Please Use ONLY THE MOUSE OR TAB KEY while filling out the form.
Complete and click the "Submit" button at the bottom of the form.
This form does not save data.

Uniform Residential Loan Application

This application is designed to be completed by the Applicant(s) with the lender's assistance.  Applicant(s) 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 of 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.

Mortgage
Applied for:

 V.A.

  FHA

 Conventional

  FmHA

 Other:
Agency Case Number
Lender Case Number
Amount
 Interest Rate
No. of Months

  Amortization
 Type:

 Fixed Rate

  GPM

 Other (explain):

 ARM (type):
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
 
Source of Down Payment, Settlement Charges and/or Subordinate Financing (explain)
 Estate will be held in:

 Fee Simple

 Leasehold
(show expiration date)
Borrower's Name (include Jr. or Sr. if applicable)
Co-Borrower's Name (include Jr. or Sr. if applicable)
Social Security Number
 Home Phone (incl. area code)
 
Age
Yrs. School
 Social Security Number
 Home Phone (incl. area code)
 
Age
Yrs. School

  Married

  Separated

Unmarried (include single,
 divorced, widowed)
Dependents (not listed by Co-Borrower)
 no.  ages

 Married

  Separated

Unmarried (include single,
 divorced, widowed)
Dependents (not listed by Borrower)
 no.  ages
Present Address (street, city, state, ZIP)

 Own

 Rent

No. Yrs.
 Present Address (street, city, state, ZIP)

 Own

 Rent

No. Yrs.
If residing at present address for less than two years, complete the following:
Former Address (street, city, state, ZIP)

 Own

 Rent

No. Yrs.
 
 Former Address (street, city, state, ZIP)

 Own

 Rent

No. Yrs.
 
Former Address (street, city, state, ZIP)

 Own

 Rent

No. Yrs.
 
 Former Address (street, city, state, ZIP)

 Own

 Rent

No. Yrs.
 
Name & Address of Employer

 Self Employed
Yrs. on this job

Yrs. employed in this line
of work/profession
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 (include area code)
Position/Title/Type of Business

Business Phone (include 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

$
Name & Address of Employer

 Self Employed 

Dates  (from - to)

Monthly Income
$
Position/Title/Type of Business

Business Phone (include area code)
Position/Title/Type of Business

Business Phone (include area code)

Name & Address of Employer

 Self Employed 
  Dates  (from - to)

Monthly Income

$
Name & Address of Employer

 Self Employed 
Dates  (from - to)

Monthly Income

$

Position/Title/Type of Business
Business Phone (include area code)
Position/Title/Type of Business
Business Phone (include area code)

Freddie Mac Form 65/Rev. 10/92 

Page 1 of 4 

Fannie Mae Form 1003/Rev. 10/92 

Borrower's Initial

HTML1003

Co-Borrower's Initial

Please Use ONLY THE MOUSE OR TAB KEY while filling out the form.
Gross Monthly Income
Borrower
Co-Borrower
Total
 Combined Monthly
 Housing Expense
Present
Proposed
Base Empl. Income
 Rent
Overtime
 First Mortgage (P&I)
Bonuses
 Other Financing (P&I)
Commissions
 Hazard Insurance
Dividends/Interest  Real Estate Taxes
Net Rental Income
 Mortgage Insurance

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

 Homeowner Assn. Dues
 Other:
Total
 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)
B/C
or Co-Borrower (C) does not choose to have it considered for repaying this loan.
Monthly Amount
 
  
     
 
     
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.
Completed 

 Jointly 

 Not Jointly
ASSETS
Description
Cash or Market
Value
Cash deposit toward purchase held by:
 $
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.
$
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 & year)
 
 
 
   
Other Assets (itemize)


 
 
 
  
Total Assets a. 
Liabilities and Pledged Assets. List the creditor's name 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 or upon refinancing of the subject property.
LIABILITIES
Monthly Payt. &
Mos. Left to Pay
Unpaid
Balance
 Name and address of Company
 
 
 
 Acct. no.
 $ Payt./Mos.

 Name and address of Company
 
 
 
 Acct. no.
 $ Payt./Mos.

   

 Name and address of Company
 
 
 
 Acct. no.
 $ Payt./Mos.

 

 

 

 Name and address of Company
 
 
 
 Acct. no.
 $ Payt./Mos.

   

 Name and address of Company
 
 
 
 Acct. no.
 $ Payt./Mos.

 

   

 Name and address of Company
 
 
 
 Acct. no.
 $ Payt./Mos.

 

   

 Name and address of Company
 
 
 
 Acct. no.
 $ Payt./Mos.

   

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.

