Completing this application will only take a short time. However, before completing, print and use our check list to collect all your personal documents that you will need in order to complete this application. We also suggest that you print and complete this application by hand for your records and ease of data entry when you are ready to submit the application on line.

Uniform Residential Loan Application

This application is designed to be completed by the applicant(s) with the lender's 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) whenthe income or assets of a person other than the "Borrower" (including the Borrower's spouse) will be used as a basis for loan qualification or  the income or assets of the Borrower's spouse will not be used as a basis for loan qualification, but his or her liabilities must be considered because the Borrower resides in a community property state, the security property is location 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.

I. TYPE OF MORTGAGE AND TERMS OF LOAN

Mortgage Applied For:
If Other, explain:
Amount:
Interest Rate:
No. of Months:
Amortization Type:
If Other or ARM, explain:

II. PROPERTY INFORMATION AND PURPOSE OF LOAN
Subject Property Address
Street:
City:
State:Zip:
County:
No. of Units:Year Built:
Lot: Block:
Purpose of Loan
If Other, explain:
Property will be:
Complete if construction or construction-permanent loan
Year Lot Acquired:
Original Cost $:
Amount Existing Liens $:
(a) Present Value of Lot $:
(b) Cost of Improvements $:
Total (a + b) $:
Complete if this is a refinance loan
Year Acquired:
Original Cost $:
Amount Existing Liens $:
Purpose of Refinance:
Describe Improvements:
Cost of Improvements $:
Title will be held in what Name(s):
Manner in which Title will be held:
Estate will be held in:
If Leasehold, enter expiration date:
Source of Down Payment, Settlement Charges
and/or Subordinate Financing (explain):

III. BORROWER INFORMATION
Borrower:
Name (include Jr. or Sr.):
Social Security Number:
Home Phone incl. area code:
Age: Yrs. School:
Status:
No.of Dependents (not listed by Co-Borrower):
Ages of Dependents:
Co-Borrower:
Name (include Jr. or Sr.):
Social Security Number:
Home Phone incl. area code:
Age: Yrs. School:
Status:
No.of Dependents (not listed by Borrower):
Ages of Dependents:
Present Address (street, city, state, zip):
No. of Years:
 Present Address (street, city, state, zip):
No. of Years:
If residing at present address for less than 2 years, complete the following:
Former Address (street, city, state, zip):
No. of Years:
 
Former Address (street, city, state, zip):
No. of Years:
If residing at present address for less than 2 years, complete the following:
Former Address (street, city, state, zip):
No. of Years:
 
Former Address (street, city, state, zip):
No. of Years:

IV. EMPLOYMENT INFORMATION
Borrower:
Name and Address of Employer:
Self Employed:Yrs. on this Job:
Yrs. employed in this line of work:
Position/Title/Type of Business: Phone:
Co-Borrower:
Name and Address of Employer:
Self Employed:Yrs. on this Job:
Yrs. employed in this line of work:
Position/Title/Type of Business: Phone:
If employed in current position for less than 2 years or currently employed in more than one position, completed the following:
Name and Address of Employer:
Self Employed:Dates from - to:
Monthly Income $:
Position/Title/Type of Business: Phone:
 
Name and Address of Employer:
Self Employed:Dates from - to:
Monthly Income $:
Position/Title/Type of Business: Phone:
 If employed in current position for less than 2 years or currently employed in more than one position, completed the following:
Name and Address of Employer:
Self Employed:Dates from - to:
Monthly Income $:
Position/Title/Type of Business: Phone:
 
Name and Address of Employer:
Self Employed:Dates from - to:
Monthly Income $:
Position/Title/Type of Business: Phone:

V. MONTHLY INCOME AND COMBINED HOUSING EXPENSE INFORMATION
Gross Monthly Income

Borrower

Co-Borrower
Base Empl. Income $*
Overtime $
Bonuses $
Commissions $
Dividends/Interest $
Net Rental Income $
Other $ **
* Self Employed Borrower(s) may be required to provide additional documentation such as tax returns and financial statements.
 
** Other Income: Alimony, child support, or separate maintenance income need not be revealed if the Borrower (B) or Co-Borrower (C) does not choose to have it considered for repaying this loan.
Describe Other Income
B/C Detail Other Income Monthly Amount
Combined Monthly Housing Expense

Present

Proposed
Rent $ XXXXXXXXXXXXX
First Mortgage (P&I) $
Other Financing (P&I) $
Hazard Insurance $
Real Estate Taxes $
Mortgage Insurance $
Homeowner Assn. Dues $
Other $
Total $

VI. ASSETS
Assets and Liabilities below are being completed
Cash deposit toward the purchase of subject home is being held by:
In the amount of $:
List checking and savings accounts below
 
Name and address of Bank, S&L, or Credit Union
Account No.: Current Cash or Market Value $:
 
Name and address of Bank, S&L, or Credit Union
Account No.: Current Cash or Market Value $:
 
Name and address of Bank, S&L, or Credit Union
Account No.: Current Cash or Market Value $:
 
Name and address of Bank, S&L, or Credit Union
Account No.: Current Cash or Market Value $:
Stocks & Bonds
Company Name/Number and description
Current Cash or Market Value $:
Life Insurance
Face Amount $:
Real Estate Owned
Enter Market Value $:
Adresses
Status
Type of
Property
Present
Market Value
Amount of
Mortgages &
Liens
Gross
Rental
Income
Mortgage
Payments
Insurance,
Maintenance,
Taxes & Misc.
Net
Rental
Income
Vested Interest in Retirement Fund
Value $:
Net worth of business(es) owned
(financial statement will be required)
Value $:
Automobiles Owned
Make and Year
Current Cash or Market Value $:
Other Assets
Describe and Itemize
Current Cash or Market Value $:

