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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 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.

 

I. TYPE OF MORTGAGE AND TERMS OF LOAN
Mortgage Applied for: VA Conventional Other: Agency Case Number Lender Case No.
FHA FmHA

Amount Interest Rate No. of Months Amortization Type: Fixed Rate Other (explain):
$

%

GPM ARM (type):

II. PROPERTY INFORMATION AND PURPOSE OF LOAN
Subject Property Address (street, city, state, & ZIP) No. of Units
Legal Description of Subject Property (attach description if necessary) Year Built
Purpose of Loan Purchase Construction Other (explain): Property will be:
Refinance
Construction Permanent
Primary
Residence
Secondary Residence
Investment
 
Complete this line if construction or construction-permanent loan.
Year Lot Acquired Original cost Amount Existing Liens (a) Present Value of Lot (b) Cost of Improvements Total (a + b)  
$ $ $ $ $  
Complete this line if this is a refinance loan.
Year Acquired Original Cost Amount Existing Loans 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  
Source of Down Payment, Settlement Charges and/or Subordinate Financing (explain) Leasehold (show expiration date)

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)
Social Security Number Home Phone (incl. area code) Age Yrs. School Social Security Number Home Phone (incl. area code) Age Yrs. School
Married Unmarried (include single, divorced, widowed Dependents (not listed by Co-Borrower Married Unmarried (include single, divorced, widowed Dependents (not listed by Co-Borrower
Separated no. ages Separated no. ages
Present Address (street, city, state, ZIP) Own Rent
No. Yrs.		 Present Address (street, city, state, ZIP) Own Rent No. Yrs.
If residing at present address for less than two years, complete the following:
Former Address (street, city, state, ZIP) Own Rent
No. Yrs.		 Former Address (street, city, state, ZIP) Own Rent No. Yrs.
Former Address (street, city, state, ZIP) Own Rent
No. Yrs.		 Former Address (street, city, state, ZIP) Own Rent No. Yrs.

Borrower                              IV. EMPLOYMENT INFORMATION                              Co-Borrower
Name & Address of Employer Self Employed Yrs. on this job Name & Address of Employer Self Employed Yrs. on this job
Yrs. employed in this line of work/profession

 Yrs. employed in this line of work/profession
Position/Title/Type of Business Business Phone (incl. area code) 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 & Address of Employer Self Employed Dates (from-to) Name & Address of Employer Self Employed Dates (from-to)
Monthly Income Monthly Income

$

$

Position/Title/Type of Business Business Phone (incl. area code) Position/Title/Type of Business Business Phone (incl. area code)

Name & Address of Employer Self Employed Dates (from-to) Name & Address of Employer Self Employed Dates (from-to)
Monthly Income Monthly Income

$

$

Position/Title/Type of Business Business Phone (incl. area code) 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
House Expense		 Present Proposed
Base Empl. Income $ $ $ Rent $  
Overtime

First Mortgage (P&I)

$
Bonuses

Other Financing (P&I)

Commissions

Hazard Insurance

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 $ $
*Self Employed Borrower(s) may be required to provide additional documentation such as tax returns and financial statements.

Describe Other Income Notice: Alimony, child support, or separate maintenance income need not be revealed if the

B/C

Borrower (B) or Co-Borrower (C) does not to 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 spouse, this Statement and supporting schedules must be completed about that spouse also.
Completed Jointly Not Jointly
Description

ASSETS

Cash or Market Value

 Liabilities and Pledged Assets. List the creditor's name,
Cash Deposit toward purchase held by:

$ Liabilities Monthly Payt. & Mos. Left to Pay Unpaid Balance
List checking and savings accounts below Name and address of Company $ Payt./Mos.  $
Name and address of Bank, S&L, or Credit Union

Acct. no.
Acct no.

$

Name and address of Company $ Payt./Mos.  $
Name and address of Bank, S&L, or Credit Union

Acct. no.
Acct no.

$

Name and address of Company $ Payt./Mos.  $
Name and address of Bank, S&L, or Credit Union

Acct. no.
Acct no.

$

Name and address of Company $ Payt./Mos.  $
Name and address of Bank, S&L, or Credit Union

Acct. no.
Acct no.

$

Name and address of Company $ Payt./Mos.  $
Stocks & Bonds (Company name/number & description) $

Life Insurance net cash value
face amount: $		 $ Acct. no.
Name and address of Company $ Payt./Mos.  $
Subtotal Liquid Assets $

Real estate owned (enter market value from schedule of real estate owned) $
Acct. no.
Vested interest in retirement fund $ Name and address of Company $ Payt./Mos.  $
Net worth of business(es) owned (attach financial statement) $

Automobiles owned (make and year) $ Acct. no.
$ Alimony/Child Support/Separate Maintenance Payments Owed to:
 		$  
$
Other Assets (itemize) $
$ Job Related Expense (child care, union dues, etc.,) $
$
$
$ Total Monthly Payments
Total Assets a. $   $ Total Liabilities b. $

VI. ASSETS AND LIABILITIES (cont.)
Schedule of Real Estate Owned (if additional properties are owned, use continuation sheet.)
Property Address (enter S if sold, PS if pending sale or R if rental being held for income)

V

 Type of Property Present Market Value Amount of
Mortgage & Liens		 Gross Rental Income Mortgage Payments Insurance, Maintenance, Taxes & Misc. Net Rental Income
$ $ $ $ $ $
Totals $ $ $ $ $ $
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 VIII. DECLARATIONS
a. Purchase Price

$

If you answer "yes" to any questions a through i, please use continuation sheet for explanation.

