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Uniform Residential Loan…
Tags: address street, amortization, case number, city state zip, co borrower, fha, fixed rate, interest rate, legal description, liabilities, loan mortgage, loan purchase, loan qualification, residential loan application, rural housing service, security property, subject property address, uniform residential loan, usda rural housing, usda rural housing service,Pages: 4
Language: english
Created: Tue Jan 28 17:48:12 2003
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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 VA Conventional Other (explain): Agency Case Number Lender Case Number
Applied for: FHA USDA/Rural
Housing Service
Amount Interest Rate No. of Months Amortization Fixed Rate Other (explain):
$ % Type: 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 Original Cost Amount Existing Liens (a) Present Value of Lot (b) Cost of Improvements Total (a + b)
Acquired
$ $ $ $ $
Complete this line if this is a refinance loan.
Year Original Cost Amount Existing Liens Purpose of Refinance Describe Improvements made to be made
Acquired
$ $ 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 Charges 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 (MM/DD/YYYY) Yrs. School Social Security Number Home Phone (incl. area code) DOB (MM/DD/YYYY) Yrs. School
Married Unmarried (include single, Dependents (not listed by Co-Borrower) Married Unmarried (include single, Dependents (not listed by Borrower)
Separated divorced, widowed) no. ages Separated divorced, widowed) 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.
Borrower IV. EMPLOYMENT INFORMATION Co-Borrower
Name & Address of Employer Self Employed Yrs. on this job Name & Address of Employer Self Employed Yrs. on this job
Yrs. employed in this Yrs. employed in this
line of work/profession 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)
Freddie Mac Form 65 01/04 Page 1 of 4 Fannie Mae Form 1003 01/04
V. MONTHLY INCOME AND COMBINED HOUSING EXPENSE INFORMATION
Combined Monthly
Gross Monthly Income Borrower Co-Borrower Total 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, Homeowner Assn. Dues
see the notice in "describe
other income," below) Other:
Total $ $ $ Total $ $
* Self Employed 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 jointly 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 basis; otherwise, 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.
Completed Jointly Not Jointly
ASSETS Cash or Market Liabilities and Pledged Assets. List the creditor's name, address and account number for all outstanding
Description Value debts, including automobile loans, revolving charge accounts, real estate loans, alimony, child support,
Cash deposit toward purchase held by: $ stock 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.
Monthly Payment &
LIABILITIES Months Left to Pay Unpaid Balance
List checking and savings accounts below Name and address of Company $ Payment/Months $
Name and address of Bank, S&L, or Credit Union
Acct. no.
Acct. no. $ Name and address of Company $ Payment/Months $
Name and address of Bank, S&L, or Credit Union
Acct. no.
Acct. no. $ Name and address of Company $ Payment/Months $
Name and address of Bank, S&L, or Credit Union
Acct. no.
Acct. no. $ Name and address of Company $ Payment/Months $
Name and address of Bank, S&L, or Credit Union
Acct. no.
Acct. no. $ Name and address of Company $ Payment/Months $
Stocks & Bonds (Company name/number $
& description)
Acct. no.
Name and address of Company $ Payment/Months $
Life insurance net cash value $
Face amount: $
Subtotal Liquid Assets $
Real estate owned (enter market value $ Acct. no.
from schedule of real estate owned) Name and address of Company $ Payment/Months $
Vested interest in retirement fund $
Net worth of business(es) owned $
(attach financial statement)
Automobiles owned (make and year) $ Acct. no.
