Uniform Residential Loan Application (Page 2 of 6) in pdf

FARM CREDIT EAST, ACA

Borrower

IV. EMPLOYMENT INFORMATION

Co-Borrower

Yrs. on this job

Name & Address of Employer

Self Employed

Name & Address of Employer

Self Employed

Yrs. employed

in this line of

work/profession:

Position/Title/Type of Business

Bus. Phone (incl. area code)

Position/Title/Type of Business

Bus. Phone:

If employed in current position for less than two years or if currently employed in more than one position, complete the foll owing:

Name & Address of Employer

Self Employed

Dates (from-to)

Name & Address of Employer

Self Employed

Dates (from-to)

Monthly Income

Position/Title/Type of Business

Bus. Phone (incl. area code)

Position/Title/Type of Business

Bus. Phone (incl. area code)

Name & Address of Employer

Self Employed

Dates (from-to)

Name & Address of Employer

Self Employed

Dates (from-to)

Monthly Income

Position/Title/Type of Business

Bus. Phone(incl. area code)

Position/Title/Type of Business

Bus. Phone (incl. area code)

V. MONTHLY INCOME AND COMBINED HOUSING EXPENSE INFORMATION

Combined

Gross Monthly Income

Borrower

Co-Borrower

Total

Monthly Housing Expense

Present

Proposed

Base Empl. Income *

Rent

XXXXXXXXXXX

Overtime

First Mortgage (P&I)

Bonuses

Other Financing (P&I)

Commissions

Hazard Insurance

Dividends/Interest

Real Estate Taxes

Net Rental Income

Mortgage Insurance

Other( before completing

Homeowner Assn. Dues

see the notice in “describe

Other:

other income: below)

TOTAL

* 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 separate maintenance income need not be revealed if the Borrower (B) or Co-Borrower (C) does not want

to have it considered for repaying this loan.

B/C

Source

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 non-

applicant spouse or other person, this Statement and supporting schedules must be completed about that spouse or other person also.

Completed:

Jointly

Not Jointly

Liabilities and Pledged Assets. List the creditor’s name, address and account number for all outstanding

ASSETS

CASH OR MARKET

Description

VALUE

debts, including automobile loans, revolving charge accounts, real estate loans, alimony, child support,

stock pledges etc. Use continuation sheet, if necessary. Indicate by (*) those liabilities which will be

Cash deposit toward purchase held by: