Universal Credit App Details

Applying for credit can be a daunting task. There are so many questions and considerations to make before you submit your application. What is the interest rate? How long will it take to get the card? Is there an annual fee? These are all important questions to ask, but you also need to make sure that you're providing accurate information on your credit application form. Any mistake could lead to a delay in getting your new card, or even worse, a denial of credit altogether. In this blog post, we'll break down everything you need to know about credit applications, including what information you need to provide and how to submit the form properly.

You'll find more info regarding the credit application form by looking through the table our team prepared.

QuestionAnswer
Form NameCredit Application Form
Form Length5 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min 15 sec
Other namesuniversal credit application online, how credit application form template, commercial credit application, blank credit application

Form Preview Example

Universal Credit Application

(Consumer Residential Real Estate)

1. Type of Application

(Check only one of the four checkboxes; and sign, if joint credit)

lIndividual Credit. If checked, this is an Application for Individual Credit - relying solely on my income and assets.

lIndividual Credit with Another. If checked, this is an Application for Individual Credit - relying on my income and assets and on income and/or assets of another as a basis for loan qualification. (Complete Applicant and Co-Applicant sections.)

lIndividual Credit (Community Property State). If checked, this is an Application for Individual Credit - relying on my income or assets. The income or assets of my spouse (or other person), who has community property rights pursuant to state law, will not be used as a basis for loan qualification. However, his or her liabilities must be considered because my spouse (or other person) has community property rights pursuant to applicable law, and, as Applicant, I reside in a community property state, the property that will secure the loan is located in a community property state, or I am relying on other property located in a community property state as a basis for repayment of the loan. (Complete Applicant and Co-Applicant sections.)

lJoint Credit. If checked, this is an Application for Joint Credit. By signing below, the Applicant and Co-Applicant agree that each of us intend to apply for joint credit. (Complete Applicant and Co-Applicant sections.)

Applicant for Joint CreditCo-Applicant for Joint Credit

2. Type of Mortgage and Terms of Credit

Mortgage Applied For

 

Lender's Case No.

l Rental Purchase

l Rental Refinance

l Home Equity/HELOC

l Home Improvement

Amount/Credit Limit

Interest Rate

No. of Months

Amortization Type

$

 

%

l Fixed l ARM l

3. Property Information and Purpose of Credit

Subject Property Address (street, city, state & ZIP)

No. of Units

Legal Description of Subject Property (attach description if necessary)

Year Built

Purpose of Loan

 

l Purchase

l Construction

l Other:

l Refinance

l Construction-Permanent

 

Property will be:

l Primary l Secondary l Investment

Residence Residence

Complete this line if construction or construction-permanent loan.

Year Lot

 

Original Cost

 

Amount Existing

 

(a) Present Value of

 

(b) Cost of

 

Total (a + b)

 

 

 

 

 

Acquired

 

 

 

 

 

 

 

Liens

 

 

Lot

 

 

 

Improvements

 

 

 

 

 

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

$

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Complete this line if this is a refinance loan.

 

 

 

 

 

 

 

 

 

 

Describe Improvements

 

 

Year

 

Original Cost

 

Amount Existing

 

Purpose of Refinance

 

 

l made

l to be made

 

 

 

 

Acquired

 

 

 

 

 

 

 

Liens

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

Cost: $

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Title will be held in what Name(s)

 

 

 

 

 

 

 

 

 

Manner in which Title will be held

 

 

Estate will be held in:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

l Fee Simple

Source of Down Payment, Settlement Charges, and/or Subordinate Financing (explain)

 

 

 

 

 

 

 

l Leasehold (show

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

expiration date)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Applicant

 

 

 

 

4. Applicant Information

 

 

Co-Applicant

 

 

Applicant's Name

 

 

 

 

 

 

 

 

 

 

 

 

Co-Applicant's Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Social Security No.

 

Primary Phone

 

 

 

 

Date of Birth

Social Security No.

Primary Phone

 

 

 

 

 

 

Date of Birth

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ID Type & No.

 

 

Issued By

 

Issue Date

Exp. Date

ID Type & No.

 

 

Issued By

Issue Date

 

Exp. Date

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

E-mail Address

 

 

 

 

 

 

 

 

 

 

 

 

E-mail Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

l Married

 

l Separated

 

Dependents

 

 

 

 

l Married

l Separated

Dependents

 

 

(including registered

 

 

 

 

 

(not listed by Co-Applicant)

 

 

 

 

(including registered

 

 

 

 

(not listed by Applicant)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

domestic partner or civil union)

 

 

 

 

 

 

 

 

 

domestic partner or civil union)

 

 

 

 

 

 

 

 

l Unmarried

 

 

 

 

 

No. Ages

 

 

 

 

l Unmarried

 

 

 

 

No. Ages

 

 

(including single, divorced, widowed)

 

 

 

 

 

 

 

 

 

(including single, divorced, widowed)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Present Address

l Own l Rent l

 

No. Yrs.

