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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 V.A. Conventional Other: Applied for: FHA FmHA			Agency Case #	Lender Case #
Amount $	Interest Rate           %	No. of Months	Amortization Fixed Rate Other (explain): Type: 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): Refinance Construction-Permanent				Property will be: 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 $