Borrower

Co-Borrower
b. Alterations, improvements, repairs Yes No Yes No
c. Land (if acquired separately) a. Are there any outstanding judgments against you?

d. Refinance (incl. debts to be paid off) b. Have you been declared bankrupt in the past 7 years?

e. Estimated prepaid items c. Have you had property foreclosed upon or given title or deed in lieu thereof in the last 7 years?

f. Estimated Closing Costs d. Are you a party to a lawsuit?

g. PMI, MIP, Funding Fee 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," provide details, including date, name and address of Lender, FHA or VA case number, if any, and reasons for the action .)

h. Discount (if Borrower will pay) 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.

i. Total Costs (add items a through h) g. Are you obligated to pay alimony, child support, or separate maintenance?

j. Subordinate financing h. Is any part of the down payment borrowed?

k. Borrower's closing costs paid by seller i. Are you a co-maker or endorser on a note?

l. Other Credits (explain) 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?

m. Loan Amount (exclude PMI, MIP, Funding Fee financed) (1) What type of property did you own-principal residence (PR), second home (SH), or investment property (IP)?

n. PMI, MIP, Funding Fee financed
o. Loan amount (add m&n) (2) How did you hold title to the home-solely by yourself (S), jointly with your spouse (SP), or jointly with another person (O)?
p. Cash from/to Borrower (subtract j,k,l & o from i)

IX. ACKNOWLEDGEMENT AND AGREEMENT
The undersigned specifically acknowledge(s) and agree(s) that: (1) The loan requested by this application will be secured by a first mortgage or deed of trust on the property described herein; (2) the property will not be used for any illegal or prohibited purpose or use; (3) all statements made in this application are made for the purpose of obtaining the loan indicated herein; (4) occupation of the property will be as indicated above; (5) verification or reverification of any information contained in the application may be made at any time by the Lender, it's agents, successors and assigns, either directly or through a credit reporting agency, from any source named in this application, and the original copy of this application will be retained by the Lender, even if the loan is not approved; (6) the Lender, its agents, successors and assigns will rely on the information contained in the application and I/we have a continuing obligation to amend and/or supplement the information provided in this application if any of the material facts which I/we have represented herein should change prior to closing; (7) in the event my/our payments on the loan indicated in this application become delinquent, the Lender, it's agents, successors and assigns, may, in addition to all their other rights and remedies, report my/our name(s) and account information to a credit reporting agency; (8) ownership of the loan may be transferred to successor or assign of the lender without notice to me and/or the administration of the loan account may be transferred to an agent, successor or assign of the lender with prior notice to me; (9) the Lender, it's agents, successors and assigns make no representations or warranties, expressed or implied, to the Borrower(s) regarding the property, the condition of the property, or the value of the property.
Certification; I/we certify that the information provided in this application is true and correct as of the date set forth opposite my/our signature(s) on this application and acknowledge my/our understanding that any intentional or negligent misrepresentation(s) of the information contained in this application may result in civil liability and/or criminal penalties including, but not limited to, fine or imprisonment or both under the provisions of title 18, United States Code, Section 1001, et seq. and liability for monetary damages to the lender, it's agents, successors and assigns, insurers and any other person who may suffer any loss due to reliance upon any misrepresentation which I/we have made on this application.
 
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 laws. You are not required to furnish this information, but are encouraged to do so. The law provides that a lender may either discriminate on the basis of this information, nor on whether you choose to furnish it. However, if you choose not to furnish it, under Federal regulations this Lender is required to note race and sex on the basis of visual observation or surname. If you do not wish to furnish the above information, please check the box below. (Lender must review the above material to assure that the disclosure satisfy all requirements to which the Lender is subject under applicable state law for the particular type of loan applied for.)
BORROWER CO-BORROWER
Race/National Origin: I do not wish to furnish this information Race/National Origin: I do not wish to furnish this information
American Indian or Alaskan Native Asian or Pacific Islander White, not of Hispanic Origin   American Indian or Alaskan Native Asian or Pacific Islander White, not of Hispanic Origin  
Black, not of Hispanic origin Hispanic     Black, not of Hispanic origin Hispanic    
Other (specify)

Other (specify)

Sex: Female Male     Sex: Female Male    
To be completed by interviewer Interviewer's Name (print or type) Name and Address of Interviewer's Employer
This application was taken by:

face-to-face interview Interviewer's Signature Date
by mail
by telephone Interviewer's Phone Number (incl. area code)

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 Agency Case Number
Co-Borrower Lender Case Number

 

 

 

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