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Uniform Residential Loan Application
Submitter Information (Required)
First Name
(required)
Last Name
(required)
Resolve the errors marked in red before submitting again.
UNIFORM RESIDENTIAL LOAN APPLICATION

Verify and complete the information on this application. If you are applying for this loan with others, each additional Borrower must provide information as directed by your Lender.

Section 1: Borrower Information.

This section asks about your personal information and your income from employment and other sources, such as retirement, that you want considered to qualify for this loan.

1a. Personal Information
Name
Alternate Names
Social Security Number
Date of birth
Citizenship
Type of Credit
If applying for JOINT CREDIT, total number of borrowers
List Name(s) of Other Borrower(s) Applying for this Loan
First, Middle, Last, Suffix - one name per line.
First NameMiddle NameLast NameSuffix
Co-Borrower 1
 
Co-Borrower 2
 
Co-Borrower 3
 
Co-Borrower 4
 
Co-Borrower 5
 
Marital Status
Select "Unmarried" for Single, Divorced, Civil Union, Domestic Partnership, or Registered Reciprocal Beneficiary Relationship status
Number of Dependents
Ages of Dependents
Contact Information
PhoneExtension
Home
 
Cell
 
Work
 
Contact Information
Email Address
 
Current Address
How Long at Current Address
YearsMonths

 
Housing
Current Address
No primary housing expense
 
Own
 
Rent
 
Monthly Housing Expense
If at Current Address for LESS than 2 years, list Former Address
How long at Former Address
YearsMonths

 
Housing
Former Address
No primary housing expense
 
Own
 
Rent
 
Monthly Housing Expense
Mailing Address
If different from Current Address
1b. Current Eployment/Self-Employment and Income
Employer or Business Name
Employer or Business Address
Employer or Business Phone Number
Position or Title
Start Date
How long in this line of work?
YearsMonths

 
Check if this statement applies
If Business Owner or Self Employed
check the appropriate option
Monthly Income (or Loss)
Gross Monthly Income
Base
 
Overtime
 
Bonus
 
Commission
 
Military Entitlements
 
Other
 
TOTAL
 
1c. IF APPLICABLE, Complete Information for Additional Employment/Self-Employment and Income
Employer or Business Name
Employer or Business Phone Number
Employer or Business Address
Position or Title
Start Date
How long in this line of work?
YearsMonths

 
Check if this statement applies
If Business Owner or Self-Employed
Gross Monthly Income
Base
 
Overtime
 
Bonus
 
Commission
 
Military Entitlements
 
Other
 
TOTAL
 
1d. IF APPLICABLE, Complete Information for Previous Employment/Self-Employment and Income
Employer or Business Name
Employer or Business Address
Position or Title
Start Date
End Date
Previous Gross Monthly Income
OTHER INCOME INSTRUCTIONS

Include income from other sources below. Under Income Source, choose from the sources listed here:

  • Alimony
  • Automobile Allowance
  • Boarder Income
  • Capital Gains
  • Child Support
  • Disability
  • Foster Care
  • Housing or Parsonage
  • Interest and Dividends
  • Mortgage Credit Certificate
  • Mortgage Differential Payments
  • Notes Receivable
  • Public Assistance
  • Retirement (e.g. Pension, IRA)
  • Royalty Payments
  • Separate Maintenance
  • Social Security
  • Trust
  • Unemployment Benefits
  • VA Compensation
  • Other

NOTE: Reveal alimony, child support, separate maintenance, or other income ONLY IF you want it considered in determining your qualification for this loan.

1e. Income from Other Sources
Use list above to identify the Income Source.
Income SourceMonthly Income

 

 

 

 

 
Provide TOTAL Monthly Amount Here
SECTION 2: Financial Information -- Assets and Liabilities

This section asks about things you own that are worth money and that you want considered to qualify for this loan. It then asks about your liabilities (or debts) that you pay each month, such as credit cards, alimony, or other expenses.

2a. Assets - Bank Accounts, Retirement and Other Accounts You Have

Include all acounts below. Under Account Type, choose from the types listed here:

  • Checking
  • Savings
  • Money Market
  • Certificate of Deposit
  • Mutual Fund
  • Stocks
  • Stock Options
  • Bonds
  • Retirement (e.g., 401k, IRA)
  • Bridge Loan Proceeds
  • Individual Development Account
  • Trust Account
  • Cash Value of Life Insurance (used for the transaction)
Use the list above to identify the Account Type.
Account TypeFinancial InstitutionAccount NumberCash or Market Value

 

 

 

 

 
Provide TOTAL Amount Here
2b. Other Assets and Credits You Have

Include all other assets and credits below. Under Asset or Credit Type, choose from the types listed here:

Assets     Credits    
  • Proceeds from REal Estate Property to be sold on or before closing
  • Proceeds from Sale of Non-Real Estate Asset
  • Secured Borrowed Funds
  • Unsecured Borrowed Funds
  • Other
  • Earnest Money
  • Employer Assistance
  • Lot Equity
  • Relocation Funds
  • Rent Credit
  • Sweat Equity
  • Trade Equity

 

Use list above to determine Asset or Credit Type
Asset or Credit TypeCash or Market Value

 

 

 

 

 
Provide TOTAL Amount Here
2c. Liabilities - Credit Cards, Other Debts, and Leases that You Owe

List all liabilities below (except real estate) and include deferred payments. Under Account Type, choose from the types listed here:

  • Revolving (e.g., credit cards)
  • Installment (e.g., car, student, personal loans)
  • Open 30-Day (balance paid monthly)
  • Lease (not real estate)
  • Other

 

Use list above to determine Account Type
Account TypeCompany NameAccount NumberUnpaid BalanceTo be paid off at or before closing (yes or no)Monthly Payment

 

 

 

 

 
2d. Other Liabilities and Expenses

List all other liabilities and expenses below. Choose from the types listed here:

  • Alimony
  • Child Support
  • Separate Maintenance
  • Job Related Expenses
  • Other
Type of Liability or ExpenseMonthly Payment

 

 

 

 
Section 3: Financial Information -- Real Estate

This section asks you to list all properties you currently own and what you owe on them.

If you are refinancing, list the property you are refinancing FIRST.

3a. Property You Own
Property Address
Property ValueStatus: Sold, Pending Sale, or RetainedIntended Occupancy: Investment, Primary Residence, Second Home, OtherMonthly Insurance, Taxes, Association Dues, etc. If not included in Monthly Mortgage PaymentMonthly Rental Income(For LENDER to calculate) Net Monthly Rental Income

 
Mortgage Loans on this Property
Creditor NameAccount NumberMonthly Mortgage PaymentUnpaid BalanceTo be paid off at or before closingType: FHA, VA, Conventional, USDA-RD, OtherCredit Limit (if applicable)

 

 

 
3b. IF APPLICABLE, Complete Information for Additional Property
Property Address
Property ValueStatus: Sold, Pending Sale, or RetainedIntended Occupancy: Investment, Primary Residence, Second Home, OtherMonthly Insurance, Taxes, Association Dues, etc. if not included in Monthly Mortgage PaymentMonthly Rental Income(For LENDER to calculate) Net Monthly Rental Income

 
Mortgage Loans on this Property
Creditor NameAccount NumberMonthly Mortgage PaymentUnpaid BalanceTo be paid off at or before closingType: FHA, VA, Conventional, USDA-RD, OtherCredit Limit (if applicable)

 

 

 
3c. IF APPLICABLE, Complete Information for Additional Property
Property Address
Property ValueStatus: Sold, Pending Sale, or RetainedIntended Occupancy: Investment, Primary Residence, Second Home, OtherMonthly Insurance, Taxes, Association Dues, etc. if not included in Monthly Mortgage PaymentMonthly Rental Income(For LENDER to calculate) Net Monthly Rental Income

 
Mortgage Loans on this Property
Creditor NameAccount NumberMonthly Mortgage PaymentUnpaid BalanceTo be paid off at or before closingType: FHA, VA, Conventional, USDA-RD, OtherCredit Limit (if applicable)

 

 

 
Section 4: Loan and Property Information.

This section asks about the loan's purpose and the property you want to purchase or refinance.

4a. Loan and Property Information
Loan Amount (required)
Loan Purpose
Property Address
Occupancy
Mixed-Use Property
If you will occupy the property, will you set aside space within the property to operate your own buisness? (e.g., daycare facility, medical office, beauty/barber shop)
Manufactured Home
Is the property a manufactured home? (e.g., a factory build dwelling built on a permanent chassis)
4b. Other New Mortgage Loans on the Property You are Buying or Refinancing
Creditor NameLien Type: First LienLien Type: Subordinate LienMonthly PaymentLoan Amount/Amount to be DrawnCredit Limit (if applicable)

 

 