VI. LIABILITIES
Outstanding Debt
Include automobile loans, revolving charge accounts, real estate loans, alimony, child support, stock pledges, etc.
Name and address of Company
Account No.
Monthly Payment $:
Months left to pay:
Unpaid Balance:
This debt will be paid off upon sale of real estate or refinance of subject prioperty.
Outstanding Debt
Include automobile loans, revolving charge accounts, real estate loans, alimony, child support, stock pledges, etc.
Name and address of Company
Account No.
Monthly Payment $:
Months left to pay:
Unpaid Balance:
This debt will be paid off upon sale of real estate or refinance of subject prioperty.
Outstanding Debt
Include automobile loans, revolving charge accounts, real estate loans, alimony, child support, stock pledges, etc.
Name and address of Company
Account No.
Monthly Payment $:
Months left to pay:
Unpaid Balance:
This debt will be paid off upon sale of real estate or refinance of subject prioperty.
Outstanding Debt
Include automobile loans, revolving charge accounts, real estate loans, alimony, child support, stock pledges, etc.
Name and address of Company
Account No.
Monthly Payment $:
Months left to pay:
Unpaid Balance:
This debt will be paid off upon sale of real estate or refinance of subject prioperty.
Outstanding Debt
Include automobile loans, revolving charge accounts, real estate loans, alimony, child support, stock pledges, etc.
Name and address of Company
Account No.
Monthly Payment $:
Months left to pay:
Unpaid Balance:
This debt will be paid off upon sale of real estate or refinance of subject prioperty.
Outstanding Debt
Include automobile loans, revolving charge accounts, real estate loans, alimony, child support, stock pledges, etc.
Name and address of Company
Account No.
Monthly Payment $:
Months left to pay:
Unpaid Balance:
This debt will be paid off upon sale of real estate or refinance of subject prioperty.
Outstanding Debt
Include automobile loans, revolving charge accounts, real estate loans, alimony, child support, stock pledges, etc.
Name and address of Company
Account No.
Monthly Payment $:
Months left to pay:
Unpaid Balance:
This debt will be paid off upon sale of real estate or refinance of subject prioperty.
Outstanding Debt
Include automobile loans, revolving charge accounts, real estate loans, alimony, child support, stock pledges, etc.
Name and address of Company
Account No.
Monthly Payment $:
Months left to pay:
Unpaid Balance:
This debt will be paid off upon sale of real estate or refinance of subject prioperty.
Alimony/Child Support/Separate Maintenance Payments Owed to:
In the amount of $:
 Job Related Expense (child care, union dues, etc.) $:
List any additional names under which credit has previously been received and indicate appropriate creditor name(s) and account number(s):
Alternate Name
Creditor Name
Account Number
List any additional names under which credit has previously been received and indicate appropriate creditor name(s) and account number(s):
Alternate Name
Creditor Name
Account Number

VII. DETAILS OF TRANSACTION
a. Purchase Price
b. Alterations, improvements, repairs
c. Land (if acquired separately)
d. Refinance (incl. debts to be paid off)
e. Estimated prepaid items to be determined
f. Estimated closing costs to be determined
g. PMI, MIP, Funding Fee to be determined
h. Discount (if Borrower will pay) to be determined
i. Total costs (add items a through h) to be determined
j. Subordinate financing
k. Borrower's closing costs paid by Seller
l. Other Credits (explain below)
m. Loan amount (exclude PMI, MIP, Funding Fee financed) to be determined
n. PMI, MIP, Funding Fee financed to be determined
o. Loan Amount (add m & n) to be determined
p. Cash from/to Borrower (subtract j, k, l & o from i)

VIII. DECLARATIONS
If you answer "yes" to any questions a through i, please explain in explanation box.
Borrower Co-Borrower
a. Are there any outstanding judgments against you?
b. Have you been declared bankrupt within the past 7 years?
c. Have you had property foreclosed upon or given title or deed in lieu thereof in the last 7 years?
d. Are you a party to a lawsuit?
e. Have you directly or indirectly been obligated on any loan which resulted in foreclosure, transfer of title in lieu of foreclosure, or judgment? (This would include such loans as home mortgage loans, SBA loans, home improvement loans, educational loans, manufactured (mobile) home loans, any mortgage, financial obligation, bond, or loan guarantee. If "Yes", provide details below, including date, name and address of Lender, FHA or VA case number, if any, and reasons for the action.)
f. Are you presently delinquent or in default on any Federal debt or any other loan, mortgage, financial obligation, bond, or loan guarantee? If "Yes", give details below as described in the preceding question.
g. Are you obligated to pay alimony, child support, or separate maintenance?
h. Is any part of the down payment borrowed?
i. Are you a co-maker or endorser on a note?
j. Are you a U.S. citizen?
k. Are you a permanent resident alien?
l. Do you intend to occupy the property as your primary residence? If "Yes", complete question m below.
m. Have you had ownership interest in a property in the last three years?
(1) What type of property did you own - principal residence (PR), second home (SH), or investment property (IP)?
(2) How did you hold title to the home - solely by yourself (S), jointly with your spouse (SP), or jointly with another person (O)?
Explanations: if you answered "yes" to any questions a through i, please explain below:

ADDITIONAL INFORMATION
Please provide any additional information or continued information from this application below:

X. INFORMATION FOR GOVERNMENT MONITORING PURPOSES
Borrower
Race/National Origin:
If Other, explain:
Sex:
Co-Borrower
Race/National Origin:
If Other, explain:
Sex: