ࡱ> a TjbjbA]A]  +?+?NZBBBB֘ZZZZZCD)3555555,rRa͹NC͹͹aŽZZvŽŽŽ͹HZZ3ŽD@͹3ŽŽR7 wB70hŽh<7ŽZZޓdZZޓUniform Residential Loan Application This application is designed to be completed by the applicant(s) with the Lenders 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  FORMCHECKBOX  the income or assets of a person other than the Borrower (including Borrowers spouse) will be used as a basis for loan qualification or  FORMCHECKBOX  the income or assets of the Borrowers 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 the 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: FORMCHECKBOX  VA  FORMCHECKBOX  FHA FORMCHECKBOX  Conventional  FORMCHECKBOX  FmHA  FORMCHECKBOX  Other: Agency Case NumberLender Case NumberAmount $Interest Rate %No. of MonthsAmortization Type: FORMCHECKBOX  Fixed Rate  FORMCHECKBOX  GPM FORMCHECKBOX  Other (explain)  FORMCHECKBOX  ARM (type)II. PROPERTY INFORMATION AND PURPOSE OF LOANSubject Property Address (street, city, state & zip code)No. of UnitsLegal Description of Subject Property (attach description if necessary)Year BuiltPurpose of Loan FORMCHECKBOX  Purchase  FORMCHECKBOX  Refinance FORMCHECKBOX  Construction  FORMCHECKBOX  Other (explain):  FORMCHECKBOX  Construction-PermanentProperty will be: Primary Secondary  FORMCHECKBOX  Residence  FORMCHECKBOX  Residence  FORMCHECKBOX  InvestmentComplete this line if construction or construction-permanent loan.Year Lot AcquiredOriginal 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 AcquiredOriginal Cost $Amount Existing Liens $Purpose of RefinanceDescribing Improvements  FORMCHECKBOX  made  FORMCHECKBOX  to be made Cost: $Title will be held in what Name(s)Manner in which Title will be heldEstate will be held in:  FORMCHECKBOX  Fee Simple  FORMCHECKBOX  Leasehold (show expiration date)Source of Down Payment, Settlement Charges and/or Subordinate Financing (explain)Borrower III. BORROWER INFORMATION Co-BorrowerBorrowers Name (include Jr. or Sr. if applicable) Co-Borrowers Name (include Jr. or Sr. if applicable)Social Security Number Home Phone (incl. Area code) Age Yrs. School Social Security NumberHome Phone (incl. Area code)AgeYrs. School FORMCHECKBOX  Married  FORMCHECKBOX  Separated FORMCHECKBOX  Unmarried (include single, divorced, widowed)Dependents (not listed by Co-Borrower) FORMCHECKBOX  Married  FORMCHECKBOX  Separated FORMCHECKBOX  Unmarried (include single, divorced, widowed)Dependents (not listed by Borrower)No. Ages No.agesPresent Address (street, city, state, zip code)  FORMCHECKBOX  Own  FORMCHECKBOX  Rent No. Yrs. Present Address (street, city, state, zip code) FORMCHECKBOX  Own  FORMCHECKBOX  Rent No. Yrs.If residing at present address for less than two years, complete the following:Former Address (street, city, state, zip code)  FORMCHECKBOX  Own  FORMCHECKBOX  Rent No. Yrs: Former Address (street, city, state, zip code) FORMCHECKBOX  Own  FORMCHECKBOX  Rent No. Yrs:Former Address (street, city, state, zip code) FORMCHECKBOX  Own  FORMCHECKBOX  Rent No. Yrs:Former Address (street, city, state, zip code) FORMCHECKBOX  Own  FORMCHECKBOX  Rent No. Yrs: Borrower IV. EMPLOYMENT INFORMATION Co-BorrowerName & Address Of Employer  FORMCHECKBOX  Self EmployedYears on this job: Name & Address Of Employer FORMCHECKBOX  Self EmployedYears on This job.Years employed In this line of work/profession Years employed In this line of work/professionPosition/Title/Type of Business Business Phone (incl. area code) Position/Title/Type of BusinessBusiness 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 FORMCHECKBOX  Self EmployedDates (from-to)Name & Address Of Employer FORMCHECKBOX  Self EmployedDates (from-to):Monthly Income $Monthly Income $Position/Title/Type of BusinessBusiness Phone (incl. area code)Position/Title/Type of BusinessBusiness Phone (incl. area code)Name & Address Of Employer FORMCHECKBOX  Self EmployedDates (from-to):Name & Address Of Employer FORMCHECKBOX  Self EmployedDates (from-to)Monthly Income $Monthly Income $Position/Title/Type of BusinessBusiness Phone (incl. area code)Position/Title/Type of BusinessBusiness Phone (incl. area code)V. MONTHLY INCOME AND COMBINED HOUSING EXPENSE