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Uniform Residential Loan Application Additional Borrower Section 1:

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Uniform Residential Loan Application — Additional Borrower
Freddie Mac Form 65 • Fannie Mae Form 1003
Effective 1/2021
To be completed by the Lender:
Lender Loan No./Universal Loan Identifier Agency Case No.
Uniform Residential Loan Application — Additional Borrower
Verify and complete the information on this application as directed by your Lender.
Section 1: Borrower Information.
This section asks about your personal information and your income from
employment and other sources, such as retirement, that you want considered to qualify for this loan.
1a. Personal Information
Name (First, Middle, Last, Suffix)
Social Security Number
(or Individual Taxpayer Identification Number)
– –
Alternate Names – List any names by which you are known or any names
under which credit was previously received (First, Middle, Last, Suffix)
Date of Birth
(mm/dd/yyyy)
/ /
Citizenship
U.S. Citizen
Permanent Resident Alien
Non-Permanent Resident Alien
Type of Credit
List Name(s) of Other Borrower(s) Applying for this Loan
(First, Middle, Last, Suffix) – Use a separator between names
Marital Status Dependents
(not listed by another Borrower)
I am applying for individual credit.
I am applying for joint credit.
Each Borrower intends to apply for joint credit. Your initials:
Total Number of Borrowers:
Married
Separated
Unmarried
(Single, Divorced, Widowed, Civil Union, Domestic Partnership, Registered
Reciprocal Beneficiary Relationship)
No primary housing expense Own
Rent ($ /month)
No primary housing expense Own
Rent /month)
($
1b. Current Employment/Self-Employment and Income Does not apply
Employer or Business Name Phone ( ) –
Street Unit #
City State ZIP Country
Gross Monthly Income
Base /month
Overtime /month
Bonus /month
Commission /month
Military
Entitlements
/month
Other /month
TOTAL $
/month
Position or Title
Start Date / /
(mm/dd/yyyy)
How long in this line of work? Years Months
Check if this statement applies:
I am employed by a family member,
property seller, real estate agent, or other
party to the transaction.
Check if you are the Business
Owner or Self-Employed
Monthly Income (or Loss)
Number
Ages
Contact Information
Home Phone ( ) –
Cell Phone ( ) –
Work Phone ( ) –
Ext.
Email
Current Address
Street Unit #
City State ZIP Country
How Long at Current Address? Years Months Housing
If at Current Address for LESS than 2 years, list Former Address Does not apply
Street Unit #
City State ZIP Country
How Long at Former Address? Years Months Housing
Mailing Address – if different from Current Address Does not apply
Street Unit #
City State ZIP Country
I have an ownership share of less than 25%.
I have an ownership share of 25% or more.
$
$
$
$
$
$
$
0.00
Borrower Name:
Freddie Mac Form 65 • Fannie Mae Form 1003
Effective 1/2021
Uniform Residential Loan Application — Additional Borrower
Section 2: Financial Information — Assets and Liabilities.
My information for Section 2 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Does not apply
Employer or Business Name Phone ( ) –
Street Unit #
City State ZIP Country
Gross Monthly Income
Base /month
Overtime /month
Bonus /month
Commission /month
Military
Entitlements
/month
Other /month
TOTAL $
/month
Position or Title
Start Date / /
(mm/dd/yyyy)
How long in this line of work? Years Months
Check if this statement applies:
I am employed by a family member,
property seller, real estate agent, or other
party to the transaction.
Check if you are the Business
Owner or Self-Employed
Monthly Income (or Loss)
Does not apply
Include income from other sources below. Under Income Source, choose from the sources listed here:
NOTE: Reveal alimony, child support, separate maintenance, or other income ONLY IF you want it considered in determining your qualification
for this loan.
• Alimony
• Automobile Allowance
• Boarder Income
• Capital Gains
• Child Support
• Disability
• Foster Care
• Housing or Parsonage
• Interest and Dividends
• Mortgage Credit Certificate
• Mortgage Differential
Payments
• Notes Receivable
• Public Assistance
•
Retirement
(e.g., Pension, IRA)
• Royalty Payments
• Separate Maintenance
• Social Security
• Trust
•
Unemployment
Benefits
• VA Compensation
• Other
Section 3: Financial Information — Real Estate.
My information for Section 3 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Does not apply
Provide at least 2 years of current and previous employment and income.
Employer or Business Name
Street Unit #
City State ZIP Country
Previous Gross Monthly
Income $
/month
Position or Title
Start Date / /
(mm/dd/yyyy)
End Date / /
(mm/dd/yyyy)
Check if you were the Business
Owner or Self-Employed
Section 4: Loan and Property Information.
My information for Section 4 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
I have an ownership share of less than 25%.
I have an ownership share of 25% or more.
