268 N 115 Street, Suite 7                         P. O. Box 453

      Omaha, Nebraska 68154                         Nebraska City NE  68410     

      Phone:  402-330-3626                             Phone:  402-209-3672

      Fax:      402-330-9717                              Fax:      402-873-3037

                                                                    

URAR (FORM 1004) CONVENTIONAL              FHA                 VA             

                                                            FHA/VA CASE NUMBER: 

FORM 2055 (DRIVEBY WITH SUBJECT AND COMP PHOTOS)

FORM 2055 (DRIVEBY WITH SUBJECT FRONT PHOTO ONLY)

FORM 2070/2075 (CONDITION & MARKETABILITY REPORT)

FORM 1025 (2-4 FAMILY INCLUDES OPERATING INCOME)

FORM ERC (RELOCATION )

FORM AI  (FEE APPRAISALS)

Borrower Name:

Property Address:

Legal Description:

Property Rights:          Fee:          Leasehold:           Rent:  $/Mo

PUD:  Yes          No HOA Fee: $ MO/YR (Select One) 

Property Type:   Single Family  Existing  New Construction with Plans 

                                    Condo             Existing  New Construction with Plans 

                                    2-4 Family       # Units    Existing      New Construction with Plans 

                                    Acreage          # Acres    Utilities:  Septic/Well   Public Water/Sewer 

ACCESS:     Lock Box:  Yes No 

CONTACT: Name:       Owner/Builder/Agent/Tenant  (Select One) 

  Phone: Home: Work: Other: (Cell)

   Special Instructions:

Sale Price: $ Refinance:  Estimate of Value $

REQUESTED BY

 Loan Officer:                                 Processor:                                                                   
 
Date Requested:                                 Institution:                                                                  

 Loan Number:                                 Office Location:                                                        

 Phone Number:                                  Fax Number:                                                                                    

E-Mail Address: