BANKWEST MANUFACTURED HOUSING CREDIT APPLICATION
SALES PRICE: $___________________________
DOWN PAYMENT (10% Minimum)*: $___________________________
LOAN AMOUNT: $___________________________
*Down payment subject to change depending
on loan program and age of home.
APPLICANT INFORMATION
Applicant’s Name (first, middle, last) Date of Birth (mm/dd/yyyy) Social Security Number
Are you a U.S. citizen? Yes No Are you a permanent resident alien? Yes No Mother’s Maiden Name:
Present Address (Street, City, State, ZIP) Time at Present Address (yrs/mo)
Mailing Address, if different from Present Address
Home Phone Listed Unlisted Work Phone Cell Phone Email Address
( ) ( ) ( )
Present Home Dependents (not listed by co-applicant)
Own Rent Other (explain) No.: Ages:
Former Address (Street, City, State, ZIP) (if at present address less than 2 years) Time at Former Address (yrs/mo)
Current Employer (name & address)
How Long with Employer (yrs/mo) Position/Title/Type of Business Monthly Gross Income
Previous Employer (name & address) (if with current employer less than 2 years)
How Long with Employer (yrs/mo) Position/Title/Type of Business Monthly Gross Income
CO-APPLICANT INFORMATION
Applicant’s Name (first, middle, last) Date of Birth (mm/dd/yyyy) Social Security Number
Are you a U.S. citizen? Yes No Are you a permanent resident alien? Yes No Mother’s Maiden Name:
Present Address (Street, City, State, ZIP) Time at Present Address (yrs/mo)
Mailing Address, if different from Present Address
Home Phone Listed Unlisted Work Phone Cell Phone Email Address
( ) ( ) ( )
Present Home Dependents (not listed by applicant)
Own Rent Other (explain) No.: Ages:
Former Address (Street, City, State, ZIP) (if at present address less than 2 years) Time at Former Address (yrs/mo)
Current Employer (name & address)
How Long with Employer (yrs/mo) Position/Title/Type of Business Monthly Gross Income
Previous Employer (name & address) (if with current employer less than 2 years)
How Long with Employer (yrs/mo) Position/Title/Type of Business Monthly Gross Income
DATE: _______________________________
LOAN PURPOSE:
Prequalification. Estimated Lot Rent (if applicable): $ _________________
Purchase
Refinance: Cash Out - Debt Consolidation. Please provide a list of accounts to be paid.
Refinance: Cash Out - Home Improvement. Estimated Cost of Improvements: $ __________________
Refinance: Rate/Term Change
HOME WILL BE:
Primary Residence Secondary Residence Non-Owner Occupied (Investment)
Equal Housing Lender | 1-800-253-0362 Page 1 of 5 BankWest Manufactured Housing Credit Application Rev 10/2021
REFERENCES (APPLICANT OR CO-APPLICANT)
Bank Reference (name and city)
Checking Savings Loan Credit Line
First Personal Reference/Relative (Name, Address and Phone Number)
Second Personal Reference/Relative (Name, Address and Phone Number)
OTHER INFORMATION
MARITAL STATUS
Complete only if for joint or secured credit, or applicant and/or co-applicant resides in a community property state or is relying on property located in such a state as a
basis for repayment of the credit requested.
Applicant (check one): Married Separated Unmarried (including single, divorced and widowed)
Co-applicant (check one): Married Separated Unmarried (including single, divorced and widowed)
Have you ever filed bankruptcy? Yes No If yes, where?________________________________________________________________ Year? ____________
Are there any claims suits or judgements against you? Yes No If yes, to whom owed? ________________________________________ Amount ___________
Are you a co-signer or guarantor for anyone? Yes No If yes, for whom? _________________________________ To whom? __________________________
Description of Assets Name in Which Account is Carried Subject to Debt? Value
Checking Account Number(s) (Where)
$
Savings Account Number(s) (Where)
$
Certificate(s) Of Deposit (Where)
$
Marketable Securities (Issuer, Type, No. Of Shares)
$
Real Estate (Location, Date Acquired)
$
Automobiles (Make, Model, Year)
$
Other (List)
$
Total Assets $
ADDITIONAL INCOME
ASSET INFORMATION (APPLICANT AND CO-APPLICANT)
Do not reveal alimony, child support or separate maintenance income unless you wish it to be considered as a basis for repayment.
Nature of Additional Income (if 2nd job, include start date) Amount How long will income continue?
Applicant: $
Co-Applicant: $
Equal Housing Lender | 1-800-253-0362 Page 2 of 5 BankWest Manufactured Housing Credit Application Rev 10/2021
MANUFACTURED HOME INFORMATION
Size Make & Model Year Serial #
Where is home to be located? (check one) Land/Lot Payment Estimate (if applicable)
Manufactured Home Community Owned Land Relatives/Leased Land $
Trade-In Information (if applicable)
Size Make & Model Year Serial #
SECURED CREDIT Complete only if credit is to be secured. Briefly describe the property to be given as security.
