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Uniform Residential Loan Application

This form is a uniform residential loan application for Fannie Mae and Freddie Mac loans. The form provided here is simply a sample of what the actual Form 1003 looks like.

Uniform Residential Loan Application

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 will not be used as a basis for loan qualification, but his or her liabilities must be considered because the 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.

I. TYPE OF MORTGAGE AND TERMS OF LOAN

Mortgage Applied for:
❑ VA
❑ FHA
❑ Conventional
❑ USDA/Rural Housing Service
❑ Other (explain): _________________________________

Agency Case Number _________________________________

Lender Case Number _________________________________

Amount $_________________________________

Interest Rate % _________________________________

No. of Months _________________________________

Amortization Type:
❑ Fixed Rate
❑ GPM
❑ 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
❑ Construction-Permanent
❑ Other (explain): _________________________________

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) $_________________________________

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)

_________________________________

III. BORROWER INFORMATION

Borrower

Borrower's Name (include Jr. or Sr. if applicable) _________________________________

Social Security Number _________________________________

Home Phone (incl. area code) _________________________________

DOB (MM/DD/YYYY) _________________________________

Yrs. School _________________________________

❑ Married
❑ Separated
❑ Unmarried (include single, divorced, widowed)

Dependents (not listed by Co-Borrower)

no. _________________________________

ages _________________________________

Present Address (street, city, state, ZIP) ❑ 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.


Co-Borrower

Borrower's Name (include Jr. or Sr. if applicable) _________________________________

Social Security Number _________________________________

Home Phone (incl. area code) _________________________________

DOB (MM/DD/YYYY) _________________________________

Yrs. School _________________________________

❑ Married
❑ Separated
❑ Unmarried (include single, divorced, widowed)

Dependents (not listed by Co-Borrower)

no. _________________________________

ages _________________________________

Present Address (street, city, state, ZIP) ❑ 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.


IV. EMPLOYMENT INFORMATION

Borrower

Name & Address of Employer _________________________________

❑ 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:

Name & Address of Employer _________________________________

❑ Self Employed Dates (from - to) _________________________________

Monthly Income $_________________________________


Co-Borrower

Name & Address of Employer _________________________________

❑ 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:

Name & Address of Employer _________________________________

❑ Self Employed Dates (from - to) _________________________________

Monthly Income $_________________________________

V. MONTHLY INCOME AND COMBINED HOUSING EXPENSE INFORMATION

Borrower Gross Monthly Income

Base Empl. Income* $_________________________________

Overtime $_________________________________

Bonuses $_________________________________

Commissions $_________________________________

Dividends/Interest $_________________________________

Net Rental Income $_________________________________

Other (before completing, see the notice in "describe other income," below) $_________________________________

Total $_________________________________


Co-Borrower Gross Monthly Income

Base Empl. Income* $_________________________________

Overtime $_________________________________

Bonuses $_________________________________

Commissions $_________________________________

Dividends/Interest $_________________________________

Net Rental Income $_________________________________

Other (before completing, see the notice in "describe other income," below) $_________________________________

Total $_________________________________


Present Combined Monthly Housing Expense:

Rent $_________________________________

First Mortgage (P&I) $_________________________________

Other Financing (P&I) $_________________________________

Hazard Insurance $_________________________________

Real Estate Taxes $_________________________________

Mortgage Insurance $_________________________________

Homeowner Assn. Dues $_________________________________

Other: $_________________________________

Total $_________________________________


Proposed Combined Monthly Housing Expense:

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 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 $_________________________________

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 spouse, this Statement and supporting schedules must be completed about that spouse also.

Completed ❑ Jointly ❑ Not Jointly

ASSETS

Description

Cash deposit toward purchase held by: _________________________

Cash or Market Value $_________________________________

List checking and savings accounts below

Name and address of Bank, S&L, or Credit Union

_________________________________


_________________________________

Acct. no. _________________________________

$_________________________________

Name and address of Bank, S&L, or Credit Union

_________________________________

_________________________________

Acct. no. _________________________________

$_________________________________

Name and address of Bank, S&L, or Credit Union

_________________________________

_________________________________

Acct. no. _________________________________

$_________________________________

Stocks & Bonds (Company name/number & description)

_________________________________

_________________________________

$_________________________________

Life insurance net cash value

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. $_________________________________

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 upon refinancing of the subject property.

LIABILITIES

Name and address of Company

_________________________________

_________________________________

Acct. no. _________________________________

Monthly Payment & Months Left to Pay:

$ Payment/Months $_________________________________

Unpaid Balance $_________________________________


Name and address of Company

_________________________________

_________________________________

Acct. no. _________________________________

Monthly Payment & Months Left to Pay:

$ Payment/Months $_________________________________

Unpaid Balance $_________________________________

Name and address of Company

_________________________________

_________________________________

Acct. no. _________________________________

Monthly Payment & Months Left to Pay:

$ Payment/Months $_________________________________

Unpaid Balance $_________________________________

Alimony/Child Support/Separate Maintenance Payments Owed to:

_________________________________

$_________________________________

Job-Related Expense (child care, union dues, etc.) _________________________________

