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About Printing Requirements Reset Show Field Borders HOME EQUITY LOAN APPLICATION PLEASE TYPE OR PRINT IMPORTANT APPLICANT INFORMATION: Federal ...

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HOME EQUITY LOAN APPLICATION

PLEASE TYPE OR PRINT

IMPORTANT APPLICANT INFORMATION: Federal law requires financial institutions to obtain sufficient information to verify your identity. You may be asked several questions and to provide one or more forms of identification to fulfill this requirement. In some instances we may use outside sources to confirm the information. The information you provide is protected by our privacy policy and federal law. TYPE OF ACCOUNT REQUESTED Check one to indicate the type of account you are requesting. Note: Married applicants may apply for separate accounts.

l Joint Account l Individual Account - Relying solely on my income and assets. l Individual Account - Relying on my income and assets and as well as income or assets of another. TERMS REQUESTED Amount

Interest Rate

Type of Loan

$

% No. of Months

Payment $

l

Fixed Rate

l

ARM (type):

l

Other:

l

Other:

Purpose

l

/

Home Improvement

l

Pay Debt:

COLLATERAL PROPERTY Date Purchased

Address

Year Built

Title in Name(s) of:

Address of Title Holder

Present Value

Balance Owing

Name and Address of Insurance Carrier

Mortgage Holder Name INDIVIDUAL APPLICANT INFORMATION

Address

Phone No. Birthdate

Social Security No.

County

Drivers License No.

Business Phone

No. of Dependents

Ages of Dependents

Position

Years Employed

Employer's Address

Name Address (Street, City, State, Zip) Home Phone

Acct. No.

Employer/Self Employed

How Often Paid

Wages, Salary, Commissions Gross $

/month

Net $

/month

Position

Previous Employer

Years Employed

Previous Employer's Address

Name and Address of Applicant's Nearest Relative

Relationship

Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered. Alimony, child support, separate maintenance received pursuant to: Other Income: Source

l

Court Order

l

l

Written Agreement

Oral Understanding. Amount/Month

Marital Status l Married l Separated l Unmarried (includes single, divorced and widowed) JOINT APPLICANT OR OTHER PARTY INFORMATION Provide the information in this section if joint credit, or the individual applicant is relying on the income of others as a basis for repayment, or the individual applicant lives in a community property state or is relying on property located in a community property state as a basis for repayment of the credit requested. Name Birthdate Social Security No. Address (Street, City, State, Zip) Home Phone

County

Drivers License No.

Business Phone

No. of Dependents

Ages of Dependents

Position

Years Employed

Employer's Address

Employer/Self Employed Wages, Salary, Commissions

How Often Paid

Gross $

/month

Net $

Previous Employer

/month

Position

Previous Employer's Address

Years Employed

Name and Address of Joint Applicant's or Other Party's Nearest Relative

Relationship

Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered. Alimony, child support, separate maintenance received pursuant to:

l

Court Order

l

Written Agreement

l

Oral Understanding.

Other Income: Source Marital Status l Married GENERAL INFORMATION

Amount/Month

l

Separated

l

Unmarried (includes single, divorced and widowed)

If you or a joint applicant or other party answers "yes" to any of the following questions, please explain in the space provided. Are you a guarantor or co-maker of any leases, contracts or debts?

Applicant:

l

Yes

l

No

Joint Applicant/Other Party:

l

Yes

l

No

Are there any suits or judgments pending against you?

Applicant:

l

Yes

l

No

Joint Applicant/Other Party:

l

Yes

l

No

Applicant:

l

Yes

l

No

Joint Applicant/Other Party:

l

Yes

l

No

. (Include amount) . Have you been declared bankrupt in the last 10 years?

. PREVIOUS CREDIT REFERENCES Describe any previous debt obligations. Please mark Applicant-related information with an "A". Date Paid 1.

$

2.

$ NOT FOR FNMA/FHLMC/FHA/VA USE

Date Paid

- 1989 Bankers Systems, Inc., St. Cloud, MN

Form HE-APP 9/19/2005

(page 1 of 2)

ASSET AND DEBT INFORMATION If "Joint Applicant or Other Party Information" section was completed above, this section should be completed giving information about both the Applicant and the Joint Applicant or Other Party. Attach additional sheets if necessary. ASSETS DESCRIPTION OF CURRENT ASSETS Checking Accounts (Institution, Acct. No.)

NAME(S) OF OWNER(S)

SUBJECT TO DEBT: YES/NO

VALUE $

Savings Accounts (Institution, Acct. No.)

