Online Loan Application

Complete Your URLA 1003 Form Online

Fill out this secure online application to get started with your mortgage loan process. All information is confidential and will be reviewed by your loan officer.

Secure & Encrypted

5-10 Minutes

URLA 1003 Compliant

Uniform Residential Loan Application

Please provide accurate information. All fields marked with * are required.

1. Loan and Property Information

Loan Amount *

$

Loan Purpose *

Property Street Address *

City *

State *

ZIP Code *

Property Type *

Occupancy *

2. Borrower Information

First Name *

Last Name *

Email Address *

Phone Number *

Date of Birth *

Social Security Number *

Marital Status *

Number of Dependents

3. Current Address

Current Street Address *

City *

State *

ZIP Code *

Housing Status *

Monthly Payment *

$

Years at Current Address *

Co-Borrower Information

Add Co-Borrower (If Applicable) Check this box if you have a co-borrower (spouse or another person applying with you)

Co-Borrower Personal Information

First Name *

Last Name *

Email Address *

Phone Number *

Date of Birth *

Social Security Number *

Relationship to Borrower *

Number of Dependents

Co-Borrower Current Address

Co-borrower lives at the same address as borrower

Current Street Address *

City *

State *

ZIP Code *

Housing Status *

Monthly Payment *

$

Years at Current Address *

Co-Borrower Employment Information

Employer Name *

Position/Title *

Employer Phone *

Employment Type *

Years at Current Job *

Monthly Gross Income *

$

Note: Co-borrower employment and financial details will be collected in subsequent sections of this application.

Your information is encrypted and secure

Employment & Financial Information

Section 4 & 5 of URLA 1003 - Please provide your current employment and financial details

4. Employment Information

Note: If you have been at your current job for less than 2 years, you must provide previous employment information. If you have a second job, please include that information as well.

Current Employment (Primary Job)

Employer Name *

Employer Address *

City *

State *

ZIP Code *

Employer Phone *

Position/Title *

Start Date *

Years at Current Job *

Employment Type *

Years in This Line of Work *

Borrower owned or Self-Employed? Self employed ownership is equal to or greater than 25%?

Self-Employment Details

Additional information required for self-employed applicants

Business Name *

Business Type *

Ownership Percentage *

%

Business Start Date *

Business Address *

City *

State *

ZIP Code *

Business Phone *

Federal Tax ID (EIN)

Note: Self-employed borrowers will need to provide 2 years of personal and business tax returns, profit & loss statements, and balance sheets.

Monthly Gross Income from This Job *

$

Previous Employment

Required if you've been at your current job less than 2 years

Previous Employer Name

Previous Position/Title

Previous Employer Phone

Start Date

End Date

Borrower owned or Self-Employed? Self employed ownership is equal to or greater than 25%?

Monthly Gross Income from Previous Job

$

Second Job (If Applicable)

Include any additional employment or part-time work

Second Employer Name

Position/Title

Employer Phone

Start Date

Employment Type

Borrower owned or Self-Employed? Self employed ownership is equal to or greater than 25%?

Monthly Gross Income from Second Job

$

Third Job (If Applicable)

Include any additional employment or side income

Third Employer Name

Employer Address

City

State

ZIP Code

Position/Title

Employer Phone

Start Date

Employment Type

Borrower owned or Self-Employed? Self employed ownership is equal to or greater than 25%?

Monthly Gross Income from Third Job

$

5. Monthly Income & Assets

Gross Monthly Income: Include base salary, overtime, bonuses, commissions, and any other income before taxes. Enter income from all jobs separately below.

Primary Job Income

Base Monthly Income (Primary Job) *

$

Overtime/Bonus (Monthly Avg - Primary Job)

$

Commissions (Monthly Avg - Primary Job)

$

Second Job Income (If Applicable)

Base Monthly Income (Second Job)

$

Overtime/Bonus (Monthly Avg - Second Job)

$

Third Job Income (If Applicable)

Base Monthly Income (Third Job)

$

Overtime/Bonus (Monthly Avg - Third Job)

$

Other Income Sources

Rental income, investments, alimony, child support, etc.

