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Check our Specials. We have a 7/23 Fixed Rate Loan at 5.00% for 30 years. 80% LTV. Certain other terms and conditions apply. Click here to contact us for details.

Uniform Residential Loan Application

This application is designed to be completed by the applicant(s). Co-Borrower information must also be provided (and the appropriate box selected below) when:

the income or assets of a person other than the "Borrower" (including the Borrowers spouse) will be used as a basis for loan qualification or
the income or assets of the Borrowers 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, or 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.

Your Name:           Email address:

I. TYPE OF MORTGAGE AND TERMS OF LOAN

Amount: $ Mortgage Applied for:
If "Other", explain here
Number of MonthsAmortization Type:
If "Other", explain here

II. PROPERTY INFORMATION AND PURPOSE OF LOAN

Subject Property Address:

Street: City: State: Zipcode:
Legal Description of Subject Property:
No. of Units: Year Built:
Purpose of Loan:
 Property will be:

Complete this line if this is a construction or construction-permanent loan.

Year Acquired Original Cost Existing Liens Present Value of Lot Cost of Improvements
$ $ $ $

Complete this line if this is a refinance loan.

Year
Acquired		 Original Cost Existing Liens Purpose of Refinance Describe Improvements
$ $ Made To be made
Details:
Cost: $

This will be held in what names(s):
Manner in which title will be held:
Estate will be held in -- Fee Simple: Leasehold: If "leasehold", show expiration date
Source of Down Payment

III. BORROWER INFORMATION

Borrower Co-Borrower
Name: First and Last (include Jr. or Sr. if applicable)
 Name: First and Last (include Jr. or Sr. if applicable)
Social Sec. No.
 Home Phone
 Social Sec. No.
 Home Phone
Age
 Yrs. of School
 Age
 Yrs. of School
Marital Status

Married
Unmarried
Separated

 Dependents

No.
Ages

 Marital Status

Married
Unmarried
Separated

 Dependents Not Listed by Borrower

No.
Ages
Present Address: Present Address:
Street
 City
 Street
 City
State
 Zip
 State
 Zip
Own Rent No. Yrs. Own Rent No. Yrs.
IF AT PRESENT ADDRESS LESS THAN TWO YEARS ...
Former Address (1): Former Address (1):
Street
 City
 Street
 City
State
 Zip
 State
 Zip
Own Rent No. Yrs. Own Rent No. Yrs.
Former Address (2): Former Address (2):
Street
 City
 Street
 City
State
 Zip
 State
 Zip
Own Rent No. Yrs. Own Rent No. Yrs.

IV. EMPLOYMENT INFORMATION

Borrower Co-Borrower
Name of Employer:
 Name of Employer:
Attn: Attn:
Address: Address:
City: City:
State: Zip: State: Zip:
Self-employed
Yes No		 Years on this job:
 Self-employed
Yes No		 Years on this job:
Yrs. in current profession: Yrs. in current profession:
Position/Title/Type of Bus:
 Position/Title/Type of Bus:
Business Phone (incl. area code): 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 BELOW:
Name of Employer:
 Name of Employer:
Attn: Attn:
Address: Address:
City: City:
State: Zip: State: Zip:
Self-employed
Yes No		 From - To:
 Self-employed
Yes No		 From - To:
Monthly Income: $ Monthly Income: $
Position/Title/Type of Business:
 Position/Title/Type of Business:
Business Phone: Business Phone:
Name of Employer:
 Name of Employer:
Attn: Attn:
Address: Address:
City: City:
State: Zip: State: Zip:
Self-employed
Yes No		 From - To:
 Self-employed
Yes No		 From - To:
Monthly Income: $ Monthly Income: $
Position/Title/Type of Business:
 Position/Title/Type of Business:
Business Phone: Business Phone:

V. MONTHLY INCOME AND COMBINED HOUSING EXPENSE INFORMATION

Gross
Monthly
Income		 Borrower Co-Borrower Total
Base Empl.
Income*
Overtime
Bonuses
Commissions
Dividends/
Interest
Net Rental
Income
Other
Total $ $ $
*Self Employed Borrowers(s) may be required to provide additional documentation such as tax returns and financial statements.
Combined
Mthly Exp.
(Housing)		 Present Proposed
Rent NOT A FIELD
First
Mortgage
Other
Financing
Hazard
Insurance
Real Estate
Taxes
Mortgage
Insurance
Homeowner Assn. Dues
Other
Total

B/C Describe Other Income. Alimony, etc. need not be revealed if not to be
considered in repaymet of loan by Borrower (B) or Co-borrower (C)		 Monthly Amount
B
C		 $
B
C		 $
B
C		 $

