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 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              V.A.       Conventional Other:
Applied for: FHA   FmHA 		Agency Case #
  		Lender Case #
 
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
 
Legal Description of  Subject Property (attach description if necessary)

 Year Built
Purpose of Loan Purchase Construction Other (explain):
Refinance Construction-Permanent 		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 made to  be made
Cost $
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 #
  		Home Phone (incl. area code)
  		Age
  		Yrs. School
  		Social Security #
  		Home Phone (incl. area code)
  		Age
  		Yrs. School
 
Married
Unmarried (include single  divorced, widowed)
Separated 		Dependents
(not listed by Co- Borrower)
no. |  ages 		Married
Unmarried (include single  divorced, widowed)
Separated 		Dependents
(not listed by Borrower)
no. |  ages
If residing at present address  for less than two years, complete the following:
Previous Address (street, city,  state, ZIP) Own Rent ____No. Yrs.

 
 Previous Address (street, city,  state, ZIP) Own Rent ____No. Yrs.

 
Previous Address (street, city,  state, ZIP) Own Rent ____No. Yrs.

 
 Previous Address (street, city,  state, ZIP) Own Rent ____No. Yrs..

 
Borrower               IV.  EMPLOYMENT INFORMATION               Co-Borrower
Name and  Address of Employer Self  Employed (check above box) Yrs. on this job
 Name and  Address of Employer Self  Employed (check above box) Yrs. on this job
Yrs. employed
in this line of
work/profession 		Yrs. employed
in this line of
work/profession
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 and  Address of Employer Self  Employed (check above box)
 Dates(from-to)
 Name and  Address of Employer Self  Employed (check above box)
Dates(from-to)
Monthly Income
$ 		Monthly Income
$
Position/Title/Type  of Business Business Phone (incl.  area code) Position/Title/Type  of Business Business Phone (incl.  area code)
Name and  Address of Employer Self  Employed (check above box)
Dates(from-to)
 Name and  Address of Employer Self  Employed (check above box)
Dates(from-to)
Monthly Income
$ 		Monthly Income
$
Position/Title/Type  of Business Business Phone (incl. area code) Position/Title/Type  of Business Business Phone (incl. area code)
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