 

Present Address l Own l Rent

l

 

No. Yrs.

 

Mailing Address, if different from Present Address

Mailing Address, if different from Present Address

Former Address l Own l Rent l

 

No. Yrs.

Former Address l Own l Rent l

 

No. Yrs.

(Complete if less than 2 years ago)

(Complete if less than 2 years ago)

Universal Credit Application-Real Estate

UCA-RE 11/1/2010

VMP , Bankers Systems* Custom MDF. ETXUCARE

VMPC148R (1011).00

Wolters Kluwer Financial Services - 2009, 2010

Page 1 of 5

 

Applicant

5. Employment

Information

Co-Applicant

 

Name & Address of Employer l Self Employed

Yrs. on this job

Name & Address of Employer l Self Employed

Yrs. on this job

 

 

 

 

 

 

 

 

Yrs. employed in

 

 

Yrs. employed in

 

 

this line of

 

 

this line of

 

 

work/profession

 

 

work/profession

 

 

 

 

 

Position/Title/Type of Business

Business Phone

Position/Title/Type of Business

 

Business Phone

 

 

 

 

 

 

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

l Self Employed

Dates (from - to)

Name & Address of Employer l Self Employed

Dates (from - to)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Business Phone

 

 

 

Business Phone

 

 

 

 

 

 

 

 

 

 

 

 

 

Position/Title/Type of Business

 

 

Gross Monthly

Position/Title/Type of Business

 

Gross Monthly

 

 

 

 

Income

 

 

 

 

 

Income

 

 

 

 

$

 

 

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name & Address of Employer

l Self Employed

Dates (from - to)

Name & Address of Employer l Self Employed

Dates (from - to)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Business Phone

 

 

 

Business Phone

 

 

 

 

 

 

 

Position/Title/Type of Business

 

 

Gross Monthly

Position/Title/Type of Business

 

Gross Monthly

 

 

 

 

Income

 

 

 

 

 

Income

 

 

 

 

$

 

 

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6. Monthly Income and Combined Housing Expense Information

 

 

Gross Monthly

Applicant

Co-Applicant

 

 

Total

Combined Monthly

Present

 

Proposed

Income

 

 

Housing Expense

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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

 

 

 

 

 

 

 

 

 

Homeowner Assn.

 

 

 

(before completing, see

 

 

 

 

 

 

 

 

 

Dues

 

 

 

the notice in "Describe

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other Income," below)

 

 

 

 

 

 

 

 

 

Other

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total

$

 

$

 

 

$

 

 

Total

$

 

$

* Self Employed Applicant(s) may be required to provide additional documentation such as tax returns and financial statements.

 

Describe Other

Notice: Alimony, child support, or separate maintenance

 

A/C

Income

income need not be revealed if the Applicant (A) or Co-Applicant (C)

Monthly Amount

 

 

does not choose to have it considered for repaying this loan.

 

 

 

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

7. Assets and Liabilities

This Statement and any applicable supporting schedules may be completed jointly by both married and unmarried Co-Applicants 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-Applicant section was completed about a non-applicant spouse or other person, this Statement and supporting schedules must also be completed about that spouse or

other person.

Completed

l Jointly l Not Jointly

 

Schedule of Real Estate Owned. (If additional properties are owned, use continuation sheet.)

Property Address

 

Type of

 

Present

 

Amount of

 

Gross Rental

 

Mortgage

 

Insurance,

 

Net Rental

 

 

 

 

 

 

 

(enter S if sold, PS if pending sale,

 

 

 

 

 

 

Maintenance,

 

 

 

 

Mortgages &

 

 

 

 

R if rental for income or O for other)

 

Property

 

Market Value

 

Liens

 

Income

 

Payments

 

Taxes & Misc.

 

Income

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

 

$

 

$

 

$

 

$

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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

Account Number

 

Universal Credit Application-Real Estate

UCA-RE 11/1/2010

VMP , Bankers Systems* MDF. ETXUCARE

VMPC148R (1011).00

Wolters Kluwer Financial Services - 2009, 2010

Page 2 of 5

7. Assets and Liabilities (Continued)

Assets

 

Cash or Market

Liabilities and Pledged Assets. List the creditor's name, address, and

Description

 

Value

account number for all outstanding debts, including automobile loans,

Cash deposit toward purchase

$

 

revolving charge accounts, real estate loans, alimony, child support, stock

held by:

 

 

 

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 Payment &

Unpaid Balance

List checking and savings accounts below

Months Left to Pay

 

 

 

 

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

Name and address of Company

$ Payment/

$

 

 

 

 

 

 

 

 

Months

 

 

 

 

 

 

 

 

 

Acct. no.

