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� <br />� <br />� <br />n <br />L_J <br />. <br />. AGREEMENT: The undersigned is applying for a loan <br />first or second mortgage or deed of trus'�t� on the <br />herein� and represents that the property will be used <br />and that all statements made are true arld are made <br />obtaining the loan. Verification may be obtained from <br />this application. <br />to be secured by a' <br />property described ! <br />for legal p'urpose, - <br />for the purpose o£ <br />any source named in <br />The original or a copy o£ this statement will be retained <br />even if the loan is not granted. The undersigned intends <br />propert.y as their primary residence. <br />I/We fully represent that the information contained in <br />statement is accurate and true. <br />r <br />� <br />by the lender, <br />to occupy Che I <br />Chis financial <br />I/ / � <br />Borrow r's Signature Date Co-t�orrower's Signature Date <br />OEfice Use Onl�► <br />AsseCs that aroduce I�icome .......................Li�hilities <br />Checkin� <br />Savings <br />I RA <br />Real �state owned other than <br />home <br />Stocks, nonds <br />Qther asse�s <br />Total <br />Tncome <br />70(� <br />� <br />' 'ro��;�l S�, 7oU <br />NeC Liquid Assets <br />Sfllary �1; , ; (1(1 Tntcres� DivLdends <br />Annuities I'ension <br />Alimony 5ocial SecuriCy <br />Gains or sales of s�curi�ies <br />Estate or trust incoi.ne <br />TOTAL QUALII'IED INCOME �1.7,7UU <br />