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WDVA 2100 - PLP APPLICATION Powered By Docstoc
					                                   STATE OF WISCONSIN, DEPARTMENT OF VETERANS AFFAIRS

                                                                30 West Mifflin Street, P.O. Box 7843, Madison, WI 53707-7843
                                                                     PHONE: (608) 266-1311 1-800-WIS-VETS (947-8387)
 Jim Doyle, Governor                                                                               WEBSITE:
 Kenneth B. Black, Secretary                                                                             FAX: (608) 267-0403

                               Application may be found immediately behind these instructions

                                                                                                          November 2009
Dear Personal Loan Program Applicant:

Thank you for your interest in our State Veterans Personal Loan Program. As a reminder, you must first
establish eligibility for state veterans benefits before submitting an application. Eligibility may be
established by visiting your County Veterans Service Office or visiting our State Office in Madison.

Personal loans can be secured by either a mortgage on real estate owned by you or your co-applicant and
located in Wisconsin or a creditworthy Wisconsin resident who is willing to guarantee the loan. If you are
married, your spouse must co-apply. Neither you nor your spouse may serve as a guarantor on the loan.

When submitting an application, we encourage you to submit the application in person through your County
Veterans Service Office or through our State Office in Madison. If you choose to mail in your application,
please make sure you sign and date the application and provide the appropriate supporting documents with
the application so we may process it in a timely manner. Please fill out the application completely (as it will
help us review it in the shortest possible time) and include the necessary supporting documents listed below.

The documents listed below are the most common submitted with an application. Please provide all those
that apply. If you have questions, please contact us at 1-800-947-8387. Each application is unique and other
documents may be required. If additional documentation is required, you will be contacted for that

    Income Verification
    • Most recent pay stubs for all (borrower and co-borrower) with year-to-date income listed. Please
       provide verification for a 30-day period for wage earners.
    • Self-employed and seasonal applicants must usually supply complete copies of their most recent state
       and federal tax returns with all attached schedules and W2s.
    • A recent bank statement or award letters showing direct deposit of VA Compensation and/or Social

                                               Continued — See Page 2
Page 2 — WDVA Personal Loan Application Instructions

If the loan is to be mortgage secured, please also provide the following information:

   Verification of existing mortgage
   • Documents from your lender showing the most recent balance and mortgage payment of your
      mortgage loan.
   Complete legal description of property
   • Provide the complete legal description for the property to be offered as security such as your deed,
      title policy, or mortgage documents. This document is necessary to verify property and ensure the mortgage is
       recorded properly.
   Current Property Value
   • A recent real estate appraisal for the subject property; or
   • The most recent property tax bill showing the current estimated fair market value.
   If the applicant or co-applicant is paying child support in a state other than Wisconsin, please provide
   verification that the support payments are current and the amount of the required payment.
   A consumer credit report is required for approval of a loan. If you have a credit report freeze in place,
   you must provide us access to your report. We will need either your credit report access code or the date
   when your credit report will be released.
   If you have experienced any credit problems in the past 5 years, please provide a written explanation and
   any related court documents for bankruptcy, foreclosure, judgments, or liens.

  If the loan is to be secured by a guarantor, please provide income verification and the following information:

   Signed and notarized copies of forms WDVA 2703 and 2105 available on our website at

Providing these documents with your application will help us review your application in the shortest possible
time. If you have specific questions, please contact your County Veterans Service Office or call us at

Thank you.
                                                STATE OF WISCONSIN, DEPARTMENT OF VETERANS AFFAIRS
                                                30 West Mifflin Street, P.O. Box 7843, Madison, WI 53707-7843
                                                                                                                                                                        Base File No.:
                                                (608) 266-1311 1-800-WIS-VETS (1-800-947-8387)
                                                                                                                                                                     Application No.:
                                                                   WDVA LOAN PROGRAM APPLICATION
The provision of your social security number is requested because of IRS reporting requirements regarding the interest paid on loans. Your number may also be used to verify
your identity regarding both your military separation documents and any credit reporting information obtained by the department. The failure to provide your social security
number may result in a delay or a denial of your application.

