Uniform Residential Loan Application

1 Uniform Residential loan ApplicationM ortgage A pplied for:V A FHAUSDA / Rural Housing Serv ic e A m ountInt erest Rat eNo. of M ont hsA m ortization T ype:A genc y Case Num berLender Case Num berFix ed Rat e GPMOt her (ex plain): A RM (t y pe):I. T Y PE OF M ORT GA GE A N D T ERM S OF LOA NII. PROPERT Y IN FORM A T ION A N D PU RPOS E OF LOA N$%No. of Unit sYear BuiltSubjec t Propert y A ddress (st reet , cit y , st at e & ZIP)Legal Desc ript ion of Subjec t Propert y (at t ac h desc ript ion if nec essary )Purpose of LoanPurc hase Ref inanc eConst ruc t ion Const ruc t ion-Perm anentOt her (ex plain):Propert y w ill be:Prim ary Residenc eSec ondary Residenc eInv est m entCom plete this line if construction or construction-perm anent Lot A c quiredOriginal CostA m ount Ex ist ing Liens(a) Present V alue of Lot(b) Cost of Im prov em ent sTot al (a + b)$$$$$Com plete this line if this is a refinance A c quiredOriginal CostPurpose of Ref inanc eDesc ribe Im prov em ent sA m ount Ex ist ing Liensm adet o be m adeCost : $Est at e w ill be held in.

2 $$Leasehold (showex pirat ion dat e)Tit le w ill be held in w hat Nam e(s)Sourc e of Dow n Pay m ent , Set t lem ent Charges, and/ or Subordinat e Financ ing (ex plain)IV . EM PLOY M EN T IN FORM A T IONCo-Borrow erBorrow erIII. BORROW ER IN FORM A T IONCo-Borrow erBorrow erCo-Borrow er' s Nam e (inc lude J r. or Sr. if applic able)M arried Separat edUnm arried (include single,div orced, w idow ed) Dependent s (not list ed by Borrow er)M anner in w hic h Tit le w ill be heldSoc ial Sec urit y Num ber Hom e Phone (inc l. area c ode)Yrs. SchoolPresent A ddress (st reet , cit y , st at e, ZIP)Ow nRentNo. er A ddress (st reet , cit y , st at e, ZIP)Ow nRentNo. er' s Nam e (inc lude J r. or Sr. if applic able)M arried Separat edUnm arried (include single,div orced, w idow ed) Dependent s (not list ed by Co-Borrow er)Soc ial Sec urit y Num ber Hom e Phone (inc l.)

3 Area c ode)DOB (m m /dd/y y y y )Yrs. SchoolForm er A ddress (st reet , cit y , st at e, ZIP)M ailing A ddress, if dif f erent f rom Present A ddressIf residing at present address for less than tw o years, com plete the follow ing:Present A ddress (st reet , cit y , st at e, ZIP)RentNo. ailing A ddress, if dif f erent f rom Present A ddressOw nRentNo. e & A ddress of Em ploy erPosit ion/ Tit le/ Ty pe of BusinessBusiness Phone (incl. area code)Dat es (f rom - t o)M ont hly Inc om eSelf Em ploy edIf em ployed in current position for less than tw o years or if currently em ployed in m ore than one position, com plete the follow ing:Nam e & A ddress of Em ploy erPosit ion/ Tit le/ Ty pe of BusinessBusiness Phone (incl. area code)Yrs. on t his jobYrs. em ploy ed in t his lineof w ork / prof essionSelf Em ploy edNam e & A ddress of Em ploy erPosit ion/ Tit le/ Ty pe of BusinessBusiness Phone (incl.

