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Uniform Residential Loan Application

Borrower Information

Borrower
Name

Social Security Number
 -  -
Home Phone
(  - 
Date of Birth
   
Years of School

Present Address - Street

City
 State
 
 Zip
 
Own Rent Number of Years

Number of dependents Ages
Marital Status
Married
Unmarried
Separated
Co-Borrower
Name

Social Security Number
 -  -
Home Phone
(  - 
Date of Birth
   
Years of School

Present Address - Street

City
 State
 
 Zip
 
Own Rent Number of Years

Number of dependents Ages
Marital Status
Married
Unmarried
Separated
If residing at the present address for less than 2 years, please complete the following.
Former Address - Street

City
 State
 
 Zip
 
Own Rent Number of Years

Former Address - Street

City
 State
 
 Zip
 
Own Rent Number of Years


Property Information
Type of loan:
Refinance Purchase
Property Address

City
 State
 
 Zip
 
Occupancy Status:
Primary Residence
Secondary Residence
Investment Property

Sales Price $
Down Payment / Equity $
Appraised Value $
Mortgage Information
Note Information:
Loan Amount $
Note Rate $
Term (in months) $
Due (in months) $
Monthly Payment $

Employment Information
Borrower
Name & Address of Employer

Self - Employed
Years on this job

Years employed in this line of work/profession

Position/Title/Type of Business

Business Phone

Co-Borrower
Name & Address of Employer

Self - Employed
Years on this job

Years employed in this line of work/profession

Position/Title/Type of Business

Business Phone

If employed in current position for less than two years or if currently employed in more than one position, complete the following section.
Name & Address of Employer

Self - Employed
Dates (From-To)

Monthly Income

Position/Title/Type of Business

Business Phone

Name & Address of Employer

Self - Employed
Dates (From-To)

Monthly Income

Position/Title/Type of Business

Business Phone

Monthly Income and Combined Housing Expense Information
Gross Montly Income Borrower Co-Borrower Total
Base Empl. Income* $ $ $
Overtime $ $ $
Bonuses $ $ $
Commissions $ $ $
Dividends/Interest $ $ $
Net Rental Income $ $ $
Other (before completing, see the notice in "describe other income" below) $ $ $
$ $ $
Total $ $ $
Combined Monthly Housing Expense
Present Proposed
Rent $ N/A
First Mortgage (P&I) $ $
Other Financing (P&I) $ $
Hazard Insurance $ $
Real Estate Taxes $ $
Mortgage Insurance $ $
Homeowner Assn. Dues $ $
Other $ $
Total $ $
Complete this section if this is a refinance loan.

Year Aquired
Original Cost
$
Existing Liens
Purpose of Refinance

Assets

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 non-applicant spouse or other person, this Statement nad supporting schedules must be completed by that spouse or other person also.

Completed: Jointly Not Jointly
Bank, Savings & Loan , or Credit Union #1
Institution Name

Street Adress

City
 State
 
 Zip
 
Account Number  Balance
  $
Bank, Savings & Loan , or Credit Union #2
Institution Name

Street Adress

City
 State
 
 Zip
 
Account Number  Balance
  $
Bank, Savings & Loan , or Credit Union #3
Institution Name

Street Adress

City
 State
 
 Zip
 
Account Number  Balance
  $
Stocks & Bonds Company
Institution Name

Street Adress

City
 State
 
 Zip
 
Account Number  Balance
 $

Vested Interest amount in retirement Fund Value of Current Real Estate owned

Liabilities

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. Indicate by (*) those liabilities will will be satisfied upon sale of real estate owned or upon refinancing the subject property.
Liability #1
Company Name

Street Adress

City
 State
 
 Zip
 
Monthly Payment Months Left Unpaid Balance
    $
Liability #2
Company Name

Street Adress

City
 State
 
 Zip
 
Monthly Payment Months Left Unpaid Balance
    $
Liability #3
Company Name

Street Adress

City
 State
 
 Zip
 
Monthly Payment Months Left Unpaid Balance
    $
Liability #4
Company Name

Street Adress

City
 State
 
 Zip
 
Monthly Payment Months Left Unpaid Balance
    $
Real Estate Owned
Total Market Value of all Real Estate Owned

Owned Property #1
Street Adress

City
 State
 
 Zip
 
Type of Property Present Market Value Amount of Mortgages & Liens Gross Rental Income Mortgage Payments Insurance, Maintenance, Taxes, Misc. Net Rental Income
$ $ $ $ $ $
Owned Property #2
Street Adress

City
 State
 
 Zip
 
Type of Property Present Market Value Amount of Mortgages & Liens Gross Rental Income Mortgage Payments Insurance, Maintenance, Taxes, Misc. Net Rental Income
$ $ $ $ $ $

Declarations

If you answer "Yes" to any questions a through i, please use the text box below for explanation
Borrower Co-Borrower
Yes No Yes No
a. Are there any outstanding judgements against you?
b. Have you been declared bankrupt within the past 7 years?
c. Have you had property foreclosed upon or given title or deed in lieu thereof in the last 7 years?
d. Are you a party to a lawsuit?
e. Have you directly or indirectly been obligated on any loan which resulted in foreclosure, transfer of the 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 VA case number, if any, and reasons for the action.)
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.
g. Are you obligated to pay alimony, child support, or separate maintenance?
h. Is any part of the down payment borrowed?
i. Are you a co-marker or endorser on a note?
j. Are you a U.S. citizen?
k. Are you a permanent resident alien?
Do you intend to occupy the property as your primary residence?
If "Yes," complete question m below
m. Have you had an ownership interest in a property in the last three years?
(1) What type of property did you own-principal resident (PR), second home (SH), or investment property (IP)?
(2) How did you hold title to the home-solely by yourself (S), or jointly with your spouse (SP), or jointly with another person (O)?
How do you hear about Mortgage Solutions? RADIO Station name
REALTOR Name
FRIEND Friends name
Internet Website
Yellow Pages City
Current or past client Year closed

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