EFTA01279979

Uniform Residential Loan Application This application Is designed to be completed by the applicants) with the Lenders assistance. Applicants should complete this form as • Borrower- or 'Co-Borrower.' as applicable. Co-Borrower information must also be provided (and the appropriate box checked) when O the income or assets of a person other than the Borrower (including the Borrowers spouse) will be used as a basis for loan qualification or 0 the income or assets of the Borrowers spouse or other person who has community properly rights pursuant to state law will not be used as a basis for loan qualification. bur his or her liabilities must be considered because the spouse or other person has community property rights pursuant to applicable law and Borrower resides in a community properly state. the security properly is located In a community property state. or the Borrower is relying on other property located in a community property state as a basis for repayment of the loan. If this is an application for joint credit. Borrower and Co-Borrower each agree that we intend to apply for joint credit (sign below): earcnver Co.tilonower I. TYPE OF MORTGAGE AND TERMS OF LOAN Mpplied edan. VA M Conventional Other (explain): A for [ 'FHA LJ USDA,Riral Housing Service Amount Interest Rale I No. of Months $325,000.00 3.000'6 180 Agency Case Number Lender Case Number 420361321 Amortization m Fixed Rate n Other (explain): Type: I GPM I I ARM (type): II. PROPERTY INFORMATION AND PURPOSE OF LOAN &tuna Properly Address (time, city. tale a DP) 435 S Tryon St Onit 700, Charlotte, NC 28202 Legal Description al Staled Property (attach clascridicn it necessary) Purpose of Loan n Purchase n Construction M Refinance I= Construction-Permanent Complete this line N construction or construction-penrianent loan. Year Lot Acquired I Original Cost I Amount Existing Liens I (a) Present Value of Lot I $ I $ Complete this line It this le a refinance lost Year Acquired Original Cost Amount Existing Liens Purpose of Refinance I 2004 S 810, 000.00 $ 318, 915.90 I Rate and Term Title will be held in what Name(s) Brian Vickers n Other (explain): No. 01 Una 1 I Year Eta 2002 Property will be: ri Primary i--i Secondary I__I Residence LXJ Residence C Investment Total (a • b) $ (s) Cost of Improvements Describe Improvements C made O to be made Cost: $ Manner in which Title will be held Title bald jointly. Source of Down Payment. Settlement Charges. and/or Subordinate Financing (explain) Estate will be held in: El Foe Singe Leasehold where caciraion date) Borrower III. BORROWER INFORMATION Co-Borrower Borrowers Name (include Jr. or Sr. it applicable) Co•Borrower's Name ($ clude Jr. or Sr. if applicable) n Marled Unmarred race shah r ind . TU"N danced Widowed) Separated 0 poweadaddreassuwatamm_no) C Own Rant 3/0 No. Yrs. Social Security Number Home Phone (incl. area code) I= Maned C Unmarried endur19 shale (homed element El &was Present Address street city. state. DPI C Own I=I Rent No. Yrs. DOB(mmrotsYyn) Yrs. School Orornacos tam Woe by &wowed no. I " Mailing Address. it different from Present Address Mailing Address. if different from Present Address If residing at present address for less than two years, complete the follow ng: Former Address tweet. city slaa WI O Own O Hart No. Yrs. Former Address (meet Sly. Mate. ZIP) O Own C Rent No. Yrs. 420361321 Uniform %Mendel then Appllcelon Fannie Maafraldia Mac YMP Wolters mews Financial Sentes Application Date: 10/2/2014 420351321 Fannie map Form leo 7105 (Rev. 6/091 F *oldie Ms Fern 6 7,06 (Rov. 6/09 YMP221I4 409071.0 Page I e. 5 CONFIDENTIAL194701044,E3211 EFTA_00141544 EFTA01279979 Borrower IV. BAPIAYIMENT INFORMATION Co-Borrower Scio Verism Corporation 329 Sea Breeze Ave Palm Beach, FL 33480 x. Sall 660440 Yrs 40 OnS230 11/9 Name& 40:019 016600n. E so 660000 Yrs on ins rob Yrs. employed in this lined workeprolessicn Yrs. employed in Iris lineal worluproleseca / PosinantIllaTypeof (Lines Race Car Driver Business Alone Pncl. area code) (336) 475-4042 PosdioniTitleaype al Business dryness Phone rind. area code) emo n current or t two Years Or COMM eMD n motet none t : Name 6 Address of Employer Sell Employed CMGs tlforn - to) Name a Addrcos of Erni:layer Sell Emeioyed Dales 010411. to) Morehly Income $ Monthly Income S PositionanletType of Business Business Phone (incl. area code) PositionfTillatType of Business Burnes Phone hind. area