Uniform Residential Loan Application

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Uniform Residential Loan Application I. TYPE OF MORTGAGE AND TERMS OF LOAN Mortgage Applied for: Amortization Type: II. PROPERTY INFORMATION AND PURPOSE OF LOAN Complete this line if construction or construction-permanent loan. Complete this line if this is a refinance loan. Borrower III. BORROWER INFORMATION Co-Borrower (not listed by Co-Borrower) (not listed by Borrower) no. ages no. ages If residing at present address for less than two years, complete the following: Borrower IV. EMPLOYMENT INFORMATION Co-Borrower If employed in current position for less than two years or if currently employed in more than one position, complete the following:

Notice 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 nonapplicant spouse or other person, this Statement and supporting schedules must be completed about that spouse or other person also. Liabilities and Pledged Assets. List the creditor s name, address and account number for all outstanding debts, including automobile loans, revolving charge accounts, real estate loans, alimony, child support, stock pledges, etc. Use continuation sheet, if necessary. Indicate by (*) those liabilities which will be satisfied upon sale of real estate owned or upon refinancing of the subject property. List checking and savings accounts below

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: Co-Borrower: Agency Case Number: Lender Case Number: IV. EMPLOYMENT INFORMATION I / We fully understand that it is a federal crime punishable by fine or imprisonment, or both, to knowingly make any false statements concerning any of the above facts as applicable under the provisions of Title 18, United States Code, Section 1001, et seq. Borrower s Signature Date Borrower s Signature: Date

Continuation Sheet /Residential Loan Application Use this continuation sheet if you Borrower: need more space to complete the Residential Loan Application. Mark B for Borrower or C for Co- Co-Borrower: Borrower Agency Case Number: Lender Case Number: Borrower III. BORROWER INFORMATION Co-Borrower Former Address (street, city, state, zip code) Own Rent No. Yrs. Former Address (street, city, state, zip code) Own Rent No. Yrs. I/We fully understand that it is a Federal crime punishable by fine or imprisonment, or both, to knowingly make any false statements concerning any of the above facts as applicable under the provisions of Title 18, United States Code, Section 1001, et seq. Borrower s Signature Date Co-Borrower s Signature Date

Use this continuation sheet if you need more space to complete the Residential Loan Application. Mark B for Borrower or C for Co-Borrower. Continuation Sheet/Residential Loan Application Borrower: Co-Borrower: Agency Case Number: Lender Case Number: I/We fully understand that it is a Federal crime punishable by fine or imprisonment, or both, to knowingly make any false statements concerning any of the above facts as applicable under the provisions of Title 18, United States Code, Section 1001, et seq. Borrower s Signature Date Co-Borrower s Signature Date