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:



(explain):    
Agency Case Number:
Lender Case Number:
Amount:
Interest Rate:
No. of Months:
Amortization Type:

(explain):
(type):
II. Property Information and Purpose of Loan

Subject Property Address

Street:
City:
State:
ZIP:
Number of Units:
Legal Description of Subject Property:
Year Built:
Purpose of Loan:



(explain):
Property will be:

Year Lot Acquired:
Original Cost:
Amount of Existing Liens:
(a) Present Value of Lot:
(b) Cost of Improvements:
Total (a + b):
Year Acquired:
Original Cost:
Amount of 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:
(show expiration date:)
Source of Down Payment, Settlement Changes, and/or Subordinate Financing (explain)
III. Borrower Information

Borrower

Borrower's Name (include Jr. or Sr. if applicable):
Social Security Number:
Home Phone (incl. area code):
DOB (mm/dd/yyyy):
Yrs School:
Marital Status:

Dependents (not listed by Co-Borrower):
Number:
Ages:
Present Address:
City:
State:
ZIP:
 
Number of Years:
Mailing Address (if different from Present Address):
City:
State:
ZIP:
If residing at present address for less than two years, complete the following:
Address:
City:
State:
ZIP:
 
Number of Years:

Co-Borrower

Co-Borrower's Name (include Jr. or Sr. if applicable):
Social Security Number:
Home Phone (incl. area code):
DOB (mm/dd/yyyy):
Yrs School:
Marital Status:

Dependents (not listed by Borrower):
Number:
Ages:
Present Address:
City:
State:
ZIP:
 
Number of Years:
Mailing Address (if different from Present Address):
City:
State:
ZIP:
If residing at present address for less than two years, complete the following:
Address:
City:
State:
ZIP:
 
Number of Years:
IV. Employment Information

Borrower

 
Name of Employer:
Employer's Address:
City:
State:
ZIP:
Yrs on this job:
Yrs employed in this line of work/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 than one position, complete the following:
 
Name of Employer:
Employer's Address:
City:
State:
ZIP:
Dates (from - to): -
Monthly Income:
Position/Title/Type of Business:
Business Phone (incl. area code):
 
Name of Employer:
Employer's Address:
City:
State:
ZIP:
Dates (from - to): -
Monthly Income:
Position/Title/Type of Business:
Business Phone (incl. area code):

Co-Borrower

 
Name of Employer:
Employer's Address:
City:
State:
ZIP:
Yrs on this job:
Yrs employed in this line of work/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 than one position, complete the following:
 
Name of Employer:
Employer's Address:
City:
State:
ZIP:
Dates (from - to): -
Monthly Income:
Position/Title/Type of Business:
Business Phone (incl. area code):
 
Name of Employer:
Employer's Address:
City:
State:
ZIP:
Dates (from - to): -
Monthly Income:
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
Base Empl. Income*
Overtime
Bonuses
Commissions
Dividends/Interest
Net Rental Income
Other (before completing, see the notice in "describe other income," below )
Total

Combined Monthly Housing Expense Present Proposed
Rent
First Mortgage (P&I)
Other Financing (P&I)
Hazard Insurance
Real Estate Taxes
Mortgage Insurance
Homeowner Assn. Dues
Other:
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) does not choose to have it considered for repaying this loan. Monthly Amount
VI. Assets and Liabilities

This Statement and any applicable supporting schedules 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 non-applicant spouse or other person, this Statement and supporting schedules must be completed about that spouse or other person also.

Completed:      

Assets

Cash deposit toward purchase held by:
Cash or Market Value

List checking and savings accounts below


Name of Bank, S&L or Credit Union
Bank Address
City
State
Zip
Account Number
Cash or Market Value

Name of Bank, S&L or Credit Union
Bank Address
City
State
Zip
Account Number
Cash or Market Value

Name of Bank, S&L or Credit Union
Bank Address
City
State
Zip
Account Number
Cash or Market Value

Name of Bank, S&L or Credit Union
Bank Address
City
State
Zip
Account Number
Cash or Market Value

Stocks & 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 estate 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

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 estate owned or upon refinancing of the subject property.