INFORMATION Gross Monthly Income Borrower Co-Borrower TotalCombined Monthly Housing Expense Present ProposedBase Empl. Income * $$Rent$OvertimeFirst Mortgage (P & I)$BonusesOther Financing (P & I)CommissionsHazard InsuranceDividends/InterestReal Estate TaxesNet Rental IncomeMortgage InsuranceOther (before completing see the notice in describe other income, below)Homeowner Assn. DuesOther:Total$$Total$$ * Self Employed Borrower(s) may be required to provide additional documentation such as tax returns and financial statements B/C Describe Other Income Notice: Alimony, child support, or separate maintenance income need not be revealed if theMonthly Amount Borrower (B) or Co-Borrower (C) doesnt choose to have it considered for repaying this loan.$$$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  FORMCHECKBOX  Jointly  FORMCHECKBOX  Not JointlyASSETS DescriptionCash or Money Value Liabilities and Pledged Assets. List the creditors 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. Cash deposits toward purchase held by:$LIABILITIESMonthly Payt. & Mos. Left to PayUnpaid BalanceName and address of Company $ Payt./Mos.$List checking and savings accounts belowName and address of Bank, S & L, or Credit Union Acct. no. Name and address of Company $ Payt./Mos.$Acct. no. $Name and address of Bank, S & L, or Credit Union Acct. no. Name and address of Company $ Payt./Mos.$Acct. no. $Name and address of Bank, S & L, or Credit Union Acct. no. Name and address of Company$ Payt./Mos.$Acct. no. $Name and address of Bank, S & L, or Credit UnionAcct. no.Name and address of Company$ Payt./Mos.$Acct. no.$Stocks and Bonds (Company name/number & description)  $ $Acct. no.Name and address of Company$ Payt./Mos.$Life Insurance net cash value Face amount: $$Subtotal Liquid Assets$Real estate owned (enter market value from schedule of real estate owned)$Acct. no. Vested interest in retirement fund$Name and address of Company$ Payt./Mos.$Net worth of business(es) owned (attach financial statement)$ Automobiles owned (make and year)  $Acct. no.Alimony/Child Support/Separate Maintenance Payments Owed to:$ Other Assets (itemize)  $Job Related Expense (childcare, union dues, etc.)$Total Monthly Payments$Total Assets a.$Net Worth (a minus b)$Total Liabilities b.$ Schedule of Real Estate Owned (if additional properties are owned, use continuation sheet.) Insurance,Property Address (enter S if sold, PS if pending sale or R if rental being held for income)Type of PropertyPresent Market ValueAmount of Mortgages & LiensGross Rental IncomeMortgage PaymentsMaintenance, Taxes & Misc.Net Rental Income$$$$$$Totals$$$$$$List any additional names under which credit has previously been received and indicate appropriate creditor name(s) and account number(s):Alternate NameCreditor NameAccount NumberVII. DETAILS OF TRANSACTIONVIII. DECLARATIONSa. Purchase price$b. Alterations, improvements, repairsIf you answer Yes to any questions a through i, please use continuation sheet for explanation.BorrowerCo-Borrowerc. Land (if acquired separately)Yes NoYes Nod. Refinance (incl. debts to be paid off)a. Are there any outstanding judgements against you? FORMCHECKBOX   FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX e. Estimated prepaid itemsb. Have you been declared bankrupt within the past 7 years? FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX f. Estimated closing costs c. Have you had property foreclosed upon or given title or deed in lieu thereof in the last 7 years? FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX g. PMI, MIP, Funding Fee paid in cashd. Are you a party to a lawsuit? FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX h. Discount (if Borrower will pay)e. Have you directly or indirectly been obligated on any loan which resulted in foreclosure, transfer of title in lieu of foreclosure, or judgement? (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 VAi. Total costs (add items a through h)j. Subordinate financingk. Borrowers closing costs paid by Seller case number, if any, and reasons for the action.) FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  l. Other Credits (explain)  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. FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX g. Are you obligated to pay alimony, child support, or separate maintenance?  