code) Name 4 Address or Employer C Sell Ernpkoyed Dates ilrern - KO Name 3 Address 01 Ernplenrer C Ball Employed Dales Morn - to) Monthly Income S Monthly Income S Position(TriletType of Business Business Mena iind. area age) Position/Title/Type 01 Busrness Business PhOne OW. Wee Cede) V. MONTHLY INCOME AND COMBINED HOUSING EXPENSE INFORMATION -= Gross Monthly Income Borrower Gamow*, Total Combined Motility HOUSIllp e490111. Present Base Ernpl. Income $ —6, 361.113 $ $ —6,361.03 Rent $ 8, 500.00 /pro/pest 7, /1, //, /, 7/ 7/ 7/ 11 Overtime First Mortgage (AM) $ 2,244.39 BalUS05 Other Financing (PSI) Commissions Hazard Insurance 243.50 Dividends/Interest Real Estate Taxes 543.73 Net Rental Income Mortgage Insurance 400.00 Fistehl re %el V int other Income.' been) Homeowner Assn. Dues 30,276.00 30,276.00 Other: Total I$ 23. 914.17 5 i 23. 914 . 17 Total $ 8,500.00 3,431.62 ' Sell Employed Borrow er(s) may be required to provide additional documentation such as tax returns and financial statements. EVC Describe Other Income Notice: Alimony. child support, or separate maintenance income need not be revealed II the Borrower (B) or Co-Borrower (C) does not choose to have It considered for repaying this loan. B Ite1ationsh $30,276.00 Monthly Amount $ 30 276.00 420361321 uniforms:go:wee Lean Application Fannie Maarreddie Mac VIAP Millen. lamer Hoarder Stevie*. Application Date: 1022014 420361321 Fannie Mae Form 1003 7/05 (Bev. 6/09/ Freddie Ms Form 65 7,06 (Rev. 6/09 YMP221N i090710 Paget 04 5 CONFIDENTIAL SDNY_GM_00030932 EFTA_00141545 EFTA01279980 VL ASSETS AND LIABILMB3 This Statement and any applicable supponing schedules maybe completed only by both mmed and unmamed Co.Boirowers the' _assets and liabilities are sufficiently pined so that the statement can de meaningfully and tolady presented or( a combined o basis: otherwise. separate statements and schedules are required. it the Co-Borrower section was completed about a non.appacant spouse or other person. this Statement and supporting schedules must be completed about that spouse or other person also. Completed Jointly Not Jointly ASSETS Description ash or Markel WAR Llabiltles and Pledged Amts. List the creditor's name. addran including automobile loam revolving charge accounts. real estate and aeccunt number tor all oitslandng &las. loans, alimony, cold ninon. stock pledges. etc. which will be satisfied upon sale of red estate Cash deposit toward purchase held by: s Use cant inuaion sheet. it necessary. 'Scale by (' ) those habillies owned or upon refinancing or the sub)ecl eroPenv• LIABILITIES Monthly Payment M & Months Len to Pay Unpaid ce Balan list checking and savings accounts below Name and address of Company CHASE $ Payment/Months 25.00 5 $ 104.00 Name and address of Bank. S&L. or Credit Union Fifth Third Thr 9/30 0 Accl• no.13895100 tb...i. no. 0000000564 $ 17,204.55 Name and address of Company CCO 14ORT CRP $ Payment/Months 3,163.00 * $ 318, 915.90 Name and address of Bank. SAL. or Credit Union Fifth Third thr 9/30 Acd. no.2930022453112 Name and address of Company $ Payment/Months $ MCI. no. 0000000414 S 9,127.57 Name and address of Bank. S&L. or Credit Union Mel. no. Name and address of Company $ Payment/Months $ Taft. no. LL Name and address of Bank. S&L. or Credit Union Atm no. Name and address of Company $ Payment/Months $ Acct. no. S i hrelstziptilmIs (Company name/number Fifth Third Private Bank — CREO Global Capital —Blue Morgan Stanley FRO Blue Chip S 515,751.96 3,108,560.00 506,946.00 Accl. no. Name and address of Company $ Payment/Months $ Life insurance net cash value Face amount: $ $ Subtotal Liquid Assets S 4,157,590.08 Acct. no. Real estate owned (enter market yak* from schedule of real estate owned) $ 620,000 Name and address of Company $ Payment/Months $ Vested interest in retirement fund S Net worth of businessies) owned (attach financial statement) $ 399,960.20 Automobiles owned (make and year) $ Alimony/Child SupporliSepane lAntenaree Payments Owed to: $ lia,,um-ene. c-ieense (chid ewe. linen dun. etc.; $ ..// Other Assets (itemize) $ Total Monthly Payments S n on Total Assets a. $ WII 5,177_,_sso.2s_telunus or .4S 4,858,530.38 Total Liabilities b. $ 319,019.90 elladule W Real Estate Owned (It additional p operties are owned. use continuation sheet.) lo'r;o4irir ryeitlir beesi Ac(ehnetzr popirt:Id..elr it pending sate. pa in ma:VIP/due Mortgages Rents Va°41nUates itisfig tall aCtIO. Rental Net 435 S Tryon Street #700 Charlotte, NC 28202 Cond $ 620,000 $ 318,916 $ $ 3,163 $ $ Totals S 620,000 $ 318,916 $ $ 3,163 $ $ LW any additional names under which credit has previously bean received and Indicate appropriste crater name(s) and account numbed.): Alternate Name Creditor Name Account Number 420361321 Uniform fiellgentld LOW Application Fannie Maafreddie Mac VMP Wolters lavas RnSfidd Santos Application Date:10/2/2014 420361321 Facile Mae Form 1003 MI5 (Rote/09i Freddie Ms Form 65 7,06 (Ray. 6/09 VMP221N/0907i.0 Page 3 or 5 CONFIDENTIAL SDNY_GM_00030933 EFTA_00141546 EFTA01279981 VI. DETAILS OFTRANSACTION-AIM VIII. DECLARATIONS a. b. C. d. e. 1. 9. h. I. k. Purchase price Alterations. improvements. repairs Land (if acquired separately) Refinance (Incl. debts to be Estimated prepaid items Estimated closing costs PMI. MIP. Funding Fee Discount Of Borrower will pay) Total costs (add Items a through h) Subordinate financing Borrowers closing costs paid by Seller Other Credits (explain) paid off) Application Fee Paid 318,915.90 650.00 9,633.25 $329,199.15 100.00 m. Leen amount froclude Fee MIP Funding Fee financed' n. PMI. MIP. Funding Fee financed o. Loan amount (add m 8 n) P. Cash from/to Borrower (subtract j. k. 18 olrom I) 325, 000.00 325,000.00 $3,799.15 If you answer Yes to any questions a through i, please Borrower Cake rapier use continuation sheet for explanation. Yes No Yes No 0. Are there any Outstanding judgments Vane you? b. Hare you been declared beetroot within Ihopast 7 years? 0 M 00 C. Kaye you had properly foredosed upon or given Idle or deed in Ism thereof an c Ili' c c the Lel 7 yeatE7 a Are yco a pacy teeter sul? e. Have you tiredly or indirectly been Othgfiled on any loan when readied foreclosure. Cando of lee an lieu el foreclosure. or judgment? (This ware include Such learn a home mortgage loans. SBA lows borne improvement loam educeienal loans. manulactured (nu:betel home loans. any mortgage. 'omelet cbhgfillen bond or loan guarantee. If 'Yea' Provide deele. encludng date. name and address of Lender. FHA or VA case number. it any, send reasons for the action.) I. _Am en you mnprecent ey deeming or in defssft on any Federal debt or any other 'Sows asnctesacarcr;tg main.bond„Cf . IC01 guarantee' II - veg.' ore g. Are you °bloated to pay alimony. child support. or separate maremance? I=1 h. Is any pan or the down payment borrowed? i. Are you ace-maker or endorser mane*? Are yco a U.S. CiliZen? [I] It. Are you a parnanert resident alien? I=1 L Do you Intend to emery the properly a your primary triedence7 2 'yes: =Hi complete oversee m below in. 14aye you had an ownership interest in a properly in 'haled tree yews? III 0 I') What typo or prop you own:: Finn:pal ressience CORI, second home (SM. irNM malls Freserly UPI? PR ix) How did you hold Idle to the home • - solely by yoursdl IS). Jointly with year aped* 'SP,. or petty wth mother Form" (DO IM 0 M 0 0 0 0 0 0 0 0 CC 0 0 O CI 0 0 O I=1 IX. ACKNOWLEDGBAENT AND AGREEMENT Each of the undersigned specifically represents o Lender and to Lenders actual or potential agents, brokers, processors, attorneys. insurers. servicers. successors and assigns and agrees and acknowledges that: (1) the information provided in this application is true and correct as of the date set forth opposite my signature and that any Intentional or negligent misrepresentation of this information contained in this application may result in civil liability. including monetary damages. to any person who may suffer any loss due to reliance upon any misrepresentation that I have made on this application. andror in criminal penalties Including, but not limited to. tine or imprisonment or both under the provisions of Title 18. United States Code. Sec. 1001. N seq.: (2) the loan requested pursuant to this application (the 'Loan') will be secured by a mortgage or deed of trust on the property described in this application: (3) the property will not be used for any Illegal or prohibited purpose or use: (4) all statements made in this application are made for the purpose ol obtaining a residential mortgage loan: (6) the properly will be occupied as indicated in this application: (6) the Lender. its servicers. successors or assigns may retain the original and/or an electronic record of this application. whether or not the Loan is approved: (7) the Lender and Its agents. brokers. insurers. service's, successors, and assigns may continuously rely on the information contained in the application. and I am obligated to amend andlor supplement the information provided in this application if any of the material facts that I have represented herein should change prior to closing ol the Loan: (8) in the event that my payments on the Loan become delinquent, the Lender, its servicers, successors or assigns may. in addition to any other rights and remedies that it may have relating to such delinquency. report my name and account information to one or more consumer reporting agencies: (9) ownership of the Loan and/or administration of the Loan account may be transferred with such notice as may be required by law: (10) neither Lender nor its agents. brokers. insurers. servicers. successors or assigns has made any representation or warranty. express or implied, to me regarding the property or the condition or value of the property: and (II) my transmission ol this application as an 'electronic record' containing my 'electronic signature: as those terms are defined in applicable lederal and/or state laws (excluding audio and video recordings), or my facsimile transmission of this application containing a facsimile ol my signature. shall be as effective. enforceable and valid as it a paper version ol this application were delivered containing my original written signature. Acknowledgement. Each ol the undersigned hereby acknowledges that any owner ol the Loan. Its service's, successors and assigns. may verily or reverify any information contained in this application or obtain any information or data relating to the Loan. for any legitimate business purpose through any source. Including a source named in this application or a consumer reporting agency. Borrowers Signature X Date 12/4/2014 Co-Borrowers Signature X Date L X. INFORMATION FOR GOVERNMENT MONITORING PURPOSES The following inlormation is requested by the Federal Government for certain types of loans related to a dweltng in order to monitor the lenders 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 ol this inlormation, or on whether you choose to lumish it. II 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 tor.) BORROVVER 71 I do not wish to lowish this iNenhation CO-BORROWER I do not wish to furnish this Information Ethnicity: hispanic or Laird Not Hispanic or Latino n Iji EthnicEy: 0 Hispanic or Leine 0 Not Hispanic or Latino Place: im Amencen Indiana man m black or Race: AMOOtal NOW or Alaska Native Watt or Alen African American man C Native Caw or COO. Pectic Wander ®White I— I Nerve Hawaiian or I I We Pacific Wander O While : - Female II ma X. - Female IM mere To be Completed by Loan Originator: This inlormation was provided: Lxj In a face-to.lace mlerview In a telephone interview Loan Originator's Signature X Loan Originator's Name (print or type) Joann Brown Loan Origination Company s Name Fifth Third Mortgage Company By the applicant and submitted by fax or mail C By the applicant and submitted via e-mail or the Internet Date Loan Originator Identifier 414603 Loan Origination Company identifier 134100 Loan Originator's Phone Number (including area code) (919) 573-1982 Lan Origination Company's Address 5001 Kingsley DR, HD: 1M0C8O, Cincinnati, OR 45227 420361321 Uniform INeltlerrial Loan Application Fannie Manfred:lieMac YMP® Waiters Mutter vinencia Starless Application Date: 10/2/2014 420381321 Fannie Mae Fenn 1003 7105 (YIN. 8/091 Freddie Ms Form 85 7,05 (Rev. 8/09 VMP221N (0907).0 Pape 04 5 CONFIDENTIAL SDNY_GM_00030934 EFTA_00141547 EFTA01279982 CONTINUATION SHEET: RESIDENTIAL LOAN APPUCATION Use this continuation sheet if you need more space to complete the Residential Loan Application. Mark B for &now er or C for Co-Borrower. Borrower: Brian Vickers Co.Borrower: Agency Case Number. Lender Case Number: 420361321 UWe fully understand that it is a Federal crime punishable by fine or imprisonment. or both. to knowmgly make any false statements concerning any of the above facts as applicable under the provisions of Title 18. United States Code. Section 1001. el seq. Borrower's Signature: Date Co.Borrowers Signature: Date X X 12/4/2014 420361321 Uniform %Mendel LON Applicebon Fannie Manfred:lieMac VMP 46, WORM laws 410134(441 Siri4e0S 420361321 FE0144(0 Mae Form 1003 7/05 (elev. 6/061 Freddie Ms Fern, 65 7,06 (Rev. 6109 VMP221N 409031.0 Page 5 04 5 CONFIDENTIAL SDNY_GM_00030935 EFTA_00141548 EFTA01279983