| If you
answer "yes" to any questions a through i, please use a continuation sheet
for explanation. |
Borrower |
Co-Borrower |
| a. Are there any outstanding judgements
against you? |
Yes No |
Yes No |
| b. Have you been declared bankrupt within the
past 7 years? |
Yes No |
Yes No |
| c. Have you had preperty foreclosed upon or
given title or deed in lieu thereof 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? (This would include such loans as home
mortgage loans, SBA loans, home improvement loans, educational loans,
manufactured (mobile) home loans, any mortgage, financial obligation,
bond, or loan guarantee. If "Yes," provide details, including date, name
and address of Lender, FHA or VA case number, if any, and reasons for the
action.) |
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? If "Yes," give details as described in the
preceding. |
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 a 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? If "Yes," complete question m below. |
Yes No |
Yes No |
| m. Have you had an ownership interest in a
property in the last three years? |
Yes No |
Yes No |
| (1) What type of property did you own -
principal residence (PR), second home (SH), or investment property
(IP)? |
______________ |
______________ |
| (2) How did you hold title to the home -
solely by yourself (S), jointly with your spouse (SP), or jointly with
another person (O)? |
______________ |
______________ |