Gilbert Pino
Mortgage ApplicationDRE #01081725 · NMLS #247051
661-817-9656

Uniform Residential Loan Application intake

Apply for a home loan

Complete the sections below. Required fields are marked with an asterisk. Your information is encrypted before it is stored.

Download fillable PDF version
1

Borrower Information

Tell us about yourself and where you live.

2

Employment and Income

Include income you want considered for this loan.

3

Assets and Liabilities

Give totals or descriptions. Do not enter full account numbers.

4

Loan and Property

Tell us what you want to finance.

5

Declarations

Answer each question accurately.

Are there any outstanding judgments against you?
Are you delinquent or in default on any federal debt or other financial obligation?
Are you a party to a lawsuit in which you potentially have personal financial liability?
Have you conveyed title to property in lieu of foreclosure in the past 7 years?
In the past 7 years, have you completed a pre-foreclosure sale or short sale?
Have you had property foreclosed upon in the past 7 years?
Have you declared bankruptcy in the past 7 years?
Are you a co-signer or guarantor on any debt not disclosed above?
Are you borrowing money for this transaction or receiving money from another party?
6

Military Service and Demographic Information

Military information may support VA eligibility. Demographic information is optional and does not affect credit decisions.

7

Certification and Contact Consent

Review before submitting.

Programs, qualification and terms are subject to lender guidelines and borrower eligibility. This online intake follows the Uniform Residential Loan Application structure but does not replace lender-required disclosures or the final signed Form 1003.