Credit Application Form – Fill Out and Use

Universal Credit Application

(Consumer Residential Real Estate)

1. Type of Application

(Check only one of the four checkboxes; and sign, if joint credit)

lIndividual Credit. If checked, this is an Application for Individual Credit - relying solely on my income and assets.

lIndividual Credit with Another. If checked, this is an Application for Individual Credit - relying on my income and assets and on income and/or assets of another as a basis for loan qualification. (Complete Applicant and Co-Applicant sections.)

lIndividual Credit (Community Property State). If checked, this is an Application for Individual Credit - relying on my income or assets. The income or assets of my spouse (or other person), who has community property rights pursuant to state law, will not be used as a basis for loan qualification. However, his or her liabilities must be considered because my spouse (or other person) has community property rights pursuant to applicable law, and, as Applicant, I reside in a community property state, the property that will secure the loan is located in a community property state, or I am relying on other property located in a community property state as a basis for repayment of the loan. (Complete Applicant and Co-Applicant sections.)

lJoint Credit. If checked, this is an Application for Joint Credit. By signing below, the Applicant and Co-Applicant agree that each of us intend to apply for joint credit. (Complete Applicant and Co-Applicant sections.)

Applicant for Joint CreditCo-Applicant for Joint Credit

2. Type of Mortgage and Terms of Credit

Mortgage Applied For			Lender's Case No.
l Rental Purchase	l Rental Refinance	l Home Equity/HELOC	l Home Improvement
Amount/Credit Limit	Interest Rate	No. of Months	Amortization Type
$		%	l Fixed l ARM l

3. Property Information and Purpose of Credit

Complete this line if construction or construction-permanent loan.

Year Lot

Original Cost

Amount Existing

(a) Present Value of

(b) Cost of

Total (a + b)

Acquired

Liens

Lot

Improvements

$

$

$

$

$

Complete this line if this is a refinance loan.

Describe Improvements

Year

Original Cost

Amount Existing

Purpose of Refinance

l made

l to be made

Acquired

Liens

$

$

Cost: $

Title will be held in what Name(s)

Manner in which Title will be held

Estate will be held in:

l Fee Simple

Source of Down Payment, Settlement Charges, and/or Subordinate Financing (explain)

l Leasehold (show

expiration date)

Applicant

4. Applicant Information

Co-Applicant

Applicant's Name

Co-Applicant's Name

Social Security No.

Primary Phone

Date of Birth

Social Security No.

Primary Phone

Date of Birth

ID Type & No.

Issued By

Issue Date

Exp. Date

ID Type & No.

Issued By

Issue Date

Exp. Date

E-mail Address

E-mail Address

l Married

l Separated

Dependents

l Married

l Separated

Dependents

(including registered

(not listed by Co-Applicant)

(including registered

(not listed by Applicant)

domestic partner or civil union)

domestic partner or civil union)

l Unmarried

No. Ages

l Unmarried

No. Ages

(including single, divorced, widowed)

(including single, divorced, widowed)

Present Address

l Own l Rent l

No. Yrs.

Present Address l Own l Rent

l

No. Yrs.

Universal Credit Application-Real Estate	UCA-RE 11/1/2010
VMP , Bankers Systems* Custom MDF. ETXUCARE	VMPC148R (1011).00
Wolters Kluwer Financial Services - 2009, 2010	Page 1 of 5

	Applicant	5. Employment	Information	Co-Applicant
	Name & Address of Employer l Self Employed	Yrs. on this job	Name & Address of Employer l Self Employed		Yrs. on this job
		Yrs. employed in			Yrs. employed in
		this line of			this line of
		work/profession			work/profession
Position/Title/Type of Business		Business Phone	Position/Title/Type of Business		Business Phone

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

l Self Employed

Dates (from - to)

Name & Address of Employer l Self Employed

Dates (from - to)

Business Phone

Business Phone

Position/Title/Type of Business

Gross Monthly

Position/Title/Type of Business

Gross Monthly

Income

Income

$

$

Name & Address of Employer

l Self Employed

Dates (from - to)

Name & Address of Employer l Self Employed

Dates (from - to)

Business Phone

Business Phone

Position/Title/Type of Business

Gross Monthly

Position/Title/Type of Business

Gross Monthly

Income

Income

$

$

6. Monthly Income and Combined Housing Expense Information

Gross Monthly

Applicant

Co-Applicant

Total

Combined Monthly

Present

Proposed

Income

Housing Expense

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

Homeowner Assn.

