EFTA01279979.pdf

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
Agency Case Number Lender Case Number
Mpepdlieadn . VA M Conventional Other (explain):
A for 'FHA LJ
[ USDA,Riral Housing Service 420361321
Amount Interest Rale I No. of Months Amortization m Fixed Rate n Other (explain):
Type:
$325,000.00 3.000'6 180 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
No. 01 Una 1
Legal Description al Staled Property (attach clascridicn it necessary) I Year Eta 2002
Purpose of Loan n Purchase n Construction n Other (explain): Property will be:
M ri Primary i--i Secondary
Refinance I= Construction-Permanent I__I Residence LXJ Residence C Investment
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 (s) Cost of Improvements Total (a • b)
I $ I $ $
Complete this line It this lea refinance lost Describe Improvements C made O to be made
Year Acquired Original Cost Amount Existing Liens Purpose of Refinance
2004 IS 810, 000.00 $ 318, 915.90 I Rate and Term Cost: $
Title will be held in what Name(s) Manner in which Title will be held Estate will be held in:
Brian Vickers El Foe Singe
Title bald jointly. Leasehold where
caciraion date)
Source of Down Payment. Settlement Charges. and/or Subordinate Financing (explain)
Borrower III. BORROWER INFORMATION Co-Borrower
Borrowers Name (include Jr. or Sr. it applicable) Co•Borrower's Name ($ clude Jr. or Sr. if applicable)
Social Security Number Home Phone (incl. area code) DOB(mmrotsYyn) Yrs. School
TU"N
Orornacos tam Woe by &wowed
n Marled Unmarred race shah r . ind I= Maned C Unmarried endur19 shale no.
danced Widowed) El &was (homed element
Separated 0 I "
poweadaddreassuwatamm_no) C Own Rant 3/0 No. Yrs. Present Address street city. state. DPI C Own I=I Rent No. Yrs.
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:
Own C
Former Address tweet. city slaa WI O Own O Hart No. Yrs. Former Address (meet Sly. Mate. ZIP) O Rent No. Yrs.
420361321 420351321
Uniform %Mendel then Appllcelon Application Date: 10/2/2014 Fannie map Form leo 7105 (Rev. 6/091
Fannie Maafraldia Mac F *oldie Ms Fern 6 7,06 (Rov. 6/09
YMP YMP221I4 409071.0
Wolters mews Financial Sentes Page I e.5
CONFIDENTIAL194701044,E3211
EFTA_00141544
EFTA01279979

Borrower IV. BAPIAYIMENT INFORMATION Co-Borrower
x. Sall 660440 Yrs 40 OnS230 Name& 40:019 016600n. E so 660000 Yrs on ins rob
Scio Verism Corporation 11/9
329 Sea Breeze Ave
Yrs. employed in this lined Yrs. employed in Iris lineal
Palm Beach, FL 33480 workeprolessicn worluproleseca
/
PosinantIllaTypeof (Lines Business Alone Pncl. area code) PosdioniTitleaype al Business dryness Phone rind. area code)
Race Car Driver (336) 475-4042
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 Monthly Income
S 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 H C O o U m S b I i l n lp e e d 4 M 90 o 1 t 1 i 1 li . t y Present /pro/pest
Base Ernpl. Income $ —6, 361.113 $ $ —6,361.03 Rent $ 8, 500.00 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
F
sitehl re %el V int Homeowner Assn. Dues 400.00
other Income.' been) 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 Monthly
Borrower (B) or Co-Borrower (C) does not choose to have It considered for repaying this loan. Amount
B Ite1ationsh $30,276.00 $ 30 276.00
420361321 420361321
uniforms:go:wee Lean Application Application Date: 1022014 Fannie Mae Form 1003 7/05 (Bev. 6/09/
Fannie Maarreddie Mac Freddie Ms Form 65 7,06 (Rev. 6/09
VIAP YMP221N i090710
Millen. lamer Hoarder Stevie*. Paget 045
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 ob asis: 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 ash or Markel WAR Llabiltles and Pledged Amts. List the creditor's name. addran and aeccunt number tor all oitslandng &las.
