First New Mexico Bank
Mortgage Application

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This Residential Loan Application is for personal loans and is NOT intended for Business use.

Uniform Residential Loan Application

This application is designed to be completed by the applicant(s) with the Lender's assistance. Applicants should complete this form as "Borrower" or "Co-Borrower", as applicable. Co-Borrower information must also be provided (and the appropriate box checked) when the income or assets of a person other than the "Borrower" (including Borrower's spouse) will be used as a basis for loan qualification or the income or assets of the Borrower's spouse will not be used as a basis for loan qualification, but his or her liabilities must be considered because the Borrower resides in a community property state, the security property is located in a community property state, or the Borrower is relying on other property located in a community property state as a basis for repayment of the loan.

If this is an application for joint credit, Borrower and Co-Borrower each agree that we intend to apply for joint credit by checking the box below:
Applicant Co-Applicant

I. TYPE OF MORTGAGE AND TERMS OF LOAN

Mortgage Applied for:
VA FHA Conventional FmHA Other:

Agency Case No.

Lender Case No.
Amount $
Interest Rate %
No. of Months
Amortization Type:
Fixed RateGPMARM (type):
Other (explain):

II. PROPERTY INFORMATION AND PURPOSE OF LOAN
Subject Property Address (street, city state & ZIP)
No. of Units
Legal Description of Subject Property
(attach description if necessary)
Year Built
Purpose of Loan:
Purchase Refinance
Other (explain)
Property will be:
Primary Residence
Secondary Residence

Investment
Complete these lines if construction or construction-permanent loan:
Year Lot Acquired
Original Cost
$
Amount Existing Liens
$
(a) Present Value of Lot
(b) Cost of Improvements
$
Total (a+b)
$
Complete these lines if this is a refinance loan.

Year Acquired

Original Cost
$
Amount Existing Liens
$
Purpose of Refinance
Describe Improvements Made To Be Made
Cost $
Title will be held in what Names(s)
Manner in which Title will be held:
Source of Down Payment, Settlement Changes
and/or Subordinate Financing (explain)
Estate will be held in:
Fee Simple
Leasehold (show expiration date)

III. BORROWER INFORMATION
Borrower
Borrower's Name (include Jr. or Sr. if applicable)
Social Security No.
Home Phone (incl. area code)
Date of Birth
Yrs. School
Married Separated
Unmarried (include single, divorced, widowed)
Dependents (not listed by Co-Borrower)
no. ages
Present Address (street, state, ZIP) Own Rent No. Yrs.
If residing at present address for less than two years, complete the following:
Former Address (street, state, ZIP) Own Rent No. Yrs.
Former Address (street, state, ZIP) Own Rent No. Yrs.
Co-Borrower
Co-Borrower's Name (include Jr. or Sr. if applicable)
Social Security No.
Home Phone (incl. area code)
Date of Birth
Yrs. School
Married Separated
Unmarried (include single, divorced, widowed)
Dependents (not listed by Borrower)
no. ages
Present Address (street, state, ZIP) OwnRent No. Yrs.
If residing at present address for less than two years, complete the following:
Former Address (street, state, ZIP) Own Rent No.of yrs.
Former Address (street, state, ZIP) Own Rent No. of yrs.

IV. EMPLOYMENT INFORMATION
Borrower
Name & Address of Employer Self Employed
Years on this job
Yrs. employed in this line of work/profession:
Position/Title/Type of Business
Business Phone (include area code)
If employed in current position for less than two years or if currently employed in more than one position, complete the following:
Name & Address of Employer Self Employed
Dates (from-to)
Monthly income:
$
Position/Title/Type of Business
Business Phone (incl. area code)
Name & Address of Employer Self Employed
Dates: from-to:
Monthly income:
$
Position/Title/Type of Business
Business Phone (incl. area code)
Co-Borrower
Name & Address of Employer Self EmployedYears on this job
Years employed in this line of work/profession:
Position/Title/Type of Business
Business Phone (incl. area code)
If employed in current position for less that two years or if currently employed in more than one position, complete the following:
Name & Address of Employer Self EmployedDates: from-to:
Monthly income:
$
Position/Title/ Type of Business
Business Phone (inc. area code)
Name & Address of Employer

