1003 Form

Uniform Residential Loan Application
___________________________________________________________________________________________________________________________________________________________________
This application is designed to be completed by the applicant(s) with the Lender’s assistance. 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 or other person who has community property rights pursuant to state law will not be used as a basis for loan qualification, but his or her
liabilities must be considered because the spouse or other person has community property rights pursuant to applicable law and 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.
If this is an application for joint credit, Borrower and Co-Borrower each agree that we intend to apply for joint credit (sign below):

_________________________________________

_________________________________________

Borrower

Co-Borrower

I. TYPE OF MORTGAGE AND TERMS OF LOAN

Mortgage
Applied for:

VA
FHA

Conventional
USDA/Rural
Housing Service

Amount
$

Interest Rate

Other (explain):

Agency Case Number

Amortization Type:

No. of Months

Fixed Rate
GPM

%

Lender Case Number

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
Other (explain):
Construction-Permanent

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

made

Describe Improvements

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)

Borrower

III. BORROWER INFORMATION

Borrower’s Name (include Jr. or Sr. if applicable)
Social Security Number

Married
Separated

Home Phone
(incl. area code)

Unmarried (include
single, divorced, widowed)

Present Address (street, city, state, ZIP)

Co-Borrower

Co-Borrower’s Name (include Jr. or Sr. if applicable)
DOB (mm/dd/yyyy)

Yrs. School

Married
Separated

Dependents (not listed by Co-Borrower)
no.

ages
Own

Social Security Number

Rent ____No. Yrs.

Home Phone
(incl. area code)

Unmarried (include
single, divorced, widowed)

Present Address (street, city, state, ZIP)

Mailing Address, if different from Present Address

DOB (mm/dd/yyyy)

Yrs. School

Dependents (not listed by Borrower)
no.

ages

Own

Rent ____No. Yrs.

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.

Borrower
Name & Address of Employer

Former Address (street, city, state, ZIP)

IV. EMPLOYMENT INFORMATION
Self Employed

Yrs. on this job

Name & Address of Employer

Yrs. employed in this
line of work/profession

Position/Title/Type of Business

Business Phone (incl. area code)

Co-Borrower
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:

Uniform Residential Loan Application
Freddie Mac Form 65 7/05 (rev.6/09)

Page 1 of 5

Fannie Mae Form 1003

7/05 (rev.6/09)

Borrower

IV. EMPLOYMENT INFORMATION (cont’d)

Name & Address of Employer

Self Employed

Dates (from – to)

Co-Borrower

Name & Address of Employer

Self Employed

Dates (from – to)

Monthly Income

Monthly Income

$
Position/Title/Type of Business

$

Business Phone
(incl. area code)

Name & Address of Employer

Self Employed

Position/Title/Type of Business

Business Phone
(incl. area code)

Name & Address of Employer

Dates (from – to)

Self Employed

Dates (from – to)

Monthly Income

Monthly Income

$
Position/Title/Type of Business

$

Business Phone
(incl. area code)

Position/Title/Type of Business

Business Phone
(incl. area code)

V. MONTHLY INCOME AND COMBINED HOUSING EXPENSE INFORMATION
Gross
Monthly Income
Base Empl. Income*

Borrower

Co-Borrower

$

$

Combined Monthly
Housing Expense

Total
$

Overtime

First Mortgage (P&I)

Bonuses

Other Financing (P&I)

Commissions

Hazard Insurance

Dividends/Interest

Real Estate Taxes

Net Rental Income

Mortgage Insurance

$

Homeowner Assn. Dues

see the notice in “describe
other income,” below)

Other:
$

*

$

Total

$

Proposed

$

Other (before completing,
Total

Present

Rent

$

$

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
$

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 non-applicant spouse or other
person, this Statement and supporting schedules must be completed about that spouse or other person also.
Completed Jointly Not Jointly
Cash or
Market Value

ASSETS
Description
Cash deposit toward
purchase held by:

$

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 or
upon refinancing of the subject property.
LIABILITIES

List checking and savings accounts below
Name and address of Bank, S&L, or Credit Union

Name and address of Company

Acct. no.

Acct. no.

$

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

Acct. no.

$

Name and address of Company

Name and address of Company

Acct. no.

Acct. no.

Uniform Residential Loan Application
Freddie Mac Form 65 7/05 (rev. 6/09)

Unpaid Balance

$ Payment/Months

$

$ Payment/Months

$

$ Payment/Months

$

Acct. no.

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

$

Monthly Payment &
Months Left to Pay

Page 2 of 5

Fannie Mae Form 1003 7/05 (rev.6/09)

VI. ASSETS AND LIABILITIES (cont’d)
Name and address of Bank, S&L, or Credit Union

Name and address of Company

$ Payment/Months

$

Acct. no.

