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 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:
Agency Case No.
Lender Case No.
applied for FHA
FmHA
____________________________________________________________________________________
Loan Amount
Interest Rate:
No. of months Amortization Fixed
rate ARM
(Type):
$ % Type:
GPM
Other
(explain):
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:
Investment
Primary
Secondary
Refinance
Construction-Permanent
Residence Residence
__________________________________________________________________________________
Complete this line if construction or
construction-permanent loan.
Year Lot
|Original Cost |Amount
Existing |(a) Present Value
|(b) Cost of
|Total (a + b)
Liens
|of Lot
Improvements
Acquired $
$ $
$ $
__________________________________________________________________________________
Complete this line if this is a refinance loan.
Year
|Original Cost |Amount Existing Liens
|Purpose of Refinance Describe Improvements made
Acquired $ $
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 Leasehold
Source of Down Payment, Settlement Charges and/or
Subordinate Financing (explain)
(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 (include area
code) Social Security Number |Home Phone (include area code)
Age
Years School
Age
Years School
Married
Unmarried
(include single, divorced
Married
Unmarried
(include single divorced
Separated
widowed)
Separated
widowed)
Dependents (not listed by C0-Borrower)
Dependents (not listed by Borrower)
No. Ages
No. Ages
Present Address (street, city, state,zip) Own
Rent
Present Address (street, city, state,zip) Own
Rent
No. Years
No. Years
If
residing at present address for less than two years, complete the
following:
Former Address (street, city, state,zip) Own
Rent
Former Address (street, city, state,zip) Own
Rent
No. Years
No. Years
Former Address (street, city, state,zip) Own
Rent
Former Address (street, city, state,zip) Own
Rent
No. Years No.
Years
Borrower
IV. EMPLOYMENT INFORMATIO N
Co-Borrower
If
employed in current position for less than two years or if
currently employed in more than on position, complete the
following:
Name and Address of Employer
Self
Employed
Name and Address of Employer Self
Employed
Years
on this job
Years
on this job
Years
employed in this line of work/profession
Years
employed in this line of work/profession
Position/Title/Type of Business:
Position/Title/Type of Business:
Business Phone (including area code)
Business Phone (including 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 and Address of Employer
Self
Employed
Name and Address of Employer Self
Employed
Dates: from to
Dates: from to
Monthly Income $
Monthly Income $
Position/Title/Type of Business:
Position/Title/Type of Business:
Business Phone (including area code)
Business Phone (including area code)
Name and Address of Employ
Self
Employed
Name and Address of Employer Self
Employed
Dates: from to
Dates: from to
Monthly Income $
Monthly Income $
Position/Title/Type of Business:
Position/Title/Type of Business:
Business Phone (including area code)
Business Phone (including area code)
V.
MONTHLY INCOME AND COMBINED HOUSING EXPENSE INFORMATION
GROSS MONTHLY INCOME
BORROWER
CO-BORROWER
TOTAL
Base Employment Income*
$
$
$
Overtime
$
$
$
Bonuses
$
$
$
Commissions
$
$
$
Dividends/Interest
$
$
$
Net Rental Income
$
$
$
Other (before completing,
$
$
$
see the notice in "describe
$
$
$
other income," below)
$
$
$
TOTAL
$
$
$
__________________________________________________________________________________
COMBINED
MONTHLY HOUSING EXPENSE
PRESENT
PROPOSED
Rent
$
$
First Mortgage (P&I)
$
$
Other Financing (P&I)
$
$
Hazard Insurance
$
$
Real Estate Taxes
$
$
Mortgage Insurance
$
$
Homeowner Association Dues
$
$
Other
$
$
TOTAL
$
$
*Self Employed Borrower ( s ) may be required t
provide additional documentation such as tax returns and
financial statements.
Describe Other Income
Notice: Alimony, child support, or separate maintenance income need
not be revealed
if the Borrower ( B ) or Co-Borrower ( C ) does
not choose to have it considered for repaying this loan.
B/C
Monthly Amount
$
$
$
$
VI.
ASSETS AND LIABILITIES
This statement and any applicable supporting
schedules may be completed jointly by both married and unmarried
Co-borrowers if
their assets and liabilities are sufficiently
joined so that the Statement can be meaningfully and fairly
presented on a combined
basis; otherwise separate Statements and
Schedules are required. If the Co-Borrower section was
completed about a spouse,
this Statement and supporting schedules
must be completed about that spouse also.
