Fillable Uniform Residential Loan Application

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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 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
II. PROPERTY INFORMATION AND PURPOSE OF LOAN
III. BORROWER INFORMATION
IV. EMPLOYMENT INFORMATION
Co-Borrower
Co-Borrower
Borrower
Borrower
Mortgage
Applied for:
Amortization Type:
VA Conventional Other (explain):
FHA USDA/Rural
Housing Service
Agency Case Number
Lender Case Number
Amount
$
Interest Rate
%
No. of Months
Fixed Rate Other (explain):
GPM ARM (type):
Subject Property Address (street, city, state & ZIP)
Purpose of Loan
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)
Property will be:
Legal Description of Subject Property (attach description if necessary)
Source of Down Payment, Settlement Charges, and/or Subordinate Financing (explain)
Complete this line if construction or construction-permanent loan.
Complete this line if this is a renance loan.
No. of Units
Year Built
Purchase Construction Other (explain):
Refinance Construction-Permanent
Year Lot Original Cost Amount Existing Liens (a) Present Value of Lot (b) Cost of Improvements Total (a + b)
Acquired
$ $ $ $ $
Year Original Cost Amount Existing Liens Purpose of Refinance Describe Improvements made  to be made
Acquired
$ $ $ Cost: $
Primary Residence Secondary Residence Investment
Borrower’s Name (include Jr. or Sr. if applicable) Co-Borrower’s Name (include Jr. or Sr. if applicable)
Social Security Number Home Phone DOB (mm/dd/yyyy) Yrs. School Social Security Number Home Phone DOB (mm/dd/yyyy) Yrs. School
(incl. area code) (incl. area code)
Married  Unmarried (include
Separated single, divorced, widowed)
Married  Unmarried (include
Separated single, divorced, widowed)
Dependents (not listed by Co-Borrower)
no. ages
Dependents (not listed by Borrower)
no. ages
Present Address (street, city, state, ZIP)  Own  Rent ____No. Yrs. Present Address (street, city, state, ZIP)  Own  Rent ____No. Yrs.
Former Address (street, city, state, ZIP)  Own  Rent ____No. Yrs. Former 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:
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 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)
Uniform Residential Loan Application
Freddie Mac Form 65 7/05 (rev.8/15) Page 1 of 5 Fannie Mae Form 1003 7/05 (rev.8/15)
Uniform Residential Loan Application
Freddie Mac Form 65 7/05 (rev.8/15) Page 2 of 5 Fannie Mae Form 1003 7/05 ( (rev.8/15)
IV. EMPLOYMENT INFORMATION (cont’d)
V. MONTHLY INCOME AND COMBINED HOUSING EXPENSE INFORMATION
VI. ASSETS AND LIABILITIES
Co-BorrowerBorrower
Name & Address of Employer  Self Employed Dates (from-to) Name & Address of Employer  Self Employed Dates (from-to)
Name & Address of Employer  Self Employed Dates (from-to) Name & Address of Employer  Self Employed Dates (from-to)
Monthly Income
$
Monthly Income
$
Monthly Income
$
Monthly Income
$
Position/Title/Type of Business Position/Title/Type of Business
Position/Title/Type of Business Position/Title/Type of Business
Business Phone
(incl. area code)
Business Phone
(incl. area code)
Business Phone
(incl. area code)
Business Phone
(incl. area code)
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
Gross Combined Monthly
Monthly Income Borrower Co-Borrower Total Housing Expense Present Proposed
Base Empl. Income*
Overtime
Bonuses
Commissions
Dividends/Interest
Net Rental Income
Other (before completing,
see the notice in “describe
other income,” below)
Total
Rent
First Mortgage (P&I)
Other Financing (P&I)
Hazard Insurance
Real Estate Taxes
Mortgage Insurance
Homeowner Assn. Dues
Other:
Total
$
$
$
$
$
$
$
$
$
$
* Self Employed Borrower(s) may be required to provide additional documentation such as tax returns and nancial 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
$
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.
ASSETS
Description
Cash or
Market Value
Cash deposit toward
purchase held by:
$
List checking and savings accounts below
LIABILITIES
Unpaid Balance
Monthly Payment &
Months Left to Pay
Name and address of Bank, S&L, or Credit Union
Name and address of Bank, S&L, or Credit Union
Name and address of Bank, S&L, or Credit Union
Name and address of Company
Name and address of Company
Name and address of Company
$ Payment/Months
$ Payment/Months