Property Description
Names and Addresses of All Co-Owners of the Property
If the security is real estate, give the full name of your spouse (if any).
CREDIT OBLIGATIONS (APPLICANT AND CO-APPLICANT)
Charge accounts, installment contracts, credit cards, rent, mortgage and other obligations. Use separate sheet if necessary.
Creditor Original Amount Present Balance Monthly Payment
Landlord or Mortgage Holder Rent Mortgage (Omit Rent) (Omit Rent)
$ $ $
Other Credit Obligations (list)
$ $ $
$ $ $
$ $ $
$ $ $
$ $ $
Total Credit Obligations $ $
Are you obligated to make alimony, support or maintenance payments? Yes No
If yes, to (Name & Address): _________________________________________________________________________ Amount per Month: $__________________
I/We are applying for credit with BankWest, Inc. (Check One)
I am applying for individual credit in my own name and I am relying on my own income and assets and not the income or assets of another person as the
basis of repayment of the credit requested.
We are applying for joint credit.
Applicant’s Name Printed: ______________________________________ Applicant’s Signature ________________________________________
Co-Applicant’s Name Printed: ___________________________________ Co-Applicant’s Signature ______________________________________
I am applying for individual credit and I am relying on my own income or assets, as well as income from alimony, child support, or separate maintenance, or
on the income or assets of another person as the basis of repayment of the credit requested.
STATEMENT OF INDIVIDUAL OR JOINT CREDIT APPLICATION
Equal Housing Lender | 1-800-253-0362 Page 3 of 5 BankWest Manufactured Housing Credit Application Rev 10/2021
SIGNATURES
I certify that everything I have stated in this application and on any attachments is correct. You may keep this application whether or not it is approved. By
signing below I authorize you to check my credit and employment history and to answer questions others may ask you about my credit record with you. I
understand that I must update credit information at your request if my financial condition changes.
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____________________________________________________________ __________________________________________________________
Applicant Signature Da
te
Co-Applicant Signature Date
INSURANCE DISCLOSURE NOTICE
In connection with your credit application, BankWest advises you of the following:
• BankWest may not condition the extension of credit you are applying for on whether you purchase an insurance product or annuity
from the bank or bank’s affiliate.
• BankWest may not condition the extension of credit you are applying for on your agreement not to obtain, or a prohibition on your obtaining,
an insurance product or annuity from an entity not affiliated with the bank.
Insurance products and annuities:
• Are not deposits or other obligations of, or guaranteed by, the bank or any affiliate of the bank;
• Are not insured by the Federal Deposit Insurance Corporation (FDIC) or any other agency of the United States, the bank, or any affiliate
of the bank;
• May involve investment risk, including the possible loss of value.
By signing below, I acknowledge that I have read and understand this Insurance Disclosure Notice.
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____________________________________________________________ __________________________________________________________
Applicant Name Printed Date Applicant Signature Date
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____________________________________________________________ __________________________________________________________
Co-Applicant Name Printed Date Co-Applicant Signature Date
AUTHORIZATION TO RELEASE INFORMATION
To whom it may concern:
1. I/We have applied for a mortgage loan from BankWest, Inc. As part of the application process, BankWest, Inc. and the mortgage guaranty insurer (if any),
may verify information contained in my/our loan application and in other documents required in connection with the loan, either before the loan is
closed or as part of its quality control program.
2. I/We authorize you to provide to BankWest, Inc. and to any investor to whom BankWest, Inc. may sell my/our mortgage, any and all information and
documentation that they request. Such information includes, but is not limited to, employment history and income; bank, money market and similar
account balances; credit history; and copies of income tax returns.
3. BankWest, Inc. or any investor that purchases the mortgage may address this authorization to any party named in the loan application.
4. A copy of this authorization may be accepted as an original.
5. I/We hereby authorize BankWest to release information to the following:
________________________________________________________ __________________________________________________________
________________________________________________________ __________________________________________________________
X
__________________________________________________________
____________________________________________________________
X
Applicant Signature Da
te
Co-Applicant Signature Date
Equal Housing Lender | 1-800-253-0362 Page 4 of 5 BankWest Manufactured Housing Credit Application Rev 10/2021
Interviewer Information
Interviewer’s Name (print or type): Name and Address of Interviewer’s Employer
Interviewer’s Signature:
Date:
Interviewer’s Phone Number (incl. area code):
TO BE COMPLETED BY FINANCIAL INSTITUTION OR INTERVIEWER (for application taken in person)
DEMOGRAPHIC INFORMATION
The purpose of collecting this information is to help ensure that all applicants are treated fairly and that the housing needs of communities and neighborhoods are
being fulfilled. For residential mortgage lending, federal law requires that we ask applicants for their demographic information (ethnicity, race and sex) in order to
monitor our compliance with equal credit opportunity, fair housing and home mortgage disclosure laws. You are not required to provide this information, but are
encouraged to do so. The law provides that we may not discriminate on the basis of this information, or on whether you choose to provide it. However, if you choose
not to provide the information and you have made this application in person, federal regulations require us to note your ethnicity, race and sex on the basis of visual
observation or surname. The law also provides that we may not discriminate on the basis of age or marital status information you provide in this application.
