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: V.A. Conventional Other(explain):  Agency Case Number  Lender Case Number FHA USDA/Rural Housing Service       Amount    Interest Rate    No. of Months    Amortization  Type: Fixed Rate: Other (explain):   GPM ARM (type):   II. PROPERTY INFORMATION AND PURPOSE OF LOAN Subject Property Address (street, city, state & ZIP)    No. of Units   Legal Description of Subject Property (attach description if necessary)  Year Built   Purpose of Loan  Purchase Construction  Other (explain):  Property will be:    Refinance  Construction-Permanent     Primary Residence     Secondary  Residence Investment 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 made  to be made  Cost Title will be held in what Name(s)  Manner in which Title will be held    Estate will be held in: Fee Simple Source of Down Payment, Settlement Charge and/or Subordinate Financing (explain) Leasehold (show expiration date)   Borrower III. BORROWER INFORMATION Co-Borrower Borrower's Name (include Jr. or Sr. if applicable)    Co-Borrower's Name (include Jr. or Sr. if applicable)   Social Security Number    Home Phone (incl. area code)    DOB   Yrs. School    Social Security Number    Home Phone (incl. area code)    DOB    Yrs. School    Married   Unmarried (include single, divorced, widowed)  Dependents (not listed  by Co-Borrower)  Married   Unmarried (include single, divorced, widowed)  Dependents (not listed  by Borrower)  Separated  no.    ages   Separated   no.    ages   Present Address (street, city, state, ZIP) Own Rent   No. Yrs.   Present Address (street, city, state, ZIP) Own Rent   No. Yrs.             Mailing Address,if different from Present Address    Mailing Address,if different from Present Address   If residing at present address for less than two years, complete the following: Former Address (street, city, state, ZIP) Own Rent   No. Yrs.  Former Address (street, city, state, ZIP) Own Rent   No. Yrs.             Borrower IV. EMPLOYMENT INFORMATION Co-Borrower Name & Address of Employer  Self Employed    Yrs. on this job    Name & Address of Employer    Self Employed    Yrs. on this job      Yrs. employed in  this line of  work/profession   Yrs. employed in  this line of  work/profession   Position/Title/Type of Business    Business Phone (incl. area code)    Position/Title/Type of Business    Business 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    Self Employed    Dates (from-to)      Name & Address of Employer    Self Employed    Dates (from-to)          Monthly Income      Monthly Income      Position/Title/Type of Business    Business Phone (incl. area code)    Position/Title/Type of Business    Business Phone (incl. area code)    Name & Address of Employer    Self Employed    Dates (from-to)      Name & Address of Employer    Self Employed    Dates (from-to)         <