back to instructions PAGE 1 of 4 on to page 2 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 V.A. Conventional Other: Applied for: FHA FmHA Agency Case #   Lender Case #   Amount $ Interest Rate           % No. of Months   Amortization Fixed Rate Other (explain): Type: 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): Refinance Construction-Permanent Property will be: 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 Liens $ Purpose of Refinance   Describe Improvements made to be made Cost $ 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 #   Home Phone (incl. area code)   Age   Yrs. School   Social Security #   Home Phone (incl. area code)   Age   Yrs. School   Married Unmarried (include single divorced, widowed) Separated Dependents (not listed by Co- Borrower) no. ages Married Unmarried (include single divorced, widowed) Separated Dependents (not listed by Borrower) no. ages If residing at present address for less than two years, complete the following: Previous Address (street, city, state, ZIP) Own Rent ____No. Yrs.   Previous Address (street, city, state, ZIP) Own Rent ____No. Yrs.   Previous Address (street, city, state, ZIP) Own Rent ____No. Yrs.   Previous Address (street, city, state, ZIP) Own Rent ____No. Yrs..   Borrower              IV. EMPLOYMENT INFORMATION              Co-Borrower Name and Address of Employer Self Employed (check above box) Yrs. on this job Name and Address of Employer Self Employed (check above box) 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 and Address of Employer Self Employed (check above box) Dates(from-to) Name and Address of Employer Self Employed (check above box) 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 and Address of Employer Self Employed (check above box) Dates(from-to) Name and Address of Employer Self Employed (check above box) 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) back to instructions PAGE 1 of 4 on to page 2