Description including automobile loam revolving charge accounts. real estate loans, alimony, cold ninon. stock pledges. etc.
Use cant inuaion sheet. it necessary. 'Scale by (' ) those habillies which will be satisfied upon sale of red estate
Cash deposit toward purchase held by: s owned or upon refinancing or the sub)ecl eroPenv•
Monthly Payment & Unpaid
LIABILITIES MM onths Len to Pay Balance
list checking and savings accounts below Name and address of Company $ Payment/Months $
Name and address of Bank. S&L. or Credit Union CHASE 25.00 104.00
Fifth Third Thr 9/30 5
0 Accl• no.13895100
tb...i. no. Name and address of Company $ Payment/Months $
0000000564 $ 17,204.55 CCO 14ORT CRP 3,163.00 318, 915.90
Name and address of Bank. SAL. or Credit Union *
Fifth Third thr 9/30
Acd. no.2930022453112
MCI. no. Name and address of Company $ Payment/Months $
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
ihrelstziptilmIs (Company name/number
Fifth Third Private Bank — S 515,751.96 Accl. no.
CREO Global Capital —Blue 3,108,560.00 Name and address of Company $ Payment/Months $
Morgan Stanley FRO Blue Chip 506,946.00
Life insurance net cash value $
Face amount: $
Subtotal Liquid Assets S 4,157,590.08 Acct. no.
Real estate owned (enter market yak* $ 620,000 Name and address of Company $ Payment/Months $
from schedule of real estate owned)
Vested interest in retirement fund S
N (a e tt t a w ch o r f t i h na o n f c b ia u l s s in ta e t s e s m ie e s n ) t o ) wned $ 399,960.20
Automobiles owned (make and year)
Alimony/Child SupporliSepane llAinnetnenaree Payments
$ Owed to: $
lia,,um-ene. c-ieense (chid ewe. dun. etc.;
Other Assets (itemize) $ $
Total Monthly Payments S n on ..//
Total Assets a. $ 5,177_,_sso.2s_telunu W s o I r I .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.)
ol'r;o4irir ryeitlirbeesiAc(ehnetzr popirt:Id..elr it pending sate. pa in ma:VIP/due Mortgages Net
Rents Va°41nUates itisfgi atll aCtIO. Rental
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 420361321
Uniform fiellgentld LOW Application Facile Mae Form 1003 MI5 (Rote/09i
Fannie Maafreddie Mac Application Date:10/2/2014 Freddie Ms Form 65 7,06 (Ray. 6/09
VMP VMP221N/0907i.0
Wolters lavas RnSfidd Santos Page 3 or 5
CONFIDENTIAL
SDNY_GM_00030933
EFTA_00141546
EFTA01279981

VI. DETAILS OFTRANSACTION-AIM VIII. DECLARATIONS
If you answer Yes to any questions a through i, please Borrower Caker apier
a. Purchase price use continuation sheet for explanation. Yes No Yes No
IM 0
b. Alterations. improvements. repairs 0. Are there any Outstanding judgments Vane you?
0 M 00
C. Land (if acquired separately) b. Hare you been declared beetroot within Ihopast 7 years?
C. Kaye you had properly foredosed upon or given Idle or deed in Ism thereof an c Ili' c c
d. Refinance (Incl. debts to be paid off) 318,915.90 the Lel 7 yeatE7
M 0 0
e. Estimated prepaid items 650.00 a Are yco a pacy teeter sul?
1. Estimated closing costs 9,633.25 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
9. PMI. MIP. Funding Fee include Such learn a home mortgage loans. SBA lows borne improvement
loam educeienal loans. manulactured (nu:betel home loans. any mortgage.
h. Discount Of Borrower will pay) 'omelet cbhgfillen bond or loan guarantee. If 'Yea' Provide deele.