$_________________________________

Total Monthly Payments _________________________________

Net Worth (a minus b) $_________________________________

Total Liabilities 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 $_________________________________

Amount of Mortgages & Liens $_________________________________

Gross Rental Income $_________________________________

Mortgage Payments $_________________________________

Insurance, Maintenance, Taxes & Misc. $________________________

Net Rental Income $_________________________________

Property Address (enter S if sold, PS if pending sale or R if rental being held for income)

_________________________________

_________________________________

Type of Property _________________________________

Present Market Value $_________________________________

Amount of Mortgages & Liens $_________________________________

Gross Rental Income $_________________________________

Mortgage Payments $_________________________________

Insurance, Maintenance, Taxes & Misc. $_________________________

Net Rental Income $_________________________________

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 _________________________________

Alternate Name _________________________________

Creditor Name _________________________________

Account Number _________________________________

VII. DETAILS OF TRANSACTION

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) $_______________________

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) $_________________________________

VIII. DECLARATIONS

Borrower

If you answer "Yes" to any questions a through i, please use continuation sheet for explanation.

a. Are there any outstanding judgments against you? Yes ❑ No ❑

b. Have you been declared bankrupt within the past 7 years? Yes ❑ No ❑

c. Have you had property foreclosed upon or given title or deed in lieu thereof in the last 7 years? Yes ❑ No ❑

d . Are you a party to a lawsuit? Yes ❑ No ❑

e. Have you directly or indirectly been obligated on any loan which resulted in foreclosure, transfer of title in lieu of foreclosure, or judgment? Yes ❑ No ❑
(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.)

f. Are you presently delinquent or in default on any Federal debt or any other loan, mortgage, financial obligation, bond, or loan guarantee? Yes ❑ No ❑
If "Yes," give details as described in the preceding question.

g. Are you obligated to pay alimony, child support, or separate maintenance? Yes ❑ No ❑

h. Is any part of the down payment borrowed? Yes ❑ No ❑

i. Are you a co-maker or endorser on a note? Yes ❑ No ❑

j. Are you a U.S. citizen? Yes ❑ No ❑

k. Are you a permanent resident alien? Yes ❑ No ❑

l. Do you intend to occupy the property as your primary residence? Yes ❑ No ❑
If "Yes," complete question m below.

m. Have you had an ownership interest in a property in the last three years? Yes ❑ No ❑

(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)? __________

Co-Borrower

If you answer "Yes" to any questions a through i, please use continuation sheet for explanation.

a. Are there any outstanding judgments against you? Yes ❑ No ❑

b. Have you been declared bankrupt within the past 7 years? Yes ❑ No ❑

c. Have you had property foreclosed upon or given title or deed in lieu thereof in the last 7 years? Yes ❑ No ❑

d . Are you a party to a lawsuit? Yes ❑ No ❑

e. Have you directly or indirectly been obligated on any loan which resulted in foreclosure, transfer of title in lieu of foreclosure, or judgment? Yes ❑ No ❑
(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.)

f. Are you presently delinquent or in default on any Federal debt or any other loan, mortgage, financial obligation, bond, or loan guarantee? Yes ❑ No ❑
If "Yes," give details as described in the preceding question.

g. Are you obligated to pay alimony, child support, or separate maintenance? Yes ❑ No ❑

h. Is any part of the down payment borrowed? Yes ❑ No ❑

i. Are you a co-maker or endorser on a note? Yes ❑ No ❑

j. Are you a U.S. citizen? Yes ❑ No ❑

k. Are you a permanent resident alien? Yes ❑ No ❑

l. Do you intend to occupy the property as your primary residence? Yes ❑ No ❑
If "Yes," complete question m below.

m. Have you had an ownership interest in a property in the last three years? Yes ❑ No ❑

(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. ACKNOWLEDGMENT 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 herein; (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 herein; (6) any owner or servicer of the Loan may verify or reverify any information contained in the application from any source named in this application, and Lender, its successors or assigns may retain the original and/or an electronic record of this application, even if the Loan is not 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 owner or servicer of the Loan 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 credit 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 fascimile 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.

Borrower's Signature _________________________________

Date _________________________________

Co-Borrower's Signature _________________________________

Date _________________________________

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 discriminate neither on the basis of this information, nor 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 or surname. 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.

Ethnicity:
❑ Hispanic or Latino
❑ Not Hispanic or Latino

Race:
❑ American Indian or Alaska Native
❑ Asian
❑ Black or African American
❑ Native Hawaiian or Other Pacific Islander
❑ White

Sex: ❑ Female ❑ Male

CO-BORROWER ❑ I do not wish to furnish this information.

Ethnicity:
❑ Hispanic or Latino
❑ Not Hispanic or Latino

Race:
❑ American Indian or Alaska Native
❑ Asian
❑ Black or African American
❑ Native Hawaiian or Other Pacific Islander
❑ White

Sex: ❑ Female ❑ Male

To be Completed by Interviewer

This application was taken by:
❑ Face-to-face interview
❑ Mail
❑ Telephone
❑ Internet

Interviewer's Name (print or type) _________________________________

Name and Address of Interviewer's Employer _________________________________

Interviewer's Signature _________________________________

Interviewer's Phone Number (incl. area code) ____________________

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 _________________________________

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