$

Acct. no.

Stocks & Bonds (Company name/
number & description)

$

Name and address of Company

$ Payment/Months

$

Life insurance net cash value

$

Acct. no.
Name and address of Company

$ Payment/Months

$

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.

$
Acct. no.
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

Amount
of Mortgages
& Liens

Present
Market Value
$

$

$

$

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

VII. DETAILS OF TRANSACTION

Net Rental
Income

$

$

$

$

Account Number

VIII. DECLARATIONS
If you answer “Yes” to any questions a through i,
please use continuation sheet for explanation.

a.

Purchase price

b.

Alterations, improvements, repairs

c.

Land (if acquired separately)

b. Have you been declared bankrupt within the past 7 years?

d.

Refinance (incl. debts to be paid off)

e.

Estimated prepaid items

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?

f.

Estimated closing costs

g.

PMI, MIP, Funding Fee

h.

Discount (if Borrower will pay)

i.

Total costs (add items a through h)

Uniform Residential Loan Application
Freddie Mac Form 65 7/05 (rev.6/09)

$

Insurance,
Maintenance,
Taxes & Misc.

Mortgage
Payments

Gross
Rental Income

Borrower
Yes No

Co-Borrower
Yes No

a. Are there any outstanding judgments against you?

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, 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.)

Page 3 of 5

Fannie Mae Form 1003

7/05 (rev.6/09)

VII. DETAILS OF TRANSACTION

j.

VIII. DECLARATIONS

Subordinate financing

k.

Borrower’s closing costs paid by
Seller

l.

Borrower

If you answer “Yes” to any question a through i, please use
continuation sheet for explanation.

Other Credits (explain)

Yes

f.

Are you presently delinquent or in default on any Federal
debt or any other loan, mortgage, financial obligation, bond,
or loan guarantee?

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?

m.

Loan amount (exclude PMI, MIP,
Funding Fee financed)

j.

Are you a U.S. citizen?

n.

PMI, MIP, Funding Fee financed

k.

Are you a permanent resident alien?

o.

Loan amount
(add m & n)

l.

Do you intend to occupy the property as your primary
residence?

p.

Cash from/to Borrower
(subtract j, k, l & o from i)

m.

Co-Borrower
No

Yes

No

-------------------------------------------------------

If Yes,” complete question m below.
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— by yourself (S),
jointly with your spouse (SP), or jointly with another person (O)?

IX. ACKNOWLEDGEMENT 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 in this application; (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 in this application; (6) the Lender, its servicers, successors or assigns may
retain the original and/or an electronic record of this application, whether or not the Loan is 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 Lender, its servicers, successors or assigns may, in addition to any other ri ghts and
remedies that it may have relating to such delinquency, report my name and account information to one or more consumer reporting agencies; (9) ownership of the Loan and/or administration of the Loan
account may be tra nsferred with such notice as m ay be require d by law; (10) neither Lender nor i ts 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 d efined in applicable federal and/or state laws (excluding audio and video recordings), or my facsimile transmission of this application containing a facsimile of my s ignature, shall be as
effective, enforceable and valid as if a paper version of this application were delivered containing my original written signature.
Acknowledgement. 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.
Borrower’s Signature

Date

X

Co-Borrower’s Signature

Date

X

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 ho me mortgage disclosure laws . You are no t requ ired to furnish this in formation, bu t are en couraged to do so . Th e law p rovides t hat a le nder m ay not discriminate ei ther o n t he bas is of t his
information, or on whether you ch oose to fu rnish it . If y ou fu rnish th e information, p lease provide bot h ethnicity and race. Fo r race, you may check m ore than one designation. If you do not furnish
ethnicity, race, o r 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:

I do not wish to furnish this information
CO-BORROWER
 Not Hispanic or Latino
Hispanic or Latino
Ethnicity:

I do not wish to furnish this information
Not Hispanic or Latino

Hispanic or Latino

American Indian or
Alaska Native
Native Hawaiian or
Other Pacific Islander
Female
Male

Asian

Race:

Black or African American

White
Sex:

To be Completed by Loan Originator:

American Indian or
Alaska Native
Native Hawaiian or
Other Pacific Islander
Female
Male

Asian

Black or African American

White

This information was provided:
In a face-to-face interview
In a telephone interview
By the applicant and submitted by fax or mail
By the applicant and submitted via e-mail or the Internet

Loan Originator’s Signature

X

Loan Originator’s Name (print or type)

Loan Originator Identifier

Date
Loan Originator’s Phone Number (including area code)