Automobiles (Make, Model, Year)

Marketable Securities (Issuer, Type, No. of Shares)

Life Insurance Cash Value (Issuer) Other Real Estate (Location, when acquired) Other Assets (Describe)

Total Assets

$

0.00 OUTSTANDING DEBTS (Include all charge accounts, installment contracts, credit cards, rents, mortgages and other obligations.) ACCOUNT NUMBER

CREDITOR

NAMES IN WHICH THE ACCOUNT IS CARRIED

ORIGINAL AMOUNT

PRESENT BALANCE

MONTHLY PAYMENTS

Auto Loans

Credit or Charge Cards

Landlord or Mortgage Holder on other Real Estate Other $

TOTAL DEBTS

0.00

$

0.00

$

0.00

Maine Residents: A consumer report may be ordered in connection with your application. Upon your request, we will inform you whether or not a report was ordered. If a report was ordered we will tell you the name and address of the consumer reporting agency that provided the report. New York Residents: A consumer report may be ordered in connection with your application. Upon your request, we will inform you whether or not a report was ordered. If a report was ordered we will tell you the name and address of the consumer reporting agency that provided the report. Subsequent reports may be ordered or utilized in connection with an update, renewal or extension of credit for which you have applied. Ohio Residents: The Ohio laws against discrimination require that all creditors make credit equally available to all credit worthy customers, and that credit reporting agencies maintain separate credit histories on each individual upon request. The Ohio Civil Rights Commission administers compliance with this law. Any person who, with intent to defraud or knowing that he is facilitating a fraud against an insurer, submits an application or files a claim containing a false or deceptive statement is guilty of insurance fraud.

l

NOTICE - JOINT CREDIT:

We intend to apply for joint credit. (initials) I certify that everything I have stated in this application and on any attachments is correct. Lender may keep this application whether or not it is approved. By signing below, I authorize Lender to check my credit and employment history, to have a consumer credit report prepared on me for the purpose of evaluating this application for credit, and to answer questions others may ask Lender about my credit record with Lender. I understand that I must update this credit information at Lender's request and if my financial condition changes. I acknowledge receipt of the Home Equity Brochure and the lender's Home Equity disclosure statement on today's date.

Applicant

Date

Joint-Applicant

Date

CREDITOR USE ONLY This application was taken by:

l

face-to-face interview

Date Application Received:

l

mail

l telephone l

Received By:

internet. Amount Requested $

Date Application Completed:

Approved By:

Amount Approved /

Rescindable?

l

Yes

l

RESPA Applicable? No

l

Yes

l

Funding Date:

No

- 1989 Bankers Systems, Inc., St. Cloud, MN

$ Initial Advance $

Form HE-APP 9/19/2005

(page 2 of 2)

Mortgage Product Choice Information We offer two types of mortgage products: In-house Conventional Mortgage Loans extended by AB&T or Conventional Mortgage Loans sold in the Secondary Market. To best determine which product is right for you, ask yourself the following questions: • • • • •

How much do you need to borrow? How long do you want to borrow? Are you interested in refinancing your loan in a few years? Are you interested in a temporary ‘bridge’ loan? How much will your down payment be?

• • •

What kind of repayment plan do you desire? What types of up-front costs are you willing to pay? Are you interested in having your property taxes, insurance premiums and other costs escrowed?

Your AB&T representative will help you consider these questions in deciding which product(s) you qualify for and which one best suits your needs. If you qualify for both products, you should compare the following features of each product to help decide which one best meets your needs: Secondary Market Mortgage Loans AB&T In-house Mortgage Loans • Minimum loan amount • No Minimum Amount • Flexible Loan to Value Limits and Equity Requirements • Flexible Loan to Value Limits and Equity Requirements • FNMA, FHA, RD, VA • Payments Serviced by AB&T • FNMA loans serviced by American Bank & Trust of the Cumberlands • Terms: 5-Years with Payments Based on 10 to 30-Years Amortization • Terms: 10 to 30-Years with payments based on 10 to 30-Years Amortization • Origination Fee $470 • Other Closing Costs (Attorney, Appraisal, Title, • Origination Fee $718 Recording Fees, etc) • Other Closing Costs (Attorney, Appraisal, Title, Recording Fees, etc.) • No Private Mortgage Insurance (PMI) • Escrow of Hazard Insurance Premiums, Taxes, • Various PMI Options Including Borrower-Paid Flood Insurance Premiums and No PMI • Escrow of Hazard Insurance Premiums, PMI, Taxes, Flood Insurance Premium • Optional Rate Buy-downs with Discount Points AB&T offers both products to all qualified applicants without regard for race, color, religion, sex, national origin, age, marital status, familial status, receipt of public assistance or exercise of consumer rights. Please review all of the above information and sign the following acknowledgment. I/We acknowledge that I/We have been provided information on both mortgage products offered by AB&T. Furthermore, I/We acknowledge that the features of both products have been explained and that I/We was/were given the opportunity to choose between the two products. I/We have made the decision to pursue an application for the product of my/our choice.

Applicant Name(Please Print)

Co-Applicant Name (Please Print)

Applicant Signature

Co-Applicant Signature