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Phone

This field is for validation purposes and should be left unchanged.

Borrower Information

Please select your loan officer below(Required)

Name(Required)

First Last

Phone

Email(Required)

Password(Required)

Verify Password(Required)

Social Security Or Taxpayer Identifier Type(Required)

Citizenship(Required)

Date of Birth(Required)

MM slash DD slash YYYY

Marital Status

dependant Ages

For multiple dependants, separate each age by a comma.

Current Address

List addresses for the last two years, starting with your current address.

First Address(Required)

Street Address City State / Province / Region ZIP / Postal Code Country

Housing

Prior Address

Street Address City State / Province / Region ZIP / Postal Code Country

Housing

Personal Information - Alternate Names

Name

First Middle Last Suffix

Current Employment/Self-Employment and Income

Employer or Business Name

Address

Street Address City State / Province / Region ZIP / Postal Code Country

Position or Title

Start Date

MM slash DD slash YYYY

How long in this line of work?

Check if this statement applies:

Check if this statement applies: I am employed by a family member, property seller, real estate agent, or other party to the transaction.

Gross Monthly Income

Base

Overtime

Bonus

Commission

Military Entitlements

Other

Income from Other Sources

Assets - Bank Accounts, Retirement, and Other Accounts You Have

Account Type

Financial Institution

Cash or Market Value

Other Assets and Credits You Have

Asset or Credit Type

Cash or Market Value

Liabilities - Credit Cards, Other Debts, and Leases that You Owe

Account Type

Company Name

Account Number

Liabilities unpaid balance

Other Liabilities and Expenses / Monthly Payment

Alimony

Child Support

Job Related Expenses

Separate Maintenance

Other

Financial Information - Real Estate

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

Properties You Own

I do not own any real estate

Address

Street Address Address Line 2 City State ZIP Code

Property Value

Status

Intended Occupancy

Monthly Payments

Monthly Rental Income

Mortgage Loans on this Property

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

Creditor Name

Account Number

Monthly Payment

Unpaid Balance

Type

Credit Limit

Loan and Property Information

Desired Loan Amount

Loan Purpose

Property Address

Street Address Address Line 2 City State ZIP Code

Number Of Units

Desired Property Value

How Will You Occupy This Property?

Will This Be A Mixed Use Property?

Will This Be A Manufactured home?

Gifts or Grants You Have Been Given or Will Receive for this Loan

Does not apply

Add to the list below all gifts and grants you have been given

Asset Type

Deposited/Not Deposited

Source

Cash or Market Value

Declarations

About this Property and Your Money for this Loan

Will you occupy the property as your primary residence?(Required)

Yes

If this is a Purchase Transaction: Do you have a family relationship or business affiliation with the seller of the property?(Required)

Yes

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?(Required)

Yes

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?(Required)

Yes

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?(Required)

Yes

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)?(Required)

Yes

Did you (or your deceased spouse) ever serve, or are you currently serving, in the United States Armed Forces?(Required)

Yes

Declarations

About Your Finances

Are you a co-signer or guarantor on any debt or loan that is not disclosed on this application?(Required)

Yes

Are there any outstanding judgments against you?(Required)

Yes

Are you currently delinquent or in default on a Federal debt?(Required)

Yes

Are you a party to a lawsuit in which you potentially have any personal financial liability?(Required)

Yes

Have you conveyed title to any property in lieu of foreclosure in the past 7 years?(Required)

Yes

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?(Required)

Yes

Have you had property foreclosed upon in the last 7 years?(Required)

Yes

Have you declared bankruptcy within the past 7 years?(Required)

Yes

Demographic Information

Ethnicity

Hispanic or Latino

Not Hispanic or Latino

I do not wish to provide this information

Sex:

Female

Male

I do not wish to provide this information

Race:

American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White

Continuation Sheet - Optional

Use this continuation sheet if you need more space to complete the Uniform Residential Loan Application.

Additional Information

I/We fully understand that it is a federal crime punishable by fine or imprisonment, or both, to knowingly make any false statements concerning any of the above facts as applicable under the provisions of federal law (18 U.S.C. §§ 1001 et seq.).

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