Mainland Financial, Inc
856-629-0216 www.MainlandFi.com fax: 856-629-0734
Manufactured Home Loan Application
Date of Application:
NMLS# 202433
Licensed by NJ DOBI
Applicant:
Co-Applicant:
Dealer/Broker:
Person to Contact: Phone #:
Physical Address of Unit:
Lot #:
______
Is Unit In Community Lot Rent:
Co-Op
Taxes: Yearly (if applicable)
Name of Community:
Purpose: Purchase Refi Refi Debt Consol Second/Vacation
Home Info
Year: Make: Model:
Size: Serial #:
Sales Price or Refinance Amount: Requested Term:
Sales Tax (if applicable)
Other Charges:
Total Amount
Down Payment
(10% down min)
Loan Amount Requested Insurance Quote:
Applicant:
Name: Date of Birth:
Marital Status Married Separate Unmarried Social Security:
Home Phone: Alt Phone:
Current Home Address:
Residence: Own Rent With Family Years there: Monthly Amount:
Previous Address: Years There:
Who do you do your banking with: Are you a first Time Home Buyer:
Name of your nearest relative: Phone:
City, State: Relationship:
Co -Applicant:
Name: Date of Birth:
Marital Status Married Separate Unmarried Social Security:
Home Phone: Alt Phone:
Current Home Address:
Residence: Own Rent With Family Years there: Monthly Amount:
Previous Address: Years There:
Who do you do your banking with: First Time Home Buyer:
Name of your nearest relative: Phone:
City, State: Relationship:
I authorize Mainland Financial Inc to make or have any credit, employment or investigative inquiry that the Bank determines for the extension of credit or the collection of amounts owed to the Bank. The Bank can furnish information concerning my account to consumer reporting agencies and others who may property receive that information. If I ask, I will be informed whether or not consumer reports were requested, I will be informed of the name and address of the consumer reporting agency that furnished this report. I agree that this application will remain the property of Mainland Financial and the Bank
I have read and understand the above statement:
Applicant: Co-Applicant:
Applicant Employment
Employer: City: State:
Gross Monthly Income: Years Employed: Position:
Work Number: Ext:
Previous Employer (if less than 2 yrs) City: State:
Additional Income: Amount: Additional Income: Amount:
Are you currently obligated to pay alimony or child support: What is the monthly amount:
Have you filed for Bankruptcy in the last 7 years: If so when was it discharged:
Co Applicant Employment
Employer: City: State:
Gross Monthly Income: Years Employed: Position:
Work Number: Ext:
Previous Employer (if less than 2 yrs) City: State:
Additional Income: Amount: Additional Income: Amount:
Are you currently obligated to pay alimony or child support: What is the monthly amount:
Have you filed for Bankruptcy in the last 7 years: If so when was it discharged:
Information for Govt Monitoring Purposes: The following information is requested by the Federal Government, if this loan is for the purchase, construction, improvement, repair maintenance or refinancing of a home, in order to monitor the lender’s compliance with the Equal Credit Opportunity and Fair Housing Laws. You are not required to furnish this information, but you are encouraged to do so. The law provides that a lender may neither discriminate on the basis of this information nor on whether or not it is furnished. If you choose not to provide this information, the law requires the creditor to note your race or national origin and sex on the basis of visual observation or surname. If you do not wish to furnish any of the following information, please initial below
Applicant: Ethnicity: Hispanic or Latino Non Hispanic or Latino
Race: American Indian or Alaska Native Asian White African American or Black Native Hawaiian or Pacific Islander
Other Please specify: Sex:
Co Applicant: Ethnicity: Hispanic or Latino Non Hispanic or Latino
Race: American Indian or Alaska Native Asian White African American or Black Native Hawaiian or Pacific Islander
Other Please specify Sex:
App Co-App
Yes No Yes No
a. Have you had a property foreclosed upon or given title or deed in lieu thereof In the past 7 years a
b. Have you directly or indirectly been obligated on any loan which resulted in foreclosure, b
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 reason for the action.)
c. Are you presently delinquent or in default on any Federal debt or any other .loan, mortgage, c
financial obligation, bond, or loan guarantee?
If “Yes” give details as described in the preceding question
d. Is any part of the down payment borrowed? D
e. Are you a co-maker or endorser on a note? E
f. Are you a U.S. Citizen f
g. Are you a permanent resident alien? G
h. Do you intend to occupy this home as your primary residence? H
If “Yes” complete question I below
i. Have you had an ownership interest in a property in the last three years I
AGREEMENT TO PROVIDE PHYSICAL DAMAGE INSURANCE
Property insurance is required in connection with this loan. Mainland Financial IS NOT an insurance agent and you can purchase insurance though any agent you prefer for the principal amount of the loan. The policy is to note the bank’s interest with a loss payable clause in its favor. Please initial below
Applicant Co-Applicant
If you intend to apply for Joint credit, please initial below:
Applicant Co-Applicant
I certify that no essential information has been concealed and that no misrepresentations have been made in this application.
______
Applicant Date Co-Applicant Date
This application was take by: Face to Face interview Mail Phone Other:
419 Sicklerville Rd • Sicklerville NJ 08081-2555
Phone: 856-629-0216 • Fax: 856-629-0734