4 Area code)Dat es (f rom - t o)M ont hly Inc om eSelf Em ploy ed$Nam e & A ddress of Em ploy erBusiness Phone (incl. area code)Dat es (f rom - t o)M ont hly Inc om eSelf Em ploy edNam e & A ddress of Em ploy erPosit ion/ Tit le/ Ty pe of BusinessBusiness Phone (incl. area code)Yrs. on t his jobYrs. em ploy ed in t his lineof w ork / prof essionSelf Em ploy ed$Nam e & A ddress of Em ploy erPosit ion/ Tit le/ Ty pe of BusinessBusiness Phone (incl. area code)Dat es (f rom - t o)M ont hly Inc om eSelf Em ploy ed$ ion/ Tit le/ Ty pe of Business$Ow nOt her (ex plain):Conv ent ionalDOB (m m /dd/y y y y )Fee Sim pleUnif orm Resident ial loan A pplicat ionFreddie M ac Form 6 5 7 /0 5 (Rev . 6 /0 9 )V M P2 1 N (0 9 0 7 ).0 1W olt ers Kluw er Financial Serv ices Page 1 of 4V M P Fannie M ae/Freddie M acFannie M ae Form 1 0 0 3 7 /0 5 (Rev . 6 /0 9 )(inc luding t he Borrow er' s spouse)

5 W ill be used as a basis f or loan qualif ic at ion orc om m unit y propert y right s pursuant t o st at e law w ill not be used as a basis f or loan qualif ic at ion, but his or her liabilit ies m ust be c onsidered bec ause t he spouse orot her person has c om m unit y propert y right s pursuant t o applic able law and Borrow er resides in a c om m unit y propert y st at e, t he sec urit y propert y is loc at ed in ac om m unit y propert y st at e, or t he Borrow er is rely ing on ot her propert y loc at ed in a c om m unit y propert y st at e as a basis f or repay m ent of t he he inc om e or asset s of a person ot her t han t he Borrow ert he inc om e or asset s of t he Borrow er' s spouse or ot her person w ho hasThis applic at ion is designed t o be c om plet ed by t he applic ant (s) w it h t he Lender' s assist anc e.

6 A pplic ant s should c om plet e t his f orm as " Borrow er" or " Co-Borrow er, "as applic able. Co-Borrow er inf orm at ion m ust also be prov ided (and t he appropriat e box c hec k ed) w henIf t his is an applic at ion f or joint c redit , Borrow er and Co-Borrow er eac h agree t hat w e int end t o apply f or joint c redit (sign below ):Borrow erCo-Borrow erGross M onthly IncomeBase Em pl. Inc om e*Ov ert im eBonusesCom m issionsDiv idends/ Int erestNet Rent al Inc om eOt her (bef ore com plet ing,see t he not ice in " describeot her incom e," below )Borrow erCo-Borrow erT otalCombined M onthly Housing ExpensePresentProposedV I. A S S ET S A N D LIA BILIT IESRentFirst M ort gage (P& I)Ot her Financ ing (P& I)Hazard Insuranc eReal Est at e Tax esM ort gage Insuranc eHom eow ner A ssn. DuesOt her:T otalT otal$$$$$* Self Employed Borrow er(s) may be required to provide additional documentation such as tax returns and financial.

7 M ON T H LY IN COM E A N D COM BIN ED H OU S IN G EX PEN S E IN FORM A T IOND escribe Other IncomeNotice: Alimony, child support, or separate maintenance income need not be revealed if the Borrow er (B) or Co-Borrow er (C) does not choose to have it considered for repaying this ont hly A m ountB/ C$This St at em ent and any applic able support ing sc hedules m ay be c om plet ed joint ly by bot h m arried and unm arried Co-Borrow ers if t heir asset s and liabilit ies aresuf f ic ient ly joined so t hat t he St at em ent c an be m eaningf ully and f airly present ed on a c om bined basis; ot herw ise, separat e St at em ent s and Sc hedules are required. Ift he Co-Borrow er sec t ion w as c om plet ed about a non-applic ant spouse or ot her person, t his St at em ent and support ing sc hedules m ust be c om plet ed about t hat spouseor ot her person also.