COMPLETED Jointly
Not
Jointly
__________________________________________________________________________________
ASSETS
CASH OR MARKET VALUE
Description
Cash deposit toward purchase held by:
$
List checking and savings accounts below:
Name and address of Bank, S&L, or Credit
Union:
Account Number
$
__________________________________________________________________________________
Name and address of Bank, S&L, or Credit
Union:
Account Number
$
__________________________________________________________________________________
Name and address of Bank, S&L, or Credit
Union:
Account Number
$
___________________________________________________________________________________
Name and address of Bank, S&L, or Credit
Union:
Account Number
$
____________________________________________________________________________________
Name and address of Bank, S&L, or Credit
Union:
Account Number
$
__________________________________________________________________________________
Stocks & Bonds (Company name/number &
Description
$
$
$
$
$
__________________________________________________________________________________
Life insurance net cash value
$
Face amount
$
Subtotal Liquid Assets
$
Real estate owned ( enter market value from
schedule of real estate owned )
$
Vested interest in retirement fund
$
Net Worth of business(es) owned ( attach financial
statement )
$
Automobiles owned ( make and year) :
$
$
$
$
Other Assets itemized:
$
$
$
$
Total Assets a. $
___________________________________________________________________________________
Liabilities and Pledged Assets. List the
creditor's name address and account number for all outstanding
debts, including
automobile loans, revolving charge
accounts, real estate loans, alimony, child support, stock pledges,
etc.
Use continuation sheet if necessary indicate by
(*) those liabilities which will be satisfied upon sale of real
estate owned
or upon refinancing.
LIABILITIES
Monthly Payment and
Unpaid Balance
Months left to pay
Name and address of Company
$Payt. Mos.
$
Account Number
Name and address of Company
$Payt. Mos.
$
Account Number
Name and address of Company
$Payt. Mos.
$
Account Number
Name and address of Company
$Payt. Mos.
$
Account Number
Name and address of Company
$Payt. Mos.
$
Account Number
Name and address of Company
$Payt. Mos.
$
Account Number
Name and address of Company
$Payt. Mos.
$
Account Number
Alimony/Child Support/Separate Maintenance
Payments:
Owed to:
$
Job Related Expense ( child care, union dues, etc.
$
$
$
$
TOTAL MONTHLY PAYMENTS
$
Net Worth ( a-b ) $
Total Liabilities b. $
.
ASSETS AND LIABILITIES (cont.)
Schedule of Real Estate Owned (if additional
properties are owned, use continuation sheet)
Property Address (enter S if sold, PS if
Type of Present
Amount of
pending sale or R if rental being held for income)
Property Market Value
Mortgages & Liens
$
$
$
$
$
$
$
$
$
$
TOTAL $
$
Gross
Mortgage
Insurance
Net
Rental Income
Payment
Maintenance,
Rental Income
Taxes & Misc.
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
TOTALS $
$
$
$
______________________________________________________________________________
List any additional names under which credit has
previously been received and indicate appropriate creditor
name (s) and account numbers (s):
Alternate Name
Creditor Name
Account Number
VII. DETAILS OF TRANSACTION
VIII. DECLARATIONS
a. Purchase price
$
b. Alterations, improvements, repairs
$
c. Land (if acquired separately)
$
d. Refinance (incl. debts to be paid off
$
e. Estimated prepaid items
$
f. Estimated closing costs
$
g. PMI, MIP, Funding Fee
$
h. Discount (if Borrower will pay
$
i. Total costs (add items a through h
$
j. Subordinate financing
$
k. Borrowers closing cost paid by
Seller
$
l. Other Credits (explain)
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
m. Loan amount (exclude PMI, MIP, $
Funding Fee
financed)
$
n. PMI, MIP, Funding Fee financed
$
o. Loan amount (add m & n)
$
p. Cash from/to Borrower
$
(subtract j, k, l,
& o from i)
If you answer "yes" to any
Borrower Co-Borrower
questions a through i, please
use continuation sheet for
Yes No | Yes No
explanation.
a. Are there any outstanding
judgments against you?
|
b. Have you be declared bankrupt within
the past
7 years?
|
c. Have you had property foreclosed upon
or given up
title or deed?
|
d. Are you party to a lawsuit?
|
e. Have you directly or indirectly
been obligated on any
loan which
resulted in foreclosure, transfer of title in
lieu of
foreclosure, or judgment? (This would include
such loans as
home mortgage loans, SBA loans, home
improvement
loans, educational loans, manufactured
(mobile) home
loans, any mortgage, financial
obligation, bond,
or loan guarantee. If "yes" provide
details,
including date, name and address of Lender,
FHA or VA case
number if any, and reasons for
the action.)
|
f. Are you presently delinquent or
in default on any
Federal debt or
any other loan, mortgage, financial
obligation bond,
or loan guarantee? If "yes" give
details as
described in the
preceding
question.