 

$

 

Acct. no.

 

l Revolving

 

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

Name and address of Company

$ Payment/

$

 

 

 

 

 

 

 

 

Months

 

 

 

 

 

 

 

 

 

Acct. no.

 

$

 

Acct. no.

 

l Revolving

 

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

Name and address of Company

$ Payment/

$

 

 

 

 

 

 

 

 

Months

 

 

 

 

 

 

 

 

 

 

Acct. no.

 

$

 

Acct. no.

 

l Revolving

 

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

Name and address of Company

$ Payment/

$

 

 

 

 

 

 

 

 

Months

 

 

 

 

 

 

 

 

 

 

Acct. no.

 

$

 

Acct. no.

 

l Revolving

 

Stocks & Bonds (Company

 

$

 

Name and address of Company

$ Payment/

$

name/number & description)

 

 

 

 

 

 

Months

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Acct. no.

 

l Revolving

 

Life Insurance net cash value

 

$

 

Name and address of Company

$ Payment/

$

Face amount: $

 

 

 

 

 

 

Months

 

 

 

 

 

 

 

 

 

 

 

Subtotal Liquid Assets

 

$

 

 

 

 

 

 

Real estate owned

 

$

 

 

 

 

 

 

(enter market value from

 

 

 

 

 

 

 

 

schedule of real estate owned)

 

 

 

 

 

 

 

 

 

 

 

Acct. no.

 

l Revolving

 

 

 

 

 

 

 

 

 

 

 

 

 

Name and address of Company

$ Payment/

$

 

 

 

 

 

 

 

 

Months

 

Vested interest in retirement

 

$

 

 

 

 

 

fund

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Net worth of business(es) owned

$

 

 

 

 

 

 

(attach financial statement)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Acct. no.

 

l Revolving

 

Automobiles owned

 

$

 

Alimony/Child Support/Separate

$

 

(make and year)

 

 

 

Maintenance Payments Owed to:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Job-Related Expense

 

$

 

 

 

 

 

 

(child care, union dues, etc.)

 

 

 

 

 

 

 

 

 

 

 

 

Other Assets (itemize)

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total Monthly Payments

$

 

 

 

 

 

 

 

 

 

 

 

Other Assets

 

$

 

Other Liabilities

 

 

$

(from continuation page, if any)

 

 

(from continuation page, if any)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total

 

$

 

Net Worth

 

$

Total

$

 

Assets (a)

 

 

(a - b)

 

Liabilities (b)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8. Declarations

a.Are there any outstanding judgments against you?

b.Have you been declared bankrupt within the past 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?

Applicant Co-Applicant

Yes

No

Yes No

l

l

l l

l

l

l l

l

l

l l

l

l

l l

e.Have you directly or indirectly been obligated on any loan which resulted in foreclosure, transfer of title in lieu of foreclosure, or judgment?

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

Applicant Co-Applicant

Yes No

Yes

No

l l

l

l

l l

l

l

Universal Credit Application-Real Estate

UCA-RE 11/1/2010

VMP , Bankers Systems* MDF. ETXUCARE

VMPC148R (1011).00

Wolters Kluwer Financial Services - 2009, 2010

Page 3 of 5

8. Declarations (Continued)

 

 

Applicant

Co-Applicant

 

 

 

 

 

 

Yes No

Yes No

g. Are you obligated to pay alimony, child

l l

l l

 

support, or separate maintenance?

h. Is any part of the down payment

l l

l l

 

borrowed?

i.

Are you a co-maker or endorser on a

l l

l l

 

note?

j.

Are you a U.S. citizen?

l l

l l

k.

Are you a permanent resident alien?

l l

l l

l.

Do you intend to occupy the property

l l

l l

 

as your primary residence?

 

 

 

 

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)?

n.Are there any other equity loans on the property?

Applicant Co-Applicant

Yes No

Yes

No

l l

l

l

 

 

 

 

 

 

 

 

l l l l

9. Continuation and Additional Information

Instructions. Use this section if you need more space to complete the Universal Credit Application. Mark "A" for Applicant and "C" for Co-Applicant. Use this space if you answered "Yes" to any of the questions in Section 8.

10. Federal Notices

Important Applicant Information. To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that identifies each person who applies for a loan or opens an account.

What this means for you. When you apply for a loan or open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver's license and/or other identifying documents. In some instances, we may use outside sources to confirm the information. The information you provide is protected by our privacy policy and Federal law.

False Statements. By signing below, 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.

11. State Notices

California Residents. Each applicant, if married, may apply for a separate account.

Massachusetts Residents. Under Massachusetts statute, Mass. Gen. L. ch. 184, Section 17B, you, the Applicant (and Co-Applicant) are entitled to know the following:

1.The responsibility of the attorney for the Mortgagee is to protect the interest of the Mortgagee.