 $

Borrower's Signature Date  Co-Borrower's Signature  Date
X  X

Freddie Mac Form 65/Rev. 10/92 

Page 2 of 4 

Fannie Mae Form 1003/Rev. 10/92 

 

Corp. HTML1003

 

Please Use ONLY THE MOUSE OR TAB KEY while filling out the form.
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

 
 

 
Totals
$
$
 $
$
 $
 $
List any additional names under which credit has previously been received and indicate creditor name(s) and account number(s):
Alternate Name
Creditor
Account Number
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
   
0. Loan amount (add m & n)
   
p.
Cash from/to Borrower
(subtract j, k, l, & o from i)
   
 If you answer "Yes" to any questions a through i, please
 use continuation sheet for explanation.
Borrower
Co-Borrower
Yes
No
Yes
No
 a. Are there any outstanding judgments against you?

 b. Have you been declared bankrupt within the last 7 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? (This would include such loans as home mortgage loans, SBA loans, home improvement loans, educational loans, manufactured (mobile) home loans, any mortgage, financial obligation, or loan guarantee.  If "Yes," provide details,
including details, including date, name and address of lender, FHA or V.A. 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 - - 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)?

The undersigned specifically acknowledge(s) and agree(s) that: (1) the loan requested by this application will be secured by a first mortgage or deed of trust on the property described herein; (2) the property will not be used for any illegal or prohibited purpose or use, (3) all statements made in this application are made for the purpose of obtaining the loan indicated herein; (4) occupation of the property will be as indicated above; (5) verification or reverification of any information contained in the application may be made at any time by the lender, its agents, successors, and assigns, either directly or through a credit reporting agency, from any source named in this application, and the original copy of this application will be retained by the lender, even if the loan is not approved; (6) the lender, its agents, successors and assigns will rely on the information contained in the application and I/we have a continuing obligation to amend and/or supplement the information provided in this application if any of the material facts which I/we have represented herein should change prior to closing; (7) in the event my/our payments on the loan indicated in this application become delinquent, the lender, its agents, successors and assigns, may, in addition to all their other rights and remedies, report my/our name(s) and account information to a credit reporting agency; (8) ownership of the loan may be transferred to successor or assign of the lender without notice to me and/or the administration of the loan account may be transferred to an agent, successor or assign of the lender with prior notice to me; (9) the lender, its agents, successors and assigns make no representations or warranties, express or implied, to the Borrower(s) regarding the property, the condition of the property, or the value of the property.
Certification: I/we certify that the information provided in this application is true and correct as of the date set forth opposite my/our signature(s) on this application and acknowledge my/our understanding that any intentional or negligent misrepresentation(s) of the information contained in this application may result in civil liability and/or criminal penalties including, but not limited to, fine or imprisonment or both under the provisions of Title 18, United States Code, Section 1001, et seq. and liability for monetary damages to the lender, its agents, successors and assigns, insurers and any other person who may suffer any loss due to reliance upon any misrepresentation which I/we have made on this application.
Borrower's Signature Date Co-Borrower's Signature Date
X X
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  Lender may neither discriminate on the basis of this information, nor on whether you choose to furnish it.  However, if you choose not to furnish it, under Federal regulations this lender is required to note race and sex on the basis of visual observation or surname.  If you do not wish to furnish the above 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
Race/National Origin:
Sex:

 I do not wish to furnish this information
 American Indian or
 Alaskan Native

 Asian or Pacific
 Islander

White, not of
Hispanic origin
 Black, not of
 Hispanic origin

 Hispanic

  Other (specify)

 Female

 Male
CO-BORROWER
Race/National Origin:
Sex:

 I do not wish to furnish this information
 American Indian or
 Alaskan Native

 Asian or Pacific
 Islander

White, not of
Hispanic origin
 Black, not of
 Hispanic origin

 Hispanic

  Other (specify)

 Female

 Male
To be Completed by Interviewer
This application was taken by:
  face-to-face interview
  by mail
  by telephone
Interviewer's Name (print or type)
Drew de la Houssaye
Interviewer's Signature
Interviewer's Phone Number (incl. area code)
888-483-9057 ext7
  Name and Address of Interviewer's Employer

Source 1 Financing, Inc.
6800 Owensmouth Ave, Suite 160
Canoga Park CA 91303

Freddie Mac Form 65/Rev. 10/92 

Page 3 of 4 

Fannie Mae Form 1003/Rev. 10/92 

 

Corp. HTML1003

 

Please Use ONLY THE MOUSE OR TAB KEY while filling out the form.

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 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
X  X

Freddie Mac Form 65/Rev. 10/92 

Page 4 of 4 

Fannie Mae Form 1003/Rev. 10/92 

 

Corp. HTML1003