 
4c. Rental Income on the Property You Want to Purchase - For Purchase Only - Complete if the property is a 2-4 Unit Primary REsidence or an Investment Property.
Expected Monthly Rental Income (required)
For LENDER to calculate: Expected Net Monthly Rental Income
4d. Gifts or Grants You Have Been Given or Will Receive for this Loan

Include all gifts and grants below. Under Source, choose from the sources listed here:

  • Community Nonprofit
  • Employer
  • Federal Agency
  • Local Agency
  • Relative
  • Religious Nonprofit
  • State Agency
  • Unmarried Partner
  • Lender
  • Other

 

Gifts or Grants
Use the list above to determine the Source.
Asset Type: Cash Gift, Gift of Equity, GrantDepositedNot DepositedSourceCash or Market Value

 

 

 
Section 5: Declarations.

This section asks you specific questions about the property, your funding, and your past financial history.

5a. About this Property and Your Money for this Loan
A. Will you occupy the property as your primary residence?
If YES, have you had an ownership interest in another property in the last three years?
If YES, complete (1) and (2) below
(1) What type of property did you own: Primary residence (PR), FHA secondary residence (SR), second home (SH), or investment property (IP)?
(2) How did you hold the title to the property: by yourself (S), jointly with your spouse (SP), or jointly with another person (O)?
B. If this is a Purchase Transaction: Do you have a family relationship or business affiliiation with the seller of the property?
C. Are you borrowing any money for this real estate transaction (e.g., money for your closing costs or down payment) or obtaining any money from another party, such as the seller or realtor, that you have not disclosed on this loan application?
If YES, what is the amount of this money?
D. 1. Have you or will you be applying for a mortgage loan on another property (not the property securing this loan) on or before closing this transaction that is not disclosed on this loan application?
D. 2. Have you or will you be applying for any new credit (e.g., installment loan, credit card, etc.) on or before closing this loan that is not disclosed on this application?
E. Will this property be subject to a lien that could take priority over the first mortgage lien, such as a clean energy lien paid through your property taxes (e.g., the Property Assessed Clean Energy Program)?
5b. About your Finances
F. Are you a co-signer or guarantor on any debt or loan that is not disclosed on this application?
G. Are there any outstanding judgments against you?
H. Are your currently delinquent or in default on a Federal debt?
I. Are you party to a lawsuit in which you potentially have any personal financial liability?
J. Have you conveyed title to any property in lieu of foreclosure in the past 7 years?
K. Within the past 7 years, have you completed a pre-foreclosure sale or short sale, whereby the property was sold to a third party and the Lender agreed to accept less than the outstanding mortgage balance due?
L. Have you had property foreclosed upon in the last 7 years?
M. Have you declared bankruptcy within the past 7 years?
If YES, identify the type(s) of bankruptcy
Chapter 7Chapter 11Chapter 12Chapter 13

 
Section 6: Acknowledgments and Agreements

This section tells you about your legal obligations when you sign this application.

Acknowlegments and Agreements

Definitions:

  • "Lender" includes the Lender's agents, service providers, and any of their successors and assigns.
  • "Other Loan Participants" includes (i) any actual or potential owners of a loan resulting from this application (the "Loan"), (ii) acquirers of any beneficial or other interest in the Loan, (iii) any mortgage insurer, (iv), any guarantor, (v) any servicer of the Loan, and (vi) any of these parties' service providers, successors, or assigns.

I agree to, acknowledge, and represent the following:

(1) The Complete Information for this Application

  • The information I have provided in this application is true, accurate, and complete as of the date I signed this application.
  • If the information I submitted changes or I have new information before closing of the Loan, I must change and supplement this application, including providing any updated/supplemented real estate sales contract.
  • For purchase transactions: The terms and conditions of any real estate sales contract signed by me in connection with this application are true, accurate, and complete to the best of my knowledge and belief. I have not entered into any other agreement, written or oral, in connection with this real estate transaction.
  • The Lender and Other Loan Participants may rely on the information contained in the application before and after closing of the Loan.
  • Any intentional or legligent misrepresentation of information may result in the imposition of:
    • (a) civil liability on me, including monetary damages, if a person suffers any loss because the person relied on any misrepresentation that I have made on this application, and/or
    • (b) criminal penalties on me including, but not limited to, fine or imprisonment or both udner the provisions of Federal law (18 U.S.C. §§ 1001 et seq.).

(2) The Property's Security
The Loan I have applied for in this application will be secured by a mortgage or deed of trust which provides the Lender a security interest in the property described in this application.

