Fillable Uniform Residential Loan Application Section 1: Borrower Information.

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Uniform Residential Loan Application Section 1: Borrower Information.

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Uniform Residential Loan Application
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
Verify and complete the information on this application. If you are applying for this loan with others, each additional Borrower must provide
information 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.
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
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
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)
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
No primary housing expense
Own
Rent /month)
($
No primary housing expense
Own
Rent
($
/month)
Dependents (not listed by another Borrower)
Number
Ages
Married
Separated
Unmarried
(Single, Divorced, Widowed, Civil Union, Domestic Partnership, Registered
Reciprocal Beneficiary Relationship)
I have an ownership share of less than 25%.
I have an ownership share of 25% or more.
1a. Personal Information
I am applying for individual credit.
Each Borrower intends to apply for joint credit. Your initials:
I am applying for joint credit. Total Number of Borrowers:
1b. Current Employment/Self-Employment and Income
$
$
$
$
$
$
$
0.00
Borrower Name:
Uniform Residential Loan Application
Freddie Mac Form 65 • Fannie Mae Form 1003
Effective 1/2021
1d. IF APPLICABLE, Complete Information for Previous Employment/Self-Employment and Income
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
1c. IF APPLICABLE, Complete Information for Additional 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
I have an ownership share of less than 25%.
I have an ownership share of 25% or more.
Monthly Income (or Loss)
1e. Income from Other Sources
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
Income Source – use list above
Monthly Income
$
$
$
Provide TOTAL Amount Here $
$
$
$
$
$
$
$
0.00
0.00
Borrower Name:
Uniform Residential Loan Application
Freddie Mac Form 65 • Fannie Mae Form 1003
Effective 1/2021
2b. Other Assets and Credits You Have Does not apply
Include all other assets and credits below. Under Asset or Credit Type, choose from the types listed here:
Assets
•
Proceeds from Real Estate
Property to be sold on or
before closing
•
Proceeds from Sale of
Non-Real Estate Asset
• Secured Borrowed Funds
• Unsecured Borrowed Funds
• Other
Credits
• Earnest Money
• Employer Assistance
• Lot Equity
• Relocation Funds
• Rent Credit
• Sweat Equity
• Trade Equity
2d. Other Liabilities and Expenses Does not apply
2c. Liabilities – Credit Cards, Other Debts, and Leases that You Owe Does not apply
List all liabilities below (except real estate) and include deferred payments. Under Account Type, choose from the types listed here:
• Revolving (e.g., credit cards) • Installment (e.g., car, student, personal loans) • Open 30-Day (balance paid monthly) • Lease (not real estate) • Other
Section 2: Financial Information — Assets and Liabilities.
This section asks about things you own that
are worth money and that you want considered to qualify for this loan. It then asks about your liabilities (or debts) that you pay
each month, such as credit cards, alimony, or other expenses.
Account Type – use list above Financial Institution Account Number
Cash or Market Value
$
$
$
$
$
Provide TOTAL Amount Here
$
2a. Assets – Bank Accounts, Retirement, and Other Accounts You Have
Include all accounts below. Under Account Type, choose from the types listed here:
• Checking
• Savings
• Money Market
• Certificate of Deposit
• Mutual Fund
• Stocks
• Stock Options
• Bonds
• Retirement (e.g., 401k, IRA)
• Bridge Loan Proceeds
•
Individual Development
Account
• Trust Account
•
Cash Value of Life Insurance
(used for the transaction)
Asset or Credit Type – use list above
Cash or Market Value
$
$
$
$
Provide TOTAL Amount Here
$
Account Type –
use list above
Company Name Account Number
Unpaid Balance
To be paid off at
or before closing
Monthly Payment
$
$
$ $
$
$
$ $
$ $
Include all other liabilities and expenses below. Choose from the types listed here:
• Alimony • Child Support • Separate Maintenance • Job Related Expenses • Other
Monthly Payment
$
$
$
0.00
0.00
Borrower Name:
Uniform Residential Loan Application
Freddie Mac Form 65 • Fannie Mae Form 1003
Effective 1/2021
Mortgage Loans on this Property Does not apply
Mortgage Loans on this Property Does not apply
Does not apply
Address Street Unit #
City State ZIP Country
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
Does not apply
Address Street Unit #
City State ZIP Country
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
Section 3: Financial Information — Real Estate.
