Uniform Residential Loan Application Form Page 2
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1
2
3
4Borrower
IV. EMPLOYMENT INFORMATION
Co-Borrower
Yrs. on this job
Yrs. on this job
Name & Address of Employer
Name & Address of Employer
Self Employed
Self Employed
Yrs. employed in this
Yrs. employed in this
line of work/profession
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 & Address of Employer
Dates (from-to)
Name & Address of Employer
Dates (from-to)
Self Employed
Self Employed
Monthly Income
Monthly Income
$
$
Position/Title/Type of Business
Business Phone (incl. area code)
Position/Title/Type of Business
Business Phone (incl. area code)
Name & Address of Employer
Name & Address of Employer
Dates (from-to)
Dates (from-to)
Self Employed
Self Employed
Monthly Income
Monthly Income
$
$
Position/Title/Type of Business
Business Phone (incl. area code)
Position/Title/Type of Business
Business Phone (incl. area code)
Name & Address of Employer
Name & Address of Employer
Dates (from-to)
Self Employed
Dates (from-to)
Self Employed
Monthly Income
Monthly Income
$
$
Position/Title/Type of Business
Business Phone (incl. area code)
Position/Title/Type of Business
Business Phone (incl. area code)
Name & Address of Employer
Name & Address of Employer
Self Employed
Dates (from-to)
Self Employed
Dates (from-to)
Monthly Income
Monthly Income
$
$
Position/Title/Type of Business
Business Phone (incl. area code)
Position/Title/Type of Business
Business Phone (incl. area code)
V. MONTHLY INCOME AND COMBINED HOUSING EXPENSE INFORMATION
Combined Monthly
Gross
Monthly Income
Borrower
Co-Borrower
Total
Housing Expense
Present
Proposed
Base Empl. Income*
$
$
$
Rent
$
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
$
$
$
Total
$
$
*
Self Employed Borrower(s) may be required to provide additional documentation such as tax returns and financial statements.
Notice:
Describe Other Income
Alimony, child support, or separate maintenance income need not be revealed if the
Borrower (B) or Co-Borrower (C) does not choose to have it considered for repaying this loan.
B/C
Monthly Amount
$
Borrower
Uniform Residential Loan Application
Co-Borrower
Freddie Mac Form 65
7/05 (rev. 6/09)
Fannie Mae Form 1003 7/05 (rev. 6/09)
Page 2
of 4
Calyx Form - Loanapp2.frm (11/09)
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