Real Estate Loan Application - Land Only/No Dwelling

Property Information

Borrower Information

Contact Information

Current Address

If residing at present address for less than 2 years, please complete the following:

Previous Address 1

Previous Address 2

Employment Information

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

Previous Company 1

Previous Company 2

Current Monthly Income

* Self-employed Borrowers may be required to provide additional documentation such as tax returns and financial statements.

** 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 for repaying this loan.

Co-Borrower Information

Contact Information

Current Address

If residing at present address for less than 2 years, please complete the following:

Previous Address 1

Previous Address 2

Employment Information

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

Previous Company 1

Previous Company 2

Current Monthly Income

* Self-employed Borrowers may be required to provide additional documentation such as tax returns and financial statements.

** 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 for repaying this loan.

Housing Expenses

Expense Type Present Amount Proposed Amount
Rent
First Mortgage
Second Mortgage (P&I)
Hazard Insurance
Real Estate Taxes
Mortgage Insurance
Homeowner Association Dues
Other

Asset Information

This statement and any applicable supporting schedules 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.







Automobiles

Year Make Current Value
Auto 1
Auto 2
Auto 3

Liability Information

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 those liabilities which will be satisfied upon sale of real estate owned or upon refinancing of the subject property.

Name of Creditor Monthly Payment Unpaid Balance Will this debt be paid off?

Other Payments

Alimony/Child Support/Separate maintenance Payments

Job related Expense (Childcare, union dues, etc.)

Schedule of Real Estate Owned

Property 1

 

Property 2

 

Property 3

 

Declarations

Borrower Answers

  1. Are there any outstanding judgments against you?
    Yes   No

    If yes, please explain below.

  2. Have you been declared bankrupt within the last 7 years?
    Yes   No

    If yes, please explain below.

  3. Have you had property foreclosed upon or given title or deed in lieu thereof in the last 7 years?
    Yes   No

    If yes, please explain below.

  4. Are you a party to a lawsuit?
    Yes   No

    If yes, please explain below.

  5. 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.
    Yes   No

    If yes, provide details in the space below including date, name and address of Lender, FHA or VA case number, if any, and reasons for the action.

  6. Are you presently delinquent or in default on any Federal debt or any other loan, mortgage, financial obligation, bond, or loan guarantee?
    Yes   No

    If yes, provide details in the space below including date, name and address of Lender, FHA or VA case number, if any, and reasons for the action.

  7. Are you obligated to pay alimony, child support, or separate maintenance?
    Yes   No

    If yes, please explain below.

  8. Is any part of the down payment borrowed?
    Yes   No

    If yes, please explain below.

  9. Are you a co-maker or endorser on a note?
    Yes   No

    If yes, please explain below.

  10. Are you a U.S. Citizen?
    Yes   No
  11. Are you a permanent resident alien?
    Yes   No

Co-Borrower Answers

  1. Are there any outstanding judgments against you?
    Yes   No

    If yes, please explain below.

  2. Have you been declared bankrupt within the last 7 years?
    Yes   No

    If yes, please explain below.

  3. Have you had property foreclosed upon or given title or deed in lieu thereof in the last 7 years?
    Yes   No

    If yes, please explain below.

  4. Are you a party to a lawsuit?
    Yes   No

    If yes, please explain below.

  5. 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.
    Yes   No

    If yes, provide details in the space below including date, name and address of Lender, FHA or VA case number, if any, and reasons for the action.

  6. Are you presently delinquent or in default on any Federal debt or any other loan, mortgage, financial obligation, bond, or loan guarantee?
    Yes   No

    If yes, provide details in the space below including date, name and address of Lender, FHA or VA case number, if any, and reasons for the action.

  7. Are you obligated to pay alimony, child support, or separate maintenance?
    Yes   No

    If yes, please explain below.

  8. Is any part of the down payment borrowed?
    Yes   No

    If yes, please explain below.

  9. Are you a co-maker or endorser on a note?
    Yes   No

    If yes, please explain below.

  10. Are you a U.S. Citizen?
    Yes   No
  11. Are you a permanent resident alien?
    Yes   No

List any additional names under which credit has previously been received and indicate appropriate creditor names and account numbers.

Alternate Name Creditor Name Account Number

At which AmeriState bank location would you like to sign your closing documents:

By submitting this online application, I/We authorize AMERISTATE Bank to check such things as my/our credit, business and employment status and histories. I/We understand that more documentation may be required in order to complete the application process. Everything that I/we have stated in this application is correct to the best of my knowledge.

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