your household and all members who live in your home. Give the relationship, age, race and ethnicity of each family member to the head of household)
  8. ANNUAL INCOME (List all income from all sources received by all household members 18 years old or older)
  9. Assets & Liabilities
  10. LIABILITIES (List outstanding obligations (your debts) including auto loans, credit cards, charge accounts, credit union, bank loans, personal loans, real estate loans (except on the home you live in), and all other debts.)
  11. If you have no monthly debts, comment above with "none"
  12. Enter $0 if not applicable
  13. Enter $0 if not applicable
  14. Enter $0 if not applicable
  15. Do you have unpaid judgements?*
  16. Have you declared bankruptcy in the past 7 years?*
  17. Are you party in a current lawsuit?*
  18. Is there a balloon payment?*
  19. The information provided above is true and complete to the best of my/our knowledge and belief. I/We consent to the disclosure of such information for purposes of verification related to my/our application for financial assistance. I/We understand that any willful misstatements will be grounds for disqualification. I/We hereby acknowledge receipt of the Home Exterior Loan Program Guidelines and agree to comply with procedures and requirements specified therein. PENALTY FOR FALSE OR FRAUDULENT STATEMENT. U.S.C. Title 18, Sec 1001, provides: “Whoever, in any matter within the jurisdiction of any department or agency of the United States knowingly and willfully falsifies or makes any false, fictitious or fraudulent statements or representations, or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry, shall be fined not more than $10,000 or imprisoned not more than five years or both.”
  20. Electronic Signature Agreement. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement. By selecting "I Accept" you consent to be legally bound by the above terms and conditions.*
  21. This is your authority to verify my bank accounts, employment, outstanding debts, including any present or previous mortgages, to order a consumer credit report, and to make any other inquiries pertaining to my qualifications for a mortgage loan from you. You may make copies of this letter for distribution to any party with which I have a financial or credit relationship and that party may treat such copy as an original. Privacy Act Notice: This information is to be used by the agency collecting it or its assignees in determining whether you qualify as a prospective mortgagor under its program. It will not be disclosed outside the agency except as required and permitted by law. You do not have to provide this information but if you do not your application for approval as a prospective mortgagor or borrower may be delayed or rejected.
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  23. This field is not part of the form submission.