Form

Harmony Home MortgageForm

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.

1a. Personal Information


(or Individual Taxpayer Identification Number)



Marital Status


Dependents (not listed by another Borrower)

(Single, Divorced, Widowed, Civil Union, Domestic Partnership, Registered Reciprocal Beneficiary Relationship)

Contact Information



Current Address
Housing

($) /month

If at Current Address for LESS than 2 years, list Former Address
Housing

($) /month

Mailing Address – if different from Current Address

1b. Current Employment/Self-Employment and Income


Check if this statement applies:
Gross Monthly Income
$

/month

$

/month

$

/month

$

/month

$

/month

$

/month

$

/month

Uniform Residential Loan Application
Freddie Mac Form 65 • Fannie Mae Form 1003
Effective 1/2021

1c. IF APPLICABLE, Complete Information for Additional Employment/Self-Employment and Income


Check if this statement applies:
Gross Monthly Income
$

/month

$

/month

$

/month

$

/month

$

/month

$

/month

$

/month

1d. IF APPLICABLE, Complete Information for Previous Employment/Self-Employment and Income

Provide at least 2 years of current and previous employment and income.


Previous Gross Monthly
$

/month

1e. Income from Other Sources

Include income from other sources below. Under Income Source, choose from the sources listed here:

  • Alimony
  • Automobile Allowance
  • Boarder Income
  • Capital Gains
  • Child Suppor
  • 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.

Income Source – use list above

Provide TOTAL Amount Here

Monthly Income

$

0.00

Uniform Residential Loan Application
Freddie Mac Form 65 • Fannie Mae Form 1003
Effective 1/2021

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:

Provide TOTAL Amount Here

$

0.00

2b. Other Assets and Credits You Have

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

Asset or Credit Type – use list above

Provide TOTAL Amount Here

Cash or Market Value

$

0.00

2c. Liabilities – Credit Cards, Other Debts, and Leases that You Owe

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

2d. Other Liabilities and Expenses

Include all other liabilities and expenses below. Choose from the types listed here:
  • • Alimony
  • • Child Support
  • • Separate Maintenance
  • • Job Related Expenses
  • • Other

Monthly Payment

Uniform Residential Loan Application
Freddie Mac Form 65 • Fannie Mae Form 1003
Effective 1/2021

Section 3: Financial Information — Real Estate. This section asks you to list all properties you currently own and what you owe on them.

3a. Property You Own

If you are refinancing, list the property you are refinancing FIRST.
Address

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

Mortgage Loans on this 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)

3b. IF APPLICABLE, Complete Information for Additional Property

Address

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

Mortgage Loans on this 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)

3c. IF APPLICABLE, Complete Information for Additional Property

Address

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

Mortgage Loans on this 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)

Uniform Residential Loan Application
Freddie Mac Form 65 • Fannie Mae Form 1003
Effective 1/2021

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

Loan Amount

Loan Purpose

Property Address

Street

Unit#

Occupancy

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)

2. Manufactured Home. Is the property a manufactured home? (e.g., a factory built dwelling built on a permanent chassis)

4b. Other New Mortgage Loans on the Property You are Buying or Refinancing

Does not apply

Creditor Name

Lien Type

First Lien

Subordinate Lien

First Lien

Subordinate Lien

Monthly Payment

Loan Amount/Amount to be Drawn

Credit Limit (if applicable)

4c. Rental Income on the Property You Want to Purchase

For Purchase Only

Does not apply

Complete if the property is a 2-4 Unit Primary Residence or an Investment Property

Expected Monthly Rental Income

For LENDER to calculate:Expected Net Monthly Rental Income

Amount

4d. Gifts or Grants You Have Been Given or Will Receive for this Loan

Does not apply

Include all gifts and grants below. Under Source, choose from the sources listed here:

Asset Type: Cash Gift, Gift of Equity, Grant

Deposited/Not Deposited

Deposited

Not Deposited

Deposited

Not Deposited

Source – use list above

Cash or Market Value

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.

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), or investment property (IP)?

(2) How did you hold title to the property: by yourself (S), jointly with yourspouse (SP), or jointly with another person (O)?

B. If this is a Purchase Transaction: Do you have a family relationship or business affiliation with the seller of the property?

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?

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., installmentloan, credit card, etc.) on or before closing thisloan that
is not disclosed on this application?

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)?

5b. About Your Finances

F. Are you a co-signer or guarantor on any debt or loan that is not disclosed on this application?

G. Are there any outstanding judgments against you?

H. Are you currently delinquent or in default on a Federal debt?

I. Are you a party to a lawsuit in which you potentially have any personal financial liability?

J. Have you conveyed title to any property in lieu of foreclosure in the past 7 years?

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?

L. Have you had property foreclosed upon in the last 7 years?

M. Have you declared bankruptcy within the past 7 years?

If YES, identify the type(s) of bankruptcy:

Uniform Residential Loan Application
Freddie Mac Form 65 • Fannie Mae Form 1003
Effective 1/2021

Section 6: Acknowledgments and Agreements. This section tells you about your legal obligations when
you sign this application.

Acknowledgments and Agreements

  • Definitions:
    • "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
  • I agree to, acknowledge, and represent the following:
  • (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.
    ×

    Date (mm/dd/yyyy)

    / /
    ×

    Date (mm/dd/yyyy)

    / /

    Uniform Residential Loan Application
    Freddie Mac Form 65 • Fannie Mae Form 1003
    Effective 1/2021

    Section 7: Military Service. This section asks questions about your (or your deceased spouse's) military service.

    Military Service of Borrower

    Military Service – Did you (or your deceased spouse) ever serve, or are you currently serving, in the United States Armed Forces?

    If YES, check all that apply:

    / /

    (mm/dd/yyyy)

    Section 8: Demographic Information. This section asks about your ethnicity, sex, and race

    Demographic Information of Borrower

    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

    Ethnicity: Check one or more

    For example: Argentinean, Colombian, Dominican, Nicaraguan, Salvadoran, Spaniard, and so on.

    Sex

    Race: Check one or more

    For example: Hmong, Laotian, Thai, Pakistani, Cambodian, and so on.

    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?

    Was the sex of the Borrower collected on the basis of visual observation or surname?

    Was the race of the Borrower collected on the basis of visual observation or surname?

    The Demographic Information was provided through:

    Face-to-Face Interview (includes Electronic Media w/ Video Component)

    Telephone Interview

    Fax or Mail

    Email or Internet

    Section 9: Loan Originator Information. To be completed by your Loan Originator.

    Loan Originator Information

    ×

    Date (mm/dd/yyyy)

    / /

    Uniform Residential Loan Application
    Freddie Mac Form 65 • Fannie Mae Form 1003
    Effective 1/2021