Home Equity Loan Application

Important - we can only invite residents of Bergen, Morris, and Passaic County, New Jersey to submit an application.

Loan Details
Purpose of Loan:
Purpose:
Term Requested:
Loan Amount Requested:
Property Information
Home Number and Street:
City:
County:
State:
Zip Code:
Lot #:
Block #:
Yearly Insurance:
Yearly Taxes:
Date Purchased:
Purchase Price $:
Present Value $:
Mortgage Information
Amount of Original Mortgage $:
Mortgage Balance $:
Mortgage Held by:
Monthly Payment $:
Taxes Included in Payment:
Insurance Included in Payment:
Rental Income:
Monthly Amount $:
Any Other Mortgages ?:
Mortgage Balance $:
Mortgage Held by:
Monthly Payment $:
INFORMATION FOR GOVERNMENT MONITORING PURPOSES

The following information is requested by the Federal Government for certain types of loans related 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 not discriminate either on the basis of this information, or on whether you choose to furnish it. If you furnish the information, please provide both ethnicity and race. For race, you may check more than one designation. If you do not furnish ethnicity, race, or sex, under Federal regulations, this lender is required to note the information on the basis of visual observation and surname if you have made this application in person. If you do not wish to furnish the information, please check the box below. (Lender must review the above material to assure that the disclosures satisfy all requirements to which the lender is subject under applicable state law for the particular type of loan applied for.

BORROWER
Ethnicity:

Race:






Sex:
     
CO-BORROWER
Ethnicity:

Race:






Sex:
     
IMPORTANT DIRECTIONS

PLEASE READ BEFORE COMPLETING THE APPLICATION

  • If you are applying for individual credit in your own name and are relying on your own income or assets and not the income or assets of another person as the basis for repayment of the credit requested, complete the Applicant Information only.
  • If you are applying for joint credit complete the Applicant and Co-Applicant Information sections of the application.
  • If you are applying for individual credit, but relying on income from alimony, child support, or separate maintenance or on the income or assets of another person as the basis for repayment of the credit requested, complete the Applicant Information section and complete the Co-Applicant Information section, to the extent possible, providing information about the person on whose alimony, support, or maintenance payments or income or assets you are relying.
Personal Information
APPLICANT INFORMATION CO-APPLICANT INFORMATION
   or
Do not complete Marital Status question if this application is for an individual account.
Marital Status: Marital Status:
First Name: First Name:
Middle Initial: Middle Initial:
Last Name: Last Name:
Mother's Maiden Name: Mother's Maiden Name:
Social Security #: Social Security #:
Date of Birth (mm/dd/yy): Date of Birth (mm/dd/yy):
Driver's License No Driver's License No
Date of Issuance Date of Issuance
State of Issuance State of Issuance
Date of Expiration Date of Expiration
Current Street Address
Street: Street:
City: City:
State: State:
Zip Code: Zip Code:
Home Phone: Home Phone:
Email Address: Email Address:
   
Prior Street Address (If Current Address less than 3 years)
Street: Street:
City: City:
State: State:
Zip Code: Zip Code:
   
Current Employer
Company Name: Company Name:
Street: Street:
City: City:
State: State:
Zip: Zip:
Business Phone: Business Phone:
   
Position/Occupation: Position/Occupation:
Gross Monthly Income $: Gross Monthly Income $:
Source of Additional Income

YOU NEED NOT FURNISH ALIMONY, CHILD SUPPORT OR MAINTENANCE INCOME INFORMATION IF YOU DO NOT WANT US TO CONSIDER IT IN EVALUATING YOUR APPLICATION.)

Gross Amount Received Monthly $: Gross Amount Received Monthly $:
Source: Source:
Current Obligations
  Name of Creditor A/C # Balance Monthly Payment Transfer balance to new credit account?
1 Yes
2 Yes
3 Yes
4 Yes
5 Yes
6 Yes
7 Yes
8 Yes
9 Yes
10 Yes
Other Disclosures

Everything that I/we have stated in this application is correct to the best of my/our knowledge. I/we understand that you will retain this application, whether or not it is approved. You are authorized to check my/our credit, make third party inquires, verify my/our identification, check my/our employment history and answer questions about your credit experience with me. If I/we ask, the bank will tell me/us if it has obtained a credit report and the name of the credit reporting company that supplied the information.

I/we cerify that I/we are at least 18 years of age and a United States Citizen.

By clicking on the "Apply Now" button, I/We are submitting this application for credit approval. I/We understand that the information provided will be verified and I/We will be notified in writing as to the status of the loan.

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