Uniform Residential Loan Application Interactive (Form 1003): PDF

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 rights pursuant to 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 has community property rights pursuant to applicable law and 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
VA
FHA
Mortgage
Applied for:
Conventional
USDA/Rural
Housing Service
Amount
$
Interest Rate
Other (explain):
No. of Months
Agency Case Number
Fixed Rate
GPM
Amortization Type:
%
Lender Case Number
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
Other (explain):
Construction-Permanent
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)
$
$
$
$
$ 0.00
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
Leasehold (show
expiration date)
Source of Down Payment, Settlement Charges, and/or Subordinate Financing (explain)
Borrower
III. BORROWER INFORMATION
Borrower’s Name (include Jr. or Sr. if applicable)
Social Security Number
Married
Separated
Home Phone
(incl. area code)
Unmarried (include
single, divorced, widowed)
Present Address (street, city, state, ZIP)
Co-Borrower
Co-Borrower’s Name (include Jr. or Sr. if applicable)
DOB (mm/dd/yyyy)
Yrs. School
Married
Separated
Dependents (not listed by Co-Borrower)
no.
ages
Own
Social Security Number
Rent ____No. Yrs.
Home Phone
(incl. area code)
Unmarried (include
single, divorced, widowed)
Present Address (street, city, state, ZIP)
Mailing Address, if different from Present Address
DOB (mm/dd/yyyy)
Yrs. School
Dependents (not listed by Borrower)
no.
ages
Own
Rent ____No. Yrs.
Own
Rent ____No. Yrs.
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.
Borrower
Name & Address of Employer
Former Address (street, city, state, ZIP)
IV. EMPLOYMENT INFORMATION
Self Employed
Name & Address of Employer
Yrs. on this job
Yrs. employed in this
line of work/profession
Position/Title/Type of Business
Business Phone (incl. area code)
Co-Borrower
Self Employed
Yrs. on this job
Yrs. employed in this
line of work/profession
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:
Freddie Mac Form 65 7/05
Page 1 of 5
Fannie Mae Form 1003 7/05
Borrower
IV. EMPLOYMENT INFORMATION (cont’d)
Name & Address of Employer
Self Employed
Co-Borrower
Name & Address of Employer
Dates (from – to)
Self Employed
Dates (from – to)
Monthly Income
Monthly Income
$
$
Position/Title/Type of Business
Business Phone
(incl. area code)
Name & Address of Employer
Self Employed
Position/Title/Type of Business
Dates (from – to)
Business Phone
(incl. area code)
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
Base Empl. Income*
Borrower
Co-Borrower
$
$
$ 0.00
Overtime
Combined Monthly
Housing Expense
Total
0.00
First Mortgage (P&I)
Bonuses
0.00
Other Financing (P&I)
Commissions
0.00
Hazard Insurance
Dividends/Interest
0.00
Real Estate Taxes
Net Rental Income
0.00
Mortgage Insurance
Other (before completing,
see the notice in “describe
other income,” below)
0.00
$ 0.00
Total
*
$
Proposed
$
$
Homeowner Assn. Dues
Other:
$ 0.00
0.00
Present
Rent
$
Total
$
0.00
0.00
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
Cash or
Market Value
Description
Cash deposit toward
purchase held by:
$
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.
LIABILITIES
List checking and savings accounts below
Name and address of Bank, S&L, or Credit Union
Name and address of Company
Acct. no.
Acct. no.
$
Name and address of Bank, S&L, or Credit Union
Acct. no.
$
Name and address of Company
Name and address of Company
Acct. no.
Acct. no.
Freddie Mac Form 65 7/05
Unpaid Balance
$ Payment/Months
$
$ Payment/Months
$
$ Payment/Months
$
Acct. no.
Name and address of Bank, S&L, or Credit Union
$
Monthly Payment &
Months Left to Pay
Page 2 of 5
Fannie Mae Form 1003 7/05
VI. ASSETS AND LIABILITIES (cont’d)
Name and address of Bank, S&L, or Credit Union
Name and address of Company
$ Payment/Months
$
Acct. no.
$
Acct. no.
Stocks & Bonds (Company name/
number & description)
$
Name and address of Company
$ Payment/Months
$
Life insurance net cash value
$
Acct. no.
