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 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 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 Applied For:
 
Agency Case Number  
 Lender Case Number   
Amount
  $
 Interest Rate
%
 No. of Months
 Amortization  Type:
II. PROPERTY INFORMATION AND PURPOSE OF LOAN
Subject Property Address (street, city, state & zip code)
No. of Units
Legal Description of Subject Property (attach description if necessary)
 Year Built
Purpose of Loan
 Property Will Be:
Primary Residence
Secondary 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
   Purpose of Refinance
  Describe Improvements
   $    $  Cost: $  
Title will be held in what Name(s)  
 Manner in which Title will be held  Estate Will Be Held In:
 
Fee Simple
Leasehold (show expiration date)
Source of Down Payment, Settlement Charges and/or Subordinate Financing (explain)
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)   
Social Security Number
Home Phone (incl. area code)
Age
Yrs. School
 Social Security Number
Home Phone (incl. area code)
Age
Yrs. School
Married
Seperated
Dependents
Unmarried (include single, divorced, widowed)
 No
ages  
Married
Seperated
Dependents
Unmarried (include single, divorced, widowed)
 No
ages  
Present Address (street, city, state, zip code)
No. Yrs:
 Present Address (street, city, state, zip code)
No. Yrs:
If residing at present address for less than two years, complete the following:
Former Address (street, city, state, zip code)
No. Yrs:
 Former Address (street, city, state, zip code)
No. Yrs:
Former Address (street, city, state, zip code)
 No. Yrs:
 Former Address (street, city, state, zip code)
No. Yrs:
Borrower IV.EMPLOYMENT INFORMATION Co-Borrower
Name & Address of Employer
Years employed in  this line of work/ profession    
Self Employed
Years on this job:  
 Name & Address of Employer
 Years employed in  this line of work/  profession:   
Self mployed
Years on this job:  
Position/Title/Type of Business
 Business Phone (incl. area code)
   
Position/Title/Type of Business
 Business Phone (incl. 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
  Dates  (from - to):
to
Self Employed
  Monthly Income  
 $   
 Name & Address of Employer
  Dates (from - to):  
to
Self Employed
 Monthly Income  
 $   
Position/Title/Type of Business
 Business Phone (incl. area code)
   
Position/Title/Type of Business
 Business Phone (incl. area code)
   
   
Name & Address of Employer
  Dates(from - to):
to
Self Employed
 Monthly Income  
 $   
   
Name & Address of Employer
  Dates  (from - to):
to
Self Employed
 Monthly Income  
$  
Position/Title/Type of Business
Business Phone (incl. area code)
   
Position/Title/Type of Business
 Business Phone (incl. area code)
   
V. MONTHLY INCOME AND COMBINED EXPENSE INFORMATION
  Gross Monthly Income Borrower Co-Borrower Total Combined Monthly
Housing Expense		 Present Proposed
  Self Empl. Income    $
 Rent
 $
 
  Overtime
 First Mortgage (P & I)
  Bonuses
 Other Financing(P & I)
  Commissions
 Hazard Insurance
  Dividends/Interest
 Real Estate Taxes
  Net Rental Income
 Mortgage Insurance
Other (before completing, see the notice in describe other incomebelow)
 Homeowner Assn. Dues
 Other:
  Total
 $
 Total
 $
* Self Employed Borrower(s) may be required to provide additional documentation such as tax returns and financial statements.
B/C
 Describe Other Income Notice: Alimony, child support, or separate maintenance income need not be revealed if the Borrower (B) or Co- Borrower (C) doesn’t choose to have it considered for repaying this loan.
Monthly Amount
 $  
 $  
 $  
VI. ASSETS AND LIABILITIES
This Statement and any applicable supporting schedule may be completed jointly by both married and unmarried Co-Borrowers if their assets and liabilities are sufficiently joined so that the Statement can be meaningfully and fairly presented on a combined basis; otherwise separate Statements and Schedules are required. If the Co-Borrower section was completed about a spouse, this Statement and supporting schedules must be completed about that spouse also.
Completed   Jointly Not Jointly
Assets Description
 Cash or Market Value
 Cash deposit toward purchase held by:
  $ 
 
 List checking and savings accounts below
 Name and address of Bank, S & L, or Credit Union
 Acct. no.  $
Name and address of Bank, S & L, or Credit Union
 Acct. no.  $
Name and address of Bank, S & L, or Credit Union
 Acct. no.  $
Name and address of Bank, S & L, or Credit Union
 Acct. no.  $
Stock & Bonds (Company name /number& description)  $
Life Insurance net cash value Face amount: $  $
 Subtotal Liquid Assets
$
Real estate owned (enter market value
from schedule of real estated owned)		  $
Vested interest in retirement fund  $
Net worth of business(es) owned
(attach financial statement)		  $
Automobiles owned (make and year)  $
Other Assets (itemize)  $
Total Assets a.  
 $
Liabilities and Pledged Assets. List the creditor’s name, address and account number for all outstanding debts, including automobile loans, revolving charge accounts, real estate loans, alimony, child support, stock pledges, etc. Use continuation sheet, if necessary. Indicate by (*) those liabilities which will be satisfied upon sale of real estate1 owned or upon refinancing of the subject property.
Monthly Payt. &
Mos. Left to Pay		   Unpaid
Balance
LIABILITIES
 Name and address of Company
 $ Payt./Mos. 
/ 		 $
 Acct. no.      
 Name and address of Company
  $ Payt./Mos.
  / 		 $
 Acct. no.      
 Name and address of Company
  $ Payt./Mos.
/
 $
 Acct. no.      
 Name and address of Company
 $ Payt./Mos.  
/ 		 $
 Acct. no.      
 Name and address of Company  
 $ Payt./Mos.  
/ 		 $
 Acct. no.      
 Name and address of Company
 $ Payt./Mos.  
/ 		 $
 Acct. no.      
 Name and address of Company
 $ Payt./Mos.  
/ 		 $
 Acct. no.      
Alimony/Child Suppport/Separate Maintenance Payments Owed to  $
 Job Related Expense (child care, union dues, etc.)  $
 Total Monthly Payments  $
   
Net Worth                      (a minus b) 
  $
Total Liabilities b.
$
Schedule of Real Estate Owned (if additional properties are owned, use continuation sheet.)
Property Address (enter S if sold, PS if pending sale
or is it rental being held for income)		 Type of
Property		 Present
Market Value		 Amount of
Mortgage & Liens		 Gross
Rental Income		 Mortgage
Payments		 Insurance,
Maint.,
Taxes & Misc.		 Net
Rental Income
 
  $
     $
   $
    $
   $
    $