(before completing, see

Dues

the notice in "Describe

Other Income," below)

Other

Total

$

$

$

Total

$

$

* Self Employed Applicant(s) may be required to provide additional documentation such as tax returns and financial statements.

	Describe Other	Notice: Alimony, child support, or separate maintenance
A/C	Income	income need not be revealed if the Applicant (A) or Co-Applicant (C)	Monthly Amount
		does not choose to have it considered for repaying this loan.
			$

7. Assets and Liabilities

This Statement and any applicable supporting schedules may be completed jointly by both married and unmarried Co-Applicants 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-Applicant section was completed about a non-applicant spouse or other person, this Statement and supporting schedules must also be completed about that spouse or

other person.	Completed	l Jointly l Not Jointly

Schedule of Real Estate Owned. (If additional properties are owned, use continuation sheet.)

Property Address

Type of

Present

Amount of

Gross Rental

Mortgage

Insurance,

Net Rental

(enter S if sold, PS if pending sale,

Maintenance,

Mortgages &

R if rental for income or O for other)

Property

Market Value

Liens

Income

Payments

Taxes & Misc.

Income

$

$

$

$

$

$

Totals

$

$

$

$

$

$

List any additional names under which credit has previously been received and indicate appropriate creditor name(s) and account

number(s):	Alternate Name	Creditor Name	Account Number

Universal Credit Application-Real Estate	UCA-RE 11/1/2010
VMP , Bankers Systems* MDF. ETXUCARE	VMPC148R (1011).00
Wolters Kluwer Financial Services - 2009, 2010	Page 2 of 5

7. Assets and Liabilities (Continued)

	Assets			Cash or Market		Liabilities and Pledged Assets. List the creditor's name, address, and
	Description			Value		account number for all outstanding debts, including automobile loans,
	Cash deposit toward purchase		$			revolving charge accounts, real estate loans, alimony, child support, stock
	held by:					pledges, etc. Use continuation sheet, if necessary. Indicate by (*) those
						liabilities, which will be satisfied upon sale of real estate owned or upon
						refinancing of the subject property.
						Liabilities			Monthly Payment &	Unpaid Balance
	List checking and savings accounts below
									Months Left to Pay
	Name and address of Bank, S&L, or Credit Union					Name and address of Company			$ Payment/	$
									Months
	Acct. no.			$		Acct. no.			l Revolving
	Name and address of Bank, S&L, or Credit Union					Name and address of Company			$ Payment/	$
									Months
	Acct. no.			$		Acct. no.			l Revolving
	Name and address of Bank, S&L, or Credit Union					Name and address of Company			$ Payment/	$
									Months
	Acct. no.			$		Acct. no.			l Revolving
	Name and address of Bank, S&L, or Credit Union					Name and address of Company			$ Payment/	$
									Months
	Acct. no.			$		Acct. no.			l Revolving
	Stocks & Bonds (Company			$		Name and address of Company			$ Payment/	$
	name/number & description)								Months
						Acct. no.			l Revolving
	Life Insurance net cash value			$		Name and address of Company			$ Payment/	$
	Face amount: $								Months
	Subtotal Liquid Assets			$
	Real estate owned			$
	(enter market value from
	schedule of real estate owned)
						Acct. no.			l Revolving
						Name and address of Company			$ Payment/	$
									Months
	Vested interest in retirement			$
	fund
	Net worth of business(es) owned			$
	(attach financial statement)
						Acct. no.			l Revolving
	Automobiles owned			$		Alimony/Child Support/Separate			$
	(make and year)					Maintenance Payments Owed to:
						Job-Related Expense			$
						(child care, union dues, etc.)
	Other Assets (itemize)			$
						Total Monthly Payments			$
	Other Assets			$		Other Liabilities				$
	(from continuation page, if any)					(from continuation page, if any)
		Total		$		Net Worth		$	Total	$
		Assets (a)				(a - b)			Liabilities (b)

8. Declarations

Universal Credit Application-Real Estate	UCA-RE 11/1/2010
VMP , Bankers Systems* MDF. ETXUCARE	VMPC148R (1011).00
Wolters Kluwer Financial Services - 2009, 2010	Page 3 of 5

8. Declarations (Continued)

9. Continuation and Additional Information

Instructions. Use this section if you need more space to complete the Universal Credit Application. Mark "A" for Applicant and "C" for Co-Applicant. Use this space if you answered "Yes" to any of the questions in Section 8.

