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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) when the 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 imcome or assets of the Borrower's spouse will not be used as a basis for loan qulification, but his or her liabilities must be considered because the borrower resides in a community property state, the security 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.
I. TYPE OF MORTGAGE AND TERMS OF LOAN
Mortgage VA Conventional Other:   Agency Case Number   Lender Case Number
Applied for: FHA USDA/Rural              
Amount   Interest Rate   No. of Months   Amortization   Fixed Rate   Other (explain):   
  $   %      Type:   GPM   ARM (type):   
II. PROPERTY INFORMATION AND PURPOSE OF LOAN
Subject Property address (street, city, state, ZIP)   No. of units
Street: City: State: Zip:   
Legal Description of Subject Property (attach description if necessary)   Year Built
  
   		  
Purpose of Loan Purchase Construction Other (explain):    Property will be:   Primary:   Secondary:
  Refi- CashOut Construction-Permanent Refi- Rate/Term     Residence: Residence Investment
Complete this line 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 this line if this is a refinance loan
Year Acquired   Original Cost   Amount Existing Liens   (a) Purpose of Refinance   (b) Describe Improvements made
to be
made
     $   $      
  Cost: $ 		   
Title will be held in what Name(s)   Manner in which Title will be held   Estate will be held in:
          Fee Simple
Source of Down Payment, Settlement Changes and/or Subordinate Financing (explain)   Leasehold (show
  
   		          expiration date)
  
Borrower                       III. BORROWER INFORMATION                       Co-Borrower
Borrower's Name (include Jr. or Sr. if applicable)   Co-Borrower's Name (include Jr. or Sr. if applicable)
  First:  Middle:  Last:  j/s:   First:  Middle:  Last:  j/s:
Social Security Number   Home Phone (include area code) DOB(mm/dd/yy)    Yrs.Sch
        
  Social Security Number   Home Phone (include area code) DOB(mm/dd/yy)   Yrs.Sch
        
Married Unmarried (include single, Dependents (not listed by Co-Borrower) Married Unmarried (include single, Dependents (not listed by Borrower)
Separated divorced, widowed) no:   Ages:   Separated divorced, widowed) no:   Ages:  
Present Address (steet, city, state, ZIP) Own Rent No.Yrs. Present Address (steet, city, state, ZIP) Own Rent No.Yrs.
  Street:
  City:   State:   Zip: 		  Street:
  City:   State:   Zip:
Mailing Address if different from Present Address Mailing Address if different from Present Address
  Street:
  City:   State:   Zip: 		  Street:
  City:   State:   Zip:
If residing at present address for less than two years, complete the following:
former Address (steet, city, state, ZIP) Own Rent No.Yrs. former Address (steet, city, state, ZIP) Own Rent No.Yrs.

  Street:

  City:   State:   Zip:
  Street:
  City:   State:   Zip:
Borrower                       IV.EMPLOYMENT INFORMATION                       Co-Borrower
Name & Address of Employer Self Employed   Mths/Yrs. on this job Name & Address of Employer Self Employed   Mths/Yrs. on this job
     /     /
   Name:      
   Street:      
   City:        
  State:   Zip:
  Yrs. employed
   in this line of
   work/profession

   		   Name:      
   Street:      
   City:        
  State:   Zip:
  Yrs. employed
   in this line of
   work/profession

  
Position/Title/Type of Business   Business Phone(include area code)
     
  Position/Title/Type of Business   Business Phone(include area code)
     
If employed in current position for less than two years or if currently employed in more than one position, complete the following:
Name & Address of Employer Self Employed   Date (from - to) Name & Address of Employer Self Employed   Date (from - to)
   Name:      
   Street:      
   City:        
  State:   Zip:
   From:    To:     		   Name:      
   Street:      
   City:        
  State:   Zip:
   From:    To:    
    Monthly Income
  $ 		    Monthly Income
  $
Position/Title/Type of Business   Business Phone(include area code)
     
  Position/Title/Type of Business   Business Phone(include area code)
     
Name & Address of Employer Self Employed   Dates(from-to) Name & Address of Employer Self Employed   Dates(from-to)
   Name:      
   Street:      
   City, State, Zip:
   From:    To:    
   Name:      
   Street:      
   City, State, Zip:
   From:    To:    
    Monthly Income
  $ 		    Monthly Income
  $
Position/Title/Type of Business   Business Phone(include area code)
     
  Position/Title/Type of Business   Business Phone(include area code)
     
Borrower's Signature:
X 		  Date
 
Borrower's Signature:
X 		  Date