Uniform Residential Loan Application

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Borrower Information

Borrower Information

1a .Personal Information

(not listed by another Borrower)

Contact Information

Current Address

Years
Months
/Month

If at Current Address for LESS than 2 years, list Former Address

Years
Months
/Month

Mailing Address

1b. Current Employment/Self Employment and Income

Years
Months

Gross Monthly Income

TOTAL :

1c. IF APPLICABLE, Complete Information for Additional Employment/Self-Employment and Income

Gross Monthly Income

TOTAL :

1d. IF APPLICABLE, Complete Information for Previous Employment/Self-Employment and Income

1e. Income from Other Sources

Include income from other sources below. Under Income Source, choose from the sources listed here:

  • Alimony
  • Automobile Allowance
  • Boarder Income
  • Capital Gains
  • Interest and Dividends
  • Notes Receivable
  • Child Support
  • Disability
  • Foster Care
  • Housing or Parsonage
  • Mortgage Credit Certificate
  • Mortgage Differential Payments
  • Public Assistance
  • Retirement
  • Royalty Payments
  • Separate Maintenance
  • Social Security
  • Trust
  • Unemployment Benefits
  • VA Compensation
  • Other

NOTE: Reveal alimony, child support, separate maintenance, or other income ONLY IF you want it considered in determining your qualification for this loan

Income Source - use list above Monthly Income

Uniform Residential Loan Application
Freddie Mac Form 65 • Fannie Mae Form 1003
Effective 1/2021

Assets and Liabilities and Financial Information

Assets and Liabilities

2a. Assets – Bank Accounts, Retirement, and Other Accounts You Have

  • Checking
  • Certificate of Deposit
  • Stock Options
  • Bridge Loan Proceeds
  • Trust Account
  • Savings
  • Mutual Fund
  • Bonds
  • Individual Development Account
  • Cash Value of Life Insurance (used for the transaction)
  • Money Market
  • Stocks
  • Retirement (e.g., 401k, IRA)
Account Type – use list above Financial Institution Account Number Cash or Market Value

2b. Other Assets and Credits You Have

  • Proceeds from Real Estate Property to be sold on or before closing
  • Proceeds from Sale of Non-Real Estate Asset
  • Unsecured Borrowed Funds
  • Secured Borrowed Funds
  • Other
  • Earnest Money
  • Relocation Funds
  • Sweat Equity
  • Employer Assistance
  • Rent Credit
  • Trade Equity
  • Lot Equity
Asset or Credit Type – use list above Cash or Market Value
X
Provide Total Amount Here $0

2c. Liabilities – Credit Cards, Other Debts, and Leases that You Owe

  • Revolving (e.g., credit cards)
  • Installment (e.g., car, student, personal loans)
  • Open 30-Day (balance paid monthly)
  • Lease (not real estate)
  • Others
Account Type – use list above Company Name Account Number Unpaid Balance (To be paid off at or before closing) Monthly Payment
X

2d. Other Liabilities and Expenses

  • Alimony
  • Child Support
  • Separate Maintenance
  • Job Related Expenses
  • Others
liabilities and expenses types Monthly Payment
X
Provide Total Amount Here $0

Uniform Residential Loan Application
Freddie Mac Form 65 • Fannie Mae Form 1003
Effective 1/2021

Financial Information — Real Estate.

This section asks you to list all properties you currently own and what you owe on them.

3a. Property You Own

Address
Property Value Status: Sold, Pending Sale, or Retained Intended Occupancy: Investment, Primary Residence, Second Home, Other Monthly Insurance,Taxes, Association Dues, etc. if not included in Monthly Mortgage Payment For 2-4 Unit Primary or Investment Property
Monthly Rental Income
For LENDER to calculate:Net Monthly Rental Income

Mortgage Loans on this Property

Creditor Name Account Number Monthly Mortgage Payment Unpaid Balance (To be paid off at or before closing) Type: FHA, VA, Conventional, USDA-RD, Other Credit Limit (if applicable)

3b. IF APPLICABLE, Complete Information for Additional Property

Property Value Status: Sold, Pending Sale, or Retained Intended Occupancy: Investment, Primary Residence, Second Home, Other Monthly Insurance,Taxes, Association Dues, etc. if not included in Monthly Mortgage Payment For 2-4 Unit Primary or Investment Property
Monthly Rental Income
For LENDER to calculate:Net Monthly Rental Income

Mortgage Loans on this Property

Creditor Name Account Number Monthly Mortgage Payment Unpaid Balance (To be paid off at or before closing) Type: FHA, VA, Conventional, USDA-RD, Other Credit Limit (if applicable)