Name of Company
Company Address
City
State
Zip
Monthly Payment
Months Left to Pay
Unpaid Balance

Name of Company
Company Address
City
State
Zip
Monthly Payment
Months Left to Pay
Unpaid Balance

Name of Company
Company Address
City
State
Zip
Monthly Payment
Months Left to Pay
Unpaid Balance

Name of Company
Company Address
City
State
Zip
Monthly Payment
Months Left to Pay
Unpaid Balance

Name of Company
Company Address
City
State
Zip
Monthly Payment
Months Left to Pay
Unpaid Balance

Name of Company
Company Address
City
State
Zip
Monthly Payment
Months Left to Pay
Unpaid Balance

Name of Company
Company Address
City
State
Zip
Monthly Payment
Months Left to Pay
Unpaid Balance

Alimony/Child Support/Separate Maintenance Payments Owed to:
Amount:

Job-Related Expense (child care, union dues, etc.)
Amount:

Total Monthly Payments

Total Liabilities b.

Net Worth (a minus b)

Schedule of Real Estate Owned (If additional properties are owned, use continuation sheet.)

Property Address (select S if sold, PS if pending sale or R if rental being held for income)
City
State
Zip
Type of Property
Present Market Value
Amount of Mortgages & Liens
Gross Rental Income
Mortgage Payments
Insurance, Maintenance, Taxes & Misc.
Net Rental Income

Property Address (select S if sold, PS if pending sale or R if rental being held for income)
City
State
Zip
Type of Property
Present Market Value
Amount of Mortgages & Liens
Gross Rental Income
Mortgage Payments
Insurance, Maintenance, Taxes & Misc.
Net Rental Income

Property Address (select S if sold, PS if pending sale or R if rental being held for income)
City
State
Zip
Type of Property
Present Market Value
Amount of Mortgages & Liens
Gross Rental Income
Mortgage Payments
Insurance, Maintenance, Taxes & Misc.
Net Rental Income

Totals
Total Present Market Value
Total Amount of Mortgages & Liens
Total Gross Rental Income
Total Mortgage Payments
Total Insurance, Maintenance, Taxes & Misc.
Total Net Rental Income

List any additional names under which credit has previously been received and indicate appropriate creditor name(s) and account number(s):

Alternate Name Creditor Name Account Number
VII. Details of Transaction
a. Purchase Price
b. Alterations, improvements, repairs
c. Land (if acquired separately)
d. Refinance (incl. debts to be paid off
Estimated prepaid items
Estimated closing costs
PMI, MIP, Funding Fee
Discount (if Borrower will pay)
i. Total costs (add items a through h)
j. Subordinate financing
k. Borrower's closing costs paid by Seller
l. Other Credits (explain  
m. Loan amount (exclude PMI, MIP, Funding Fee financed)
n. PMI, MIP, Funding Fee financed
o. Loan amount (add m & n)
p. Cash from/to Borrower (subtract j, k, l & o from i)
VIII. Declarations

Borrower

a. Are there any outstanding judgments against you?
b. Have you been declared bankrupt within the past 7 years?
c. Have you had property foreclosed upon or given title or deed in lieu thereof in the last 7 years?
d. Are you a party to a lawsuit?
e. Have you directly or indirectly been obligated on any loan which resulted in foreclosure, transfer of title in lieu of foreclosure, or judgment? (This would include such loans as home mortgage loans, SBA loans, home improvement loans, educational loans, manufactured (mobile) home loans, any mortgage, financial obligation, bond, or loan guarantee. If "Yes," Are you presently delinquent or in default on any Federal debt or any other loan, mortgage, financial obligation, bond, or loan guarantee? If "Yes," provide details, including date, name, and address of Lender, FHA or VA case number, if any, and reasons for the action.)
f. Are you presently delinquent or in default on any Federal debt or any other loan, mortgage, financial obligation, bond, or loan guarantee? If "Yes," give details as described in the preceding question.
g. Are you obligated to pay alimony, child support, or separate maintenance?
h. Is any part of the down payment borrowed?
i. Are you a co-maker or endorser on a note?
j. Are you a U.S. citizen?
k. Are you a permanent resident alien?
l. Do you intend to occupy the property as your primary residence? If "Yes," complete question m below.
m. Have you had an ownership interest in a property in the last three years?
(1) What type of property did you own - - principal residence (PR), second home (SH), or investment property (IP)?
How did you hold title to the home - solely by yourself (S), jointly with your spouse (SP), or jointly with another person (O)?

