EFTA01279974.pdf

Unifon Residential Loan Application
Tiss appecatIon is designed to ba somaieleid by the applicanfis) weh IM Lrinclerr's ensistance Apellcents should camptet • Ihn form as -Borrower or •Co-Borrower.•
as ripplicablo. CO-BOVTOW er information rrust also be providid (and Ihro approprim• box checked) when L J th• income or astet s of • person oder (han the Borrower
eintluden the Boasones sponse) will be used asa besä toi loan quaktkation or Ei the income or essets of the Borrower's spouse or other priesen who has
community propeny regMs pursutet to state km wll not be used asa bass for loen qualificatiort Out bis or her hablaus most be considered because the spane or
«hin person Ras community property nghts pursuant to appleable la« and Borrower resides in a community property state. the sacurdy proparty is located in a
community propony Wate. or the Borrower is retying on other property located in a communty properly state as a basis for repayment of the loan.
Il Uns is an apptIcition for joint erriet. Borrower find Co-Borrower *ach ergreis thel w • intrind to epply for joint <rede (sie below)
Dinenor C ob(
Mortgage n I. TYPE OF MORTGAGE AND 11EMS OF LOAN
Agency Gase Numbor Lende Ces* Number
VA i X Conventimel I I OIMr Wanne.
Applied fa:
:3 FRA QUSDNRurd Housing Service 420361321
Amount Inteest Rat• ! No of Months I Arnonlaallen x geie Szt• i eher (explain):
Typo:
5325,000.00 3.000" 180 A et (type):
II. PROPERTY INFORMATION AND PURPOSE OF LOAN
Simoct Propoly Meire., Strell. city. dem 4 ZP)
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UOthe etiptelett Ftspony wle be:
I »Saue 2002
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Refinance Romfluchen-Permanent [—] Recirnce W art:Pcelniece I I Investment
Complete INS Uns II conttruction or constructIon-perrnatiord han
Teer tot Acquked I Odgmal Cost Amouni Eulting UM. I tat nennt Vakua of Lot I(b) Colt of Improvernents Tetel (e + b)
5 $ I $ 5 IS
001110060 rols Inla lt Iltis Isa rellnance bare. Dastebe Improvements M. made .M. to be made
Teer Acquired Onginal Gott Amoont Brosting Lenz Papose of Refeance
2004 5810,000.00 5316,915.90 I Rate and Terz Cost:5
Title will be held in what Name(s) Iden in wisch Title will be hold State wil be hald in:
Brien Vickers ril Foll Seele
Title held jointly. I I Leat41,4(1 Wieg
os preien mo)
Saures of Down Paymem. Settlement Chatges. andrer Subordinate Hienring (expein)
I Botrower III. BORROWER INFORMATION Co-Donower
Borrotter's Name (melodi Jr. or St il *ppkable) Coeeifer er's Name (melodi Jr. Or St il stipicatfin
Brien Vickere
Senat Secerita Nussbar Home flime Opel. enecode) 00.(neneletYY) 4r. school Neil Security Nute« Horne Rene Oncl. en« sode) 00likeirendrnerri *in scnol
0
unmemed(mcrude Inot bAerM otte (nol losteebytsorronee)
la Mened M UnnamedOncludesinde Cnoer.nalclase (P:t g. Y °en") C Slamel C I •Ofis
dtverCe4. ev444444) ovareis widowedl
Sperried 0 Smievd
Li bi,' Li
Present Address lernt. cey. stete 2ipi Cent Rant 3/0 No. Yrs. neunt Address Wwe. etc. stete. 0wn I__I Ranl No. Vis.
Melling Address, lt dillonnt from Present Addreas Mmung Aadress il different Ironi Rennt Address
If residing at present address for less (han two years, compkge the following:
CI
Form« Add.ess (ereil. Mai ade. Zevi Former Address ht nee. zmDown Rot he Yrs
420361321 420361321
Umrom neua rte' Lom apenceiten Applecation Date: 10/2/2014 reine 144. rem 1003 7/05 (Rev 0109)
Ferme Mee/Frelsee Kees . ..,* - Form eS 7/0S (Rev 6/09)
VM sie VMP22 IN (0907 ) 03
weites Kamee Finersid Sorv'en Priel of 5
CONFIDENTIN111947010429022
EFTA_00141529
EFTA01279974

Oomovver m• IV. EMPLOYMENT INFORMATION Co-Borrower
Nano 6 nIcfrois N Ern rInvor X I: 4.1 YTS on itu job
Scio Verum Corporation 11/9
329 Sea Breeze Ave
,ropbood It, 'roof Yrs cfnolOyed in MR ire Of
Palm Beach, FL 33480 OflOTAVIrf fa On ddlOIXOWSSan
Pouhrirdlortypo of &Anon BUSnani Mani find Onto <00.1 POstionfroll.4100 of eunntSS Eltmens Alone nod roe 04)
Race Car Driver
If employed In =rent position for less than two years or If cwrently employed In more than one poilka, complete the fOllOwIllil•
0
Nene 6 Atern of ElltloYet Elsa Fneetwed ogee Mom -101 Name a A611121 of Setforn SW Ern/flow.] Otles0rcer -10)
Manner Income wriNy InCOMO
f I
PositbniThionypo of 8usinws Business Plan had. wee coal Position/Title/Typo of Wenn fewness Alone Ilse dennOde
0
Name 8 A4d145. Of ST rioy E Sea Efnindind Dan (nom -101 Nan* 8 AOress Of &OOP.; 54f Snoloyecl Caw Won - to)
MoMhty Income Monthly Means
S S
Pesitianaille/Type of Business panels Ftene(inct stwoon PosilootTSIOTypo of Business ausanws mono ond BIOS C000)
le_ V. MONTHLY INCOME AND COMBINED HOUSING EXPENSE INFORMATION
0twe Menthe Income Ilenerwr Co P0..0,, ,r Teo HC:21=4ort e N v y e Omer, Agmee
i A
Boo &V Income' -6.361 83 $ S -6,361.83 Rent S 8,500.00
Arnim* First Monroe (PM) S 2,244.39
Drum Ott*. Anomaly (P41)
Commlailom Meant Insurance 243.60
Dividends/Interest Real Estate Taxes 543.73
Nit Rental Income Mort9epe Murano
Other lbeGge nOmpletini Homeowner rem. Dun 400.00
toe Wand coin 'desalt*
OM& Mean (1.• bOIOW) 30,276.00 30.276.00 Other:
Total S 23.914.17 $ S 23.914.17 Total S 8,600.00 S 3,431.62
• Self Employed Borrower(s) may be required to provide attritional documentation such as tax returns and financial statemests.
B/C Describe Other Income Notice: Allmcmy, child support, or separate maintenance Income need not be revealed If the Monthly
Borrower (B) or Co-Borrower (C) don not 0110Oila to have It considered for repaying this loan. Amount
B Belot i orishpBank 530.276.00 5 30,276.00
C
420341321 670351371
unlem malarial tow nwercalno Application Date: 1012/2014 FameMee Form 1003 7/05 (Rev 0109)
Faro MeerFrodidee Mtn f-redo. Mac Form 65 7/05 Odev 641)
vMP le YMF22 IN 10907)03
WcItens lavrei t Femme Services No*245
CONFIDENTIAL
SDNY_GM_00030917
EF1'A_00141530
EFTA01279975

VI. ASSETS AND LIABILITIES
This Statement and any applicable supportrig schedules may be completed Jointly by both marned and unmarried Coltorrowers if thew assets and liabilities are
sufficiently joined so the/ the Statement can be meaningfully and fairly presented on a combined basis: otherwise separate Statements and Schedules are required. If
the Co-Borrower section was completed about a non-applicant spouse or other person. this Statement and supporting schedules must be completed about that spouse
or other person also.
Completed 1 Jointly ri Not Jointer
ASSETS Cash erMatiot Yak* USW. arid Metaled Assets. -A the credues nano. amicss d4 3....ut men be ict at ostUaticang netts.