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX h. Is any part of the down payment borrowed? FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX i. Are you a co-maker or endorser on a note? FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX j. Are you a U.S. citizen? Are you a permanent resident alien? FORMCHECKBOX   FORMCHECKBOX  FORMCHECKBOX   FORMCHECKBOX  FORMCHECKBOX   FORMCHECKBOX  FORMCHECKBOX   FORMCHECKBOX m. Loan amount/ (excluded PMI, MIP, Funding Fee financed)l. Do you intend to occupy the property as your primary residence? If Yes, complete question m below. FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  m. Have you had an ownership interest in a property in the last three years? FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX  FORMCHECKBOX n. PMI, MIP, Funding Fee financedo. Loan amount/ (1) What type of property did you ownprincipal residence (PR), second home (SH), or investment property (IP)? (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 / 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 indicated above; (5) verification or reverification of any information contained in the application may be made at any time by the Lender, its 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 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, its 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 successors or assign of the Lender without notice to me and/or the administrator of the loan account may be transferred to an agent, successor or assign of the Lender with prior notice to me; (9) the Lender, its agents,, successors and assigns make no representations or warranties, express or implied, to the Borrower(s) regarding the property, the condition of the property, or the value of the property. Right to Receive Copy of Appraisal. I/WE have the right to a copy of the appraisal report used in connection with this application for credit. To obtain a copy, I/WE must send Lender a written request at the mailing address Lender has provided. Lender must here from me/us no later than 90 days after Lender notifies me/us about the action taken on this application, or I/We withdraw this application. 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, its agent, successors or 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. Borrowers Signature X Date Co-Borrowers Signature X DateX. INFORMATION FOR GOVERNMENT MONITORING PURPOSESThe following information is requested by the Federal Government for certain types of loans related to a dwelling, in order to monitor the Lenders 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 neither 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 on 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 disclosures satisfy all requirements to which the Lender is subject under applicable state law for the particular type of loan applied for.) BORROWER FORMCHECKBOX  I do not wish to furnish this informationCO-BORROWER FORMCHECKBOX  I do not wish to furnish this informationRace/National Origin: FORMCHECKBOX   FORMCHECKBOX American Indian Or Alaskan Native Black, not of Hispanic origin FORMCHECKBOX   FORMCHECKBOX Asian or Pacific Islander Hispanic  FORMCHECKBOX   White, not of Hispanic originRace/National Origin: FORMCHECKBOX   FORMCHECKBOX American Indian Or Alaskan Native Black, not of Hispanic origin FORMCHECKBOX   FORMCHECKBOX Asian or Pacific Islander Hispanic FORMCHECKBOX White, not of Hispanic origin FORMCHECKBOX  Other (specify) FORMCHECKBOX  Other (specify)Sex: FORMCHECKBOX  Female FORMCHECKBOX  MaleSex: FORMCHECKBOX  Female FORMCHECKBOX  MaleTo be Completed by Interviewer Interviewers Name (print or type)Name and Address of Interviewers EmployerThis application was taken by:  FORMCHECKBOX  face-to-face interview  FORMCHECKBOX  by mail  FORMCHECKBOX  by telephoneInterviewers Signature DateInterviewers 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. 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