Loan Amount Requested:                                      Loan Term:                                 Purpose:                                                                     Request Deferment
                    Applicant Personal Information                                                                           Co-Applicant Personal Information
    Mr.               Ms.                                                                                      Mr.                 Ms.
Last Name                                                                            Suffix (Jr, Sr)      Last Name                                                                             Suffix (Jr, Sr)

First Name                                                               Middle Name                      First Name                                                                  Middle Name

Present Street Address                                                                                    Present Street Address
                                                                                   Rent       Own                                                                                             Rent       Own
City                                 State            Zip                           Since Date            City                                  State            Zip                           Since Date

Former Street Address            If less than 2 yrs at present address                                    Former Street Address             If less than 2 yrs at present address
                                                                                   Rent       Own                                                                                             Rent       Own
City                                 State            Zip                           Since Date            City                                  State            Zip                           Since Date

Date of Birth     SS#                Total Dependents                       Home Phone                    Date of Birth      SS#                                                        Home Phone

Cell Phone #                                      E-Mail Address                                          Cell Phone #                                       E-Mail Address

Marital Status     Married             Separated                         No. of months   ______
Spouse: Name and Address (if not Co-Applicant)

                    Applicant Current Employment                                                                             Co-Applicant Current Employment
Employer Name                                                                                             Employer Name
                                                                                Self-Employed                                                                                             Self-Employed
Employer Address                                                           Yrs Employed in                Employer Address                                                             Yrs Employed in
                                                                           this Line of Work                                                                                           this Line of Work
City                                 State            Zip                                                 City                                  State            Zip

Type of Business                                        Start Date with Current Employer                  Type of Business                                         Start Date with Current Employer

Position/Title                                          Business Phone                                    Position/Title                                           Business Phone

                             If Employed in Current Position for Less Than Two Years, Complete the Following
                                 (Also additional current employment information if more than 1 current employment income source.)
App / Co-App            Employer Name                                       City                       State         Type of Business          Position/Title                       Date From        Date To

                            Gross Monthly Income                                                                                   Monthly Housing Expenses
          Item               Applicant                Co-Applicant                        Total
Base Emp Income                                                                                           Rent
Overtime                                                                                                  Home Owners Insurance
Bonuses                                                                                                   Real Estate Taxes
Commissions                                                                                               Condo Fees
VA Comp                                                                                                   Other Expenses
Guard/Reserve                                                                                             (do not include utilities)
Social Security                                                                                           Mortgage Payment(s)
Child Support
Other Income
Total                                                                                                     Total
App / Co-App                                                                         Source of Other Income                                                                              Monthly Amount

WDVA 2100 (11/09)        Page 3 of 5                                                                                                    You can print the most recent version of this form
W:\Templates\                                                                                from the WDVA website at
                                                                                          Applies to Applicant and Co-Applicant
          Check all true statements & explain. Include explanation (on separate sheet) and additional documents for each checked response.
     There are outstanding liens and/or judgments against me.

     I have declared bankruptcy within the last 7 years. (If within 5 years, provide bankruptcy documents.)

     I have had property foreclosed upon or given title or deed in lieu thereof in the last 7 years.

     I am a party to a lawsuit.

     I am a co-maker or endorser on a note.

     I am obligated to pay alimony, child support, or separate maintenance. (Include amount in liabilities.)

     I have delinquent child support.

     I/we have a security freeze placed on my credit report. If this box is checked, please provide your access codes. Applicant ______. Co-applicant ______. If
     you do not provide an access code, please indicate the time frame in which your credit report will be available to WDVA for credit underwriting purposes.
     My/our credit reports will be released from ______ to ______. If you provide your access code, your credit report will remain frozen to other creditors and
     loan processing will be expedited.
                                                                                                                  Security Offered
                                                      Real Estate                                                                                                                         Loan Guarantor
Property Street Address                                                                                                               Last Name                                                 First Name                                         Middle Initial

City                                                         State             Zip                                                    Address                                                                                            Phone

Mortgagor Name (1st)                                                                                       Balance                    City                                                           State                Zip

Mortgagor Name (2nd)                                                                                       Balance                    Date of Birth                   SS#                                                 Marital Status

Nearest Living Relative (Not Living With You)                                           Address                                                        City                                          State                Zip                  Phone

                                                                                       Statement of Assets - Liquid Assets Only
  App / Co-App                            Asset Type                                                    Name / Description                                                        Acc # / Yr                      Account Type                          Value

