1003 – Online Uniform Residential Loan Application

Type of Mortgage and Terms of Loan

Are you in contact with a Loan Officer? If yes, choose name: —Please choose an option—Augustine (Austin) JourdanDavid T BackamKiran M MoorayMalik M TanveerMarayyam K jonesMaria GamblinTeena B Bister

The income or assets of a person other than the "Borrower" (including the Borrowers spouse) will be used as a basis for loan qualification.The income or assets of the Borrower's spouse will not be used as a basis for loan qualification.

Loan Applied For:

V.AConventionalFHAUSDA/Rural Housing ServiceOther

Loan, Tax & Insurance Information

Amortization Type: (Choose one)

Fixed RateGPMARMOther

Property Information And Purpose Of Loan

Subject Property Address:

Year Built:

Legal Description:

Purpose of Loan: (Choose one)

PurchaseConstructionRefinanceConstr.-permanentOther

Property will be used as: (Choose one)

Primary ResidenceSecondary ResidenceInvestment

Complete below if construction or construction-to-permanent loan

Year Lot Acquired:

Complete below if this is a refinance loan

Year Acquired:

Purpose of Refinance:

No Cash-OutCash-Out/OtherCash-Out/Home ImprovemenCash-Out/Debt ConsolidationLimited Cash-Out

Improvements Made:

UnknownMadeTo Be Made

Vesting Information

Source of Down Payment, Settlement Charges and/or Subordinate Financing:

Checking/SavingsDeposit on Sales ContractEquity Sold on PropertyEquity Pending from SaleEquity Pending from Subject PropertyGift FundsStocks and BondsLot EquityBridge LoanUnsecured Borrowed FundsTrust FundsRetirement FundsRent with Option to PurchaseLife Insurance Cash ValueSale of ChattelTrade EquitySweat EquityCash on HandSecured Borrowed FundsFHA - Gift - Source   N/A   Relative   Government Assistance   Employer   Nonprofit/Religious/Community Seller Funded   Nonprofit/Religious/Community Non-seller FundedOther

Estate will be held in:

Fee SimpleLeasehold

If Leasehold Estate, enter expiration date:

Personal Information