8 $$Liabilities and Pledged Assets. List t he credit or' s nam e, address, and account num ber f or all out st anding debt s,including aut om obile loans, rev olv ing charge account s, real est at e loans, alim ony , child support , st ock pledges, et cont inuat ion sheet , if necessary . Indicat e by (* ) t hose liabilit ies, w hich w ill be sat isf ied upon sale of real est at eow ned or upon ref inancing of t he subject propert y .A S S ET SCash or M arket V alueDesc ript ionCash deposit t ow ard purc hase held by :List checking and savings accounts belowNam e and address of Bank , S& L, or Credit UnionLif e insuranc e net c ash v alueA cct . no.$Nam e and address of Bank , S& L, or Credit Union$Nam e and address of Bank , S& L, or Credit UnionA cct . e and address of Bank , S& L, or Credit Union$St oc k s & Bonds (Com pany nam e/ num ber & desc ript ion)Fac e am ount : $$$$$$$$$$S ubtotal Liquid A ssetsReal est at e ow ned (ent er m ark et v alue f rom sc hedule of real est at e ow ned)V est ed int erest in ret irem ent f undNet w ort h of business(es) ow ned (at t ac h f inanc ial st at em ent )A ut om obiles ow ned (m ak e and y ear)Ot her A sset s (it em ize)LIA BILIT IESU npaid Balance$Nam e and address of Com pany$$Nam e and address of Com pany$$Nam e and address of Com panyA cct.

9 Cct . e and address of Com panyNam e and address of Com panyA cct . lim ony / Child Support / Separat e M aint enanc ePay m ent s Ow ed t o:Nam e and address of Com panyJ ob-Relat ed Ex pense (c hild c are, union dues, et c . )T otal M onthly Paym ents$A cct . e and address of Com panyA cct . otal A ssets J oint lyJ oint lyCom plet edM onthly Paym ent & M onths Left to Pay$ Pay m ent / M ont hs$ Pay m ent / M ont hs$ Pay m ent / M ont hs$ Pay m ent / M ont hs$ Pay m ent / M ont hs$$$ Pay m ent / M ont hs$T otal Liabilities b.$ Pay m ent / M ont hs$$$$A cct . cct . cct . cct . no.$$$$Unif orm Resident ial loan A pplicat ionFreddie M ac Form 6 5 7 /0 5 (Rev . 6 /0 9 )V M P2 1 N (0 9 0 7 ).0 1W olt ers Kluw er Financial Serv ices Page 2 of 4V M P Fannie M ae/Freddie M acFannie M ae Form 1 0 0 3 7 /0 5 (Rev . 6 /0 9 )N et W orth (a m inus b)X.

10 IN FORM A T ION FOR GOV ERN M EN T M ON IT ORIN G PU RPOS ESS chedule of Real Estate Ow ned (If addit ional propert ies are ow ned, use c ont inuat ion sheet . )Propert y A ddress (ent er S if sold, PS if pending sale or R if rent al being held f or inc om e)T y pe of Propert yPresent M arket V alueA m ount of M ort gages& LiensGross Rent al Incom eM ort gage Pay m ent sInsurance,M aint enance, T ax es & M Rent al Incom e$$$$$$$$$$$$Tot alsList any additional nam es under w hich credit has previously been received and indicate appropriate creditor nam e(s) and account num ber(s):Credit or Nam eA c c ount Num berV I. A S S ET S A N D LIA BILIT IES (cont' d)A lt ernat e Nam eD o you intend to occupy the property as your prim aryresidence? If " Yes, " c om plet e quest ion m below .A cknow ledgem ent. Each of t he undersigned hereby acknow ledges t hat any ow ner of t he loan , it s serv icers, successors and assigns, m ay v erif y or rev erif y any inf orm at ion cont ained in t his applicat ionor obt ain any inf orm at ion or dat a relat ing t o t he loan , f or any legit im at e business purpose t hrough any source, including a source nam ed in t his applicat ion or a consum er report ing agency.