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*First Name |
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Middle Name |
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*Last Name |
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*SSN |
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*Birthdate (MM/DD/YYYY) |
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*Daytime Phone |
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*Email |
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*Marital Status |
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*Mother's Maiden Name |
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Current Address (You must have a physical address. No P.O. Boxes.) |
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*Address |
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*City |
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*State |
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*ZIP |
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*Length of time at this address |
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County of Residence |
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*Do you own or rent your current home? |
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If Other, please explain |
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*Monthly Mortgage/Rent Payment |
$
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Employment & Income Information |
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*Current Employer |
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*Annual Earnings |
$
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*Length of Employment |
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*Employer Phone |
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Do you have any other sources of income? If so, please explain: |
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*Are you applying with a Co-Applicant? |
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Co-Applicant Information (If you are not applying with a co-applicant, click here to skip to the next section of this form. Fields marked with a + are required if you are applying with a co-applicant.) |
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+First Name |
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Middle Name |
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+Last Name |
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+SSN |
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+Birthdate (MM/DD/YYYY) |
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+Daytime Phone |
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Email |
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+Marital Status |
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+Mother’s Maiden Name |
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+Address |
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+City |
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+State |
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+ZIP |
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+Length of time at this address |
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+Do you own or rent your current home? |
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If Other, please explain |
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+Monthly Mortgage/Rent Payment |
$
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+Current Employer |
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+Annual Earnings |
$
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+Length of Employment |
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+Employer Phone |
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Do you have any other sources of income? If so, please explain: |
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*What type of loan are you applying for? |
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If you are applying for a Home Equity Loan or Line of Credit, you must review the Home Equity Loan and Home Equity Line of Credit Disclosures, if you have not already done so. |
*Please select the option that best applies: |
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*Desired Loan Amount |
$
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*Approximate Value of the Property |
$
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*Desired Loan Term |
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*Loan Purpose |
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If Other, please explain: |
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*Will the proceeds from this loan be used for home improvement? |
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*Will you be making a down payment? |
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If Yes, how much? |
$
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*Do you already have a mortgage on the property currently? |
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If Yes, what is the outstanding balance? |
$
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Who is it currently financed through? |
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*Do you currently have a second mortgage on the property? |
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If Yes, what is the outstanding balance? |
$
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Who is it currently financed through? |
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Tell us a little more about your purchase. Is there anything else we should know about the purchase, in order to process your application? |
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For the following questions, answer Yes if the situation is true for you or, if applicable, your co-borrower. If you answer Yes to any of these questions, you may be required to provide a written explanation. |
*Are there any outstanding judgments against you? |
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*Have you declared bankruptcy within the past 7 years? |
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*Have you had property foreclosed upon, or have you given up a title or deed in lieu of foreclosure, within the last 7 years? |
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*Are you currently a party to a lawsuit? |
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*Have you directly or indirectly been obligated on any loan which resulted in foreclosure, or in transfer of title in lieu of foreclosure? |
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*Are you presently delinquent or in default on any federal debt or any other loan, mortgage, financial obligation, bond, or loan guarantee? |
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*Are you obligated to pay alimony, child support, or separate maintenance? |
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*Will any part of the down payment on your new loan be borrowed? |
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*Are you the co-maker or endorser on any other current loan or note? |
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*Are you a U.S. citizen? |
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*Are you a permanent resident alien? |
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*Do you intend to occupy the property as your primary residence? |
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*Have you had an ownership interest in a property within the last 3 years? |
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What type of property did you own? |
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How did you hold the title to the property? |
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Information For Government Monitoring Purposes
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. The law provides that a lender may discriminate neither on the basis of this information, nor on whether you choose to furnish it. If you furnish the information, please provide both ethnicity and race. For race, you may check more than one designation. If you do not furnish ethnicity, race, or sex, under Federal regulations, this Lender is required to note the information on the basis of visual observation or surname. If you do not wish to furnish the information, please check the box below. (Lender must review the below material to assure that the disclosures satisfy all requirements to which the Lender is subject under applicable state law for the particular type of loan applied for.) |
Primary Borrower |
Check this box if you do not wish to provide this information. |
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Ethnicity |
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Race |
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Sex |
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Co-Borrower (if applicable) |
Check this box if you do not wish to provide this information. |
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Ethnicity |
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Race |
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Sex |
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Are you interested in purchasing additional insurance on this loan? If so, please check the boxes for the insurance products you would like: |
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Notice to Ohio Residents: The Ohio laws against discrimination require that all creditors make credit equality to all creditworthy customers, and that credit reporting agencies maintain separate credit histories on each individual upon request. The Ohio Civil Rights Commission administers compliance with this law.
I (We) certify that the above information is true and complete. I (We) also authorize the credit union to verify or obtain further information that the credit union may deem necessary concerning my (our) credit standing. If an account is opened, I (we) authorize you to report our credit experience with me (us). The undersigned jointly and severally agree to be responsible for all charges. I (We) hereby authorize Miami University Community Federal Credit Union to act on my (our) behalf to transfer the balance(s) listed above to my new Miami University Community Federal Credit Union credit card. Miami University Community Federal Credit Union reserves the right to transfer only the current credit card balance(s).
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