I. TYPE OF MORTGAGE AND TERMS OF LOAN
Mortgage Applying For:
Requested Loan Amount
Requested Rate
Rate Type
Amortization or Term Request
II. PROPERTY INFORMATION AND PURPOSE OF LOAN
Subject Property Address
City
State
Zip
Property Type
Legal Description of Subject Property
Purpose of Loan
Property will be:
Purpose of Refinance
Year Home Purchased
Original Cost
Mortgage Balance
Property Value
Title will be held in what name(s)
Manner in which Title will be Held
III. BORROWER INFORMATION
Borrower's Name (First & Last)
Home Phone (Inc. area code)
DOB(mm/dd/yyyy)
Yrs. In school
Marital Status
No. of Dependents
Social Security Number (optional)
Email Address (required)
Present Address if different from Subject Property Address:
Present Address
City
State
Zip
III B. CO-BORROWER INFORMATION
Co-Borrower's Name (First & Last)
Home Phone (Inc. area code)
DOB(mm/dd/yyyy)
Yrs. In school
Marital Status
No. of Dependents
Social Security Number (optional)
Email Address
Present Address if different from Subject Property Address:
Present Address
City
State
Zip
IV. EMPLOYMENT INFORMATION FOR BORROWER
Name of Employer
Address
City
State
Zip
Work Phone
Employment
Years Employed
Position/ Title
Estimated Gross Monthly Income
IV B. EMPLOYMENT INFORMATION FOR CO-BORROWER
Name of Employer
Address
City
State
Zip
Work Phone
Employment
Years Employed
Position/ Title
Estimated Gross Monthly Income
V. ADDITIONAL INFORMATION
Credit Rating
Current Rate
Current Rate Type
Payment History
How many times late on mortgage  in the last 12 months?
Co-Borrower's Credit Rating
Mortgage Payment (principal & interest)
Annual Taxes
Annual Insurance
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FHA Uniform Residential Loan Application