Loan Origination Company’s Name

Loan Origination Company Identifier

Loan Origination Company’s Address

Uniform Residential Loan Application
Freddie Mac Form 65 7/05 (rev.6/09)

Page 4 of 5

Fannie Mae Form 1003

7/05 (rev.6/09)

CONTINUATION SHEET/RESIDENTIAL LOAN APPLICATION
Use this continuation sheet if you need more
space to complete the Residential Loan
Application. Mark B f or 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

X

Uniform Residential Loan Application
Freddie Mac Form 65 7/05 (rev.6/09)

X

Page 5 of 5

Fannie Mae Form 1003 7/05 (rev.6/09)

INSTRUCTIONS
Uniform Residential Loan Application
The lender uses this form to record relevant financial information about an applicant
who applies for a conventional one- to four-family mortgage. Roman numerals in
these instructions correspond to the sections on the form.
Lenders must use the PDF dated 6/09 for mortgage loans applications taken on or
after July 1, 2010.
Printing Instructions
We provide Form 1003 in an electronic format that prints as a letter size document.
However, lenders may print Form 1003 as a legal size document or with different
fonts or margins that may affect pagination; we have no specific standards for the
number or size of pages the form may have. Consequently, the number and size of
pages will not affect compliance with Fannie Mae requirements pertaining to use of
the Uniform Residential Loan Application, provided that the content of the form has
not been materially altered. When printing this form, you must use the "shrink to fit"
option in the Adobe Acrobat print dialogue box.
Instructions
The lender may accept applications taken during a face-to-face interview, over the
telephone, through the mail, or via the Internet. The lender should complete all
blanks and attach any separate exhibits, details, or statements that are relevant to
underwriting the mortgage. The borrower(s) must sign the original application at the
time it is completed. If the application is taken over the telephone or via the Internet,
the borrower(s) must sign the completed application as soon as possible thereafter.
However, an electronic signature or facsimile of the borrower's signature is
acceptable as indicated in the "Acknowledgment and Agreement" section of the
application. The lender should retain the original application with the supporting
information provided by the borrower(s). Before or at the loan closing, the
borrower(s) must sign the final application that the lender prepares based on its
verification of the information that the borrower(s) provided in the original application.
The instructions at the top of Form 1003 are consistent with the permissible
inquiries that creditors are allowed to make under the Equal Credit Opportunity Act
(ECOA). Although ECOA permits the lender in a community property state to obtain
information regarding the liabilities of a borrower's spouse even though he or she is
not applying for the mortgage and his or her income will not be considered for loan
qualification purposes, we do not require the lender to obtain the information. This
also means that in states where another person shares community property rights
with the applicant, the lender does not need to include information on that person's
liabilities if he or she is not an applicant.
Fannie Mae Form 1003 Instructions (Form Rev. 6/09, Instructions 12/13)

Page 1 of 4

Note: The following instructions highlight certain sections of the form.
Introductory Statement
We recognize that the introductory paragraph of Form 1003 differs slightly from the
introductory paragraph in the Uniform Residential Loan Application found on Freddie
Mac's website, Freddie Mac Form 65. However, because we have determined that
these differences are not material, Fannie Mae will deem either version to comply
with our requirements for use of the Uniform Residential Loan Application.

V. Monthly Income and Combined Housing Expense Information
Gross Monthly Income: If the net cash flow for an investment property is a positive
number , it should be listed as "net rental income." If it is a negative number, it must
be included in the applicant's monthly obligations. If the property is a two- to fourunit property for which the applicant occupies one of the units as a principal
residence, the monthly rental income should be listed as "net rental income."
Combined Monthly Housing Expense: The present monthly housing expenses for
the borrower and the co- borrower should be listed on a combined basis. The
proposed monthly housing expense for a two- to four-unit property in which the
applicant will occupy a unit as a principal residence should reflect the monthly
payment (PITIA) for the subject property. For all one- to four-unit investment
properties the present monthly housing expense should reflect the applicant's
principal residence.
VI. Assets and Liabilities
When the borrower's and co-borrower's assets and liabilities are not sufficiently
joined to make a combined statement meaningful, a separate Statement of Assets
and Liabilities (Form 1003A) should be completed for the co-borrower.
VII. Details of Transaction
The purchase price shown on Line "a" under the "Details of Transaction" should not
include any discounts or rebates or other allowances paid or allowed to the
purchaser. For refinancing, the amount being refinanced should be shown on Line
"d" -- Refinance. The figure should include the total amount of all existing liens plus
the costs of improvements that have been -- or will be -- made. Lines "a", "b", and "c"
should not be used to describe a refinance transaction.
VIII. Declarations
Noncitizen Applicants: If an applicant indicates in his response to Question J that he is
not a U.S. citizen, and also indicates in his response to Question K that he is not a
permanent resident alien, the lender may wish to ask whether he is a nonpermanent
resident alien or otherwise is lawfully present in the United States.
Fannie Mae Form 1003 Instructions (Form Rev. 6/09, Instructions 12/13)

