First Western Mortgage Company provides fast mortgage approvals with our Secure online 1003 Application. This application takes approximatly 35 minutes to fill out or if you prefer you can download a printable 1003 application and fax or mail it to us.
Please provide your current address information.
If you have a co-borrower with the same address, please check the co-borrower address box.
If you have lived at your current residence for less than two years, please provide a former address.
Check here if you are retired or do not draw income
Current Employer:
Employer's Address:
City State, Zip Code:
Position or Title:
Work Phone Number:
Time with employer: Years Months
Years in this line of work:
Are you self employed:
Co-Borrower Secondary/Previous Employment Information
Current Employer
Previous Employer
Employer's Name:
Employer's Address:
City State, Zip Code:
Work Phone Number:
Your position:
Monthly Income:
Date employed from: (mm/dd/yyyy)
Date employed to: (mm/dd/yyyy)
Are you self employed:
Please provide your current income information.
Enter your monthly income before taxes from your current employment and the monthly average amounts for any overtime, bonuses, or commissions you received in the previous twelve months.
If self employed, you may be required to provide additional documentation such as tax returns and financial statements.
Please describe other income if reported in the provided box.
Alimony, child support, or separate maintenance income need not be revealed if the you choose not to have it considered for repayment.
Current Borrower Income Information
Monthly Base Income before Taxes: $
Average monthly Overtime before taxes: $
Average monthly Bonuses before Taxes: $
Average monthly Commissions before Taxes: $
Average monthly dividend/interest income before Taxes: $
Average monthly dividend/interest income before Taxes: $
Other monthly income: $
Description of Other monthly income:
Federal laws and regulations require that we ask you, and you provide answers to the following questions.
Borrower Declarations
YES
NO
1
Are there any judgments against you?
2
Have you declared bankruptcy in the past 7 years?
3
Have you had a property foreclosed upon or given a deed in lieu of foreclosure in the past 7 years?
4
Are you party to a lawsuit?
5
Have you directly or indirectly been obligated on any loan which resulted in foreclosure, transfer of title in lieu or foreclosure of judgment?
(This would include such loans as home mortgage loans, SBA loans, home improvement loans, educational loans, manufactured (mobile) home loans, any mortgages, financial obligation, bond, or loan guarantees.)
6
Are you presently delinquent on any Federal debt or any other loan, mortgage, financial obligation, bond, or loan guarantee?
7
Are you obligated to pay alimony, child support, or separate maintenance?
8
Is or will any part of the down payment borrowed?
9
Are you a co-maker or endorser on any other person's obligation(s)?
(This question does not apply to your spouse if he/she is to be a co-borrower on the subject transaction)
10
Do you intend to occupy this subject property as your primary residence?
11
If yes, have you had an ownership interest in a property in the past 3 years?
12
If yes, what type or property did you own?
13
How is the title held on your previous property?
14
What is your citizenship?
Government Monitoring
The following information is requested by the Federal Government for certain types of loans relating 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 neither discriminate on the basis of this information, nor on whether you choose to furnish it. However, if you choose not to furnish it, under Federal Regulation, this Lender is required to note race and sex based on visual observation or surname.
Do you wish to provide information regarding your race, national origin, or sex?
Have you had a property foreclosed upon or given a deed in lieu of foreclosure in the past 7 years?
4
Are you party to a lawsuit?
5
Have you directly or indirectly been obligated on any loan which resulted in foreclosure, transfer of title in lieu or foreclosure of judgment?
(This would include such loans as home mortgage loans, SBA loans, home improvement loans, educational loans, manufactured (mobile) home loans, any mortgages, financial obligation, bond, or loan guarantees.)
6
Are you presently delinquent on any Federal debt or any other loan, mortgage, financial obligation, bond, or loan guarantee?
7
Are you obligated to pay alimony, child support, or separate maintenance?
8
Is or will any part of the down payment borrowed?
9
Are you a co-maker or endorser on any other person's obligation(s)?
(This question does not apply to your spouse if he/she is to be a co-borrower on the subject transaction)
10
Do you intend to occupy this subject property as your primary residence?
11
If yes, have you had an ownership interest in a property in the past 3 years?
12
If yes, what type or property did you own?
13
How is the title held on your previous property?
14
What is your citizenship?
Government Monitoring
The following information is requested by the Federal Government for certain types of loans relating 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 neither discriminate on the basis of this information, nor on whether you choose to furnish it. However, if you choose not to furnish it, under Federal Regulation, this Lender is required to note race and sex based on visual observation or surname.
Do you wish to provide information regarding your race, national origin, or sex?