Instructions: You may select one or more “Hispanic or Latino” origins and one or more designations for “race.” If you do not wish to provide some or all of this
information, select the applicable check box.
APPLICANT
Ethnicity: Hispanic or Latino
Mexican Puerto Rican Cuban
Other Mexican or Latino - Enter origin:
______________________________________________
Examples: Argentinian, Colombian, Dominican,
Nicaraguan, Salvadoran, Spaniard, etc.
Not Hispanic or Latino
I do not wish to provide this information
Race: American Indian or Alaskan Native - Enter name of enrolled
or principal tribe: ___________________________________
Asian
Asian Indian Chinese Filipino
Japanese Korean Vietnamese
Other Asian - Enter race:
______________________________________________
Black or African American
Native Hawaiian or Other Pacific Islander
Native Hawaiian Guamanian or Chamorro Samoan
Other Pacific Islander - Enter race:
______________________________________________
Examples: Fijian, Tongan, etc.
White
I do not wish to provide this information
Sex: Female
Male
I do not wish to provide this information
CO-APPLICANT
Ethnicity: Hispanic or Latino
Mexican Puerto Rican Cuban
Other Mexican or Latino - Enter origin:
______________________________________________
Examples: Argentinian, Colombian, Dominican,
Nicaraguan, Salvadoran, Spaniard, etc.
Not Hispanic or Latino
I do not wish to provide this information
Race: American Indian or Alaskan Native - Enter name of enrolled
or principal tribe: ___________________________________
Asian
Asian Indian Chinese Filipino
Japanese Korean Vietnamese
Other Asian - Enter race:
______________________________________________
Black or African American
Native Hawaiian or Other Pacific Islander
Native Hawaiian Guamanian or Chamorro Samoan
Other Pacific Islander - Enter race:
______________________________________________
Examples: Fijian, Tongan, etc.
White
I do not wish to provide this information
Sex: Female
Male
I do not wish to provide this information
Demographic Information was provided through:
Face-to-Face Interview (includes electronic media w/video component) Telephone Interview Fax or Mail Email or Internet
Was the ethnicity of the APPLICANT collected on the basis of visual observation or surname? No Yes
Was the ethnicity of the CO-APPLICANT collected on the basis of visual observation or surname? No Yes
Was the race of the APPLICANT collected on the basis of visual observation or surname? No Yes
Was the race of the CO-APPLICANT collected on the basis of visual observation or surname? No Yes
Was the sex of the APPLICANT collected on the basis of visual observation or surname? No Yes
Was the sex of the CO-APPLICANT collected on the basis of visual observation or surname? No Yes
Equal Housing Lender | 1-800-253-0362 Page 5 of 5 BankWest Manufactured Housing Credit Application Rev 10/2021
Return Completed Application to:
Mail: BankWest Mortgage
Manufactured Housing Department
PO Box 998
Pierre, SD 57501
Fax: 605-945-3882
Questions?
Phone: 1-800-253-0362 or 1-605-224-7391
E-mail: [email protected]
For your protection, please do not include condential information such as
account numbers, social security numbers, etc. in your e-mail message.
Notes:
Thank you for choosing BankWest Mortgage.
Equal Housing Lender | 1-800-253-0362 BankWest Manufactured Housing Credit Application Rev 10/2021
Rev 7/2022
Addendum to BankWest Manufactured Home Application
This credit application will be submitted to BankWest Inc. for review. Following the receipt of your credit application, BankWest’s
designated representative (or a person under their supervision, as appropriate) may contact you to communicate its status or discuss
your application. Should you have any questions about this application or the loan process, please contact the BankWest Manufactured
Housing Department at 1-800-253-0362 or mfdhousing@bankwest-sd.bank.
BankWest Mortgage Loan Originators
Name
NMLSR ID #
Division
NMLSR ID #
Division
Rebecca Whidby
2051452
Chattel/Home Only Loans
1409924
Land/Home Loans
Scott Kohlenberg
747392
Chattel/Home Only Loans
400925
Land/Home Loans
Mary C. Nutter
699176
Chattel/Home Only Loans
648733
Land/Home Loans
Julie Bass
1738873
Chattel/Home Only Loans
2029228
Land/Home Loans
Donna Larson
608989
Chattel/Home Only Loans
2254665
Land/Home Loans
Denise Foster
747399
Land/Home Loans
1276533
VP Mortgage Division
Darla Jones
747401
Land/Home Loans
685987
Dona Mae Johnson
747396
Land/Home Loans
Equal Housing Lender. All loans subject to credit approval. Member FDIC.
NOTICE OF RIGHT TO RECEIVE COPY OF APPRAISAL
BankWest may order an appraisal to determine the property’s value and charge you for this appraisal.
BankWest will
promptly give you a copy of any appraisal, even if your loan does not close.
You can pay for an additional appraisal for your own use at your own cost.
Customer Copy - Please retain for your records.