I. Total costs (add Items a through h) $329,199.15 e se n n c d l u re d a n s g o n d s a t f e o . r n t a h m e a e c a ti n o d n . a ) d dress of Lender. FHA or VA case number. it any, 0 0
Subordinate financing I. _Amen yomunpreceenyt deemi m ng a or i i n n . d b e o fss n ft d o „. n C a f ny Federal debt or any other
k. Borrowers closing costs paid by Seller 'Sows asnctesacacrr;tg IC01 guarantee' II -veg.' ore 0 0
I=1 0 0
Other Credits (explain) g. Are you °bloated to pay alimony. child support. or separate maremance?
h. Is
Application Fee Paid 100.00 any pan or the down payment borrowed?
CC
i. Are you ace-maker or endorser mane*?
0 0
Are yco a U.S. CiliZen? [I]
m. Leen amount I=1 O CI
froclude Fee MIP Funding Fee financed' 325, 000.00 It. Are you a parnanert resident alien?
n. PMI. MIP. Funding Fee financed L D co o m y p o le u t e In o t v e e n r d s e to e e m m b e e r lo y w t he properly a your primary triedence7 2 'yes: =Hi 0 0
0 O I=1
o. Loan amount (add m 8 n) 325,000.00 in. 1I4'a) ye you had an ownership interest in a properly in 'haled tree yews? III
P. Cash from/to Borrower $3,799.15 h W o h m a e t ( t S yp M o . or i p r r N op Mm alslF r y e o s u e r o ly w U n PI : ? : Finn:pal ressience CORI, second PR
(subtract j. k. 18 olrom I) ix) How did you hold Idle to the home • - solely by yoursdl IS). Jointly with
year aped* 'SP,. or petty wth mother Form" (DO
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 Date Co-Borrowers Signature Date
X 12/4/2014 X
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 tnhis i Nenhation CO-BORROWER I do not wish to furnish this Information
Ethnicity: EthnicEy:
Place:
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No
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Hispa
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0 H
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0 Not Hispanic or
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Alaska Native Alen African American
C Native Caw or I— I Nerve Hawaiian or
COO. Pectimc aWnander ®White 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 By the applicant and submitted by fax or mail
In a telephone interview C By the applicant and submitted via e-mail or the Internet
Loan Originator's Signature Date
X
Loan Originator's Name (print or type) Loan Originator Identifier Loan Originator's Phone Number (including area code)
Joann Brown 414603 (919) 573-1982
Loan Origination Company s Name Loan Origination Company identifier Lan Origination Company's Address
Fifth Third Mortgage Company 5001 Kingsley DR, HD: 1M0C8O,
134100 Cincinnati, OR 45227
420361321 Application Date: 10/2/2014 420381321
Uniform INeltlerrial Loan Application Fannie Mae Fenn 1003 7105 (YIN. 8/091
Fannie Manfred:lieMac Freddie Ms Form 85 7,05 (Rev. 8/09
YMP® VMP221N (0907).0
Waiters Mutter vinencia Starless Pape 04 5
CONFIDENTIAL
SDNY_GM_00030934
EFTA_00141547
EFTA01279982

CONTINUATION SHEET: RESIDENTIAL LOAN APPUCATION
Borrower: Agency Case Number.
Use this continuation sheet if
you need more space to
complete the Residential Loan Brian Vickers
Application. Mark B for Co.Borrower: Lender Case Number:
&now er or C for Co-Borrower.
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 12/4/2014 X
420361321 420361321
Uniform %Mendel LON Applicebon FE0144(0 Mae Form 1003 7/05 (elev. 6/061
Fannie Manfred:lieMac Freddie Ms Fern, 65 7,06 (Rev. 6109
VMP 46, VMP221N 409031.0
WORM laws 410134(441 Siri4e0S Page 5 04 5
CONFIDENTIAL
SDNY_GM_00030935
EFTA_00141548
EFTA01279983