Uniform Residential Loan Application



Property Information and Purpose of Loan

Subject Property Address (city, state, zip)

Purpose of Loan

Property will be


Borrower Information

Borrower's Name (include Jr. or Sr. if applicable)


Social Security Number


Home Phone (incl. area code)

E-mail address


Date of Birth


Yrs. School


Spouse


Number and Ages of Dependants (not listed by Borrower)
  

Present Address (street, city, state, zip)


Own / Rent


Number of Years


If residing at present address for less than two years, complete the following:

Former Address (street, city, state, zip)


Own / Rent


Number of Years


Borrower Employment Information

Name and Address of Employer


Self Employed


Years on this job


Years employed in this line of work / profession


Position / Title / Type of Business


Business Phone (incl. area code)

If employed for less that 2 years at current job, please include previouse employment below

Name and Address of Employer


Self Employed


Years on this job


Years employed in this line of work / profession


Position / Title / Type of Business


Business Phone (incl. area code)


Co-Borrower Information

Co-Borrower's Name (include Jr. or Sr. if applicable)


Social Security Number


Home Phone (incl. area code)


Date of Birth


Yrs. School


Spouse


Number and Ages of Dependants (not listed by Co-Borrower)
  

Present Address (street, city, state, zip)


Own / Rent


Number of Years


If residing at present address for less than two years, complete the following:

Former Address (street, city, state, zip)


Own / Rent


Number of Years


Co-Borrower Employment Information

Name and Address of Employer


Self Employed


Years on this job


Years employed in this line of work / profession


Position / Title / Type of Business


Business Phone (incl. area code)


Assets

List checking and savings accounts below

Name and address of bank or Credit Union


Account Number


Amount in Account



Name and address of bank or Credit Union


Account Number


Amount in Account


Name and address of bank or Credit Union


Account Number


Amount in Account


Name and address of bank or Credit Union


Account Number


Amount in Account


Stocks and Bonds (Company name / number / description)


Amount in Account



Life insurance net cash value



Subtotal of 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



Automobiles owned (make,model & year)
Value

Value

Value



Other assests


Households


Total Assets


Liabilities

Name of Company, payment, unpaid balance

Name of Company, payment, unpaid balance

Name of Company, payment, unpaid balance

Credit Score (if known)


Schedule of Real Estate Owned
Property Address

Type of property

Present market value

Amount of mortgages and liens

Gross rental income

Mortgage payment

Insurance, maintenance, taxes and Misc

Net rental income


Schedule of Real Estate Owned
Property Address

Type of property

Present market value

Amount of mortgages and liens

Gross rental income

Mortgage payment

Insurance, maintenance, taxes and Misc

Net rental income


Schedule of Real Estate Owned
Property Address

Type of property

Present market value

Amount of mortgages and liens

Gross rental income

Mortgage payment

Insurance, maintenance, taxes and Misc

Net rental income


Declarations

If you answer "yes" to any questions a through i, please explain at bottom of questions.

a. Are there any outstanding judgements against you?
Borrower
Co-Borrower

b. Have you been declared bankrupt within the last 7 years?
Borrower Co-Borrower

c. Have you had property foreclosed upon or given title or deed in lieu thereof in the past 7 years?
Borrower Co-Borrower

d. Are you a party to a lawsuit?
Borrower Co-Borrower

e. Have you directly or indirectly been obligated on any loan which resulted in foreclosure, transfer of title in lieu of foreclosure, or judgement? (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", provide details, including date, name and address of lender, FHA or VA case number, if any, and reason for the action.)
Borrower Co-Borrower

f. Are you presently delinguent or in default on any federal debt or any other loan, mortgage, financial obligation bond, or loan guarantee? If "Yes", give details as descibed in the proceding question.
Borrower Co-Borrower

g. Are you obligated to pay obligated to pay alimony, child support, or separate maintenance?
Borrower Co-Borrower

h. Is any part of the down payment borrowed?
Borrower Co-Borrower

i. Are you a co-maker or endorser on a note?
Borrower Co-Borrower

j. Are you a U.S. citizen?
Borrower Co-Borrower

k. Are you a permanent resident alien?
Borrower Co-Borrower

l. Do you intend to occupy the property as your primary residence? If "Yes", complete question below.
Borrower Co-Borrower

m. Have you had an ownership interest in a property in the last three years?
Borrower Co-Borrower

   1. What type of property did you own?

   2. How did you hold title to the home?

If you answered "Yes" to any of the above, explain here.

 

    


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