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 income or assets of the Borrower's spouse or other person who has community property rights pursuant to state law will not be used as a basis for loan qualification, but his or her liabilities must be considered because the spouse or other person has community property rights pursuant to applicable law and 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.

If this is an application for joint credit, Borrower and Co-Borrower each agree that we intend to apply for joint credit (sign below):

Borrower Co-Borrower

I. TYPE OF MORTGAGE AND TERMS OF LOAN

Mortgage Applied for:

VA
FHA

Conventional
USDA/Rural Housing Service

Other (explain):

Agency Case Number

Lender Case Number

Amount
$

Interest Rate
%

No. of Months

Amortization Type:

Fixed Rate
GPM

Other (explain):
ARM (type):

II. PROPERTY INFORMATION AND PURPOSE OF LOAN

Subject Property Address (street, city, state, & ZIP)

No. of Units

Legal Description of Subject Property (attach description if necessary)

Year Built

Purpose of Loan:

Purchase
Refinance

Construction
Construction-Permanent

Other (explain):

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 $		made to be made

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)
Social Security Number	Home Phone incl.area code)	DOB (mm/dd/yyyy)	Yrs. School
Married (includes registered domestic partners) Unmarried (includes single, divorced, widowed) Separated		Dependents (not listed by Co-Borrower) No. ------------------------------------------- Ages
Present Address (street, city, state, ZIP) Own Rent No. Yrs.
Mailing Address, if different from Present Address
If residing at present address for less than two years, complete the following:
Former Address (street, city, state, ZIP) Own Rent No. Yrs.
Former Address (street, city, state, ZIP) Own Rent No. Yrs.
Email

Co-Borrower's Name (include Jr. or Sr. if applicable)
Social Security Number	Home Phone incl.area code)	DOB (mm/dd/yyyy)	Yrs. School
Married (includes registered domestic partners) Unmarried (includes single, divorced, widowed) Separated		Dependents (not listed by Co-Borrower) No. ------------------------------------------- Ages
Present Address (street, city, state, ZIP) Own Rent No. Yrs.
Mailing Address, if different from Present Address

Former Address (street, city, state, ZIP) Own Rent No. Yrs.
Former Address (street, city, state, ZIP) Own Rent No. Yrs.

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