Description 'flown) tutomotoe loins ronAN-no cteroe /recounts root osId• coals etm u,/ chid support. stock pledges. Vs
Use continuation sheet it necessity inciCate by (' ) th010 Itibilion which will be SatiSheit Upon Sale of reel falai)
Cash depose toward purchase held by: $ owned ce uoon refinancini of the SlityKI PtOpotly
Monthly paymerd &
UABUTIES Months Left to Pay Balance
Ust checking and sayings accounts below Name and address of Convey S Payment/Months
Name and address of Bank, S&L. or Credit Union CHASE 25.00 104.00
Fifth Third Thr 9/30 5
0 Ace r4
— Name and address of Company Peyment/Months
17 .204 .55 CCO MORT CRP 3,163.00 318,915.90
Name and oddress of Benk. S&L. or Credit Union •
Fifth Third thr 9/30
agas i - Name and address of Company S Payment/Month
LP 9,127.57
lamen es of Bask. S&L a Crock Union
Name and address of Company 5 Pt/MIMI/Months
Name and address of Bank, S&L, or Credit Union
Name and address of Corrymny S Payment/Month
A.a to
Sinaesi & Rends (Company name/number
a d cription)
Fifth Third Private Bank - 515.751.96
flame and address of Cornpasy S PoymentrMonths
CREO Global Capital -81ue 3,108,560.00
Morgan Stanley FEW Blue Chip 506.946.00
Life insurance set cash value
Face amount: S
Sabah/ Uqukli Assets 4 157 590 08 1 no
Real estate owned (enter market value 620,000 Name end address of Company S Payment/Months S
from schedule of reel estate owned)
$
Vested Interest in retirement fund
N (a e tt t a w ch o r m th a o w f b s us s ln ta es te s m (e e s n ) t o ) w ned 399,960.20
Automobiles owned (make and yea) Aod no
O Al w im e o d n to y/ O9a S.ipporl6morde of anion/me Payment $
et.p.siged E./ ant* (rthrd t.thbn duos. etc )
Other Assets (ternte)
Total PO onthl Payments s / 1., /i:/
Total Assets S 5,177,550.28 la°mt ruirt1.1 ►S 4. n8.530.38 Total liabilities b. $ 319,019.90
Schedule of Real Estate Owned (If addnional properties are ow nod. use continuahon sheet.) Insurance.
Ftoperty Address (enter S if sold, PS if renting sole. Type of Present Amount_ of Goss Net
or Rif rental being held for income) property Market Value Mortgages & Liam Rental Income Rental Income
S 620,000 S 318,916 S 3,163
Tot ais S 620,000 $ 318,916 S S 3,163 S
List any additional names under which credit has previously been received and indicate appropriate creditor narne(s) and actors* number(s):
Alternate Name Creditor Name Account Number
420361321 420361321
Untom RenOtetiti Local Am/nation Garner Ilea Form 1003 7/05 (Rev 0/09)
FernieMariFrodfro Mac Application (NW 1012/201 Fredoe Mac Ron I/05(090w 6/09)
vial!. 90 9M$5P22 N 07 )0$
Watts Wove- Finarod Savo,: Pogo 3 of 5
CONFIDENTIAL
SDNY_CM_00030918
EFTA_00141531
EFTA01279976

VM. DECLARATIONS
If you answer "Yes" to any questions a through I, please CnAonnoier
S. Rushes* price S use continuation sheet for explanation. Yneso No Yes No
b. Alteratkem Improvements. repairs a Arethem any oul t. ageing palmed s [goon you? IMI M IL) =
C. Land (If acquked separately) 0 Ham you teen dedared baskApt w Ohm Moped f yeerP = Fl = =
C Nine yen helscopany foroCk400 unto or p or deed In 4),) 1 'root n -
d. Refinance (ind. debts to be paid off) 318,915.90 the last f RS'S' IM Iii C
OD 0 0
5. Estimated prepaid BIM% 650.00 d AM yea 8 piny to a IrseinP (=I
f. Estimated closin• costs 9 633.25 4 n lo a re te c lo yo w u ie d . ir t e im ctl b y e o r r o o r r i I e s tr i a s d i l n y l t ie e u e n o f o t t te o r r : o M c e l d o s a a l it a o n r y M O o a m t e w n in ts c h e l r m es s i s M ted o l i d n
g. RM. MP, Funding Fee recede sun IOW% SS nettle mOrkkke loan. SBA belt Mme improvemett
was, raordiered roan. moth:clued (motile) rinse loan, my mottoes.
