EFTA Document EFTA01279969

Uniform Residential Loan Application Applied for: I- 1 Amount $320,000.00 This application Is designed to be completed by the applicants) with the Lenders assistance. Applicants should complete this form as • Borrower- or 'Co-Borrower.' as applicable. Co-Borrower information must also be provided (and the appropriate box checked) when 0 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 0 the income