Self Employed
Dates: from-to:
Monthly income:
$
Position/Title/Type of Business
Business Phone (incl. area code)

V. MONTHLY INCOME AND COMBINED HOUSING EXPENSE INFORMATION
Gross Monthly Income
Borrower
Co-Borrower
Total
Base Empl. Income *$ $ $
Overtime $ $ $
Bonuses$ $ $
Commissions$ $ $
Dividends/Interest$ $ $
Net Rental Income$ $ $
Other (before completing, see the notice in "describe other income" below)$ $ $
Total$ $ $
Combined Monthly Housing Expense
Present

Proposed

-
Rent$ -
First Mortgage
(P & I)
$ $
Other Financing(P & I)$ $
Hazard Insurance$ $
Real Estate Taxes$ $
Mortgage Insurance$ $
Homeowner Assn. Dues$ $
Other$ $
Total$ $
* Self Employed Borrower(s) may be required to provide additional documentation such as tax returns and financial statements.
Describe Other Income
B/C
Notice:Alimony, child support, or separate maintenance income need not be revealed if the Borrower (B) or co-Borrower(C) does not choose to have it considered for repaying this loan.Monthly
Amount
B C
$
B C $
B C
$

VI. ASSETS AND LIABILITIES
This Statement and any applicable supporting schedule may be completed jointly by both married and unmarried Co-Borrowers if their assets and liabilities are sufficiently joined so that the Statement can be meaningfully and fairly presented on a combined basis; otherwise separate Statements and Schedules are required. If the Co-Borrower section was completed about a spouse, this Statement and supporting schedules must be completed about that spouse also.
Completed Jointly Not Jointly

ASSETS
Description
Cash or Market Value
Cash deposit toward purchase held by:

$
List checking and savings accounts below
Name and address of Bank, S & L, or Credit Union
Acct. no. $
Name and address of Bank, S & L, or Credit Union
Acct. no. $
Name and address of Bank, S & L, or Credit Union
Acct. no. $
Name and address of Bank, S & L, or Credit Union
Acct. no. $
Stock & Bonds (Company name/number & description
$
Life Insurance net cash value
Face amount: $
$
Subtotal Liquid Assets$
Real estate owned (enter market value from schedule of real estate owned)$
Vested interest in retirement$
Net worth of business(es) owned
(attach financial statement)
$
Automobiles owned (make and year)
$
Other Assets (itemized)
$
Total Assets (a)$

Liabilities and Pledged Assets. List the creditor's name, address and account number for all outstanding debts, including automobile loans, revolving charge accounts, real estate loans, alimony, child support, stock pledges, etc. Use continuation sheet, if necessary. Indicate by (*) those liabilities which will be satisfied upon sale of real estate owned or upon refinancing of the subject property.
LiabilitiesMonthly
Payt. & Mos.
Left to Pay
Unpaid Balance
Name and Address of Company
$ Payt./Mos. $
Acct. No.
Name and Address of Company
$ Payt./Mos. $
Acct. no.
Name and Address of Company
$ Payt./Mos. $
Acct. no.
Name and Address of Company
$ Payt./Mos. $
Acct. no.
Name and Address of Company
$ Payt./Mos. $
Acct. no.
Name and Address of Company
$ Payt./Mos. $
Acct. no.
 
Alimony/Child Support/Separate Maintenance Payments Owed to: $ -
Job Related Expense (child care, union dues, etc.)
$
Total Monthly Payments$
Net Worth (a minus b)
Total Liabilities(b)$

VI. ASSETS AND LIABILITIES(cont.)
Schedule of Real Estate Owned (if additional properties are owned use continuation sheet
Property Address
(enter S if sold,
PS if pending sale
or R if rental being held for income)
Type of
Property
Present
Market
Value
Amount of Mortgage
& Liens
Gross Rental Income
Mortgage Payments
Insurance
Maintenance,
Taxes & Misc.
Net
Rental Income

SPSR
$ $ $ $ $ $

S
PS R
$ $ $ $ $ $

S PS R
$ $ $ $ $ $
Totals
$ $
$
$ $ $
List any additional names under which credit has previously been received and indicate appropriate creditor name(s) and account number(s):
Alternative Name
Creditor Name
Account Number