h. Discount (if SWIM aor Mil pry) anonnal orotiolitn. tote or low guwerent If 'Yes;
inCludon die ease and 832r•SS Cl LeferSr. FHA or VA MSS mMtinle rerf..i itt Wty,
I. Total costs (add items a through h) $329.199.15 are morn lot thoectiOn / — WV = =
J. Subordinate fiaancling I Are you onnertly Pandont Cr el Waist on my Fintocil den or
loss mitres loWinal dslodion. toot or loon piwardm it •Yes. give C M C C
ic. Borrowers do • costs paid b Sae dela SS 0OSOmIted in the Orecedtn0 Wrenn
I. Other Creeks (explain) 9 Ani You 006900010 pay *morn. mad SuCpoot. Or emerge male-mon =MEC
0 II 0 0
Application Fee Paid 400.00 ri Is ray men or Int Comm paymint ternmverr
. Fl 0 -
An you • co-maker or endorsor orlon:PO CI
I. Ate you GU 5 oleo& WI = = =
M. Loananrxrr4
0.0(40RAL MP Ronne Foe toon0)31 326,000. 00 ii An you a pa-maned resident Mont =MCC
L oo you Wend to «ow eatpipet/ IC YOUr Oran rooldaso•S if 'YoS: m ®m m
n. Nil MIR Funding Fee financed temple. mieStrto rn Wow
o. Loan amount (add m 6 n) 325,000.00 ril Hare you std an owmeshy trbirest m a prOpirty in lb? Rd three yearSs WM - C Ini
$3, O i tv,mg fig 00r,,p,r,,004,,143.co),,turn1;16-r; pampa reliance tat). pR
p. Cash frorrito Borrower 799.15
laubtraCt J. k, I & 0 from I) (-.' H ..., :id ..., ,.i ;:..- i 0,- tiv.t.. . - :H. : • ir`i . ",51 pointlY rich
•
IX. ACKNOWLEDGEMENT AND AGREEMENT
Each of the undersigned specificity represents to Lando, end to Lender's actual or potential agents, brans processor, attorneys, Insurers. SIMMS. successors
end ensigns and egrets and acknowledges that: (1) the information provided in this application is true end correct as of the date set forth epode my signature end
that any intentional or negligent misrepresentation of this information contained in this application may result in dui liability. including monetary damages. to any
person who may suffer any loss die to reliance upon any rnisrepresentMion that I have made on this application, and/or is criminal penalties including, but not limited
to. fine or mprisonment or both under the provisions of Title le. United States Code. Sec. 1001. et seq.: (2) the loan requested pursuant to this application (the
'Loan") wilt be secured by a mortgage or deed of trust on the property described in this application; (3) the property wdl not be used for any 'Neel or prohbited
purpose or use: (4) all statements made in this appication me made for the purpose of obtaining a residential mortgage loan: (5) the property will be occupied as
indicated in this application: (e) the Lender. Its servitors. successors or assigns may retain the anginal and/or an electronic record of this application. whether Cr not
the Loan is approved. (7) the Lender and its agents. brokers, Insurers, setvicers. successors. and assigns may continuously rely on the information contained in the
application, and I am °bigoted to amend andfor supplement the information provided in this application if any of the material facts that I have represented herein
should change prior to closing of the Loan: (6) in the event that my payments on the Loan become delinquent. the Lender. its semicers. successors or assigns may. in
addition to any other rights and remedies that it may have relating to such delinmiency, report my name and account infonnation 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, broken, insurers. servicers. successors or assigns has made any representation or warranty. express or implied, to me resorting the property or the
condition or value of the property: and (11) my transmission of this application as an 'electronic record' containing my 'electronic signature.' as those terms are
defined in applicable federal and/or state laws (excluding audio and video recordings). or my facsimile transmission ot this application containing a facsimile of my
signature. shall be as effective. enforceable and valid es if a paper version of this application were delivered containing my ongnal written signature.
