56001 Credit Application for Property Improvement Loan

Title I Property Improvement and Manufactured Home Loan Programs

56001

OMB: 2502-0328

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Credit Application for
Property Improvement Loan

U.S. Department of Housing
and Urban Development
Office of Housing

OMB Approval No. 2502-0328
(exp. 08/31/2009)

See Public Reporting Burden and Privacy Act Statements on the last page before completing this application
This application is submitted to obtain credit under the provisions of Title I of the National Housing Act. Please answer all questions.

I/We hereby apply for a loan of $

(net) to be repaid in

months

Date

1. Do you have any past due obligations owed to or insured by any agency of the Federal Government?
(If the answer is "Yes," you are not eligible to apply for an FHA Title I loan until the existing debt has been brought current.)

Yes

No

3. Are you refinancing a Title I loan?

Yes

No

5. Are you a party in a pending lawsuit?

Yes

No

7. Has your property been foreclosed upon

Yes

No

2. Have you any other application for an FHA Title I loan pending at this time?
Yes

No

If "Yes," enter

If "Yes," with whom?

... the loan number
... and balance owing $
4. Are there any unsatisfied judgments against you?

Yes

6. Have you been declared bankrupt in the last seven years?

Yes

No
No

in the last seven years?

Explain any "Yes" answers to items 4 thru 7.

Applicant

Co-Applicant

Name of Applicant

Name of Co-Applicant (if any)

Social Security Number

Telephone Number

Social Security Number

Present Address

Present Address

How long

Own or Rent

How long

Previous Address

Own or Rent

How long

Marital Status

Own or Rent

Marital Status

Separated

Sex

Unmarried (incl. Single, Divorced, Widowed)

Date of Birth

Male

Own or Rent

Previous Address

How long

Married

Telephone Number

No. of Dependents

Married

Female

Unmarried (incl. Single, Divorced, Widowed )

Date of Birth

Male

No. of Dependents

Female

Ethnicity: (select only one)

Ethnicity: (select only one)
Hispanic or Latino

Separated

Sex

Hispanic or Latino

Not Hispanic or Latino

Not Hispanic or Latino

Race: (select one or more)

Race: (select one or more)
American Indian or Alaska Native

Asian

Black or African American

White

American Indian or Alaska Native

Asian

Black or African American

White

Native Hawaiian or Other Pacific Islander

Native Hawaiian or Other Pacific Islander

Name and Address of Nearest Relative Not Living with You

Name and Address of Nearest Relative Not Living with You

Relationship

Relationship

Previous editions are obsolete

Telephone No.

Page 1 of 4

Telephone No.

ref. Handbook 1060.2

form HUD-56001 (06/2003)

Employment & Income. If self-employed, submit a current financial statement. (Note: Alimony, child support, or separate maintenance income need
not be reported unless you will rely upon it for repaying this loan.)
Applicant

Co-Applicant

Employer's Name & Business Address

Employer's Name & Business Address

Business Phone

Type of Work or Position

Number of Years

Salary Per Week or Month

$

Business Phone

Number of Years

Type of Work or Position

Salary Per Week or Month

$

per

per

Previous Employer's Name & Business Address (if less than two years earlier)

Previous Employer's Name & Business Address (if less than two years earlier)

Business Phone

Type of Work or Position

Business Phone

Type of Work or Position

Number of Years

Salary Per Week or Month

Number of Years

Salary Per Week or Month

$

$

per

Other Income Source

Amount Per Week or Month

$

Amount Per Week or Month

$

per

Bank Accounts

Checking

per

Other Income Source

per

Bank Accounts

Savings

None

Checking

Name & Address of Bank or Branch

Savings

None

Name & Address of Bank or Branch

Debts. List all fixed obligations, installment accounts, FHA loans, and debts to banks, finance companies and Government agencies.
If more space is needed, list additional debts on separate pages and attach them to this form.
Automotive Lienholder

Automotive Lienholder

Real Estate Lienholder

Real Estate Lienholder

To Whom Indebted

To Whom Indebted

To Whom Indebted

To Whom Indebted

To Whom Indebted

To Whom Indebted

To Whom Indebted

To Whom Indebted

To Whom Indebted

To Whom Indebted

To Whom Indebted

Previous editions are obsolete

Year & Make

Year & Make

FHA Insured (yes/no)

FHA Insured (yes/no)

Account No.

Account No.

Account No.

Account No.

Account No.

Account No.

Account No.

Account No.

Account No.

Account No.

Account No.

Page 2 of 4

Original Amount of Debt

Present Balance

Monthly Payment

$

$

$

Original Amount of Debt

Present Balance

Monthly Payment

$

$

$

Original Amount of Debt

Present Balance

Monthly Payment

$

$

$

Original Amount of Debt

Present Balance

Monthly Payment

$

$

$

Original Amount of Debt

Present Balance

Monthly Payment

$

$

$

Original Amount of Debt

Present Balance

Monthly Payment

$

$

$

Original Amount of Debt

Present Balance

Monthly Payment

$

$

$

Original Amount of Debt

Present Balance

Monthly Payment

$

$

$

Original Amount of Debt

Present Balance

Monthly Payment

$

$

$

Original Amount of Debt

Present Balance

Monthly Payment

$

$

$

Original Amount of Debt

Present Balance

Monthly Payment

$

$

$

Original Amount of Debt

Present Balance

Monthly Payment

$

$

$

Original Amount of Debt

Present Balance

Monthly Payment

$

$

$

Original Amount of Debt

Present Balance

Monthly Payment

$

$

$

Original Amount of Debt

Present Balance

Monthly Payment

$

$

$

ref. Handbook 1060.2

form HUD-56001 (06/2003)

Property to be Improved
Type of Property

Is this property

Single family
Multifamily (No. of units ______________ )
Nonresidential (Type of use ________________________)
Manufactured home (not classed as realty)
Historic residential structure (No. of units _____________)
Health care facility

Owned by you?
Leased from someone else?
Being purchased on a land installment contract?
Is there a mortgage or deed of trust on this property?