10. Federal Notices

Important Applicant Information. To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that identifies each person who applies for a loan or opens an account.

What this means for you. When you apply for a loan or open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver's license and/or other identifying documents. In some instances, we may use outside sources to confirm the information. The information you provide is protected by our privacy policy and Federal law.

False Statements. By signing below, I/we fully understand that it is a Federal crime punishable by fine or imprisonment, or both, to knowingly make any false statements concerning any of the above facts as applicable under the provisions of Title 18, United States Code, Section 1001, et seq.

11. State Notices

California Residents. Each applicant, if married, may apply for a separate account.

Massachusetts Residents. Under Massachusetts statute, Mass. Gen. L. ch. 184, Section 17B, you, the Applicant (and Co-Applicant) are entitled to know the following:

1.The responsibility of the attorney for the Mortgagee is to protect the interest of the Mortgagee.

2.Mortgagors may, at their own expense, engage an attorney of their own selection to represent their interests in the transaction.

For Home Equity Line of Credit. The current annual percentage rate for finance charges and, if the rate may vary, a statement to that effect and of the circumstances under which the rate may increase and whether there are any limitations on any such increase, as well as the effects of any such increase; the conditions under which a finance charge may be imposed, including the time period within which any credit extended may be repaid without incurring a finance charge; whether any annual fee is charged and the amount of any such fee; and whether any other charges or fees may be assessed, the purposes for which they are assessed, and the amounts of any such charges or fees.

New York Residents. A consumer report may be ordered in connection with your application. Upon your request, we will inform you whether or not a report was ordered. If a report was ordered, we will tell you the name and address of the consumer reporting agency that provided the report. Subsequent reports may be ordered or utilized in connection with an update, renewal or extension of credit for which you have applied.

Ohio Residents. The Ohio laws against discrimination require all creditors make credit equally available to all creditworthy customers, and that credit reporting agencies maintain separate credit histories on each individual upon request. The Ohio Civil Rights Commission administers compliance with this law.

Any person who, with intent to defraud or knowing that he is facilitating a fraud against an insurer, submits an application or files a claim containing a false or deceptive statement is guilty of insurance fraud.

Texas Residents. The owner of the homestead is not required to apply the proceeds of the extension of credit to repay another debt except debt secured by the homestead or debt to another lender.

Wisconsin Residents. Notice to Married Applicants. No provision of any marital property agreement, unilateral statement under Wisc. Statutes §766.59 or a court decree under Wisc. Statutes §766.70 adversely affects the interest of the lender unless the lender, prior to the time the credit is granted, is furnished a copy of the agreement, statement or decree or has actual knowledge of the adverse provision when the obligation to the lender is incurred.

For married Wisconsin Residents. The credit being applied for, if granted, will be incurred in the interest of my marriage or family. I understand the creditor may be required by law to give notice of this transaction to my spouse.

12. Acknowledgment and Agreement

Each of the undersigned specifically represents to Lender and to Lender's actual or potential agents, brokers, processors, attorneys, insurers, servicers, successors and assigns and agrees and acknowledges that: (1) the information provided in this application is true and correct as of the date set forth opposite my signature and that any intentional or negligent misrepresentation of this information contained in this application may result in civil liability, including monetary damages, to any person who may suffer any loss due to reliance upon any misrepresentation that I have made on this application, and/or in criminal penalties including, but not limited to, fine or imprisonment or both under the provisions of Title 18, United States Code, Sec. 1001, et seq.; (2) the loan requested pursuant to this application (the "Loan") will be secured by a mortgage or deed of trust on the property described in this application; (3) the property will not be used for any illegal or prohibited purpose or use;

Universal Credit Application-Real Estate	UCA-RE 11/1/2010
VMP , Bankers Systems* MDF. ETXUCARE	VMPC148R (1011).00
Wolters Kluwer Financial Services - 2009, 2010	Page 4 of 5