Page 2 of 4

X. Information for Government Monitoring Purposes
This section is included to aid the federal government in monitoring compliance with
equal credit opportunity, fair housing and home mortgage disclosure laws. Supplying
this information is strictly voluntary on the part of the applicant, but lenders should ask
all applicants to provide it, including those who apply by telephone and through the
Internet, and should describe the reason for collecting this data. Race and ethnicity
are separate categories, and although the lender should ask applicants to furnish
information for both, applicants may furnish one but not the other. Note that there is
no longer a place for applicants to indicate race as "Other" but applicants may check
as many races as apply.
The Home Mortgage Disclosure Act and its implementing Regulation C generally
require Lenders to collect sex, race, and ethnicity data on all applications.
When an application is taken in person and an applicant elects not to provide some
or all of this information, federal law requires the lender to note the applicant's sex,
ethnicity, and race on the form, based on the lender's visual observation or the
applicant's surname. To aid in identifying applicants who may be of Hispanic ethnicity
and who elect not to self-identify, the lender may wish to consult the list of Spanish
surnames developed by the U.S. Bureau of the Census. Furthermore, the lender may
wish to advise the applicant that he may complete or change the information in this
section after the application is approved, at any time up until closing.
To Be Completed By Interviewer
The interviewer must complete this portion of the form to indicate the method used to
take the application and to provide the name and telephone number of the
interviewer, as well as his or her employer's name and address.
To Be Completed By Loan Originator (for PDF dated 06/09 for mortgage loans
applications taken on or after January 1, 2010)
The loan originator must complete this portion of the form to indicate the method used
to take the application and to provide the loan originator's name, ID, and telephone
number, as well as his or her employer's name, company ID, and address.
Continuation Sheet/Residential Loan Application
Lenders may amend this section by including space to evidence intent to apply for
joint credit. Other approaches, such as including this information on a separate
document, are also acceptable to Fannie Mae, provided they meet the requirements
of applicable law. Lenders should consult counsel to determine their alternatives.
Special Notice for Balloon Mortgages
For each balloon mortgage, the lender must insert a special notice regarding the
nature of the balloon features on Form 1003 or in a separate attachment to the form.
Fannie Mae Form 1003 Instructions (Form Rev. 6/09, Instructions 12/13)

Page 3 of 4

If an attachment is used, the borrower(s) must sign the attachment. The following
language must be inserted, using capital letters:

"THIS LOAN MUST EITHER BE PAID IN FULL AT MATURITY OR REFINANCED TO
A MARKET LEVEL FIXED-RATE MORTGAGE. YOU MUST REPAY THE ENTIRE
PRINCIPAL BALANCE OF THE LOAN AND UNPAID INTEREST THEN DUE IF YOU
DO NOT QUALIFY FOR THE CONDITIONAL RIGHT TO REFINANCE AS
SPECIFIED IN THE NOTE ADDENDUM AND MORTGAGE RIDER. THE LENDER IS
UNDER NO OBLIGATION TO REFINANCE THE LOAN IF QUALIFICATION
CONDITIONS ARE NOT MET. YOU WILL, THEREFORE, BE REQUIRED TO MAKE
PAYMENT OUT OF OTHER ASSETS THAT YOU MAY OWN, OR YOU WILL HAVE
TO FIND A LENDER, WHICH MAY BE THE LENDER YOU HAVE THIS LOAN WITH,
WILLING TO LEND YOU THE MONEY. IF YOU REFINANCE THIS LOAN AT
MATURITY, YOU MAY HAVE TO PAY SOME OR ALL OF THE CLOSING COSTS
NORMALLY ASSOCIATED WITH A NEW LOAN EVEN IF YOU OBTAIN
REFINANCING.”

For California Applications
California Civil Code 1812.30 (j) requires that credit applications clearly specify that
the applicant, if married, may apply for a separate account. This requirement is not
inconsistent with the language at the beginning of Form 1003.
Lenders may revise the description of the "Married" box in Section III for Borrowers
and Co-Borrowers by adding "(includes registered domestic partners)." If lenders are
unable to insert the language due to the format of the form, this language may be
added to the continuation sheet or included as an attachment to Form 1003.

Fannie Mae Form 1003 Instructions (Form Rev. 6/09, Instructions 12/13)

Page 4 of 4