(3) The Property's Appraisal, Value, and Condition

  • Any appraisal or value of the property obtained by the Lender is for use by the Lender and Other Loan Participants.
  • TheLender and Other Loan Participants have not made any representation or warranty, express or implied, to me about the property, its condition, or its value.

(4) Electronic Records and Signatures

  • The Lender and Other Loan Participants may keep any paper record and/or electronic record of this application, whether or not the Loan is approved.
  •  If this application is created as (or converted into) an "electronic application", I consent to the use of "electronic records" and "electronic signatures" as the terms are defined in and governed by applicable Federal and/or state electronic transactions laws.
  • I intend to sign and have signed this application either using my:
    • (a) electronic signature; or
    • (b) a written signature and agree that if a paper version of this application is converted into an electronic application, the application will be a n electronic record, and the representation of my written signature on this application will be my binding electronic signature.
  • I agree that the application, if delivered or transmitted to the Lender or Other Loan PArticipants as an electronic record with my electronic signature, will be a s effectiv eand enforceable as a paper application signed by me in writing.

(5) Delinquency

  • The Lender and Other Loan Participants may report information about my account to credit bureaus. Late payments, missed payments, or other defaults on my account may be reflected in my credit report and will likely affect my credit score.
  • If I have trouble making my payments I understand that I may contact a HUD-approved housing counseling organization for advice about actions I can take to meet my mortgage obligations.

(6) Authorization for Use and Sharing of Information
By signing below, in addition to the representations and agreements made above, I expressly authorize the Lender and Other Loan Participants to obtain, use, and share with each other (i) the loan application and related loan information and documentation, (ii) a consumer credit report on me, and (iii) lmy tax return information, as necessary to perform the actions listed below, for so long as they have an interest in my loan or its servicing:

  • (a) process and underwrite my loan;
  • (b) verify any data contained in my consumer credit report, my loan application, and other information supporting my loan application;
  • (c) inform credit and investment decisions by the Lender and Other Loan Participants;
  • (d) performaudit, quality control, and legal compliance analysis and reviews;
  • (e) perform analysis and modeling for risk assessments;
  • (f) monitor the account for this loan for potential delinquencies and determine any assistance that may be available to me; and
  • (g) other actions permissible under applicable law.

 

Signatures
Borrower Signature
Name (First, Middle, Last, Suffix)Date
Borrower
 
Additional Borrower
 
Additional Borrower
 
Additional Borrower
 
Section 7: Military Service.

This section asks questions about your (or your deceased spouse's) military service.

Military Service of Borrower
Did you (or your deceased spouse) ever serve, or are you currently serving, in the United States Armed Forces?
If YES, check all that apply
If currently serving on active duty, projected expiration date of service/tour
Section 8: Demographic Information.

This section asks about your ethnicity, sex, and race.

Demographic Information of Borrower

The purpose of collecting this information is to help ensure that all applicants are treated fairly and that the housing needs of ocmmunities and neighborhoods are being fulfilled. For residential mortgage lending, Federal law requires that we ask applicants for their demographic informatoin (ethnicity, ex, and race) in order to monitor our compliance with equal credit opportunity, fair housing, and home mortgage disclosure laws. You are not required to provide this information, but are encouraged to do so. You may select one or more designations for "Ethnicity" and one or more designations for "Race". The law provides that we may not descriminate on the basis of this information, or on whether you choose to provide it. However, if you choose not to provide the information and you have made this application in person, Federal regulations require us to note your ethnicity, sex, and race on the basis of visual observation or surname. The law also provides that we may not discriminate on the basis of age or marital status information you provide in this application. If you do not wish to provide some or all of this information, please check below.

Ethnicity
Check one or more
Sex
Race
If American Indian or Alaska Native, print name of enrolled or principal tribe
To Be Completed by Financial Institution (for application taken in person)
NOYES
Was the ethnicity of the Borrower collected on the basis of visual obervation or surname?
 
Was the sex of the Borrower collected on the basis of visual obervation or surname?
 
Was the race of the Borrower collected on the basis of visual obervation or surname?
 
The Demographic Information was provided through
Section 9: Loan Originator Information

To be competed by your Loan Originator

Loan Originator Information
Loan Originator Organization Name
Address
Loan Originator Organization NMLSR ID #
 
State License ID #
 
Loan Originator Name
 
Loan Originator NMLSR ID #
 
State License ID #
 
Email
 
Phone
 
Signature
Date

This electronic form is based on:

Uniform Residential Loan Application,
Freddie Mac Form 65 • Fannie Mae Form 1003