IPS Mortgage Corp.  Short Application

 
 
Please fill out all fields completely.
 
 
  Realtor/Contact:   Phone:    
  Type of loan: Conventional  FHA   VA   Home Path   Other
 
 
  Primary Borrower Name: DOB:

SSN:

(no dashes)  
  Phone (H):

   Phone (W):  Phone (C):

 
     
  Co-Borrower Name:   DOB:

SSN:

(no dashes)  
  Phone (H):    Phone (W):  Phone (C):  
       .
 

Current Address

No.

Street:

City:

 

Zip:

   
      Own or rent?  Own  Rent  
      Type:    
    .
    Name Balance Interest Rate Payment    
  Mortgage Holder 1 % $    
  Mortgage Holder 2 % $    
              .
 

Purchase (Listed Home)

 
     
  Home Type:  Single Family   Duplex   Multiplex   Townhome   Condo  
           
 

Purchase Price:

 $

   MLS#:    
 

Home Address:

No.

Street:

City:

Zip:

 
                      .
 

Employment History (Borrower)

 
     
 

Employer Name:

   
 

Employer Address:

No.

Street:

 

City:

 

Zip:

   
 

Position/Title:

 

Years on Job:

     
 

Gross Income:

$

 

per  

  Paid on: W2   1099   Self Empl.  
    .
 

Employment History (Co-Borrower)

 
     
 

Employer Name:

   
 

Employer Address:

No.

Street:

City:

 

Zip:

   
 

Position/Title:

 

Years on Job:

     
 

Gross Income:

$

 

per  

  Paid on: W2   1099   Self Empl.  
    .
 

Assets

 
  Cash in Bank Accounts (include savings & checking)  
     
    Account Type Bank Name Account Number   Balance  
 

1. 

$

 
 

2. 

$

 
 

3. 

$

 
 

4. 

$

 
 

5. 

$

 
 

6. 

$

 
              .
  Investments (including 401K, brokerage accounts, stocks, bonds, Etc...):  
   
     
  Other Property Owned (including rental units, cabins, 2nd homes & land):  
   
         
 

Address:

No.

Street:

City:

Zip:

   
      Commercial  Residential    .
    .
 

Additional Questions/Comments

 
           
  Do you pay child support or alimony? Yes   No

Amount/Mo: $

 
  Real Estate taxes? Yes   No

Yearly: $

MO (if known): $

 
  Home Insurance Yes   No

Yearly: $

MO (if known): $

 
  Credit History: Excellent   Good   Average   Challenged  
  Agree to Credit Check: Yes   No

Date:

Time:

Score:

 
  Have you had any late payments on your mortgage (past 12 mo)? Yes   No  
  Describe credit issues (judgments, bankruptcy, collections):    
     
    .
 

Disclosure Notices

 
   

 

Check each box below to Agree  
   

ECOA Notice

 
    The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the bases of race, color, religion, national origin, sex, marital status, age (provided that the application has the capacity to enter into a binding contract): because all of part of the applicant's income is derived from a public assistance program; or because the applicant has in good faith exercised any rights under the Consumer Credit Protection Act. The Federal Agency that administers compliance with this law concerning this creditor is: Federal Trade Commission, Equal Credit Opportunity, Washington DC 20580.

We are required to disclose to you that you need not disclose income from alimony, child support or separate maintenance payment if you choose not to do so.
 
     
 

Occupancy Statement

 
    Applicant(s) hereby certify and acknowledge that , upon taking title to the real property described above, their occupancy status will be as follows:  
        Primary Residence  
        Secondary Residence  
        Investment Property  
    The applicant(s) acknowledge it is a federal crime punishable by fine or imprisonment, or both, to knowingly make any false statement concerning this loan application under the provisions of Title 18, United States Code, Section 1014  
    .
 

Authorization to Pull Credit

 
    I further authorize IPS Mortgage to order a mortgage credit report and verify all other credit information, including past and present mortgage and landlord references. It is understood that a photocopy of this document shall also serve as an authorization to provide the information requested.

The information obtained is only to be used in the processing of my mortgage loan application.

 
     
 

FHA Loans Only

 
    If you prepay your loan on other than the regular installment date, you may be assessed interest charges until the end of that month.  
 

Government Loans Only

 
      RIGHT TO FINANCIAL PRIVACY ACT OF 1978 - This is notice to you as required by the Right of Financial Privacy Act of 1978 that the Department of Housing and Urban Development or Department of Veterans Affairs has a right of access to financial records held by a financial institution in connection with the consideration of administration of assistance to you. Financial records involving your transaction will be available to the Department of Housing and Urban Development of Department of Veterans Affairs without further notice or authorization but will not be disclosed or released to another Government agency or Department without your consent except as required or permitted by law.  
     
 

Employment Certification

 
    An approval for a loan is based upon employment, income and obligations as shown on the loan application. At closing, the applicant and co-applicant/spouse, if applicable, are required to execute a sworn statement affirming that they are currently working as previously reported, have not received notice of layoff nor have knowledge of pending layoff, and that outstanding obligations are substantially the same as reported on the application. Should a change occur in your employment or financial status prior to loan closing, immediately notify your loan officer, as it will be necessary to obtain approval of any changes.  
     
 
.
  Type in your full name below to electronically sign this loan application:  
     
         
    Signature Date   Signature Date    
    .