Uniform Residential Loan Application
This form is normally filled in by the borrower and or co-borrower with the assistance of the lender. Should you have any problems filling out some parts, please call me at 954-565-1400 or 866-565-1400.

- Kim Naimoli

1. TYPE OF MORTGAGE AND TERMS OF LOAN

Mortgage Applied For:

VA
FHA
Conventional
FmHA
Other

Amount $ 
Interest Rate:%
Number of Months:

Amortization Type:
Fixed Rate
GPM
Other (explain)
ARM (Type)

2. PROPERTY INFORMATION AND PURPOSE OF LOAN

Subject Property Address

Street:
Street:
City:
State:
Zip:
No. of Units:
Year Built:
Legal Description of Property:

Purpose of loan:

Purchase
Refinance
Construction
Construction Permanent
Other

Property Will Be:

Primary Residence
Secondary Residence
Investment

Complete this section if this is a construction or construction permanent loan.

Year Lot Acquired:
Original Cost: $
Amount Existing Liens: $
(a) Present Value of Lot: $
(b) Cost of Improvements: $
(a)+(b) Total: $


Complete this section if this is a refinance loan.
Year Acquired:
Original Cost: $
Amount Existing Liens: $
Purpose of Refinance:
Describe Improvements:
Cost of Improvements Made: $
Cost of Improvements to be Made: $ 


Title Will be Held in What Name(s):
Manner in Which Title Will be Held:
Source of Down Payment:

Estate Will Be Held in:

Fee Simple
Leasehold

3. BORROWER INFORMATION
Copyright © 2000 Coral Mortgage, Inc.. All rights reserved.
Revised: July 09, 2007.

Borrower Information:

Borrower's First Name & M.I.:
Borrower's Last Name:
Borrower's Email Address:
Social Security Number:
Home Phone (Including Area Code):
Age:
Yrs. School:
Married
Separated
Unmarried (Include Single, Divorced,Widowed)

Dependents (Not Listed By Co-Borrower)
No.
Ages:


Present Address
Street:
Street:
City:
State:
Zip:
No. Years: OwnRent



If Residing at Present Address Less Than Two Years, Complete the Following:



Former Address
Street:
Street:
City:
State:
Zip:
No. Years: OwnRent

Former Address
Street:
Street:
City:
State:
Zip:
No. Years: OwnRent






Co-Borrower Information:
Co-Borrower's First Name & M.I.:
Borrower's Last Name:
Social Security Number:
Home Phone (Including Area Code):
Age:
Yrs. School:
Married
Separated
Unmarried (Include Single, Divorced,Widowed)

Dependents (Not Listed By Borrower)
No.
Ages:


Present Address
Street:
Street:
City:
State:
Zip:
No. Years: OwnRent



If Residing at Present Address Less Than Two Years, Complete the Following:



Former Address
Street:
Street:
City:
State:
Zip:
No. Years: OwnRent

Former Address
Street:
Street:
City:
State:
Zip:
No. Years: OwnRent


4. Employment Information


Borrower Employment Information

Name and Address of Employer

Company: Self Employed
Street:
Street:
City:
State:
Zip:
Dates: (from-to)
Position:
Monthly Salary:$
Business Phone (Incl. Area Code):


If Employed in Current Position for Less Than 2 Years or if Currently in More Than One Position, Complete the Following:



Name and Address of Employer

Company: Self Employed
Street:
Street:
City:
State:
Zip:
Dates: (from-to)
Position:
Monthly Salary:$
Business Phone (Incl. Area Code):


Name and Address of Employer

Company: Self Employed
Street:
Street:
City:
State:
Zip:
Dates: (from-to)
Position:
Monthly Salary:$
Business Phone (Incl. Area Code):






Co-Borrower Employment Information

Name and Address of Employer

Company: Self Employed
Street:
Street:
City:
State:
Zip:
Dates: (from-to)
Position:
Monthly Salary:$
Business Phone (Incl. Area Code):


If Employed in Current Position for Less Than 2 Years or if Currently in More Than One Position, Complete the Following:



Name and Address of Employer

Company: Self Employed
Street:
Street:
City:
State:
Zip:
Dates: (from-to)
Position:
Monthly Salary:$
Business Phone (Incl. Area Code):


Name and Address of Employer

Company: Self Employed
Street:
Street:
City:
State:
Zip:
Dates: (from-to)
Position:
Monthly Salary:$
Business Phone (Incl. Area Code):


5. 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


Combined Monthly Housing Expense Present Proposed
Rent  
First Mortgage (P/I)
Other Financing (P/I)
Hazard Insurance
Real Estate Taxes
Mortgage Insurance
Homeowner Assn. Dues
Other
TOTAL


6. Assets and Liabilities

ASSETS



Name of Company Cash Value
Cash Deposit Toward Purchase
Checking/Savings Account
Checking/Savings Account
Checking/Savings Account
Checking/Savings Account
Stocks and Bonds
Life Insurance
Real Estate owned (Enter Market Value)
Vested Interest in Retirement Fund
Net Worth of Businesses Owned
Automobiles Owned
Other Assets
Total Assets (a)


LIABILITIES



Company Monthly Payment Months Left Unpaid Balance
Alimony/Child Support
Job Related Expenses (Child care, Union dues etc.)
Total Monthly Payments
Total Liabilities (b)
Net Worth ((a)-(b))


7. Details of Transaction


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. Estimated Closing Costs
g. PMI, MIP, Funding Fee
h. Discount (If Borrower Will Pay)
Total Costs (add Items a through h)
j. Subordinate Financing
k. Borrower's Closing Costs Paid by Seller
l. Other Credits
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)


8. Declarations


If you answer yes to any questions a through l, please use the following text box. Borrower Co-Borrower
yes No Yes No
a. Are there any outstanding judgments against you?
b. Have you been declared bankrupt within the past 7 years?
c. Have you had property foreclosed upon or given title or deed in lieu thereof in the last 7 years?
d. Are you a party to a lawsuit?
e. Have you directly or indirectly been obliged 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 preceeding 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 Principle 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)?



9. Acknowledement and Agreement


MAY WE OBTAIN YOUR CREDIT REPORT IN CONNECTION WITH THIS APPLICATION? NOTE: WE CANNOT ISSUE AN APPROVAL LETTER UNTIL WE HAVE REVIEWED YOUR CREDIT.



Please type: "Yes, get credit report." Or "No, do not get credit report."

10. Information for Government Monitoring Purposes

Borrower:


American Indian or Alaskan Native
Black, not of Hispanic Origin
Asian or Pacific Islander
Hispanic
White, not of Hispanic Origin
Other (Specify)

Male
Female

Co-Borrower:


American Indian or Alaskan Native
Black, not of Hispanic Origin
Asian or Pacific Islander
Hispanic
White, not of Hispanic Origin
Other (Specify)

Male
Female
If you are confident that the information you have enclosed is accurate to the best of your knowledge, click on the "submit" button to send your application.