Uniform Residential Loan Application




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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 or other person who has community property or similar rights pursuant to applicable state law will not be used as a basis for loan qualification, but his or her liabilities must be considered because the spouse or other person who has community property or similar rights and 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.

If this is an application for joint credit, Borrower and Co-Borrower each agree that we intend to apply for joint credit (sign below):


________________________________ __________________________________________

Borrower Co-Borrower




I. TYPE OF MORTGAGE AND TERMS OF LOAN

Mortgage Applied for:

 VA  USDA/Rural Housing Service

 FHA  Conventional  Other (explain):

 


Agency Case Number  

Lender Case Number

Amount

$  


Interest Rate  

%


No. of Months  

Amortization Type:

 Fixed Rate

 GPM


 Other (explain):

 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  Refinance  Construction

 Construction-Permanent  Other (explain):

 


Property will be:

 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  made  to be made

Improvements



Title will be held in what Name(s)

 


Manner in which Title will be held

 


Estate will be held in:

 Fee Simple

 Leasehold

(show expiration date)




Source of Down Payment, Settlement Charges, and/or Subordinate Financing (explain)  




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

 Separated

Dependents

(not listed by Co-Borrower)  



 Married

 Separated

Dependents

(not listed by Borrower)  



 Unmarried

(include single, divorced, widowed)



no.



ages


 Unmarried

(include single, divorced, widowed)



no.


ages


Present Address  Own  Rent __No. Yrs.

(street, city, state, ZIP)


 

Present Address  Own  Rent __No. Yrs.

(street, city, state, ZIP)





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  Own  Rent __No. Yrs.

(street, city, state, ZIP)

 


Former Address  Own  Rent __No. Yrs.

(street, city, state, ZIP)





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 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 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 non-applicant spouse or other person, this Statement and supporting schedules must be completed about that spouse or other person also.

Completed  Jointly  Not Jointly



ASSETS
Description

Cash or

Market Value

Liabilities and Pledged Assets. List the creditor’s name, address, and account number for all outstanding debts, including automobile loans, revolving charge accounts, real estate loans, alimony, child support, 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.

Cash deposit toward purchase held by:

$

LIABILITIES

Monthly Payment &

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

$



















VI. ASSETS AND LIABILITIES (cont’d)

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.







Life insurance net cash value

$

Name and address of Company

$ Payment/Months

$

Face amount: $















Subtotal Liquid Assets

$

Acct. no.







Real estate owned

(enter market value from schedule of real estate owned)



$

Alimony/Child Support/Separate

Maintenance Payments Owned to:



$

$

Vested interest in retirement fund

$










Net worth of business(es) owned

(attach financial statement)



$

Job-Related Expense

(child care, union dues, etc.)



$




Automobiles owned

(make and year)




$










Other Assets (itemize)

$














































Total Monthly Payments

$




Total Assets

a.

$

Net Worth

(a minus b)


$

Total Liabilities

b.

$



















Schedule of Real Estate Owned (If additional properties are owned, use continuation sheet.)

Property Address (enter S if sold, PS if 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

a.

Purchase price

$

If you answer “Yes” to any questions a through i, please use continuation sheet for explanation.

Borrower

Co-Borrower

b.

Alterations, improvements, repairs







Yes

No

Yes

No

c.

Land

(if acquired separately)






  1. Are there any outstanding judgments against you?









d.

Refinance

(incl. debts to be paid off)






  1. Have you been declared bankrupt within the past 7 years?









e.

Estimated prepaid items




  1. Have you had property foreclosed upon or given title or deed in lieu thereof in the last 7 years?









f.

Estimated closing costs




  1. Are you a party to a lawsuit?









g.

PMI, MIP, Funding Fee




  1. Have you directly or indirectly been obligated on any loan of which resulted in foreclosure, transfer of title in lieu of foreclosure, or judgment?

(This would include such loans as home mortgage loans, SBA loans, home improvement loans, 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 VA case number, if any, and reasons for the action.)











h.

Discount

(if Borrower will pay)






  1. 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.









i.

Total costs

(add items a through h)




  1. Are you obligated to pay alimony, child support, or separate maintenance?









j.

Subordinate financing




  1. Is any part of the down payment borrowed?









VII. DETAILS OF TRANSACTION (cont’d)

VIII. DECLARATIONS (cont’d)

k.

Borrower’s closing costs paid by Seller




  1. Are you a co-maker or endorser on a note?









l.

Other Credits (explain)




-------------------------------------------------------






















  1. Are you a U.S. citizen?
















  1. Are you a permanent resident alien?









m.

Loan amount (exclude PMI, MIP, Funding Fee financed)




  1. Do you intend to occupy the property as your primary residence?

If “Yes,” complete question m below.









n.

PMI, MIP, Funding Fee financed




  1. Have you had an ownership interest in a property in the last three years?









o.

Loan amount

(add m & n)






(1) What type of property did you own—principal residence (PR), second home (SH), or investment property (IP)?

___

___

___

___

p.

Cash from/to Borrower

(subtract j, k, l & o from i)






(2) How did you hold title to the home— by yourself (S), jointly with your spouse or jointly with another person (O)?

___

___

___

___

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 in this application; (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 in this application; (6) the Lender, its servicers, successors or assigns may retain the original and/or an electronic record of this application, whether or not the Loan is 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 should change prior to closing of the Loan; (8) in the event that my payments on the Loan become delinquent, the Lender, its servicers, successors or assigns 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 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 facsimile 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.
Acknowledgement. Each of the undersigned hereby acknowledges that any owner of the Loan, its servicers, successors and assigns, may verify or reverify any information contained in this application or obtain any information or data relating to the Loan, for any legitimate business purpose through any source, including a source named in this application or a consumer reporting agency.


Borrower’s Signature

X

Date

Co-Borrower’s Signature

X

Date




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 not discriminate either on the basis of this information, or 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 and surname if you have made this application in person. 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 Alaska Native

 Asian


 Black or African American

 Native Hawaiian or Other Pacific Islander

 White


Race:

 American Indian or Alaska Native

 Asian


 Black or African American

 Native Hawaiian or Other Pacific Islander

 White





Sex:  Female  Male

Sex:  Female  Male

To be Completed by Loan Originator


This information was provided:

 In a face-to-face interview

 In a telephone interview

 By the applicant and submitted by fax or mail

 By the applicant and submitted via e-mail or the Internet


Loan Originator’s Signature

Date

Loan Originator’s Name (print or type)

Loan Originator Identifier

Loan Originator’s Phone Number (including area code)


Loan Origination Company’s Name

Loan Origination Company Identifier

Loan Origination Company’s Address



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

X

Date

Co-Borrower’s Signature

X

Date




Uniform Residential Loan Application

Freddie Mac Form 65 7/05 (rev.6 /09)

Page of


Fannie Mae Form 1003 7/05 (rev.6/09)





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