Uniform Residential Loan Application

Freddie Mac Form 65 • Fannie Mae Form 1003

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I. Type of Mortgage and Terms of Loan

Agency Case Number:

Lender Case Number:

Amount:

Interest Rate:

No. of Months:

Amortization Type:

II. Property information and purpose of loan

Subject Property Address:

No. of Units:

Legal Description of Property:

Year Built:

Purpose of Loan:

Property Type:

Complete this line if construction or construction-permanent

Year Lot
Acquired:

Original
Cost:

Amount
Existing Liens:

Present Value
of Lot:

Cost of
Improvements:

Complete this line if This is a Refinance Loan

Year
Acquired:

Original
Cost:

Amount
Existing Liens:

Purpose of
Refinance:

Describe
Improvements:

Title will be held in what Name(s):

Manner in which Title will be held:

Estate will be held in:

Source of Down Payment, Settlement Charges, and/or Subordinate Financing:

III. Borrower Information

Borrower

Borrower's Name:

Phone:

Social Security No.

Date of Birth:

Marital
Status:

Dependents:
(Not Listed By Co-Borrower)

Present Address:

Previous Address:
(If less than two years at Present Address)

Mailing Address:
(If different from Present Address)

Co-Borrower

Co-Borrower's Name:

Phone:

Social Security No.

Date of Birth:

Marital
Status:

Dependents:
(Not Listed By Co-Borrower)

Present Address:

Previous Address:
(If less than two years at Present Address)

Mailing Address:
(If different from Present Address)

IV. Employment Information

Borrower

Employer Name:

Business Phone:

Employer Address:

Yrs. on this job:

Yrs. in same industry:

If Employed in current position for less than two years or if currently employed in more than one position, complete the following:

Employer's Name:

Business Phone:

Employer Address:

Dates:

From

Mthly Income:

Co-Borrower

Employer Name:

Business Phone:

Employer Address:

Yrs. on this job:

Yrs. in same industry:

If Employed in current position for less than two years or if currently employed in more than one position, complete the following:

Employer's Name:

Business Phone:

Employer Address:

Dates:

From

Mthly Income:

V. Income and Expenses

Monthly Income

Base:

Overtime:

Bonuses:

Commissions:

Dividends:

Interest:

Rental:

Other:

Total

Combined Monthly Expenses

Rent:

Mortgage (P&I):

Other Financing:

Hazard Ins.:

Real Estate Taxes:

Mortgage Ins.:

HOA:

Other:

Total

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.

VI. Assets and Liabilities

Assets

Cash Deposit Held By:

Stocks and Bonds:

Life Insurance Net Cash Value:

Subtotal Net Liquid Assets

Real Estate Owned:

Vested Interest in Retirement Fund:

Net Worth of Business(es):

Automobiles Owned:

Other Assets:

Liabilities

Alimony:

Child Support:

Separate Maintenance:

Job Related:

Union Dues:

Child Care:

Total Assets

Total Payments

Total Liabilities

Net Worth:

Schedule of Real Estate Owned:

Totals:

List any additional names under which credit has previously been received and indicate appropriate creditor name(s) and Account Number(s)

VII. Details of Transaction

(a)

Purchase Price:

(b)

Alterations, Improvements, and Repairs:

(c)

Land:

(If acquired separately)

(d)

Refinance:

(Including debts to be paid)

(e)

Estimated Pre-Paid Items:

(f)

Estimated Closing Costs:

(g)

PMI, MIP, Funding Fee:

(h)

Discount:

(If borrower will pay)

(i)

Total Costs:

Add items (a) thru (h)

(j)

Subordinate Financing:

(k)

Borrower’s Closing Costs Paid by Seller:

(l)

Other Credits:

(m)

Loan Amount:

(Exclude PMI, MIP, Funding Fee Financed)

(n)

PMI, MIP, Funding Fee Financed:

(o)

Loan Amount:

Add (m) and (n)

(p)

Cash From/To Borrower:

Subtract (j), (k), (l), & (o) from (i)

VIII. Declarations

(a)

Are there any outstanding judgements against you?

(b)

Have you been declared bankrupt within the past seven 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?

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?

If “Yes,” give details as described in the preceding question.

(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 ?

2.How did you hold title to the home?

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:

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.
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.
The property will not be used for any illegal or prohibited purpose or use.
All statements made in this application are made for the purpose of obtaining a residential mortgage loan.
The property will be occupied as indicated in this application.
The Lender, its servicers, successors or assigns may retain the original and/or electronic record of this application, whether or not the Loan is approved.
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.
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.
Ownership of the Loan and/or administration of the Loan account may be transferred with such notice as may be required by law.
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.
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.

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.

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.

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

Ethnicity:

Race:

Sex:

Co-Borrower

Ethnicity:

Race:

Sex:

Continuation Section

Use this continuation Section if you need more space to complete the Residential Loan Application.

Borrower:

Co-Borrower:

Agency Case Number:

Lender Case Number:

Additional Information:

Thank you! Your submission has been received!

Oops! Something went wrong while submitting the form :(

Mortgage Applied For

Key Terms

Uniform Residential Loan Application

Freddie Mac Form 65 • Fannie Mae Form 1003

ProfessionalAssistance

Have questions about your application? Call us for answers to many of your mortgage questions.

Do-It-YourselfExperts

Are you a true DIY’er at heart?Descriptions, key terms, and instructions make applying on your own a breeze.

In-Person Consultation

Filling out applications isn’t your cup of tea? Our in-person consultations are fast, accurate, and free.

I. Type of Mortgage and Terms of Loan

II. Property information and purpose of loan

Complete this line if construction or construction-permanent

Complete this line if This is a Refinance Loan

III. Borrower Information

Borrower

Co-Borrower

IV. Employment Information

Borrower

If Employed in current position for less than two years or if currently employed in more than one position, complete the following:

Co-Borrower

If Employed in current position for less than two years or if currently employed in more than one position, complete the following:

V. Income and Expenses

Monthly Income

Combined Monthly Expenses

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.

VI. Assets and Liabilities

Assets

Liabilities

Schedule of Real Estate Owned:

List any additional names under which credit has previously been received and indicate appropriate creditor name(s) and Account Number(s)

VII. Details of Transaction

VIII. Declarations

IX. Acknowledgment AND AGREEMENT

Acknowledgment

X. Information for government monitoring purposes

Borrower

Co-Borrower

Continuation Section

Use this continuation Section if you need more space to complete the Residential Loan Application.

Antelope Valley

San Fernando Valley

Los Angeles

Las Vegas (Coming Soon)

Professional
Assistance

Have questions about your application?
Call us for answers to many of your mortgage questions.

Do-It-Yourself
Experts

Are you a true DIY’er
at heart?
Descriptions, key terms, and instructions make applying on your own a breeze.

In-Person
Consultation

Filling out applications isn’t your cup of tea?
Our in-person consultations are fast, accurate, and free.