$ Payment/Months
$
$
$
Acct. no. $
Acct. no.
Acct. no. $
Acct. no.
Acct. no. $
Acct. no.
Uniform Residential Loan Application
Freddie Mac Form 65 7/05 (rev.8/15) Page 3 of 5 Fannie Mae Form 1003 7/05 (rev.8/15)
VI. ASSETS AND LIABILITIES (cont’d)
VII. DETAILS OF TRANSACTION VII. DETAILS OF TRANSACTION
Name and address of Bank, S&L, or Credit Union Name and address of Company $ Payment/Months $
Acct. no. $ Acct. no.
Acct. no.
Acct. no.
Stocks & Bonds (Company name/
number & description)
$ Name and address of Company $ Payment/Months $
$ Name and address of Company $ Payment/Months $
Life insurance net cash value
Face amount: $
Subtotal Liquid Assets
Total Assets a.
Total Liabilities b.
Total Monthly Payments
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)
Alimony/Child Support/Separate
Maintenance Payments Owed to:
Job-Related Expense (child care, union dues, etc.)
Other Assets (itemize)
Net Worth
(a minus 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
Gross
Rental Income
Mortgage
Payments
Net Rental
Income
Insurance,
Maintenance,
Taxes & Misc.
Amount
of Mortgages
& Liens
$ $ $ $ $ $
$ $ $ $ $ $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
If you answer “Yes” to any questions a through i,
please use continuation sheet for explanation.
a. Are there any outstanding judgments against you?
b. Have you been declared bankrupt within the past 7 years?
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?
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.)
a. Purchase price
b. Alterations, improvements, repairs
c. Land (if acquired separately)
d. Refinance (incl. debts to be paid off)
e. Estimated prepaid items
f. Estimated closing costs
g. PMI, MIP, Funding Fee
h. Discount (if Borrower will pay)
i. Total costs (add items a through h)
$
Borrower Co-Borrower
Yes No Yes No
Uniform Residential Loan Application
Freddie Mac Form 65 7/05 (rev.8/15) Page 4 of 5 Fannie Mae Form 1003 7/05 (rev.8/15)
VII. DETAILS OF TRANSACTION VIII. DECLARATIONS
IX. ACKNOWLEDGMENT AND AGREEMENT
X. INFORMATION FOR GOVERNMENT MONITORING PURPOSES
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.
Acknowledgment. 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.
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.
Sex: Female Male Sex: Female Male
j. Subordinate financing
k. Borrower’s closing costs paid by
Seller
l. Other Credits (explain)
m. Loan amount (exclude PMI, MIP,
Funding Fee financed)
n. PMI, MIP, Funding Fee financed
o. Loan amount
(add m & n)
p. Cash from/to Borrower
(subtract j, k, l & o from i)
Borrower Co-Borrower
Yes No Yes No
If you answer “Yes” to any question a through i, please use
continuation sheet for explanation.
f. Are you presently delinquent or in default on any Federal
debt or any other loan, mortgage, financial obligation, bond,
or loan guarantee?
g. Are you obligated to pay alimony, child support, or
separate maintenance?
h. Is any part of the down payment borrowed?
i. Are you a co-maker or endorser on a note?
j. Are you a U.S. citizen?
k. Are you a permanent resident alien?
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?
(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— by yourself (S),
jointly with your spouse (SP), or jointly with another person (O)?
Borrower’s Signature Date Co-Borrower’s Signature Date
x x
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
x
Race: American Indian or Asian Black or African American
Alaska Native
Native Hawaiian or White
Other Pacific Islander
Race: American Indian or Asian Black or African American
Alaska Native
Native Hawaiian or White
Other Pacific Islander
Ethnicity: Hispanic or Latino Not Hispanic or Latino
Ethnicity: Hispanic or Latino Not Hispanic or Latino
BORROWER I do not wish to furnish this information CO-BORROWER I do not wish to furnish this information
NMLS# 677617
1
st
Colonial Community Bank
P: 856-869-3250 • F: 856-321-8272
210 Lake Drive East, Cherry Hill, NJ 08002
Uniform Residential Loan Application
Freddie Mac Form 65 7/05 (rev.8/15) Page 5 of 5 Fannie Mae Form 1003 7/05 (rev.8/15)
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
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Uniform Residential Loan Application

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Completed 8 March 2022

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