This section asks you to list all properties you currently own
and what you owe on them.
I do not own any real estate
Mortgage Loans on this Property Does not apply
If you are refinancing, list the property you are refinancing FIRST.
Address
Street Unit #
City State ZIP Country
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
3a. Property You Own
3b. IF APPLICABLE, Complete Information for Additional Property
3c. IF APPLICABLE, Complete Information for Additional 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)
$ $
$
$ $
$
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)
$ $
$
$ $
$
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)
$ $
$
$ $
$
$ $ $ $
$ $ $ $
$ $ $ $
Borrower Name:
Uniform Residential Loan Application
Freddie Mac Form 65 • Fannie Mae Form 1003
Effective 1/2021
Does not apply
Creditor Name Lien Type
Monthly Payment
Loan Amount/
Amount to be Drawn
Credit Limit
(if applicable)
First Lien Subordinate Lien $ $ $
First Lien
Subordinate Lien
$ $ $
Loan Amount $ Loan Purpose
Property Address Street Unit #
City State ZIP County
Number of Units Property Value $
Occupancy
Primary Residence
Second Home
Investment Property FHA Secondary Residence
1.
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)
NO
YES
2. Manufactured Home. Is the property a manufactured home? (e.g., a factory built dwelling built on a permanent chassis)
NO
YES
Section 4: Loan and Property Information.
This section asks about the loan’s purpose and the property you
want to purchase or refinance.
For Purchase Only Does not apply
Does not apply
Include all gifts and grants below. Under Source, choose from the sources listed here:
• Community Nonprofit
• Employer
• Federal Agency
• Local Agency
• Relative
• Religious Nonprofit
• State Agency
• Unmarried Partner
• Lender
• Other
4b. Other New Mortgage Loans on the Property You are Buying or Refinancing
4a. Loan and Property Information
4c. Rental Income on the Property You Want to Purchase
4d. Gifts or Grants You Have Been Given or Will Receive for this Loan
Refinance Purchase (specify)Other
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 $
Asset Type: Cash Gift, Gift of Equity, Grant Deposited/Not Deposited Source – use list above Cash or Market Value
Deposited Not Deposited
$
Deposited
Not Deposited $
Borrower Name:
Uniform Residential Loan Application
Freddie Mac Form 65 • Fannie Mae Form 1003
Effective 1/2021
Section 5: Declarations.
This section asks you specific questions about the property, your funding, and your past
financial history.
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?
NO YES
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?
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
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
5a. About this Property and Your Money for this Loan
5b. About Your Finances
A. Will you occupy the property as your primary residence?
(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
Borrower Name:
Uniform Residential Loan Application
Freddie Mac Form 65 • Fannie Mae Form 1003
Effective 1/2021
Definitions:
I agree to, acknowledge, and represent the following:
•
"Lender" includes the Lender’s agents, service providers, and any of
their successors and assigns.
•
"Other Loan Participants" includes (i) any actual or potential owners of
a loan resulting from this application (the “Loan”), (ii) acquirers of
any beneficial or other interest in the Loan, (iii) any mortgage insurer,
(iv) any guarantor, (v) any servicer of the Loan, and (vi) any of these
parties' service providers, successors or assigns.
(1) The Complete Information for this Application
•
The information I have provided in this application is true, accurate,
and complete as of the date I signed this application.
•
If the information I submitted changes or I have new information
before closing of the Loan, I must change and supplement this
application, including providing any updated/supplemented real
estate sales contract.