Acknowledgement. Bich of the undersigned hereby acknowledges that any owner of the Loan. as senicers. successors and assigns. may verify or reverify any
information contained in this eppication or obtain any information or data relating to the Loan, for any legitimate business purpose through any source. including a
scarce named in this application or a consumer reporting agency.
Borrowets Signature Date I C-oBerra/ ers Signature Date
X 12/4/2O14 X
X. INFORMATION FOR GOVERNMENT MONITORING PURPOSES
The following automation is requested by the Federal Government for certain types of loans related to a dwelling in order to monitor the lenders compliance wah
equal credit opportunity, far housing and home mortgage disclosure laws. You are not required to furnish this information. but are encouraged to do so. The taw
provides that • 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 nice. you may check more than one designation. If you do not furnish ethnicity. race. or sex. under Federal regulations, this lender
is requked 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 al requirements to which the lender is subject
under applicable state law for the particular type of loan applied for.)
BORROWER 0 i dO net *Oh tO Mobs did witaindOn CO-BORROWER NI I CO not went° knish liss Information
allnkitY: 14 rat or Limo Hot Hi Mc or Lino alltit Y: Wit or Limo NW Rs <or Lahr*
Rae& col HY` Rau:
Alan* Nao* Aspen AftwanArarrican — Masks Nine Avon Arntal Am Oleo
C r heirereeciltn Or r—n
Mr Pittoeiriavn or W Wale t_j Valle
• Foredo Fa Maid Sex: Fl Ferns. - liter
To be Completed by Loan OrIginMor:
This hteimatiem was provided: ('Ti In a face-toface interview By the applicant and seibmilted by fax or mail
In a telephone interview 7Th By the applicant and submitted via e-mail or the Internet
Loan Originators Skalatwo f Date
X
Loan Originators Name (print or Lean Originator Identifier Loan Originator's Phone Number (including area code)
Joann Brown 414603
LOan Origination Company's Name Loan Origination Company idertifler •t Ir.at on ompany's Address
Fifth Third Mortgage Company 5001 Kingsley OR. MO: 11.10CBC1,
134100 Cincinnati, COI 45227
420361321 Application Date 10/2/2014 420361321
Untenn Rotaries Loon apricatim Corner Mee Form 1003 7/05 (Rov 0/09)
Fame mairedche Mac Frmitio Mac Ferri 7/05 (rev 6/09)
times v6m$F 22 I NI09 07 )03
writers merge rancid Services Pagel of 5
CONFIDENTIAL
SDNY_GM_00030919
EFFA_00141532
EFTA01279977

CONTINUATION SHEET/RESIDENTIAL LOAN APPUCATION
Botrow et. Agency Case Number.
Use this continuation sheet if
you need more space to
compete the Residential Loan Brian Vickers
Application. Mark B for Co-Borrower Lender Case Number:
Bonnet a C for Co-8mme t
420361321
lfWe fully understand that it Is a Federal crane punishable by fine or imprisonmeat. or both, to knowingly make any false statemeMs concerning any of the above facts
as applicable under the provisions of Title ft United StMes Code, Section 1001. M seq.
Borrower's Signature: Date C-oBorrower's Signature: Date
X 12/4/2014 X
120361321 420361321
unforin Rimidentie Lan ApOita.C41 Cornell., rpm 1003 7/05 (Rev 0109)
Femme Msi ffni61.6 Ike Freddie mac form 65 7/05 (Aev 6/09)
VAIP 30 V 1AP22 1 N109 07 )03
WM." Wow Frsmod Sorsere Pogo 5 015
CONFIDENTIAL
SDNY_GM_000343920
EFTA_00141533
EFTA01279978