3c. IF APPLICABLE, Complete Information for Additional Property

Property Value Status: Sold, Pending Sale, or Retained Intended Occupancy: Investment, Primary Residence, Second Home, Other Monthly Insurance,Taxes, Association Dues, etc. if not included in Monthly Mortgage Payment For 2-4 Unit Primary or Investment Property
Monthly Rental Income
For LENDER to calculate:Net Monthly Rental Income

Mortgage Loans on this Property

Creditor Name Account Number Monthly Mortgage Payment Unpaid Balance (To be paid off at or before closing) Type: FHA, VA, Conventional, USDA-RD, Other Credit Limit (if applicable)

Loan Details

Loan and Property Information.

4a. Loan and Property Information

Property Address

Mixed-Use Property. If you will occupy the property, will you set aside space within the property to operate your own business? (e.g., daycare facility, medical office, beauty/barber shop)
Manufactured Home. Is the property a manufactured home? (e.g., a factory built dwelling built on a permanent chassis)

4b. Other New Mortgage Loans on the Property You are Buying or Refinancing

Creditor Name Lien Type Monthly Payment Loan Amount/ Amount to be Drawn Credit Limit (if applicable)

4c. Rental Income on the Property You Want to Purchase For Purchase Only

Complete if the property is a 2-4 Unit Primary Residence or an Investment Property Amount
Expected Monthly Rental Income
For LENDER to calculate: Expected Net Monthly Rental Income

4d. Gifts or Grants You Have Been Given or Will Receive for this Loan

  • Community Nonprofit
  • Federal Agency
  • Relative
  • State Agency
  • Lender
  • Employer
  • Local Agency
  • Religious Nonprofit
  • Unmarried Partner
  • Other
Asset Type: Cash Gift, Gift of Equity, Grant Deposited/Not Deposited Source – use list above Cash or Market Value

Declarations and Military Service

Declarations and Military Service

5a. About this Property and Your Money for this Loan

Will you occupy the property as your primary residence?
If YES, have you had an ownership interest in another property in the last three years?
If YES, complete (1) and (2) below:
(1) What type of property did you own: primary residence (PR), FHA secondary residence (SR), second home (SH), or investment property (IP)?
(2) How did you hold title to the property: by yourself (S), jointly with yourspouse (SP), or jointly with another person (O)?
If this is a Purchase Transaction: Do you have a family relationship or business affiliation with the seller of the property?
Are you borrowing any money for this real estate transaction (e.g., money for your closing costs or down payment) or obtaining any money from another party, such as the seller or realtor, that you have not disclosed on this loan application?
If YES, what is the amount of this money?
1. Have you or will you be applying for a mortgage loan on another property (not the property securing this loan) on or before closing this transaction that is not disclosed on this loan application?
2. Have you or will you be applying for any new credit (e.g., installmentloan, credit card, etc.) on or before closing this loan that is not disclosed on this application?
Will this property be subject to a lien that could take priority over the first mortgage lien, such as a clean energy lien paid through your property taxes (e.g., the Property Assessed Clean Energy Program)?

5b. About Your Finances

Are you a co-signer or guarantor on any debt or loan that is not disclosed on this application?
Are there any outstanding judgments against you?
Are you currently delinquent or in default on a Federal debt?
Are you a party to a lawsuit in which you potentially have any personal financial liability?
Have you conveyed title to any property in lieu of foreclosure in the past 7 years?
Within the past 7 years, have you completed a pre-foreclosure sale or short sale, whereby the property was sold to a third party and the Lender agreed to accept less than the outstanding mortgage balance due?
Have you had property foreclosed upon in the last 7 years?
Have you declared bankruptcy within the past 7 years?
If YES, identify the type(s) of bankruptcy:

Military Service

This section asks questions about your (or your deceased spouse's) military service

Military Service of Borrower

Demographic Information

Demographic Information

For example: Argentinean, Colombian, Dominican, Nicaraguan, Salvadoran, Spaniard, and so on
For example: Hmong, Laotian, Thai, Pakistani, Cambodian, and so on
For example: Fijian, Tongan, and so on

To Be Completed by Financial Institution (for application taken in person):

Was the ethnicity of the Borrower collected on the basis of visual observation or surname?
Was the sex of the Borrower collected on the basis of visual observation or surname?
Was the race of the Borrower collected on the basis of visual observation or surname?

The Demographic Information was provided through:

Loan Originator Information

Loan Originator Information