Co-Borrower

a. Are there any outstanding judgments against you?
b. Have you been declared bankrupt within the past 7 years?
c. Have you had property foreclosed upon or given title or deed in lieu thereof in the last 7 years?
d. Are you a party to a lawsuit?
e. Have you directly or indirectly been obligated on any loan which resulted in foreclosure, transfer of title in lieu of foreclosure, or judgment? (This would include such loans as home mortgage loans, SBA loans, home improvement loans, educational loans, manufactured (mobile) home loans, any mortgage, financial obligation, bond, or loan guarantee. If "Yes," Are you presently delinquent or in default on any Federal debt or any other loan, mortgage, financial obligation, bond, or loan guarantee? If "Yes," provide details, including date, name, and address of Lender, FHA or VA case number, if any, and reasons for the action.)
f. Are you presently delinquent or in default on any Federal debt or any other loan, mortgage, financial obligation, bond, or loan guarantee? If "Yes," give details as described in the preceding question.
g. Are you obligated to pay alimony, child support, or separate maintenance?
h. Is any part of the down payment borrowed?
i. Are you a co-maker or endorser on a note?
j. Are you a U.S. citizen?
k. Are you a permanent resident alien?
l. Do you intend to occupy the property as your primary residence? If "Yes," complete question m below.
m. Have you had an ownership interest in a property in the last three years?
(1) What type of property did you own - - principal residence (PR), second home (SH), or investment property (IP)?
How did you hold title to the home - solely by yourself (S), jointly with your spouse (SP), or jointly with another person (O)?
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 that: (1) the information provided in this application is true and correct as of the date set forth opposite my signature and that any intentional or negligent misrepresentation of this information contained in this application may result in civil liability, including monetary damages, to any person who may suffer any loss due to reliance upon any misrepresentation that I have made on this application, and/or in criminal penalties including, but not limited to, fine or imprisonment or both under the provisions of Title 18, United States Code, Sec. 1001, et seq.; (2) the loan requested pursuant to this application (the "Loan" ) will be secured by a mortgage or deed of trust on the property described in this application; (3) the property will not be used for any illegal or prohibited purpose or use; (4) all statements made in this application are made for the purpose of obtaining a residential mortgage loan; (5) the property will be occupied as indicated in this application; (6) the Lender, its servicers, successors or assigns may retain the original and/or an electronic record of this application, whether or not the Loan is approved; (7) the Lender and its agents, brokers, insurers, servicers, successors, and assigns may continuously rely on the information contained in the application, and I am obligated to amend and/or supplement the information provided in this application if any of the material facts that I have represented herein should change prior to closing of the Loan; (8) in the event that my payments on the Loan become delinquent, the Lender, its servicers, successors or assigns may, in addition to any other rights and remedies that it may have relating to such delinquency, report my name and account information to one or more consumer reporting agencies; (9) ownership of the Loan and/or administration of the Loan account may be transferred with such notice as may be required by law; (10) neither Lender nor its agents, brokers, insurers, servicers, successors or assigns has made any representation or warranty, express or implied, to me regarding the property or the condition or value of the property; and (11) my transmission of this application as an "electronic record" containing my "electronic signature," as those terms are defined in applicable federal and/or state law s (excluding audio and video recordings), or my facsimile transmission of this application containing a facsimile of my signature, shall be as effective, enforceable and valid as if a paper version of this application were delivered containing my original written signature.

Acknowledgement. Each of the undersigned hereby acknowledges that any owner of the Loan, its servicers, successors and assigns, may verify or reverify any information contained in this application or obtain any information or data relating to the Loan, for any legitimate business purpose through any source, including a source named in this application or a consumer reporting agency.

Borrower's Signature Date
Co-Borrower's Signature Date
X. INFORMATION FOR GOVERNMENT MONITORING PURPOSES

The following information is requested by the Federal Government for certain types of loans related to a dwelling in order to monitor the lender's compliance with equal credit opportunity, fair housing and home mortgage disclosure law s. You are not required to furnish this information, but are encouraged to do so. The law provides that a lender may not discriminate either on the basis of this information, or on whether you choose to furnish it. If you furnish the information, please provide both ethnicity and race. For race, you may check more than one designation. If you do not furnish ethnicity, race, or sex, under Federal regulations, this lender is required to note the information on the basis of visual observation and surname if you have made this application in person. If you do not wish to furnish the information, please check the box below. (Lender must review the above material to assure that the disclosures satisfy all requirements to which the lender is subject under applicable state law for the particular type of loan applied for.)

Borrower

I do not wish to furnish this information.

Ethnicity:    
Race:



Sex:    

Co-Borrower

I do not wish to furnish this information.

Ethnicity:    
Race:



Sex:    
Continuation Sheet/Residential Loan Application

Use this continuation sheet if you need more space to complete the Residential Loan Application. Mark B for Borrower or C for Co-Borrower

Borrower
Co-Borrower
Agency Case Number
Lender Case Number

I/We fully understand that it is a Federal crime punishable by fine or imprisonment, or both, to knowingly make any false statements concerning any of the above facts as applicable under the provisions of Title 18, United States Code, Section 1001, et seq.

Borrower's Signature Date
Co-Borrower's Signature Date