What is your sex?
What is your National Origin?
If Other, Please specify
Please enter information about your financial assets. Include checking and savings accounts, mutual funds, money market accounts, 401k accounts and IRA accounts. Enter only accounts held by you personally. Do not include business or non-personal accounts.
Borrower Assets
Bank Name:
Account Number:
Cash or Market Value:
Bank 1
Bank 2
Bank 3
Bank 4
Bank 5
Stocks & Bonds
Company Name:
Number:
Cash or Market Value:
Company 1
Company 2
Company 3
Company 4
Company 5
Other Assets
Type of Asset
Cash or Market Value:
Vested interest in Retirement Fund:
Net worth of business(es) owned:
Automobile 1.
Automobile 2.
Automobile 3.
Other 1.
Other 2.
Other 3.
Please provide your liability information:
Enter the Creditor's Name
The liability account number
Enter the total unpaid balance of the credit
Enter the monthly payment of the credit .
Borrower Liabilities
Company Name:
Account Number:
Unpaid Balance:
Monthly Payment:
Debt 1.
Debt 2.
Debt 3.
Debt 4.
Debt 5.
Debt 6.
Debt 7.
Debt 8.
Debt 9.
Debt 10.
Other Liabilities
Other Liabilities
Monthly Payment:
Alimony:
Child Support:
Separate Maintenance:
Job Related Expenses:
Please provide your current mortgage or rent information:
Mortgage Information
Current Housing Expense
Proposed Mortgage Loan
Rent:
OR
First Mortgage (P & I)
First Mortgage (P & I)
Other Financing (P & I)
Other Financing
Hazard Insurance
Hazard Insurance
Real Estate Taxes
Real Estate Taxes
Mortgage Insurance
Mortgage Insurance
Homeowners Dues
Homeowners Dues
Other Expenses
Other Expenses
Please provide your current Real Estate Information:
Real Estate Owned Information
Property 1.
Street:
Market Value:
City State, Zip
Mtg Pmt:
Property Type:
Mtg Liens:
Property 2.
Street:
Market Value:
City State, Zip
Mtg Pmt:
Property Type:
Mtg Liens:
Property 3.
Street:
Market Value:
City State, Zip
Mtg Pmt:
Property Type:
Mtg Liens:
Add your comments or any special instructions
Acknowledgement & Agreement
The undersigned specifically acknowledge(s) and agree(s) that:
(1) The loan requested by this application will be secured by a first mortgage or deed of trust on the property. Described herein;
(2) the property will not be used for any illegal or prohibited purpose or use;
(3) all statements made in this application are made for the purpose of obtaining the loan indicated herein;
(4) occupation of the property will be as indicated above;
(5) verification or re-verification of any information contained in the application may be made at any time by the lender, its agents, successors and assigns, either directly or through a credit reporting agent, from any source named in this application, and the original copy of this application will be retained by the lender, even if the loan is not approved;
(6) the lender, its agents, successors and assigns will rely on the information contained in the application and I/we have a continuing obligation to amend and/or supplement the information provided in this application if any of the material facts which I/we have represented herein should change prior to closing;
(7) in the event my/our payments on the loan indicated in this application become delinquent, the lender, its agents, successors and assigns, may, in addition to all their other rights and remedies, report my/our name(s) and account information to a credit reporting agency;
(8) ownership of the loan may be transferred to successor or assign of the lender without notice to me and/or the administration of the loan account may be transferred to an agent, successor or assign of the lender with prior notice to me; (9) the lender, its agents, successors and assigns make no representations or warranties, expressed or implied, to the borrower(s) regarding the property, the condition of the property, or the value of the property.
I/We have the right to a copy of the appraisal report used in connection with this application for credit. To obtain a copy, I/We must send Lender a written request at the mailing address Lender has provided. Lender must hear form me/us no later than 90 days after Lender notifies me/us about the action taken on this application, or I/We withdraw this application.
I/we certify that the information provided in this application is true and correct as of the date set forth opposite my/our signature(s) on this application and acknowledge my/our understanding that my intentional or negligent misrepresentation(s) of the information contained in this application may result in civil liability and/or criminal penalties including, but not limited to, fine or imprisonment or both under the provisions of title 18, United States Code, Section 1001, et seq. and liability for monetary damages to the lender, its agents, successors and assigns, insurers and any other person who may suffer any loss due to the reliance upon any misrepresentation which I/we have made on this application.
Borrower Acknowledgement
Co-Borrower Acknowledgement
I hereby authorize First Western Mortgage to run a Credit Report