|
g. Are you obligated to pay alimony,
child support, or
separate
maintenance?
|
h. Is any part of the down payment
borrowed?
|
i. Are you a co-maker or
endorser
on a note?
|
_____________________________
j. Are you a U.S. citizen?
|
k. Are you a permanent resident
alien?
|
l. Do you intend to occupy the
property as your primary residence? If
"Yes," complete question m
below.
|
m. Have you had an ownership
interest in a property in
the last
three years?
|
(1) What
type of property did you own-principal
residence (PR), second home (SH), or investment
property (IP)
|
(2)
How did you hold title to the home-solely by
yourself (S), jointly with your spouse (SP), or
jointly with another person (O)
|
IX.
ACKNOWLEDGEMENT AND AGREEMENT
The undersigned specifically acknowledge (s)
and agree (s) that: (1)the loan requested by this application will
be secured by a first
mortgage or deed of trust on the property
described herein;(2) the property will not be used for any illegal
or prohibited purpose or use;
(3) all statements made in this application
are made for the purpose of obtaining the loan indicated herein: (4)
occupation of the
property will be indicated above; (5)
verification or reverification of any information contained in the
application may be made at
any time by the Lender, its agents, successors and
assigns, either directly or through a credit reporting agency from
any source named in
this application, and the original copy of this
application will be retained by the Lender, even if the loan is not
approved; (6)the Lender,
its agents, successors and assigns will
rely on the information contained in the application and I/we have
continuing obligation to
amend and/or supplement the information provided
in this application if any of the material facts which I/we have
represented herein
should change prior to closing. (7) In the event
my/our payments on the loan indicated in this application become
delinquent, the Lender,
its agents, successors and other assigns,
may, in addition to all their other rights and remedies, report
my/our name (s) and account
information to a credit reporting agency; (8)
ownership of the loan may be transferred to successor or assign of
the lender without notice
to me and/or the administration of the loan
account may be transferred to an agent, successor or assign of the
Lender with prior notice to
me; (9) the Lender its agents, successors
and assigns make no representations or warranties, express or
implied, to the Borrower (s)
regarding the property, the condition of
the property, or the value of the property.
CERTIFICATION: I/We certify that the information
provided in this application is true and correct as of the date set
forth opposite
my/our signature (s) on this application and
acknowledge my/our understanding that any intentional or negligent
misrepresentation (s)
of the information contained in this
application may result in civil liability and and/or criminal
penalties including, but not limited
to, fine or imprisonment of both under the
provisions of Title 18, United States Code, Section 1001, et seq.
and liability for monetary
damages to the Lender, its agents, successors and
assigns, insurers and any other person who may suffer any loss due
to reliance upon
any misrepresentation which I/we have made
on this application.
Borrower's Signature
Date
Co-Borrower's Signature
Date
X
X
X.
INFORMATION FOR GOVERNMENT MONITORING PURPOSES
The following information is requested by the Federal
Government for certain types of loans related to a dwelling, in
order to monitor the
Lender's
compliance with equal credit opportunity, fair housing and home
mortgage disclosure laws. You are not required to furnish this
information, but are encouraged to do so. The
law provides that a Lender may neither discriminate on the basis of
this information, nor on
whether you choose to furnish it.
However, if you choose not to furnish it, under Federal regulations
this Lender is required to note race and
sex on the basis of visual observation or
surname. If you do not wish to furnished the above information
please check the box below. (Lender
must review the above material to assure that the
disclosure satisfy all requirement to which the Lender is subject
under applicable state law
for the particular type of loan applied for.)
BORROWER
I
do not wish to furnish this information
Race/National American
Indian or Alaskan Native Asian
or Islander
Origin:
Black,
not of Hispanic
White,
not of
Hispanic origin
Hispanic origin
Other
(specify)
Sex:
Female
Male
________________________________________________________________________________
CO-BORROWER
I
do not wish to furnish this information
Race/National American
Indian or Alaskan Native Asian
or Islander
Origin:
Black,
not of Hispanic
White,
not of
Hispanic origin
Hispanic origin
Other
(specify)
Sex:
Female
Male
___________________________________________________________________________________
To be Completed by Interviewer
Interviewer's Name
Name and Address of Provider:
This application was taken by:
NATIONAL NOTEBUYERS
face-to-face
interview
Interviewer's Signature
P.O. Box 3492
Springfield, Ma 01101
by
mail
phone (413)-592-0858
Interviewer's Phone Number
by
telephone
Internet Address
Internet Address: maxicash.com
by
internet
E-Mail address
E-Mail address: richard@maxicash.com