VII. DETAILS OF TRANSACTION
a. Purchase Price$
b. Alterations, improvements, repairs$
c. Land (if acquired separately)$
d. Refinance (incl. in debts to be paid off)$
e. Estimated prepaid items$
f. Estimated closing costs$
g. PMI, MIP, Funding Fee$
h. Discount (if Borrower will pay)$
i. Total costs (add items a through h)$
j. Subordinate financing$
k. Borrower's closing costs paid by Seller$
l. Other Credits (explain)
$
m. Loan amount
(exclude PMI, MIP, Funding Fee financed)

$
n. PMI, MIP, Funding Fee financed$
o. Loan amount (add m & n)$
p. Cash from/to Borrower
(subtract j, k, l & o from i)

$

VIII. DECLARATIONS
If you answer "Yes" to any questions a through i, please use continuation sheet for explanation.
Borrower
Co-Borrower
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 last 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 lieu 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. If "Yes," provide details, including date, name and address of Lender, FHA or VA case number, if any, and reasons for the action.)
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 question.
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? If "Yes," complete question below.
m. Have you had an ownership interest in a property in the last three years?
(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)?

IX. ACKNOWLEDGMENT AND AGREEMENT
Each of the undersigned specifically represents to Lender and to Lender's actual or potential agents, brokers, processors, attorneys, insurers, servicers, successors and assigns and agrees and acknowledges that: (1) the information provided in this application is true and correct as of the date set forth opposite my signature and that any intentional or negligent misrepresentation of this information contained in this application may result in civil liability, including monetary damages, to any person who may suffer any loss due to reliance upon any misrepresentation that I have made on this application, and/or in criminal penalties including, but not limited to, fine or imprisonment or both under the provisions of Title 18, United States Code, Sec. 1001, et seq.; (2) the loan requested pursuant to this application (the "Loan") will be secured by a mortgage or deed of trust on the property described herein; (3) the property will not be used for any illegal or prohibited purpose or use; (4) all statements made in this application are made for the purpose of obtaining a residential mortgage loan; (5) the property will be occupied as indicated herein; (6) any owner or servicer of the Loan may verify or reverify any information contained in the application from any source named in this application, and Lender, its successors or assigns may retain the original and/or an electronic record of this application, even if the Loan is not approved; (7) the Lender and its agents, brokers, insurers, servicers, successors and assigns may continuously rely on the information contained in the application, and I am obligated to amend and/or supplement the information provided in this application if any of the material facts that I have represented herein should change prior to closing of the Loan; (8) in the event that my payments on the Loan become delinquent, the owner or servicer of the Loan may, in addition to any other rights and remedies that it may have relating to such delinquency, report my name and account information to one or more consumer credit reporting agencies; (9) ownership of the Loan and/or administration of the Loan account may be transferred with such notice as may be required by law; (10) neither Lender nor its agents, brokers, insurers, servicers, successors or assigns has made any representation or warranty, express or implied, to me regarding the property or the condition or value of the property; and (11) my transmission of this application as an "electronic record" containing my "electronic signature," as those terms are defined in applicable federal and/or state laws (excluding audio and video recordings), or my facsimile transmission of this application containing a fascimile of my signature, shall be as effective, enforceable and valid as if a paper version of this application were delivered containing my original written signature.
Borrower's Name
Date
CO-Borrower's Name
Date

X. 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:
I do not wish to furnish this information.

Ethnicity:
Hispanic or Latino
Not Hispanic or Latino

Race or National Origin:
American Indian, Alaskan Native
Asian
Native Hawaiian or other Pacific Islander
White
Black or African American

Sex:
Female Male
Co-Borrower:
I do not wish to furnish this information.

Ethnicity:
Hispanic or Latino
Not Hispanic or Latino

Race or National Origin:
American Indian, Alaskan Native
Asian
Native Hawaiian or other Pacific Islander
White
Black or African American

Sex:
Female Male

To be completed by Interviewer (if applicable)
This application was taken by:
face-to-face interview
by mail
by telephone
over Internet

Interviewer's Name

Interviewer's Phone Number (incl. area code)
Name and address of Interviewer's Employer
To be completed and submitted by Borrowers
*If this is an application for joint credit, Borrower and Co-Borrower each agree that we intend to apply for joint credit by checking the box below:
Applicant Co-Applicant




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