Uniform Residential Loan Application | ||
This application is designed to be completed by the applicant(s) with the lender's 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 the income or assets of a person other than the "Borrower" (including the Borrower's spouse) will be used as a basis for loan qualification or the income or assets of the Borrower's spouse will not be used as a basis for loan qualification, but his or her liabilities must be considered because the Borrower resides in a community property state, the security property is located in a community property state, or the Borrower is relying on other property located in a community property state as a basis for repayment of the loan. | ||
I. TYPE OF MORTGAGE AND TERMS OF LOAN | ||
Mortgage Applied for: | V.A. | Conventional | Other(explain): | Agency Case Number | Lender Case Number | |||||
FHA | USDA/Rural Housing Service |
|||||||||
Amount |
Interest Rate |
No. of Months |
Amortization Type: |
Fixed Rate: | Other (explain): | ||||||
GPM | ARM (type): | ||||||||||
II. PROPERTY INFORMATION AND PURPOSE OF LOAN | ||
Subject Property Address (street, city, state & ZIP) |
No. of Units |
|
Legal Description of Subject Property (attach description if necessary) |
Year Built |
|
Purpose of Loan | Purchase | Construction | Other (explain): | Property will be: | |||||||||
Refinance | Construction-Permanent | Primary Residence | Secondary Residence | Investment | |||||||||
Complete this line if construction or construction-permanent loan. |
Year Lot Acquired |
Original Cost |
Amount Existing Liens |
(a) Present Value of Lot |
(b) Cost of Improvements |
Total (a+b) |
|||||
Complete this line if this is a refinance loan. | ||||||||||
Year Acquired |
Original Cost |
Amount Existing Liens |
Purpose of Refinance |
Describe Improvements made
to be made Cost |
||||||
Title will be held in what Name(s) |
Manner in which Title will be held |
Estate will be held in: Fee Simple |
||
Source of Down Payment, Settlement Charge and/or Subordinate Financing (explain) |
Leasehold (show expiration date) |
Borrower | III. BORROWER INFORMATION | Co-Borrower | ||
Borrower's Name (include Jr. or Sr. if applicable) |
Co-Borrower's Name (include Jr. or Sr. if applicable) |
|||||||||||||
Social Security Number |
Home Phone (incl. area code) |
DOB |
Yrs. School |
Social Security Number |
Home Phone (incl. area code) |
DOB |
Yrs. School |
|||||||
Married | Unmarried (include single, divorced, widowed) |
Dependents (not listed by Co-Borrower) |
Married | Unmarried (include single, divorced, widowed) |
Dependents (not listed by Borrower) |
|||||||||||
Separated | no. |
ages |
Separated | no. |
ages |
|||||||||||
Present Address (street, city, state, ZIP) | Own | Rent | |
No. Yrs. | Present Address (street, city, state, ZIP) | Own | Rent | |
No. Yrs. | |||||
Mailing Address,if different from Present Address |
Mailing Address,if different from Present Address
|
||
If residing at present address for less than two years, complete the following: | |||
Former Address (street, city, state, ZIP) | Own | Rent | |
No. Yrs. | Former Address (street, city, state, ZIP) | Own | Rent | |
No. Yrs. | |||||
|
Name & Address of Employer |
Self Employed |
Yrs. on this job |
Name & Address of Employer |
Self Employed |
Yrs. on this job |
|||||
|
||||||||||
Yrs. employed in this line of work/profession |
Yrs. employed in this line of work/profession |
|||||||||
Position/Title/Type of Business |
Business Phone (incl. area code) |
Position/Title/Type of Business |
Business Phone (incl. area code) |
|||||||
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 |
Self Employed |
Dates (from-to) |
Name & Address of Employer |
Self Employed |
Dates (from-to) |
|||||
|
|
|||||||||
Monthly Income |
Monthly Income |
|||||||||
Position/Title/Type of Business |
Business Phone (incl. area code) |
Position/Title/Type of Business |
Business Phone (incl. area code) |
|||||||
Name & Address of Employer |
Self Employed |
Dates (from-to) |
Name & Address of Employer |
Self Employed |
Dates (from-to) |
|||||
|
|
|||||||||
Monthly Income |
Monthly Income |
|||||||||
Position/Title/Type of Business |
Business Phone (incl. area code) |
Position/Title/Type of Business |
Business Phone (incl. area code) |
|||||||
V. MONTHLY INCOME AND COMBINED HOUSING EXPENSE INFORMATION | ||
Gross Monthly Income | Borrower | Co-Borrower | Total | Combined Monthly Housing Expense | Present | Proposed | ||||||
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 (before completing, see the notice in "describe other income," below) |
Homeowner Assn. Dues | |||||||||||
Other | ||||||||||||
Total | Total | |||||||||||
*Self Employer Borrower(s) may be required to provide additional documentation such as tax returns and financial statements. | |
Describe Other Income | Notice:
Alimony, child support, or separate maintenance income need not be revealed if the Borrower(B) or Co-Borrower(C) does not choose to have it considered for repaying this loan. |
B/C | Monthly Amount | |||
VI. ASSETS AND LIABILITIES | ||
This statement and any applicable supporting schedules may be completed joinly by both married and unmarried Co-borrowers if their assets and liabilities are sufficiently joined so that the Statement can be meaningfully and fairly presented on a combined basisotherwise separate Statements and Schedules are required. If the Co-borrower section was completed about a spouse, this Statement and supporting schedules must be completed about that spouse also. |
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|
VI. ASSETS AND LIABILITIES (cont.) | ||
Schedule of Real Estate Owned (If additional properties are owned, use continuation sheet.) |
Property Address (enter S if sold, PS is pending sale or R if rental being held for income) |
Type of Property | Present Market Value | Amount of Mortgages & Liens | Gross Rental Income | Mortgage Payments | Insurance, Maintenance, Taxes & Misc. | Net Rental 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 |
|
|
|
VII. DETAILS OF TRANSACTION | VIII. DECLARATIONS | ||
|
|
IX. ACKNOWLEDGEMENT 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 herein(3) the property will not be used for any illegal or prohibited purpose or use(4) all statements made in this application are made for the purpose of obtaining a residential mortgage loan(5) the property will be occupied as indicated herein(6) any owner or servicer of the Loan may verify or reverify any information contained in the application from any source named in this application, and Lender, its successors or assigns may retain the original and/or an electronic record of this application, even if the Loan is not approved(7) the Lender and its agents, brokers, insurers, servicers, successors and assigns may continuously rely on the information contained in the application, and I am obligated to amend and/or supplement the information provided in this application if any of the material facts that I have represented herein should change prior to closing of the Loan(8) in the event that my payments on the Loan become delinquent, the owner or servicer of the Loan may, in addition to any other rights and remedies that it may have relating to such delinquency, report my name and account information to one or more consumer credit reporting agencies(9) ownership of the Loan and/or administration of the Loan account may be transferred with such notice as may be required by law(10) neither Lender nor its agents, brokers, insurers, servicers, successors or assigns has made any representation or warranty, express or implied, to me regarding the property or the condition or value of the propertyand (11) my transmission of this application as an "electronic record" containing my "electronic signature," as those terms are defined in applicable federal and/or state laws (excluding audio and video recordings), or my facsimile transmission of this application containing a fascimile of my signature, shall be as effective, enforceable and valid as if a paper version of this application were delivered containing my original written signature. |
Borrower's Signature | Date | Co-Borrower's Signature | Date | |||
X | X |
X. INFORMATION FOR GOVERNMENT MONITORING PURPOSES | ||
The following information is requested by the Federal Government for certain types of loans related to a dwelling, in order to monitor the Lender's compliance with equal credit opportunity, fair housing and home mortgage disclosure laws. You are not required to furnish this information, but are encouraged to do so. The law provides that a Lender may neither discriminate on the basis of this information, nor on whether you choose to furnish it. However, if you choose not to furnish it, under Federal regulations this Lender is required to note race and sex on the basis of visual observation or surname. If you do not wish to furnish the above information, please check the box below. (Lender must review the above material to assure that the disclosure satisfy all requirements to which the Lender is subject under applicable state law for the particular type of loan applied for.) | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
BORROWER I do not wish to furnish this information | CO-BORROWER I do not wish to furnish this information | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
Ethnicity: Hispanic Not Hispanic | Ethnicity: Hispanic Not Hispanic | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|
To be Completed by Interviewer This application was taken by: Face-to-face interview Telephone Internet |
Interviewer's Name (print or type) |
Name and Address of Interviewer's Employer |
||||
Interviewer's Signature |
Date |
|||||
Interviewer's Phone Number (incl. area code) |
||||||
Continuation Sheet/Residential Loan Application | ||
Use this continuation sheet if you need more space to complete the Residential Loan Application. Mark B for Borrower or C for Co-Borrower. | Borrower: |
Agency Case Number: |
||
Co-Borrower: |
Lender Case Number: |
|||
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. | ||||||
Borrower's Signature | Date | Co-Borrower's Signature | Date | |||
X | X | |||||
Freddie Mac Form 65 | Fannie Mae Form 1003 |
|||||