Alimony/Child Support/Separate Maintenance $
Payments Owed to:
Other Assets (itemize) $
Job-Related Expense (child care, union dues, etc.) $
Total Monthly Payments $
Total Assets a. $
Net Worth
(a minus b) $ Total Liabilities b. $
Freddie Mac Form 65 01/04 Page 2 of 4 Fannie Mae Form 1003 01/04
dddfdd
VI. ASSETS AND LIABILITIES (cont.)
Schedule of Real Estate Owned (If additional properties are owned, use continuation sheet.) Insurance,
Property Address (enter S if sold, PS if pending sale Type of Present Amount of Gross Mortgage Maintenance, Net
or R if rental being held for income) Property Market Value Mortgages & Liens Rental Income Payments Taxes & Misc. 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
a. Purchase price $ If you answer "Yes" to any questions a through i, please use continuation Borrower Co-Borrower
sheet for explanation.
b. Alterations, improvements, repairs Yes No Yes No
c. Land (if acquired separately) a. Are there any outstanding judgments against you?
d. Refinance (incl. debts to be paid off) b. Have you been declared bankrupt within the past 7 years?
e. Estimated prepaid items c. Have you had property foreclosed upon or given title or deed in lieu thereof
f. Estimated closing costs in the last 7 years?
g. PMI, MIP, Funding Fee d. Are you a party to a lawsuit?
h. Discount (if Borrower will pay) e. Have you directly or indirectly been obligated on any loan which resulted in
i. Total costs (add items a through h) foreclosure, transfer of title in lieu of foreclosure, or judgment?
(This would include such loans as home mortgage loans, SBA loans, home improvement loans,
j. Subordinate financing educational loans, manufactured (mobile) home loans, any mortgage, financial obligation, bond,
or loan guarantee. If "Yes," provide details, including date, name and address of Lender, FHA or
k. Borrower's closing costs paid by Seller VA case number, if any, and reasons for the action.)
l. Other Credits (explain) f. Are you presently delinquent or in default on any Federal debt or any other
loan, mortgage, financial obligation, bond, or loan guarantee?
If "Yes," give details as described in the preceding question.
g. Are you obligated to pay alimony, child support, or separate maintenance?
m. Loan amount h. Is any part of the down payment borrowed?
(exclude PMI, MIP, Funding Fee financed) i. Are you a co-maker or endorser on a note?
n. PMI, MIP, Funding Fee financed j. Are you a U.S. citizen?
k. Are you a permanent resident alien?
o. Loan amount (add m & n) l. Do you intend to occupy the property as your primary residence?
If "Yes," complete question m below.
m. Have you had an ownership interest in a property in the last three years?
p. Cash from/to Borrower (1) What type of property did you own--principal residence (PR),
(subtract j, k, l & o from i) second home (SH), or investment property (IP)? __________ __________
(2) How did you hold title to the home--solely by yourself (S),
jointly with your spouse (SP), or jointly with another person (O)? __________ __________
IX. 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 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 property; and (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
discriminate neither on the basis of this information, nor on whether you choose to furnish it. If you furnish the information, please provide both ethnicity and race. For race, you
may check more than one designation. If you do not furnish ethnicity, race, or sex, under Federal regulations, this lender is required to note the information on the basis of visual
observation or surname. If you do not wish to furnish the information, please check the box below. (Lender must review the above material to assure that the disclosures 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 or Latino Not Hispanic or Latino Ethnicity: Hispanic or Latino Not Hispanic or Latino
Race: American Indian or Asian Black or Race: American Indian or Asian Black or
Alaska Native African American Alaska Native African American
Native Hawaiian or White Native Hawaiian or White
Other Pacific Islander Other Pacific Islander
Sex: Female Male Sex: Female Male
To be Completed by Interviewer Interviewer's Name (print or type) Name and Address of Interviewer's Employer
This application was taken by:
Face-to-face interview Interviewer's Signature Date
Mail
Telephone
Internet Interviewer's Phone Number (incl. area code)
Freddie Mac Form 65 01/04 Page 3 of 4 Fannie Mae Form 1003 01/04
Continuation Sheet/Residential Loan Application
Use this continuation sheet if you need Borrower: Agency Case Number:
more space to complete the Residential
Loan Application. Mark B for Borrower or Co-Borrower: Lender Case Number:
C for Co-Borrower.
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 01/04 Page 4 of 4 Fannie Mae Form 1003 01/04