Does not apply
Include income from
other sources below. Under Income Source, choose
from the sources listed
here:
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
NOTE: Reveal alimony, child support, separate maintenance, or other income ONLY IF you want it considered in determining your qualification for this loan.
Borrower Name :*
Uniform Residential Loan Application Freddie Mac Form 65 • Fannie Mae Form 1003 Effective 07/2019
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.
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)
2b. OTHER ASSETS YOU HAVE
Does not apply
Include all other
assets below. Under Asset Type, choose from the
types listed here:
Earnest Money
Proceeds from Sale of Non-Real Estate Asset
Proceeds from Real Estate Property to be sold on or before closing
Sweat Equity
Employer Assistance
Rent Credit
Secured Borrowed Funds
Trade Equity
Unsecured Borrowed Funds
Other
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)
2d. OTHER LIABILITIES AND EXPENSES
Does not apply
Include all other
liabilities and expenses below. Choose from the
types listed here:
Borrower Name :*
Uniform Residential Loan Application
Freddie Mac Form 65 • Fannie Mae Form 1003
Effective 07/2019
If you are refinancing,
list the property you are refinancing
FIRST .
Address
3b. IF APPLICABLE, COMPLETE INFORMATION
FOR ADDITIONAL PROPERTY
3c. IF APPLICABLE, COMPLETE INFORMATION FOR ADDITIONAL PROPERTY
Borrower Name :*
Uniform Residential Loan Application Freddie Mac Form 65 • Fannie Mae Form 1003 Effective 07/2019
Section 4: Loan and Property Information.
This section asks about the loan’s purpose and the property you want to purchase or refinance.
4a. LOAN AND PROPERTY INFORMATION
4b. OTHER NEW MORTGAGE LOANS ON THE
PROPERTY YOU ARE BUYING OR
REFINANCING
Does not apply
4c. RENTAL INCOME ON THE PROPERTY YOU EANT TO PURCHASE
For Purchase Only
Does not apply
4d.
GIFTS OR GRANTS YOU HAVE BEEN GIVEN OR
WILL RECIEVE FOR THIS LOAN
Does not apply
Include all gifts and grants
below. Under Source, choose from the sources
listed here:
Relative
Unmarried Partner
Employer
Religious Nonprofit
Community Nonprofit
Federal Agency
State Agency
Local Agency
Other
Borrower Name :*
Uniform Residential Loan Application Freddie Mac Form 65 • Fannie Mae Form 1003 Effective 07/2019
Section 5: Declarations.
This section asks you specific questions about the property, your funding, and your past financial history.
5a. ABOUT THIS PROPERTY AND YOUR MONEY FOR THIS LOAN
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:
(1) What type of property did
you own: primary residence (PR),
FHA secondary residence (SR),
second home (SH),
(2) How did you hold title to
the property: by yourself (S),
jointly with your spouse (SP),
or jointly with another person
(O)?
or investment property (IP)?
Yes
No
Yes
No
B. If this is a Purchase
Transaction: Do you have a
family relationship or business
affiliation with the seller of
the property?
Yes
No
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?
Yes
No
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?
Yes
No
Yes
No
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)?
Yes
No