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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 INFORMATION

  • Borrower

  • Borrower's Name (include Jr. or Sr. if applicable)
  • Borrower's Email
  • Social Security Number
  • Home Phone (incl. area code)
  • DOB (mm/dd/yyyy)
  • Yrs. School
  • Married (includes registered domestic partners)Unmarried (includes single, divorced, widowed)Separated
  • Dependents (not listed byCo-Borrower)
  • No.
  • Ages

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

  • OwnRent
  • OwnRent
  • Co-Borrower

  • Social Security Number
  • Home Phone (incl. area code)
  • DOB (mm/dd/yyyy)
  • Yrs. School
  • Married (includes registered domestic partners)Unmarried (includes single, divorced, widowed)Separated
  • Dependents (not listed byCo-Borrower)
  • No.
  • Ages
  • OwnRent
  • If residing at present address for less than two years, complete the following:

  • OwnRent
  • OwnRent
  • Borrower
  • Co-Borrower

II.EMPLOYMENT INFORMATION

  • Borrower

  • Self Employed
  • If employed in current position for less than two years or if currently employed in more than one position,complete the following:

  • Self Employed
  • Self Employed
  • Self Employed
  • Self Employed
  • Co-Borrower

  • Self Employed
  • If employed in current position for less than two years or if currently employed in more than one position,complete the following:

  • Self Employed
  • Self Employed
  • Self Employed
  • Self Employed

    MONTHLY INCOME AND COMBINED HOUSING EXPENSE INFORMATION

    Gross Monthly Income BORROWER Co-Borrower Total Combined Monthly Housing Expense Present Purposed
    Base Empl. Income* Rent
    Overtime First Mortgage(P&I)
    Bonuses Other Financing(P&I)
    Commissions Hazard Insaurance
    Dividends/Interest Real Estate Taxes
    Net Rental Income Mortgage Insurance
    Other(before completing,see the notice in describe other income,below) Homeowner Assn.Dues
    Other:
    Total Total

III. ASSETS AND LIABILITIES

This Statement and any applicable supporting 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 by that spouse or other person also.

  • Completed JointlyNot Jointly
    • ASSETS
    • Description
    • Cash or Market Value
    • List checking and savings accounts below

    • IV.DECLARATIONS

        If you answer "Yes" to any questions a through i, please use continuation sheet for explanation. Borrower Co-Borrower
        a. Are there any outstanding judgments against you? YesNo YesNo
        b. Have you been declared bankrupt within the past 7 years? YesNo YesNo
        c. Have you had property foreclosed upon or given title or deed in lieu thereof in the last 7 years? YesNo YesNo
        d. Are you a party to lawsuit? YesNo YesNo
        e. Have you directly or indirectly been obligated on any loan which resulted in foreclosure, transfer of title in lieu of foreclosure, or judgement? YesNo YesNo
        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 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. YesNo YesNo
        g. Are you obligated to pay alimony, child support, or separate maintenance? YesNo YesNo
        h. Is any part of the down payment borrowed? YesNo YesNo
        i. Are you a co-maker or endorser on a note? YesNo YesNo
        j. Are you a U.S citizen? YesNo YesNo
        k. Are you a permanent resident alien? YesNo YesNo
        1. Do you intend to occupy the property as your primary residence?
        If "Yes," complete question m below.
        YesNo YesNo
        m.Have you had an ownership interest in a property in the last three years? YesNo YesNo
        (1)What type of property did you own-principal residence (PR), second home (SH), or investment property (IP)?
        (2)How did you hold title to the home-solely by yourself (S), jointly with your spouse (SP), or jointly with another person (O)?

      V. ACKNOWLEDGEMENT AND AGREEMENT

      Each of the undersigned specifically represents to Lender and to Lenders actual or potential agents, brokers, processors, attorneys, insurers. servicers, successors and assigns and agrees and acknowledges thaw (1) the infomalion provided in this application is true and correct as of the date set forth opposite my signature and that any intentional or negligent mis- representation of this infomation contained in this application may result in civil liability, including monetary damages, to any person who may sutfer any loss due to reliance upon any misrepresentation that I have made on this application, and/or in criminal penalties including, bul 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 tcisl on the propeny 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 frx the purpose of obtaining a ‹esidential 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 ihis application, whether or not the loan is approved; (7) the Lender and its egents, brokers, insurers, servicers, successors and assigns may continuously rely on the infomation contained in ihe application, and I am obligated to amend and/or supplement the infomation 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 il may have relating to such delinquency, report my name and account infomation to one or more consumer credit 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 representa- tion or warranty, express or implied, to me regarding the property or the condition or value of the property; and (11) my transmission of ihis application as an "electronic record" containing my "electronic signature," as those terms are defined in applicable federal and/or state laws (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 purpose through any source, including a source named in this application or a consumer reporting agency.

    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 mongage disclosure laws. 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 satis all requirements to which the lender is subject under applicable state law for the particular pe of loan applied for.)

    • I do not wish to furnish this information
    • Hispanic or LatinoNot Hispanic or Latino
    • American Indian or Alaska NativeAsianBlack or African AmericanNative Hawaiian or Other Pacific IslanderWhite
    • FemaleMale
    • I do not wish to furnish this information
    • Hispanic or LatinoNot Hispanic or Latino
    • American Indian or Alaska NativeAsianBlack or African AmericanNative Hawaiian or Other Pacific IslanderWhite
    • FemaleMale