Name and address of Company
$ Payment/Months
$
Face amount: $
$
Subtotal Liquid Assets
Real estate owned (enter market value
from schedule of real estate owned)
Vested interest in retirement fund
$
Net worth of business(es) owned
(attach financial statement)
$
Automobiles owned (make
and year)
$
Other Assets (itemize)
$
Total Assets a.
0.00
$
Acct. no.
Alimony/Child Support/Separate
Maintenance Payments Owed to:
$
Job-Related Expense (child care, union dues, etc.)
$
Total Monthly Payments
$
Net Worth
(a minus b)
0.00
$
►
$
$
Total Liabilities b.
0.00
0.00
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
Amount
of Mortgages
& Liens
Present
Market Value
$
$
0.00
$
0.00
$
0.00
$
0.00
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
VII. DETAILS OF TRANSACTION
$
$
Net Rental
Income
$
0.00
$
Account Number
VIII. DECLARATIONS
a.
Purchase price
b.
Alterations, improvements, repairs
c.
Land (if acquired separately)
b. Have you been declared bankrupt within the past 7 years?
d.
Refinance (incl. debts to be paid off)
e.
Estimated prepaid items
c. Have you had property foreclosed upon or given title
or deed in lieu thereof in the last 7 years?
d. Are you a party to a lawsuit?
f.
Estimated closing costs
g.
PMI, MIP, Funding Fee
h.
Discount (if Borrower will pay)
i.
Total costs (add items a through h)
If you answer “Yes” to any questions a through i,
please use continuation sheet for explanation.
Borrower
Yes No
Co-Borrower
Yes No
a. Are there any outstanding judgments against you?
0.00
Freddie Mac Form 65 7/05
Insurance,
Maintenance,
Taxes & Misc.
Mortgage
Payments
Gross
Rental Income
e. Have you directly or indirectly been obligated on any
loan 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.)
Page 3 of 5
Fannie Mae Form 1003 7/05
VII. DETAILS OF TRANSACTION
VIII. DECLARATIONS
j.
Subordinate financing
If you answer “Yes” to any questions a through i,
please use continuation sheet for explanation.
k.
Borrower’s closing costs paid by Seller
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.
l.
Other Credits (explain)
g. Are you obligated to pay alimony, child support, or
separate maintenance?
Borrower
Yes No
Co-Borrower
Yes No
_______
_______
_______
_______
h. Is any part of the down payment borrowed?
m.
Loan amount (exclude PMI, MIP,
Funding Fee financed)
i. Are you a co-maker or endorser on a note?
-----------------------------------------------------------------------------------j. Are you a U.S. citizen?
n.
k. Are you a permanent resident alien?
PMI, MIP, Funding Fee financed
l. Do you intend to occupy the property as your primary residence?
If “Yes,” complete question m below.
o.
Loan amount (add m & n)
0.00
p.
m. Have you had an ownership interest in a property in the last three years?
Cash from/to Borrower (subtract j, k, l &
o from i)
(1) What type of property did you own—principal residence (PR),
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. ACKNOWLEDGEMENT 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 herein
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
Date
X
Co-Borrower’s Signature
Date
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 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
American Indian or
Alaska Native
Native Hawaiian or
Other Pacific Islander
Sex:
Female
Male
To be Completed by Interviewer
This application was taken by:
Face-to-face interview
Mail
Telephone
Internet
Race:
 Not Hispanic or Latino
Asian
Black or African American
Ethnicity:
Hispanic or Latino
Race:
American Indian or
Asian
Black or African American
Alaska Native
Native Hawaiian or
White
Other Pacific Islander
Female
Male
Name and Address of Interviewer’s Employer
White
Sex:
Interviewer’s Name (print or type)
Interviewer’s Signature
Not Hispanic or Latino
Date
Interviewer’s Phone Number (incl. area code)
Freddie Mac Form 65 7/05
Page 4 of 5
Fannie Mae Form 1003 7/05
CONTINUATION SHEET/RESIDENTIAL LOAN APPLICATION
Use this continuation sheet if you need more
space to complete the Residential Loan
Application. Mark B f or 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.
Date
Co-Borrower’s Signature
Date
Borrower’s Signature
X
Freddie Mac Form 65 7/05
X
Page 5 of 5
Fannie Mae Form 1003 7/05