* indicates a required field

Is this an individual or joint loan? Individual
Joint

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We intend to apply for joint credit X
Applicant Signature
X
Co-Applicant Signature

Primary Borrower Information

*Name (First M. Last)
Date of Birth (mm/dd/yyyy)
*Social Security Number
Level of Education
Number of Dependents
Driver's License Number State
E-mail
 
Current Address
City, State Zip ,
Current Home Phone Number ( ) -
Number of years at present address
Current Employer
Current Job Title
Number of years at present job
Current Work Address
City, State ,
Zip
Current Work Phone Number ( ) -
 
Former Address
City, State Zip ,
Former Home Phone Number ( ) -
Former Employer
Former Job Title
Former Address
City, State ,
Zip
Former Work Phone Number ( ) -

Co-Borrower Information

Name (First M. Last)
Date of Birth (mm/dd/yyyy)
Social Security Number
Level of Education
Number of Dependents
Driver's License Number State
E-mail
 
Current Address
City, State Zip ,
Current Home Phone Number ( ) -
Number of years at present address
Current Employer
Current Job Title
Number of years at present job
Current Work Address
City, State ,
Zip
Current Work Phone Number ( ) -
 
Former Address
City, State Zip ,
Former Home Phone Number ( ) -
Former Employer
Former Job Title
Former Work Address
City, State ,
Zip
Former Work Phone Number ( ) -

Monthly Income

  Borrower Co-Borrower
Base Monthly Employ Income
Overtime/Bonus
Dividends/Interest
Gross Rental Income
Other
*Total Monthly Income:
Note: Alimony, child support, or separate maintenance income need not be revealed if the Borrower or Co-Borrower does not choose to have it considered for repaying this loan.
 
Loan Purpose
*Loan Amount Requested
Type of Loan
Term Requested
*Collateral
Where do you currently have checking / savings accounts?? Financial Institution Balance
 
 

Demographic Information Addendum. This section asks about your ethnicity, sex, and race.

Demographic Information of Borrower

The purpose of collecting this information is to help ensure that all applicants are treated fairly and that the housing needs of communities and neighborhoods are being fulfilled. For residential mortgage lending, Federal law requires that we ask applicants for their demographic information (ethnicity, sex and race) in order to monitor our compliance with equal credit opportunity, fair housing, and home mortgage disclosure laws. You are not required to provide this information, but are encouraged to do so. You may select one or more designations for "Ethnicity" and one or more designations for "Race." The law provides that we may not discriminate on the basis of this information, or on whether you choose to provide it. However, if you choose not to provide the information and you have made this application in person, Federal regulations require us to note your ethnicity, sex, and race on the basis of visual observation or surname. The law also provides that we may not discriminate on the basis of age or marital status information you provide in this application. If you do not wish to provide some or all of this information, please check below.

Ethnicity: Check one or more
Hispanic or Latino   

  •  
  •  
  •  
  •  

    For example: Argentinean, Colombian, Dominican, Nicaraguan,Salvadoran. Spaniard, and so on.

  Not Hispanic or Latino   
  I do not wish to provide this information   

Sex
  Female   
  Male
  I do not wish to provide this information

Race/National Origin: Check one or more
  American Indian, Alaskan Native - Print name of enrolled or principal tribe:

  Asian

  •  
  •  
  •  
  •  
  •  
  •  
  •  

    For example: Hmong, Laotian, Thai, Pakistani, Cambodian, and so on.

  Black or African American
  Native Hawaiian or other Pacific Islander   
  •  
  •  
  •  
  •  

    For example: Fijian, Tongan, and so on.
  White
  I do not wish to provide this information

CO-Borrower    I do not wish to furnish this information

Ethnicity: Check one or more
Hispanic or Latino   

  •  
  •  
  •  
  •  

    For example: Argentinean, Colombian, Dominican, Nicaraguan,Salvadoran. Spaniard, and so on.

  Not Hispanic or Latino   
  I do not wish to provide this information   

Sex
  Female   
  Male
  I do not wish to provide this information

Race/National Origin: Check one or more
  American Indian, Alaskan Native - Print name of enrolled or principal tribe:

  Asian

  •  
  •  
  •  
  •  
  •  
  •  
  •  

    For example: Hmong, Laotian, Thai, Pakistani, Cambodian, and so on.

