Financial Worksheet - Wells Fargo Home Mortgage
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4FINANCIAL WORKSHEET
WELLS FARGO HOME MORTGAGE, INC.
LOAN NUMBER:
MIC/LGIC No: ___________________
Primary Insurance Certificate No:
____________
Borrower’s Name
Social Security Number
Borrower’s Name
Social Security Number
Home Telephone Number (
)
Work Telephone Number(s) (
)
(
)
If necessary, who should we call to set up an appointment to appraise the property:
PROPERTY ADDRESS
Street Address, City, State, Zip Code
MAILING ADDRESS (If different than property address)
Rent
Own How Long _________
Street Address, City, State, Zip Code
I. MONTHLY INCOME DATA
DESCRIPTION
INCOME BORROWER
INCOME CO-BORROWER
TOTAL
NET SALARY/WAGES
COMMISSION/BONUSES
OTHER (IDENTIFY)
TOTAL NET INCOME
II.
ASSETS
III.
LIABILITIES
DESCRIPTION
ESTIMATED
DESCRIPTION
MONTHLY
BALANCE DUE
VALUE
PAYMENT
HOME
MORTGAGE
OTHER REAL ESTATE (explain)
OTHER MORTGAGE/RENT
AUTOMOBILE
ALIMONY/CHILD CARE
AUTOMOBILE
AUTOMOBILE
CHECKING ACCOUNTS
AUTOMOBILE
SAVINGS/MONEY MKT.
UTILITIES (total)
IRA/KEOGH ACCOUNTS
INSURANCE
401K/ESOP ACCOUNTS
STUDENT LOAN
STOCKS/BONDS, CD’S
CREDIT CARDS (total)
OTHER INVESTMENT (explain)
OTHER EXPENSES (identify)
TOTAL
Please briefly explain your hardship or reason for being delinquent:
I (we) certify that the financial information stated above is true, and is an accurate statement of my/our financial condition. I/We
understand and acknowledge that any action taken by the lender of my/our mortgage loan on my/our behalf will be made in strict reliance
on the financial information provided. My/Our signature(s) below grants the holder of my/our mortgage the authority to obtain a credit
report to verify the information in this financial to be accurate.
NOTICE: ATI Title Co. is a subsidiary of Wells Fargo Home Mortgage, Inc. A lender is allowed to require the use of an Attorney, Escrow
Agent, Credit Reporting Agency or Real Estate Appraiser chosen to represent the lender’s interest.
By _________________________
Date _____ / _____ / _____
By _______________________
Date _____ / _____ / _____
FINAL INSTRUCTIONS
•
Make sure you have signed and dated the form
•
Include copy of your last year’s Federal Tax Return with all attachments
•
Include copy of your most recent paystubs or proof of income if self-employed
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