6. Mortgage guaranty insurer (if any: )

(Borrower's Name)	(Social Security Number)
(Borrowers E-Mail Address)
(Borrower's Name)	(Social Security Number)
(Borrowers E-Mail Address)
(Borrower's Name)	(Social Security Number)
(Borrowers E-Mail Address)
(Borrower's Name)	(Social Security Number)
(Borrowers E-Mail Address)

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 a 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
Amount	Interest Rate	No. of Months	Amortization Type:	Fixed Rate GPM Other(explain): ARM(type):
II. PROPERTY INFORMATION AND PURPOSE OF LOAN
Subject Property Address (street, city, state & zip code)				No. of Units
Legal Description of Subject Property				Year Built
Purpose of Loan: Purchase Construction Refinance Construction-Permanent Other (explain):				Property will be: Primary Residence Secondary Residence Investment

Complete this line if construction or construction-permanent loan.

Year Lot Acquired

Original Cost

Amount Existing Liens

(a) Present Value of Lot

(b) Cost of Improvements

Total (a + b)

Complete this line if this is a refinance loan.

Year Lot Acquired

Original Cost

Amount Existing Lien

Purpose of Refinance

Describe Improvements made 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 (show expiration date)
Source of Down Payment, Settlement Charges and/or subordinate Financing (explain)

III. Borrower Information
Borrower
Borrower's Name (include Jr. or Sr. if applicable)
Social Security Number	Home Phone (include area code)	Age
Married Separated Unmarried (include single, divorced, widowed)	Dependents (not listed by Co-Borrower) No. Ages:	Yrs. School
Present address (street, city, state, zip code)		own rent No. Yrs.
If residing at present address for less than two years, complete the following:
Former Address (street, city, state, zip code)		own rent No. Yrs.
Former Address (street, city, state, zip code)		own rent No. Yrs.

Co-Borrower
Co-Borrower's Name (include Jr. or Sr. if applicable)
Social Security Number	Home Phone (include area code)	Age
Married Separated Unmarried (include single, divorced, widowed)	Dependents (not listed by Borrower) no. Ages:	Yrs. School
Present address (street, city, state, zip code)		own rent No. Yrs.
If residing at present address for less than two years, complete the following:
Former Address (street, city, state, zip code)		own rent No. Yrs.
Former Address (street, city, state, zip code)		own rent No. Yrs.

IV. Employment Information
Borrower	Co-Borrower
Name and Address of Employer Self-employed	Name and Address of Employer Self-employed
Yrs. on this job Yrs. employed in the line of work/profession	Yrs. on this job Yrs. employed in the line of work/profession
Position/Title/Type of Business Business Phone (incl. area code)	Position/Title/Type of Business 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 the following:
Name and Address of Employer Self-employed	Name and Address of Employer Self-employed
Dates (from-to) Monthly Income	Dates (from-to) Monthly Income
Position/Title/Type of Business Business Phone (incl. area code)	Position/Title/Type of Business Business Phone (incl. area code)
Name and Address of Employer Self-employed	Name and Address of Employer Self-employed
Dates (from-to) Monthly Income	Dates (from-to) Monthly Income
Position/Title/Type of Business Business Phone (incl. area code)	Position/Title/Type of Business Business Phone (incl. area code)

"I/We acknowledge that the information provided in this section is true and correct

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 (before completing, see the notice in "describe other income," below)

Combined Monthly Housing Expenses	Present	Proposed
Rent
First Mortgage (P & I)
Other Financing (P& I)
Hazard Insurance
Real Estate Taxes
Mortgage Insurance
Homeowner Assn. Dues
Other:

*Self Employed Borrower(s) may be required to provide additional documentation such as tax returns and financial statements.

Describe Other Income Notice: Alimony child support, or seperate maintenance income need not be revealed if the Borrower or Co-borrower does not choose to have it considered for repaying this loan.

Borrower Monthly Amount Co-Borrower 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 deposit toward purchase held by	Amount
Bank Address	Account Number Type Savings Checking	Amount
Bank Address	Account Number Type Savings Checking	Amount
Bank Address	Account Number Type Savings Checking	Amount
Bank Address	Account Number Type Savings Checking	Amount
Stocks & Bonds (Company name/number & description)		Amount
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(s) owned
Automobiles owned (make and year)
Other Assets (itemize)

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. Indicate by (*) those liabilities which will be satisfied upon sale of real estate owned or upon refinancing of the subject property.

LIABILITIES	Monthly Payt. & Mos. Left to Pay	Unpaid Balance
Name and Address of Company	$ Monthly Payment Months Left to Pay
Acct. no.
Name and Address of Company	$ Monthly Payment Months Left to Pay
Acct. no.
Name and Address of Company	$ Monthly Payment Months Left to Pay
Acct. no.
Name and Address of Company	$ Monthly Payment Months Left to Pay
Acct. no.
Name and Address of Company	$ Monthly Payment Months Left to Pay
Acct. no.
Name and Address of Company	$ Monthly Payment Months Left to Pay
Acct. no.
Name and Address of Company	$ Monthly Payment Months Left to Pay
Acct. no.
Alimony/Child Support/ Separate Maintenance Payments Owed to:
Job Related Expense (child care, union dues, etc.)

"I/We acknowledge that the information provided in this section is true and correct

VI. Assets and Liabilities (cont.)

Schedule of Real Estate Owned

Property Address (Enter S if Sold, PS if pending sale or R if rental being held for income)	Type of Property	Present Market Value	Amount of Mortgages & Liens	Gross Rental Income	Mortgage Payments	Insurance, Maintenance, Taxes & Misc.
Net Rental Income
Net Rental Income
Net Rental Income
Net Rental Income

List any additional names under which credit has previously been received and include appropriate creditor name(s) and account number(s):

Alternate Name	Creditor Name	Account Number

VII. Details of Transaction
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. Subordinate Financing	$

VIII. Declarations
	Borrower	Co-Borrower
a. Are there any outstanding judgments against you?	yes no	yes no
b. Have you been declared bankrupt within the past 7 years?	yes no	yes no
c. Have you had property foreclosed upon of given title or deed in Lieu thereof 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? (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)	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 a 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? (if "yes", complete question m below.	yes no	yes no
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)?	yes no	yes no

IX. Acknowledgment 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 in this application are made for the purpose of obtaining the loan indicated herein; (4) occupation of the property will be as 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 names 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 a 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 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 or assigns made no representation 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 obtained in this application may result in civil liability and/or criminal penalties including, but not limited to, fine or imprisonment or 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 or assigns, insurers and any other person who may suffer any loss due to reliance upon any misrepresentations which I/we have made on this application.

Borrower's Agreement to Terms above

Date

Co-Borrower's Agreement to Terms above

Date

X. Information for Government Monitoring Purposes

The following information is requested by the Federal Government for certain types of loans related to 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 virtual observation or surname. If you do not wish to furnish the above information, please check the box below. (Lender must review the above material to assure that the disclosures satisfy all requirements to which the Lender is subject under applicable state law for the particular type of loan applied for.)

BORROWER
Race/National Origin:	I do not wish to furnish this information American Indian or Alaskan Native Asian or Pacific Islander White, not of Hispanic origin Black, not of Hispanic origin Hispanic Other(specify)
Sex:	Female Male

CO-BORROWER
Race/National Origin:	I do not wish to furnish this information American Indian or Alaskan Native Asian or Pacific Islander White, not of Hispanic origin Black, not of Hispanic origin Hispanic Other(specify)
Sex:	Female Male