  Black or African American
  Native Hawaiian or other Pacific Islander   
  •  
  •  
  •  
  •  

    For example: Fijian, Tongan, and so on.
  White
  I do not wish to provide this information

Co-Borrower Information

Demographic Information Addendum. This section asks about your ethnicity, sex, and race.

Demographic Information of Borrower

The purpose of collecting this information is to help ensure that all applicants are treated fairly and that the housing needs of communities and neighborhoods are being fulfilled. For residential mortgage lending, Federal law requires that we ask applicants for their demographic information (ethnicity, sex and race) in order to monitor our compliance with equal credit opportunity, fair housing, and home mortgage disclosure laws. You are not required to provide this information, but are encouraged to do so. You may select one or more designations for "Ethnicity" and one or more designations for "Race." The law provides that we may not discriminate on the basis of this information, or on whether you choose to provide it. However, if you choose not to provide the information and you have made this application in person, Federal regulations require us to note your ethnicity, sex, and race on the basis of visual observation or surname. The law also provides that we may not discriminate on the basis of age or marital status information you provide in this application. If you do not wish to provide some or all of this information, please check below.

Ethnicity: Check one or more
Hispanic or Latino   

  •  
  •  
  •  
  •  

    For example: Argentinean, Colombian, Dominican, Nicaraguan,Salvadoran. Spaniard, and so on.

  Not Hispanic or Latino   
  I do not wish to provide this information   

Sex
  Female   
  Male
  I do not wish to provide this information

Race/National Origin: Check one or more
  American Indian, Alaskan Native - Print name of enrolled or principal tribe:

  Asian

  •  
  •  
  •  
  •  
  •  
  •  
  •  

    For example: Hmong, Laotian, Thai, Pakistani, Cambodian, and so on.

  Black or African American
  Native Hawaiian or other Pacific Islander   
  •  
  •  
  •  
  •  

    For example: Fijian, Tongan, and so on.
  White
  I do not wish to provide this information

CO-Borrower    I do not wish to furnish this information

Ethnicity: Check one or more
Hispanic or Latino   

  •  
  •  
  •  
  •  

    For example: Argentinean, Colombian, Dominican, Nicaraguan,Salvadoran. Spaniard, and so on.

  Not Hispanic or Latino   
  I do not wish to provide this information   

Sex
  Female   
  Male
  I do not wish to provide this information

Race/National Origin: Check one or more
  American Indian, Alaskan Native - Print name of enrolled or principal tribe:

  Asian

  •  
  •  
  •  
  •  
  •  
  •  
  •  

    For example: Hmong, Laotian, Thai, Pakistani, Cambodian, and so on.

  Black or African American
  Native Hawaiian or other Pacific Islander   
  •  
  •  
  •  
  •  

    For example: Fijian, Tongan, and so on.
  White
  I do not wish to provide this information

Schedule of Real Estate

Address of Property
(Indicate S if Sold, PS 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 Payment Taxes, Ins., Maintenance and Misc. Net Rental Income
TOTALS →
*Total Assets

Liabilities

  LIABILITY BALANCE MONTHLY
PAYMENT
Rent
Real Estate
 
 
Autos
 
 
Credit Cards
 
 
Others
 
*Total Liabilities
*Net Worth (assets - liabilities)

Collateral
Property Address/Collateral Description:
Block
Lot

Other Questions
(Check box for 'yes' or leave blank for 'no')

Borrower
Are there any judgments against you?
Have you been declared bankrupt within the past 7 years?
Have you had property foreclosed upon or given title/deed in lieu thereof in the last 7 years?
Are you a party to a law suit?
Are you obligated to pay alimony, child support, or separate maintenance?
Are you a co-maker or endorser on a note?
Are you a US citizen?
If no, are you a resident alien?

Co-Borrower
Are there any judgments against you?
Have you been declared bankrupt within the past 7 years?
Have you had property foreclosed upon or given title/deed in lieu thereof in the last 7 years?
Are you a party to a law suit?
Are you obligated to pay alimony, child support, or separate maintenance?
Are you a co-maker or endorser on a note?
Are you a US citizen?
If no, are you a resident alien?
I authorize Franklin Bank to obtain a copy of my current credit report as a condition of acceptance of this application and for the purpose of extension of or renewal of credit.




I certify that the facts contained in this application are true and complete to the best of my knowledge and agree that completing this form does not obligate Franklin Bank to extend credit.
* indicates a required field

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