Income Source – use list above
$
Monthly Income
$
$
$
Provide TOTAL Amount Here $
1c. IF APPLICABLE , Complete Information for Additional Employment/Self-Employment and Income
1d. IF APPLICABLE, Complete Information for Previous Employment/Self-Employment and Income
1e. Income from Other Sources
$
$
$
$
$
$
$
0.00
0.00
Borrower Name:
Freddie Mac Form 65 • Fannie Mae Form 1003
Effective 1/2021
Uniform Residential Loan Application — Additional Borrower
Section 6: Acknowledgements and Agreements.
My signature for Section 6 is on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 5: Declarations.
This section asks you specific questions about the property, your funding, and your past
financial history.
A. 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:
B. If this is a Purchase Transaction: Do you have a family relationship or business affiliation with the seller of the property?
C.
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?
NO YES
D.
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?
NO
YES
2. Have you or will you be applying for any new credit (e.g., installment loan, credit card, etc.) on or before closing this loan that
is not disclosed on this application?
NO YES
E.
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)?
NO
YES
F. Are you a co-signer or guarantor on any debt or loan that is not disclosed on this application? NO YES
G. Are there any outstanding judgments against you? NO YES
H. Are you currently delinquent or in default on a Federal debt? NO YES
I. Are you a party to a lawsuit in which you potentially have any personal financial liability?
NO
YES
J. Have you conveyed title to any property in lieu of foreclosure in the past 7 years? NO YES
K.
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?
NO
YES
L. Have you had property foreclosed upon in the last 7 years? NO YES
M.
Have you declared bankruptcy within the past 7 years?
If YES, identify the type(s) of bankruptcy:
Chapter 7
Chapter 11 Chapter 12
Chapter 13
NO YES
Military Service – Did you (or your deceased spouse) ever serve, or are you currently serving, in the United States Armed Forces? NO YES
If YES, check all that apply: Currently serving on active duty / / (mm/dd/yyyy)
with projected expiration date of service/tour
Currently retired, discharged, or separated from service
Only period of service was as a non-activated member of the Reserve or National Guard
Surviving spouse
Section 7: Military Service.
This section asks questions about your (or your deceased spouse's) military service.
NO YES
(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 your spouse (SP), or jointly with another person (O)?
NO
YES
NO YES
5a. About this Property and Your Money for this Loan
5b. About Your Finances
Military Service of Borrower
$
Borrower Name:
Freddie Mac Form 65 • Fannie Mae Form 1003
Effective 1/2021
Uniform Residential Loan Application — Additional Borrower
Section 8: Demographic Information.
This section asks about your ethnicity, sex, and race.
The purpose of collecting this information is to help ensure that all applicants are treated fairly and that the housing needs of communities
and neighborhoods are being fulfilled. For residential mortgage lending, Federal law requires that we ask applicants for their demographic
information (ethnicity, sex, and race) in order to monitor our compliance with equal credit opportunity, fair housing, and home mortgage
disclosure laws. You are not required to provide this information, but are encouraged to do so. You may select one or more designations for
"Ethnicity" and one or more designations for "Race." The law provides that we may not discriminate on the basis of this information, or on
whether you choose to provide it. However, if you choose not to provide the information and you have made this application in person, Federal
regulations require us to note your ethnicity, sex, and race on the basis of visual observation or surname. The law also provides that we may not
discriminate on the basis of age or marital status information you provide in this application. If you do not wish to provide some or all of this
information, please check below.
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? NO
YES
Was the sex of the Borrower collected on the basis of visual observation or surname? NO YES
Was the race of the Borrower collected on the basis of visual observation or surname? NO YES
The Demographic Information was provided through:
Face-to-Face Interview (includes Electronic Media w/ Video Component)
Telephone Interview
Fax or Mail Email or Internet
Asian
For example: Hmong, Laotian, Thai, Pakistani, Cambodian, and so on.
Other Asian – Print race:
Asian Indian
Chinese
Filipino
Japanese Korean
Vietnamese
Black or African American
Native Hawaiian or Other Pacific Islander
Native Hawaiian Guamanian or Chamorro
Samoan
Other Pacific Islander – Print race:
For example: Fijian, Tongan, and so on.
I do not wish to provide this information
or principal tribe :
Print name of enrolled
American Indian or Alaska Native –
White
Race: Check one or moreEthnicity: Check one or more
Hispanic or Latino
Mexican
Puerto Rican
Cuban
Other Hispanic or Latino –
For example: Argentinean, Colombian, Dominican, Nicaraguan,
Salvadoran, Spaniard, and so on.
Print origin:
Not Hispanic or Latino
I do not wish to provide this information
Sex
Female
Male
I do not wish to provide this information
Section 9: Loan Originator Information.
To be completed by your Loan Originator.
Loan Originator Organization Name
Address
Loan Originator Organization NMLSR ID# State License ID#
Loan Originator Name
Loan Originator NMLSR ID# State License ID#
Email Phone ( ) –
Date (mm/dd/yyyy)
/ /
Demographic Information of Borrower
Loan Originator Information
Signature
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Completed 18 March 2022

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