First Name Middle Last Name Social Security Number
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 Agency case number
(VA and FHA)		 Lender case number

If you chose 'Other', specify:
Loan Amount Interest rate No. of months Amortization type
$ % mos.
If 'other', explain:
If ARM, type:

 

II - PROPERTY DESCRIPTION AND PURPOSE OF LOAN
Subject Property Address City State Zip (+4) No. of Units
-
Legal Description of Subject Property Year Built
Purpose of Loan Property will be
explain other:
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
Cost $
Title will be held in what name(s) Manner in which
title will be held		 Estate will be held in:

Leasehold expiration date
MM/DD/YYYY
Source of Down Payment, Settlement Charges, and/or Subordinate Financing (explain)
Down Pmt Amount: $
Down Pmt Amount: $
Down Pmt Amount: $
- or -