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 a "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.

Please complete this form as best as possible.
 

I. TYPE OF MORTGAGE AND TERMS OF LOAN
  Mortgage Applied For V.A. Conventional Other:
FHA FmHA  
Amount
$
Years
Amortization Type Fixed Rate Other (explain)
GPM ARM (type):
Give a summary of why you are applying for this loan, and what the borrowed moneys will be used for.
email address
 

II. PROPERTY INFORMATION AND PURPOSE OF LOAN
Subject Property Address (street, city, state, zip)
 No. of Units Year Built
 
Property will be
Primary Residence Secondary Residence Investment
Purpose of Loan Purchase Construction Other:
Refinance Construction-Permanent  
Complete this line if construction or construction-permanent loan.
Year Lot Acquired
Original Cost

$
Existing Liens

$
(a) Value of Lot

$
(b) Cost of improvements

$
Total (a + b)

$
Complete this line if this is a refinance loan.
Year Acquired
Original Cost

$
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 Sample  Leasehold
If Leasehold, expires  
Source of Down Payment, Settlement Charges and/or Subordinate Financing

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)
Home Phone Age Years of School Social Security #
Home Phone Age Years of School Social Security #
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
Present Address
(street, city, state, ZIP)
rent
own
years
Present Address
(street, city, state, ZIP)
rent
own
years

If residing at the present address for less than 2 years, complete the following:
Former Address
(street, city, state, ZIP)
rent
own
years
Former  Address
(street, city, state, ZIP)
rent
own
years
Former Address
(street, city, state, ZIP)
rent
own
years
Former Address
(street, city, state, ZIP)
rent
own
years

Borrower

 IV. EMPLOYMENT INFORMATION

Co-Borrower
Name & Address of Employer
Self Employed
years on the job
Years employed in this Profession
Position/Title/Type of Business Business Phone
(incl. area code)
Name & Address of Employer
Self Employed
years on the job
Years employed in this Profession
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 that one position, complete the following:
Name & Address of Employer
Self Employed
years on the job
Years employed in this Profession
Position/Title/Type of Business Business Phone
(incl. area code)
Name & Address of Employer
Self Employed
years on the job
Years employed in this Profession
Position/Title/Type of Business Business Phone
(incl. area code)
Name & Address of Employer
Self Employed
years on the job
Years employed in this Profession
Position/Title/Type of Business Business Phone
(incl. area code)
Name & Address of Employer
Self Employed
years on the job
Years employed in this Profession
Position/Title/Type of Business Business Phone
(incl. area code)

V. MONTHLY INCOME AND COMBINED HOUSING EXPENSE INFORMATION
Gross Monthly Income Borrower Co-Borrower Total Combined Monthly Housing Expense Present Proposed
Base Empl. Income *
(take hourly wage multiply it by regular pay hours per week).
$
$
$
Rent
$
$
Overtime
$
$
$
First Mortgage (P&I)
$
$
Bonuses
$
$
$
Other Financing (P&I)
$
$
Commissions
$
$
$
Hazard Insurance
$
$
Dividends/Interest
$
$
$
Real Estate Taxes