VI. ASSETS AND LIABILITIES

ASSETS
Completed Jointly Not Jointly
Cash deposit held by: (for purchase only)

Amount:
$
Checking/Savings Accounts
Name of Bank/S&L/Credit Union:

Address:

City:

State: Zip:
A/C No.:
Balance: 		Name of Bank/S&L/Credit Union:

Address:

City:

State: Zip:
A/C No.:
Balance:
Name of Bank/S&L/Credit Union:

Address:

City:

State: Zip:
A/C No.:
Balance: 		Name of Bank/S&L/Credit Union:

Address:

City:
State: Zip:
A/C No.:
Balance:
Name of Bank/S&L/Credit Union:

Address:

City:

State: Zip:
A/C No.:
Balance: 		Stocks and Bonds:
Company name/number & description:

Amount:

Company name/number & description:

Amount:

Company name/number & description:

Amount:
Life Insurance Net Cash Value:
$

Face Amount:
$

Vested Interest in Retirement Fund:
$

Net Worth of Business(es) Owned:
$

Automobiles:
Year & Make: Value: $
Year & Make: Value: $

Other Assets: (e.g. Furniture, Jewelry, Household Goods, Personal Property, etc.)

Item:

Amount
$

Item:

Amount
$

Item:

Amount
$

Liabilities
Enter only if this is a refinance loan (details of first mortgage on subject property):

First Mortgage Creditor:
Name:
Loan Number:
Address:
City:
State: Zip: Monthly pmt: Balance:
Present Market Value:

Details of second mortgage on subject property (if any):

Second Mortgage Creditor:
Name:
Loan Number:
Address:
City:
State: Zip: Monthly pmt: Balance:

All other monthly liabilities:
(Include credit card debt, auto loans, student loans, instalment loans etc.) You may use an estimate; we will obtain details from your credit report.

Monthly pmt: Balance:

ALL REAL ESTATE OWNED (Enter total for all properties including subject property)

Property Address Status Type of Property Market Value Amt. of Liens Gross Income Mortgage Pmt Tax/Ins. Maint. Net Rental Inc
Sold
Pending
Rental
Sold
Pending
Rental
Sold
Pending
Rental

VII. DETAILS OF TRANSACTION

Purchase Price $
Alterations, improvements, repairs $
Land (if acquired separately) $
Refinance (incl. debt to be paid off) $

VIII. DECLARATIONS

Items Borrower Co-Borrower
a. Are there any outstanding judgements against you? Yes No Yes No
b. Have you been declared bankrupt within the last 7 years? Yes No Yes No
c. Have you had property foreclosed upon in the last 7 years? Yes No Yes No
d. Are you a party to a lawsuit? Yes No Yes No
e. Have you directly or indirectly been obligated on any loan which resulted in foreclosure, transfer of title in lieu of foreclosure, or judgment? Yes No Yes No
f. Are you presently delinquent or in default on any Federal debt or any other loan, mortgage, financial obligation, bond or loan guarantee? Yes No Yes No
g. Are you obligated to pay alimony child support or separate maintenance? Yes No Yes No
h. Is any part of the down payment borrowed? Yes No Yes No
i. Are you the co-maker or endorser on a note? Yes No Yes No
j. Are you a U.S. citizen? Yes No Yes No
k. Are you a permanent resident alien? Yes No Yes No
l. Do you intend to occupy the property as your primary residence? Yes No Yes No
m. Have you had an ownership interest in a property in the last 3 years? Yes No Yes No

If the answer to the above is "yes":

1. What type of property did you own? Principal residence
Second home
Investment Property		 Principal residence
Second home
Investment Property
2. How did you hold title to the home? Solely by yourself
Jointly with spouse
Jointly with another person		 Solely by yourself
Jointly with spouse
Jointly with another person

VIII. INFORMATION FOR GOVERNMENT MONITORING PURPOSES

This information is entirely optional.

Borrower Co-Borrower
I do not wish to furnish this information.

Race/National Origin:

Sex: Female Male

 I do not wish to furnish this information.

Race/National Origin:

Sex: Female Male

Please use the following space to describe in more detail what you are seeking by filling out this form (refinance, purchase, qualify etc.):

Congratulations! You have now completed the on-line loan application. We appreciate the time you have spent - it will result in reduced processing time beyond this point.

When you have verified your information entered and are ready to submit it to us, please click on the submit button below.

Click here when application is complete.

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ADDITIONAL FINANCIAL LINKS:
21st Century Loans | Laffranchini Financial