1003 Loan Application

First American Finance Corp.
Formal Loan Application

Please complete the following information to the best of your ability. If you cannot complete one of the questions for whatever reason please move on to the questions you can answer, we will contact you if additional information is required.

You may submit this application electronically or you may print it out and submit it by fax to 765-768-4121. Please don't hesitate to contact us with any questions you may have at 260-726-8508 or by email info@firstafc.com. Thank you for choosing First American Finance.

After submitting your application please fax your last 2 years W-2's or 1099's and your last 2 paystubs to 765-768-4121.

Type and Term of Loan

Purchase Refinance

Loan Amount Needed
Loan Term (years)

Fixed Rate Adjustable Rate

Property to be Financed

Primary Residence Second Home Investment Property (Non-owner occupied)
Street Address
City, State, Zip
$ Purchase Price (estimated value if a refinance)
$ Yearly Real Estate Taxes
$ Yearly Hazard Insurance
$ Yearly Homeowner Assn. Dues (if applicable)
Title will be held in what name(s)

Manner in which title will be held - solely by yourself (S), jointly with your spouse (SP), or jointly with another person (O)?

Source of down payment , settlement charges and/or subordinate financing (explain)

Complete this section if this is a refinance loan

Year Acquired
$ Original Cost
$ Amount of existing loans on property

Purpose of refinance
Describe improvements
Made To be made
$ Cost of improvements

Client Information :

Borrower:	Co-Borrower:
		E-Mail Address (required)
		First Name, MI, Last Name
		Social Security Number
		Home Telephone Number
		Your Street Address
		City, State, Zip
		Since Mo/Yr
Own Rent	Own Rent

		Birthday (MMDDYY)
		Years of School
		Number of Dependents
		Ages of Dependents
		Marital Status

If Residing at present address less than 2 years, complete the following

		Previous Street Address
		City, State, Zip
		From Mo/Yr - Mo/Yr
Own Rent	Own Rent

Employment History:

Borrower:	Co-Borrower:
		Present Employer
		Street Address
		City, State, Zip
		Work Telephone Number
		Start Date
		Years in this Profession
$	$	Gross Monthly Income
		Position/Title

If employed in current position less than 2 years, or if currently employed in more than one position, complete the following

		Previous Employer #1
		Street Address
		City, State, Zip
		Work Telephone Number
		Dates Employed
$	$	Gross Monthly Income
		Position/Title

		Previous Employer #2
		Street Address
		City, State, Zip
		Work Telephone Number
		Dates Employed
$	$	Gross Monthly Income
		Position/Title

Other income (if any):

Other Income Source
How Long Receiving
$$Monthly Amount
Other Income Source
How Long Receiving
$$Monthly Amount

Please Note: Alimony, child support, or separate maintenance income need not be revealed if you do not wish it to be considered as a basis for repaying this obligation.

Other Expenses:

$ $Monthly Alimony and/or Child Support

Asset Information (please complete for all checking, savings, money market, CD, stock, bond or other liquid asset accounts):

Name of Realtor Holding Ernest Money (if purchase):
$Amount of Ernest Money Deposited with Realtor (if Purchase)
Bank or Institution Name
Type of Account $ Balance
Bank or Institution Name
Type of Account $ Balance
Bank or Institution Name
Type of Account $ Balance
Bank or Institution Name
Type of Account $ Balance

Stocks & Bonds
Company Name / # Shares
$ Market Value

$ Estimated value of personal property
$ Life insurance net cash value
$ Life insurance face value

$ Vested interest in retirement funds (401K)
$ Net worth of business(s) owned

Real Estate Owned:

Type of Property
Street Address
City, State, Zip
Lender
$Monthly Payment $Balance Owed
$Property Value $Rent Received Monthly, if any

Vehicles Owned:

Year Make Model $ Value

Landlord Information (If any):

Landlord's Name
Landlord's Address
Landlord's Phone Number
$Monthly Rental Payment

Debts (mortgages, auto loans or leases, personal loans, credit cards or other contractual obligations):

Name of Company
Loan Description
$Monthly Payment $Balance Owed

Borrower	Co-Bor
Yes No	Yes No
			a. Are there any outstanding judgments against you?
			b. Have you been declared bankrupt within the past 7 years?
			c. Have you had property foreclosed upon or given title or deed in lieu thereof in the past 7 years
			d. Are you a party to a lawsuit?
			e. Have you directly or indirectly been obligated on any loan which resulted in foreclosure, transfer of title in lie of foreclosure, or judgment? (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.
			f. Are you presently delinquent or in default on any Federal debt or any other loan mortgage, financial obligation, bond, or loan guarantee?
			g. Are you obligated to pay alimony, child support, or separate maintenance?
			h. Is any part of the down payment borrowed?
			i. Are you a co-maker or endorser on a note?
			*j. Are you a U.S. citizen?*
			k. Are you a permanent resident alien?
			l. Do you intend to occupy the property as your primary residence?
			m. Have you had an ownership interest in a property in the last three years?
		What type of property did you own - Principal residence (PR), second home (SH), or investment property (IP)
		How did you hold title to the home- solely by yourself (S), jointly with your spouse (SP), or jointly with another person (O)?
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 above 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.)
	Borrower			Co-Borrower
Ethnicity:

Race:

Sex:

Please click on "Submit Form" below if you agree to the following:

I/We certify that the information I/We have provided is true and correct. I/We authorize First American Finance, to verify any information included in this application or in other documents required to obtain the loan I/We are requesting. I/We also authorize any party named in this application to provide any and all information First American Finance may request, such as employment history, credit history, income and income tax returns, and bank, money market, and similar account balances.

I/We understand that First American Finance will incur time and expense on my/our behalf to process and approve my/our loan. Therefore, I/we agree that if First American Finance approves my/our loan and closing of the loan can not occur due to any act, failure to act, or misrepresentation on my/our part, I/we will pay First American Finance one half of one percent (.5%) of the loan amount as well as any bona fide third party fees such as credit reports, appraisals, title fees etc. which First American Finance has paid on my/our behalf.

I/we understand that I/we may submit this application to First American Finance electronically by clicking "Submit Form" below, or I/we may submit the application by fax or mail by printing out this form. If I choose to submit this application electronically, I acknowledge that, regardless of the fact that Microsoft Explorer security features are available, First American Finance is unable to ensure that the data can not be intercepted by third parties. I agree that First American Finance will not be held liable should such interception occur.

After submitting your application please fax your last 2 years W-2's or 1099's and your last 2 paystubs to 765-768-4121.

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