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Second Mortgage or Home Improvement Loan Application

InBank
15533 South Cicero Avenue Oak Forest, Illinois 60452 (708) 687-6000
Member F.D.I.C.

Amount: $
Interest Rate:
Simple Interest
Add-On
%
No. of Months:
Monthly payment Principle & Interest:


Address of Property to be Improved:
Street Address:
Address Line 2:
City:
State:
Postal / Zip Code:
Date Purchased:
Cash Down Payment:
Purchase Price:$
Present Value of Home:$

Title in name of:
Address of title holder:
Street Address:
Address Line 2:
City:
State:
Postal / Zip Code:
 

Yr. house built:
No. of Rooms:
No. of Bedrooms:
No. of Baths:
Family Room or Den?
No Yes
Gross Living Area: Sq. Ft.
Garage or Carport:(Specify type & no.)
Central Air?
No Yes
If this is a new residential structure, has it been completed and occupied for 90 days or longer? No Yes

Purpose
Home Improvements
Home Purchase
Home Refinance
Debt Consolidation
Tuition

The Co-Borrower Section and all other Co-Borrower questions must be completed and the appropriate box(es) checked if:
another person will be jointly obligated with the Borrower on the loan, or
the Borrower is relying on income from alimony, child support or separate maintenance or on the income or assets of another person as basis for repayment of the loan, or
the Borrower is married and resides, or the property is located, in a community property state.
We intend to apply for joint credit

Applicant

Co-Applicant

Date

Date

Borrower
Name Date of Birth

Present Address: No. of Years: Own Rent
Street: City: State: Zip Code:

Former Address (if less than 2 years at present address):
Street: City: State: Zip Code:
Years at former address: Own Rent
Complete for secured loans only:
Married Separated
Unmarried (incl. single, divorced, widowed)
Dependents other than listed by Co-Borrower:
No.: Ages:
Name and Address of Employer:
Years employed in this line of work or profession?
Years: Years on this job:
Self-Employed
Drivers License Num.: State I.D.: Other:
Position/Title: Type of Business: Social Security Number:
Home Phone: Business Phone:
Name and Address of nearest relative not living with you:
Relationship: Home Phone:

Co Borrower
Name Date of Birth

Present Address: No. of Years: Own Rent
Street: City: State: Zip Code:

Former Address (if less than 2 years at present address):
Street: City: State: Zip Code:
Years at former address: Own Rent
Complete for secured loans only:
Married Separated
Unmarried (incl. single, divorced, widowed)
Dependents other than listed by Co-Borrower:
No.: Ages:
Name and Address of Employer:
Years employed in this line of work or profession?
Years: Years on this job:
Self-Employed
Drivers License Num.: State I.D.: Other:
Position/Title: Type of Business: Social Security Number:
Home Phone: Business Phone:
Name and Address of nearest relative not living with you:
Relationship: Home Phone:

Gross Monthly Income Bank Account No. Name & Address of Depository
Item Borrower Co-Borrower Total Checking
No
Yes
Empl. Income
Other (before completing, see the notice in ‘Describe Other Income’ below.)
Savings
No
Yes
Total

Describe Other Income
Borrower
Co-Borrower
NOTICE: Alimony, child support, or separate maintenance income need not be revealed if the Borrower or Co-Borrower does not choose to have it considered as a basis for repaying this loan. Monthly Amount
$
$
$

If Employed in Current Position for Less Than Two Years, Complete the Following
Borrower
Co-Borrower
Previous Employer/School City/State Type of Business Position/Title Dates From/To Monthly Income
$
$

These Questions Apply to Both Borrower and Co-Borrower
If a "yes" answer is given to a question in this column, please explain on an attached sheet. Borrower Co-Borrower
Are there any outstanding judgements against you? No
Yes
No
Yes
Have you been declared bankrupt within the past 7 years? No
Yes
No
Yes
Have you had property foreclosed upon or given title or deed in lieu thereof in the last 7 years? No
Yes
No
Yes
Are you a party to a law suit? No
Yes
No
Yes
Are you obligated to pay alimony, child support, or separate maintenance? No
Yes
No
Yes
Are you a co-maker or endorser on a note? No
Yes
No
Yes
Do you have any past due obligations owed to or insured by any agency of the federal government?** No
Yes
No
Yes
Are you a U.S. citizen? No
Yes
No
Yes
If "no", are you a resident alien? No
Yes
No
Yes
If "no", are you a non-resident alien? No
Yes
No
Yes
**Required only if FHA or VA home improvement loan.

DEBTS: List all fixed obligations and installment accounts. (*Indicate by asterisk all FHA and Government Agency Loans.) If no outstanding debt, list three previous credit references.
Borrower
Co-Borrower
Creditor's Name and Address Account No. Date Incurred (mm/dd/yyyy) Original Amount Present Balance Monthly Payments Amount Past Due
$ $ $ $
$ $ $ $
$ $ $ $
$ $ $ $
$ $ $ $
$ $ $ $
$ $ $ $
$ $ $ $
Auto Real Estate
Lien Holder:
Year: 
Make:
$ $ $ $
Lien Holder:
Year: 
Make:
$ $ $ $
Name & Address of First Lien Holder of Security Property:
$ $ $ $
Name & Address of Subordinate Lien Holder(s) of Security:
$ $ $ $
$ $ $ $
List Debts on Other Real Estate Owned:
$ $ $ $
$ $ $ $
List any additional names under which credit has previously been received:
If not included in monthly mortgage payment enter the following:
Monthly payment for Taxes and Insurance: $ $
Monthly payment for Home Owner Association dues: $ $
Total Monthly Obligations: $ $

Important - Applicant Read Before Signing
I/We apply for the loan indicated in this application which may be secured by a mortgage or deed of trust on the property described herein and represent that the property will not be used for any illegal or restricted purpose, and that all statements made in this application are true and are made for the purpose of obtaining the loan. Verification may be obtained from any source named in this application. The original or a copy of this application will be retained by the lender, even if the loan is not granted. I/We hereby consent to and authorize the lender or HUD-FHA, after the giving of reasonable notice, to enter the improved property for the sole purpose of determining that the improvements specified in this application have been completed.
I/WE UNDERSTAND THAT THE SELECTION OF A CONTRACTOR OR DEALER, ACCEPTANCE OF MATERIAL USED AND WORK PERFORMED IS MY/OUR RESPONSIBILITY. NEITHER THE LENDER NOR HUD-FHA GUARANTEES THE MATERIAL OR WORKMANSHIP.
I/We Do Do Not intend to occupy the property as my/our primary residence.
I/We understand that it may be a federal crime punishable by fine or imprisonment, or both, to knowingly make any false statements concerning any of the above facts as applicable under the provisions of the United States/Criminal Code.

Borrower's Signature

Date

Co-Borrower's Signature

Date