Other Monthly Income

$

Source of Other Income

Total Monthly Gross Income

Sum of all income sources listed above

Will be calculated

$___.__

Assets & Down Payment

Checking/Savings Balance *

$

Retirement Accounts (401k, IRA)

$

Stocks/Bonds/Investments

$

Down Payment Amount *

$

Co-Borrower Employment & Financial Information

Complete this section only if you have a co-borrower

Note: If a co-borrower was added in Section 2/3, please provide their complete employment and financial information below. This information mirrors what was collected for the primary borrower.

Co-Borrower Current Employment (Primary Job)

Employer Name *

Employer Address *

City *

State *

ZIP Code *

Employer Phone *

Position/Title *

Start Date *

Years at Current Job *

Employment Type *

Years in This Line of Work *

Borrower owned or Self-Employed? Self employed ownership is equal to or greater than 25%?

Monthly Gross Income from This Job *

$

Co-Borrower Previous Employment

Required if co-borrower has been at current job less than 2 years

Previous Employer Name

Previous Position/Title

Previous Employer Phone

Start Date

End Date

Borrower owned or Self-Employed? Self employed ownership is equal to or greater than 25%?

Monthly Gross Income from Previous Job

$

Co-Borrower Second Job (If Applicable)

Include any additional employment or part-time work

Second Employer Name

Position/Title

Employer Phone

Start Date

Employment Type

Borrower owned or Self-Employed? Self employed ownership is equal to or greater than 25%?

Monthly Gross Income from Second Job

$

Co-Borrower Third Job (If Applicable)

Include any additional employment or side income

Third Employer Name

Employer Address

City

State

ZIP Code

Position/Title

Employer Phone

Start Date

Employment Type

Borrower owned or Self-Employed? Self employed ownership is equal to or greater than 25%?

Monthly Gross Income from Third Job

$

Co-Borrower Monthly Income & Assets

Co-Borrower Primary Job Income

Base Monthly Income (Primary Job)

$

Overtime/Bonus (Monthly Avg - Primary Job)

$

Commissions (Monthly Avg - Primary Job)

$

Co-Borrower Other Income Sources

Rental income, investments, alimony, child support, etc.

Other Monthly Income

$

Source of Other Income

Co-Borrower Assets

Checking/Savings Balance

$

Retirement Accounts (401k, IRA)

$

Stocks/Bonds/Investments

$

Online Loan Application

Uniform Residential Loan Application

1. Loan and Property Information

2. Borrower Information

3. Current Address

Previous Address

Co-Borrower Information

Co-Borrower Personal Information

Co-Borrower Current Address

Co-Borrower Previous Address

Co-Borrower Employment Information

Employment & Financial Information

4. Employment Information

Current Employment (Primary Job)

Self-Employment Details

Previous Employment

Second Job (If Applicable)

Third Job (If Applicable)

5. Monthly Income & Assets

Primary Job Income

Second Job Income (If Applicable)

Third Job Income (If Applicable)

Other Income Sources

Total Monthly Gross Income

Assets & Down Payment

Co-Borrower Employment & Financial Information

Co-Borrower Current Employment (Primary Job)

Co-Borrower Previous Employment

Co-Borrower Second Job (If Applicable)

Co-Borrower Third Job (If Applicable)

Co-Borrower Monthly Income & Assets

Co-Borrower Primary Job Income

Co-Borrower Other Income Sources

Co-Borrower Assets

Liabilities & Declarations

6. Current Liabilities

Co-Borrower Current Liabilities

7. Declarations

Co-Borrower Declarations

Demographic Information

Why We Collect This Information

Primary Borrower Demographic Information

Co-Borrower Demographic Information

Fair Lending Notice

Additional Information

Consent & Authorization

Total Borrowers

Application Submitted Successfully!

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