•
For purchase transactions: The terms and conditions of any real
estate sales contract signed by me in connection with this application
are true, accurate, and complete to the best of my knowledge and
belief. I have not entered into any other agreement, written or oral, in
connection with this real estate transaction.
•
The Lender and Other Loan Participants may rely on the information
contained in the application before and after closing of the Loan.
•
Any intentional or negligent misrepresentation of information may
result in the imposition of:
(a)
civil liability on me, including monetary damages, if a
person suffers any loss because the person relied on any
misrepresentation that I have made on this application, and/or
(b)
criminal penalties on me including, but not limited to, fine or
imprisonment or both under the provisions of Federal law
(18 U.S.C. §§ 1001 et seq.).
(2) The Property’s Security
The Loan I have applied for in this application will be secured by
a mortgage or deed of trust which provides the Lender a security
interest in the property described in this application.
(3) The Property’s Appraisal, Value, and Condition
•
Any appraisal or value of the property obtained by the Lender is
for use by the Lender and Other Loan Participants.
•
The Lender and Other Loan Participants have not made any
representation or warranty, express or implied, to me about the
property, its condition, or its value.
(4) Electronic Records and Signatures
•
The Lender and Other Loan Participants may keep any paper record
and/or electronic record of this application, whether or not the Loan
is approved.
•
If this application is created as (or converted into) an “electronic
application”, I consent to the use of “electronic records” and
“electronic signatures” as the terms are defined in and governed by
applicable Federal and/or state electronic transactions laws.
• I intend to sign and have signed this application either using my:
(a) electronic signature; or
(b)
a written signature and agree that if a paper version of this
application is converted into an electronic application, the
application will be an electronic record, and the representation
of my written signature on this application will be my binding
electronic signature.
•
I agree that the application, if delivered or transmitted to the Lender
or Other Loan Participants as an electronic record with my electronic
signature, will be as effective and enforceable as a paper application
signed by me in writing.
(5) Delinquency
•
The Lender and Other Loan Participants may report information about
my account to credit bureaus. Late payments, missed payments, or
other defaults on my account may be reflected in my credit report and
will likely affect my credit score.
•
If I have trouble making my payments I understand that I may contact
a HUD-approved housing counseling organization for advice about
actions I can take to meet my mortgage obligations.
(6) Authorization for Use and Sharing of Information
By signing below, in addition to the representations and agreements
made above, I expressly authorize the Lender and Other Loan
Participants to obtain, use, and share with each other (i) the loan
application and related loan information and documentation, (ii) a
consumer credit report on me, and (iii) my tax return information, as
necessary to perform the actions listed below, for so long as they have
an interest in my loan or its servicing:
(a) process and underwrite my loan;
(b)
verify any data contained in my consumer credit report, my
loan application and other information supporting my loan
application;
(c)
inform credit and investment decisions by the Lender
and Other Loan Participants;
(d)
perform audit, quality control, and legal compliance analysis
and reviews;
(e) perform analysis and modeling for risk assessments;
(f)
monitor the account for this loan for potential delinquencies and
determine any assistance that may be available to me; and
(g) other actions permissible under applicable law.
Borrower Signature
Date (mm/dd/yyyy) / /
Additional Borrower Signature Date (mm/dd/yyyy) / /
Section 6: Acknowledgments and Agreements.
This section tells you about your legal obligations when
you sign this application.
Acknowledgments and Agreements
Borrower Name:
Uniform Residential Loan Application
Freddie Mac Form 65 • Fannie Mae Form 1003
Effective 1/2021
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? YESNO
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
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
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.
Military Service of Borrower
Demographic Information of Borrower
Asian
Other Asian – Print race:
For example: Hmong, Laotian, Thai, Pakistani, Cambodian, and so on.
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 enrolledAmerican Indian or Alaska Native
White
Borrower Name:
Uniform Residential Loan Application
Freddie Mac Form 65 • Fannie Mae Form 1003
Effective 1/2021
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) / /
Loan Originator Information
Signature
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Completed 18 March 2022

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