UNIFORM RESIDENTIAL LOAN APPLICATION

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.

Amount: $

Please enter numeric data only (no decimals, commas or dollar signs)

Property Address:

Street:

City:

St:

Zipcode:

No. of Units: Single Family HomeCondo/TownhomeDuplexTri-Plex4-Plex	Year Built:
Purpose of Loan: Purchase Construction Permanent Construction Refinance Other	Property will be: Primary Residence Secondary Residence Investment

Complete this line only if this is a refinance loan.

Year Acquired	Original Cost	Existing Liens	Purpose of Refinance
	$	$
Your extimate of current market value of home. $

Borrower		Co-Borrower
Name (include Jr. or Sr. if applicable)		Name (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	Addl Dependents 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:		Former Address:
Street	City	Street	City
State	Zip	State	Zip
Own Rent	No. Yrs.	Own Rent	No. Yrs.

Gross Monthly Income Borrower Co-Borrower Base Empl, Income* Overtime Bonuses Commissions Dividends/ Interest Net Rental Income Other *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 First Mortgage Other Financing Hazard Insurance Real Estate Taxes Homeowner Assn. Dues Other

ASSETS
Completed Jointly Not Jointly
Cash deposit held by: (for purchase only)	Amount: $
Checking/Savings Accounts
Name of Bank/S&L/Credit Union: A/C No.: Balance:	Name of Bank/S&L/Credit Union: A/C No.: Balance:
Name of Bank/S&L/Credit Union: A/C No.: Balance:	Name of Bank/S&L/Credit Union: A/C No.: Balance:
Name of Bank/S&L/Credit Union: A/C No.: Balance:	Stocks and Bonds: Company name/number & description: Amount: Company name/number & description: Amount: Company name/number & description: Amount:
Vested Interest in Retirement Fund: $ Automobiles: Year & Make: Value: $ Year & Make: Value: $ (e.g. 1992 Toyota Camry)	Other Assets: (e.g. Furniture, Jewelery, Household Goods, Personal Property, etc.) $

Liabilities
Enter only if this is a refinance loan (details of first mortgage on subject property): First Mortgage Creditor: Name Monthly pmt. Balance
Details of second mortgage on subject property (if any): Second Mortgage Creditor: Name 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

OTHER REAL ESTATE OWNED (Enter total for all properties not including subject property)

Market Value

Amt. of Liens

Rental Income

Mortgage Pmt

Tax/Ins. Maint.

Net Rental Inc

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 m 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

This information is entirely optional.

Borrower	Co-Borrower
I do not wish to furnish this information Race/National Origin: American Indian/Alaskan Native Asian or Pacific Islander Black Hispanic White Other Sex: Female Male	I do not wish to furnish this information Race/National Origin: American Indian/Alaskan Native Asian or Pacific Islander Black Hispanic White Other Sex: Female Male

The Housing Financial Discrimination Act of 1977

It is illegal to discriminate in the provision of or in the availability of financial assistance because of the consideration of: Trends, characteristics or conditions in the neighborhood or geographic area surrounding housing accommodation, unless the financial institution can demonstrate in the particular case that such consideration is required to avoid an unsafe and unsound business practice, or, Race, color, religion, sex, marital status, national origin or ancestry. It is illegal to consider the racial, ethnic, religious or national origin composition of a neighborhood or geographic area surrounding a housing accommodation or whether or not such composition is undergoing change, or is expected to undergo change, in appraising a housing accommodation or in determining whether or not, or under what terms and conditions, to provide financial assistance. These provisions govern financial assistance for the purchase, construction, rehabilitation or refinancing of one-to-four unit family residences occupied by the owner and for the purpose of home improvement of any one-to-four unit family residence. The Federal Equal Credit Opportunity Act (ECOA) prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national origin, sex, marital status, age (provided that the applicant has the capacity to enter into a binding contract); because all or part of the applicant's income derives from any public assistance program; or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. The Federal Agency which administers compliance with this law is the Federal Trade Commission, D.C.

Please use the space below for additional information/explanation