                                                                                                           Statement of Liabilities
Pay              Liable                                                                                                                                          Liability                                               No. Pmts.                    Current
Off?             Person                                             Institution                                              Account #                            Type                       Monthly Pmt.                  Left                       Balance
                                                                                                                                                                                         $                                                     $
                                                                                                                                                                                         $                                                     $
                                                                                                                                                                                         $                                                     $
                                                                                                                                                                                         $                                                     $
                                                                                                                                                                                         $                                                     $
                                                                                                                                                                                   $                                                           $
   App / Co-App                    Real Estate Loans                               Creditor’s Name                                      Account Number                     Monthly Payments                     # Mths Pay Left                Unpaid Balance

Liabilities Totals:                                                                                                                           Total Monthly                                                            Total Liable
                                                                            Applicant’s and Co-Applicant’s Real Estate Owned
                                                                                                                                   Type of                                              Amount of              Monthly           Monthly               Monthly
                                                                                                                                   Property                  Present                     Liens &                Rental          Mortgage              Taxes, Ins,
App / Co-App                   Mortgage Holder                                   Address of Property                             (Rec, Rental)             Market Value                 Mortgages              Income           Payments              Main & Misc

        Statements made in this application are true and made for the purpose of obtaining the loan. You are authorized to contact and obtain from any source verification of the above information and/or any information that you deem necessary relating to
this application.
        The undersigned understands that a loan becomes immediately due and payable if it is found to have been granted to an ineligible person. If the undersigned knowingly makes any false statement of any material fact or submits fraudulent evidence on
or in connection with this application, the undersigned is subject to severe penalties provided under law including fine or imprisonment or both, acceleration on the loan balance and suspension of all veterans’ benefits from the Wisconsin Department of
Veterans Affairs. I understand that I may appeal any denial or modification on loan benefits to the Wisconsin Department of Veterans Affairs in writing within 60 days of the denial or modification.
        The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national origin, sex, marital status, age (provided that the applicant has the capacity to enter into a binding
contract); because all or a part of the applicant’s income derives from any public assistance program, or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. The federal agency that administers compliance
with this law concerning this creditor is the Consumer Response Center, Federal Trade Commission, 600 Pennsylvania Ave NW, Washington, DC 20580.
        For Married Wisconsin Residents Applying for Individual Credit: No provision of any marital property agreement, unilateral statement under Chapter 766.59 Wis. Stats., or court decree under Chapter 766.70 adversely affects the interest of the
Wisconsin Department of Veterans Affairs unless the Department, prior to the time credit is granted, is furnished with a copy of the agreement or statement, or has actual knowledge of the adverse provision. The applicant warrants and represents to the
Department that the loan being applied for is intended to be incurred in the interest of the applicant’s marriage or family. The applicant understands the Department may be required by state law to give written notice of this credit transaction to his or her
spouse and for such notification purposes, provides the name and address as the last known name and address of said spouse.
        Information regarding social security identification is solicited on a voluntary basis and will be used to verify veteran status and credit reports.
        NOTICE: Alimony, child support, or separate maintenance income need not be revealed if the Borrower or Co-Borrower does not choose to have it considered as a basis for repaying this loan.
Applicant’s Signature                                                                                    Date                           Co-Applicant’s Signature                                                                               Date

WDVA 2100 (11/09)                     Page 4 of 5                                                                                                                               You can print the most recent version of this form
W:\Templates\                                                                                                                        from the WDVA website at
                 Survey -- Personal Loan Program / Home Improvement Loan Program

Your responding to this survey will help us continue providing support to Wisconsin veterans.
Thank you for participating.

Applicant's Name:                                                           Base File #:

How did you hear about the Personal Loan Program / Home Improvement Loan Program? (Check one only)

       Wisconsin Department of Veterans Affairs Web site
       Direct Mail Solicitation
       Veterans Supermarket/Benefits Fair
       County Veterans Service Officer
       Newspaper Article
       Veterans Organization Publication
       Word of Mouth
       Newspaper Ad
       Radio Ad

WDVA 2100 (11/09)        Page 5 of 5                                         You can print the most recent version of this form
W:\Templates\                     from the WDVA website at

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Tags: Personal, loans
Description: Personal loans, also known as the retail loan business, after decades of development, has become an important loans. Personal loan, the lender is granted to the borrower for the purchase of housing and urban residents repair their own use, built-occupied housing (excluding sales of housing) loans. Lender to grant housing loans, the borrower must provide security. If a borrower can not repay principal and interest loans, the lender shall be entitled to deal with the quality of its collateral or property, or repayment of principal and interest by the guarantor to assume joint and several liability.