To apply please make sure that all fields are filled in.  
VA
 USDA/Rural
Housing
Service
Subject Property Address (street, city, state, & ZIP)
Complete this section if construction or construction-permanent loan.
Leasehold
(show expiration
date)
Source of Down Payment, Settlement Charges and/or Subordinate Financing (explain)
Borrower' s Name (include Jr. or Sr. if applicable)
Unmarried
(include single,
divorced, widowed)
Mailing Address, if different from Present Address
If residing at present address for less than two years, complete the following:
Co-Borrower' s Name (include Jr. or Sr. if applicable)
Unmarried
(include single,
divorced, widowed)
Mailing Address, if different from Present Address
If residing at present address for less than two years, complete the following:
If employed in current position for less than two years or if currently employed in more than one position, complete the
following:
MONTHLY INCOME AND COMBINED HOUSING EXPENSE INFORMATION
Gross Monthly
Income
 Borrower
 Co-Borrower
Base Employment
Income
    
Overtime
    
Bonuses
    
Commissions
    
Other
    
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:
    
* Self Employed Borrower(s) may be required to provide additional documentation
such as tax returns and financial statements.

Describe Other Income 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.
B/C
   Monthly Amount
     
     
     
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.
Total Assets
(checking, savings, investments and other)
Total Balance for all Credit Cards,
Auto Loans, Student Loans, etc
Alimony/Child Support/Separate
Maintenance Payments Owed to:
   
YES
 NO
 YES
 NO
a. Are there any outstanding judgments against you?
        
b. Have you been declared bankrupt within the last 7 years?
        
c. Have you had property foreclosed upon 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?
        
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 the co-maker or endorser on a note?
        
j. Are you a U.S. citizen?
        
k. Are you a permanent resident alien?
        
k. Are you a permanent resident alien?
        
l. Do you intend to occupy the property as your primary residence? (if "Yes," complete question m
below.)
        
l. Do you intend to occupy the property as your primary residence? (if "Yes," complete question m
below.)
        
m. Have you had an ownership interest in a property in the last 3 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)?
        


The Premiere Mortgage Corporation






Your Hometown Mortgage Lender, representing over 30
different Banks and Mortgage Companies Interest Rates and
Mortgage Products serving Michigan!
Email:
 *Please provide email for further contact.
TYPE OF MORTGAGE AND TERMS OF LOAN
Mortgage Applied for:
 FHA
 Conventional
 Other
(explain):
Loan Amount:
 Interest Rate:
 No. of Months:
Amortization Type:
 Fixed
Rate
 ARM
 GMP
 Other
(explain):
PROPERTY INFORMATION AND PURPOSE OF LOAN
No. of Units
Legal Description of Subject Property
 Year Built
Purpose of Loan
 Purchase
 Refinance
 Construction
 Construction
Permanent
 Other
(explain):
Property will be:
 Primary
Residence
 Secondary
Residence
 Investment
Year Lot
Acquired
 Original
Cost
 Amount
Existing Liens
 (a) Present Value
of Lot
 (b) Cost of
Improvements
Complete this line if this is a refinance loan.
Year Lot
Acquired
 Original
Cost
 Amount
Existing Liens
 Purpose of
Refinance
Describe Improvements
 Cost:
Made
 To be
Made
Title will be held in what Name(s)
 Manner in which Title will be held
 Estate will be held in:
Fee Simple
BORROWER INFORMATION
BORROWER
Social Security Number
 Home Phone (area code)
DOB(MM/DD/YYYY)
 Yrs. School
Married
 Separated
Present Address (street, city, state, ZIP)
Own
 Rent
 No. Yrs.
Former Address (street, city, state, ZIP)
Own
 Rent
 No. Yrs.
CO-BORROWER
Social Security Number
 Home Phone (area code)
DOB(MM/DD/YYYY)
 Yrs. School
Married
 Separated
Present Address (street, city, state, ZIP)
Own
 Rent
 No. Yrs.
Former Address (street, city, state, ZIP)
Own
 Rent
 No. Yrs.
IMPLOYMENT INFORMATION
BORROWER
Name & Address of Employer
 Years on this job
Self Imployed
Yrs. employed in this line of
work/profession
Phone (incl. area code)
Position/Title/Type of Business Business
Name & Address of Employer
 Dates (from-to)
Self Imployed
Monthly Income
Phone (incl. area code)
Position/Title/Type of Business Business
Name & Address of Employer
 Dates (from-to)
Self Imployed
Monthly Income
Phone (incl. area code)
Position/Title/Type of Business Business