Uniform Residential Loan Application

Instructions
Fill out the form completely, then click "Submit" at the end of the application form. After your application has been submitted, you will be asked for payment information to proceed with the application process.

This application is designed to be completed by the applicant(s). Co-Borrower information must also be provided.

Your Email Address:

Who referred you to our web site?:
I. Type of Mortgage and Terms of Loan
Loan Amount: $ Interest Rate:
Term of Loan: Type of Loan:
Amortization Type:

II. Property Information and Purpose of Loan
Street Address:
City: State: Zipcode:
Purpose of Loan:
If purchasing, enter purchase price of home:
If this is a refinance loan, complete the following:
Purpose of Refinance:
Year acquired: Original Cost:
Manner in Which Title Will be Held:

III. Borrower Information

Borrower
First Name:    
Last Name:    
Social Security No.:
Home Phone:
Birth Date (mm/dd/yy):  
Yrs. of Schooling:
Present Address:
Street Address:
City:
State: Zip:
Own / Rent

Co-Borrower
First Name:   
Last Name:   
Social Security No.:
Home Phone:
Birth Date (mm/dd/yy):   
Yrs. of Schooling:
Present Address:
Street Address:
City:
State: Zip:
Own / Rent

If residing at present address for less than 2 years, complete the following:
Previous Address:
Street Address:
City:
State: Zip:
Number of Years at this address:
Own / Rent 		Previous Address:
Street Address:
City:
State: Zip:
Number of Years at this address:
Own / Rent

IV. Employment Information
Borrower

Name of Employer:
Street Address:
City:
State: Zip:
Position/Title/Type of Bus:
Years on this job:
Years in current profession:
Business Phone:
Self-employed: Yes No

Co-Borrower

Name of Employer:
Street Address:
City:
State: Zip:
Position/Title/Type of Bus:
Years on this job:
Years in current profession:
Business Phone:
Self-employed: Yes No
If employed in current position for less than two years, complete below:
Name of Employer:
Street Address:
City:
State: Zip:
Position/Title/Type of Bus:
Business Phone:
Monthly Income: $
From - To:
Self-employed: Yes No 		Name of Employer:
Street Address:
City:
State: Zip:
Position/Title/Type of Bus:
Business Phone:
Monthly Income: $
From - To:
Self-employed: Yes No
Name of Employer:
Street Address:
City:
State: Zip:
Position/Title/Type of Bus:
Business Phone:
Monthly Income: $
From - To:
Self-employed: Yes No 		Name of Employer:
Street Address:
City:
State: Zip:
Position/Title/Type of Bus:
Business Phone:
Monthly Income: $
From - To:
Self-employed: Yes No

V. Monthly Income & Combined Housing Expense Information
Gross Monthly Income
Borrower
Co-Borrower
Base Employment Monthly Income*:
Monthly Overtime Pay:
Monthly Bonuses:
Monthly Commissions:
Monthly Dividends/Interest:
Net Rental Income per Month:
See Schedule of Real Estate Owned
Other:
Please describe other income, if any:
Notice: Alimony, child support or separate maintenance income need not be revealed if the Borrower or Co-Borrower doesn't choose to have it considered for repaying this loan.
For
Description
*Self Employed Borrowers(s) may be required to provide additional documentation such as tax returns and financial statements.
Combined Monthly Expenses (Housing)
Present
Proposed
Monthly Rent (if you are currently renting):
 
Current monthly mortgage:
 
Other Financing (ie. 2nd mortgage or home equity line):
Monthly Hazard Insurance:
Monthly Real Estate Taxes:
Monthly Mortgage Insurance (if applicable):
Monthly Homeowner Association Dues:
Other Monthly Expenses:

VI. Assets and Liabilities
Assets
Checking/Savings Accounts
Name of Bank/S&L/Credit Union:

Account Type:
Account No.:
Balance: $ 		Name of Bank/S&L/Credit Union:

Account Type:
Account No.:
Balance: $
Name of Bank/S&L/Credit Union:

Account Type:
Account No.:
Balance: $
401K or Retirement Accounts
Name of Financial Institution:
Account Type (401K, IRA, etc):
Account No.:   Amount: $
Stocks and Bonds:
Company name/number & description: Amount ($)
Other Assets: $
Automobiles:
Year & Make Value ($)

Liabilities
Creditor Name:
Account Number:
Monthly payment: $ Months left to pay: Balance: $
Creditor Name:
Account Number:
Monthly payment: $ Months left to pay: Balance: $
Creditor Name:
Account Number:
Monthly payment: $ Months left to pay: Balance: $
Creditor Name:
Account Number:
Monthly payment: $ Months left to pay: Balance: $

Schedule of Real Estate Owned
(Enter total for all properties not including subject property)

Property 1
Property 2
Property 3
Address
Type of Property
Market Value $ $ $
Amount of Mortgages & Liens $ $ $
Gross Rental Income $ $ $
Mortgage Payments $ $ $
Insurance, Tax, Maint. & Misc. $ $ $

VII. Declarations

Items Borrower Co-Borrower
a. Are there any outstanding judgements against you?
Yes
No
Yes
No
b. Have you declared bankruptcy within the last 7 years?
Yes
No
Yes
No
c. Have you had property foreclosed upon in the last 7 years?
Yes
No
Yes
No
d. Are you a party to a lawsuit?
Yes
No
Yes
No
e. Have you directly or indirectly been obligated on any loan which resulted in foreclosure, transfer of title in lieu of foreclosure, or judgment?
Yes
No
Yes
No
f. Are you presently delinquent or in default on any Federal debt or any other loan, mortgage, financial obligation, bond or loan guarantee?
Yes
No
Yes
No
g. Are you obligated to pay alimony child support or separate maintenance?
Yes
No
Yes
No
h. Is any part of the down payment borrowed?
Yes
No
Yes
No
i. Are you the co-maker or endorser on a note?
Yes
No
Yes
No
j. Are you a U.S. citizen?
Yes
No
Yes
No
k. Are you a permanent resident alien?
Yes
No
Yes
No
l. Do you intend to occupy the property as your primary residence?
Yes
No
Yes
No
m. Have you had an ownership interest in a property in the last 3 years?
Yes
No
Yes
No

If the answer to m above is "yes":
1. What type of property did you own?
2. How did you hold title to the home?