Address (number, street, city, State & zip code)

Year Built

Yes
Yes
Yes

No
No
No

Yes

No

Yes

No

Name & Address of Property Owner (if different from the applicant)

Date of Purchase

Monthly Lease Payment

Lease Expiration Date

$
Purchase Price
$

If this is a new residential structure, has it been
completed and occupied for 90 days or longer?

Present Value
$

Improvements (itemized cost breakdown must be attached)
Description of Improvements

Name & Address of Dealer / Contractor

Estimated Cost

$
Notice: If this structure was built before 1978, it may contain lead-based paint which, if eaten, may cause mental retardation, blindness, paralysis, or even
death. Symptoms may include stomach aches, vomiting, headaches, a loss of appetite, crankiness or frequent tiredness. A child who is suspected of having
eaten lead-based paint should be taken immediately to your local doctor, clinic or hospital for screening or treatment. The best way to prevent lead-based
paint poisoning is to keep your home in good condition and remove any lead-based paint hazards. For detailed information on the prevention and elimination
of lead-based paint hazards, please contact your local HUD office for a free pamphlet entitled "Lead Poisoning: Watch Out for Lead-Based Paint."
Important! Applicant, Read this before Signing.

Note to Salesperson. If the loan proceeds will be disbursed to a

I /We certify that the above statements are true, accurate, and
complete to the best of my (our) knowledge and belief. This
application shall remain the property of the lending institution to
which it is submitted for the purpose of obtaining a loan.
I /We hereby consent to and authorize the lending institution or
HUD, after giving reasonable notice, to enter the improved property
to determine that the improvements specifed in this application
have been completed.
I /We understand that the selection of a dealer or contractor and
the acceptance of the materials used and the work performed is my
(our) responsibility, and HUD does not guarantee the quality or
workmanship of the property improvements.

dealer or contractor, the person selling the improvements must
sign the following certification:
I certify that: 1) I am the person who sold the job; 2) the
Contract contains the whole agreement with the borrowers; 3)
the borrowers have not been given or promised any cash payment, rebate, cash bonus, sales commission, or anything of value
in excess of $25 as an inducement to enter into this loan transaction; 4) the improvements have not been misrepresented; 5)
no promises have been made that are impossible of attainment,
encourage trial purchase, or imply that the improvements will be
used as a model for advertising or other demonstration purposes;
and 6) no offer of debt consolidation has been made.

Applicant's Signature

Salesperson's Name

X

Salesperson's Signature

X

Co-Applicant's Signature
Name of Dealer/Contractor

X
If this application is prepared by someone other than the applicants, that person must sign below. I certify that the statements made herein
are based upon information given to me by the applicants and are true, accurate and complete to the best of my knowledge and belief.
Warning: HUD will prosecute false claims and statements. Conviction may result in criminal and/or civil penalties. (18 U.S.C. 1001, 1010, 1012; 31 U.S.C. 3729, 3802)
Prepared by

Address

X
Representing

Previous editions are obsolete

Page 3 of 4

ref. Handbook 1060.2

form HUD-56001 (06/2003)

Information verified with applicant by

Name & Address of the Lending Institution

Face-to-face interview

Telephone interview

By (Signature of Loan Officer)

X
Social Security Number Verification

Credit Alert Access Code

Applicant

Applicant

Co-Applicant

Co-Applicant

Reserved for use by the Lending Institution

Public reporting burden for this collection of information is estimated to average 30 minutes per response, including the time for reviewing instructions,
searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. This agency may
not collect this information, and you are not required to complete this form, unless it displays a currently valid OMB control number.
Privacy Act Statement: The Department of Housing and Urban Development (HUD) is authorized to collect this information by Title I, section 2 of the
National Housing Act (12 U.S.C. 1703), and to obtain and verify your Social Security Number (SSN) by section 165 of the Housing and Community
Development Act of 1967 (42 U.S.C. 3543). You must provide all of the information requested. This information will be used to determine your
creditworthiness and to assist HUD in accounting for and monitoring the use of Title I funds. Your SSN is a unique identifier which may be used to conduct
computer matches to verify the information you provide. This information may be given to Federal, State, or local agencies when relevant to civil, criminal,
or regulatory investigations or prosecutions. It will not be otherwise disclosed or released outside of HUD or the lending institution which will provide the
loan funds, except as required or permitted by law. Failure to provide any of the requested information may result in delay or rejection of your application.
General Information: You are required to answer the questions on sex, race and ethnic background. Your answers are needed to determine the
characteristics of Title I program beneficiaries, and willl not affect consideration of your application. By providing this information, you will assist us in
ensuring that this program is administered in a nondiscriminatory manner. If you feel you have been discriminated against and you want to report it, the
Fair Housing and Equal Opportunity Hotline Number is (800) 424-8590.
This information is being collected to permit more efficient risk management of the Title I loan portfolio as well as facilitate claims processing for loan
defaults. The information provides a more comprehensive basis for evaluating Title I lender underwriting practices and thereby improving risk management
of the loan portfolio and also enhances management’s ability to determine appropriate policy changes affecting the Title I portfolio as a whole. Responses
are required in order to obtain benefits. No assurance of confidentiality is provided.
Previous editions are obsolete

Page 4 of 4

ref. Handbook 1060.2

form HUD-56001 (06/2003)


File Typeapplication/pdf
File Title56001
Subject56001
AuthorELK
File Modified2006-08-17
File Created2002-07-02

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