Uniform Residential Loan Application

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.

I. TYPE OF MORTGAGE AND TERMS OF LOAN

Mortgage type: VA Conventional Other

Applied for: FHA USDA/Rural Housing Service Agency Case Number Lender Case Number

Amount Interest Rate No. of Months Amortization Type: Fixed Rate Other GPM ARM

II. PROPERTY INFORMATION AND PURPOSE OF LOAN

Subject Property Address No. of Units

Legal Description of Subject Property Year Built

Purpose of Loan Purchase Construction Other Property will be: Primary Residence Secondary Residence Investment

Complete this line if construction or construction-permanent loan.

Year Acquired Original Cost Amount Existing Liens Present Value of Lot Cost of Improvements Total

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

Title will be held in what Name(s) Manner in which Title will be held Estate will be held in: Fee Simple Leasehold

Source of Down Payment, Settlement Charges, and/or Subordinate Financing

III. BORROWER INFORMATION

IV. EMPLOYMENT INFORMATION

V. MONTHLY INCOME AND COMBINED HOUSING EXPENSE INFORMATION

Gross Monthly Income: Base Empl. Income Co-Borrower Total

Other Income

Combined Monthly Housing Expense: Present Rent Proposed Rent

VI. ASSETS AND LIABILITIES

Cash deposit toward purchase held by Amount

List checking and savings accounts below

Stocks & Bonds Life Insurance net cash value Face amount

Real estate owned Vested interest in retirement fund Net worth of business(es) owned

Automobiles owned Other Assets

Alimony/Child Support/Separate Maintenance Payments Owed To Job-Related Expense

VI. ASSETS AND LIABILITIES (cont’d) - Schedule of Real Estate Owned

Property Address

Type of Property Present Market Value Amount of Mortgages & Liens

VII. DETAILS OF TRANSACTION

Purchase price Alterations, improvements, repairs

Land (if acquired separately) Refinance Estimated closing costs

PMI, MIP, Funding Fee Discount Loan amount

VIII. DECLARATIONS

If you answer “Yes” to any questions a through i, please use continuation sheet for explanation.

IX. ACKNOWLEDGEMENT AND AGREEMENT

Each of the undersigned specifically represents to Lender and to Lender’s actual or potential agents, brokers, processors, attorneys, insurers, servicers, successors and assigns and agrees and acknowledges the terms of this application.

X. INFORMATION FOR GOVERNMENT MONITORING PURPOSES

Borrower

Ethnicity: Hispanic or Latino Not Hispanic or Latino I do not wish to furnish this information

Race: American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White

Sex: Female Male

Co-Borrower

Ethnicity: Hispanic or Latino Not Hispanic or Latino I do not wish to furnish this information

Race: American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White

Sex: Female Male

Interviewer Information

This application was taken by:

Face-to-face interview Mail Telephone Internet

Continuation Sheet / Residential Loan Application

Use this continuation sheet if Borrower or Co-Borrower needs more space to complete the application.