2.Mortgagors may, at their own expense, engage an attorney of their own selection to represent their interests in the transaction.

For Home Equity Line of Credit. The current annual percentage rate for finance charges and, if the rate may vary, a statement to that effect and of the circumstances under which the rate may increase and whether there are any limitations on any such increase, as well as the effects of any such increase; the conditions under which a finance charge may be imposed, including the time period within which any credit extended may be repaid without incurring a finance charge; whether any annual fee is charged and the amount of any such fee; and whether any other charges or fees may be assessed, the purposes for which they are assessed, and the amounts of any such charges or fees.

New York Residents. A consumer report may be ordered in connection with your application. Upon your request, we will inform you whether or not a report was ordered. If a report was ordered, we will tell you the name and address of the consumer reporting agency that provided the report. Subsequent reports may be ordered or utilized in connection with an update, renewal or extension of credit for which you have applied.

Ohio Residents. The Ohio laws against discrimination require all creditors make credit equally available to all creditworthy customers, and that credit reporting agencies maintain separate credit histories on each individual upon request. The Ohio Civil Rights Commission administers compliance with this law.

Any person who, with intent to defraud or knowing that he is facilitating a fraud against an insurer, submits an application or files a claim containing a false or deceptive statement is guilty of insurance fraud.

Texas Residents. The owner of the homestead is not required to apply the proceeds of the extension of credit to repay another debt except debt secured by the homestead or debt to another lender.

Wisconsin Residents. Notice to Married Applicants. No provision of any marital property agreement, unilateral statement under Wisc. Statutes §766.59 or a court decree under Wisc. Statutes §766.70 adversely affects the interest of the lender unless the lender, prior to the time the credit is granted, is furnished a copy of the agreement, statement or decree or has actual knowledge of the adverse provision when the obligation to the lender is incurred.

For married Wisconsin Residents. The credit being applied for, if granted, will be incurred in the interest of my marriage or family. I understand the creditor may be required by law to give notice of this transaction to my spouse.

12. Acknowledgment 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;

Universal Credit Application-Real Estate

UCA-RE 11/1/2010

VMP , Bankers Systems* MDF. ETXUCARE

VMPC148R (1011).00

Wolters Kluwer Financial Services - 2009, 2010

Page 4 of 5

12.Acknowledgment and Agreement (Continued)

(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 rights 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 transferred with such notice as may be required by law; (10) neither Lender nor its 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 defined in applicable federal and/or state laws (excluding audio and video recordings), or my facsimile transmission of this application containing a facsimile of my signature, shall be as effective, enforceable and valid as if a paper version of this application were delivered containing my original written signature.

Acknowledgment. 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.

X

 

 

X

 

 

 

 

 

 

Applicant's Signature

Date

Co-Applicant's Signature

Date

13. Information for Government Monitoring Purposes

Instruction to Lender: Cross out this entire section (or instruct the applicant to do so), if this information is not required by law for this type of credit.

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 a lender may not discriminate neither on the basis of this information, nor on whether you choose to furnish it. If you furnish the information, please provide both ethnicity and race. For race, you may check more than one designation. If you do not furnish ethnicity, race, or sex, under Federal regulations, the Lender is required to note the information on the basis of visual observation or surname. If you do not wish to furnish the information, please check the box below.

Applicant

l I do not wish to furnish this information

Co-Applicant

l I do not wish to furnish this information

 

Ethnicity:

l Hispanic or Latino

 

l Not Hispanic or Latino

Ethnicity:

l Hispanic or Latino

l Not Hispanic or Latino

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Race: l American Indian or Alaska Native

 

l Asian

l Black or

Race: l American Indian or Alaska Native

l Asian

l

Black or

l Native Hawaiian or Other Pacific Islander l White

African

 

 

l Native Hawaiian or Other Pacific Islander

l White

 

African

American

 

 

 

American

Sex:

l Female

 

 

l Male

 

 

Sex:

l Female

 

l Male

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

For Mortgage Loan Originator

 

 

 

 

 

This information

l In a face-to-face interview

 

 

 

 

l In a telephone interview

 

 

 

 

 

was provided:

l By the applicant and submitted by fax or mail

l By the applicant and submitted via e-mail or the Internet

 

 

 

 

 

 

 

 

 

 

 

 

 

Loan Originator's Signature

 

 

 

 

 

 

Date

Loan Originator's Phone Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

X

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Loan Originator's Name

 

Loan Originator Identifier

 

 

 

Loan Origination Company's Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Loan Origination Company's Name

Loan Origination Company Identifier

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Transaction Worksheet - Optional

 

 

 

 

 

a. Purchase price

 

 

 

$

 

 

 

k. Applicant's closing costs paid by Seller

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

b. Alterations, improvements, repairs

 

 

 

 

 

l.

Other Credits (explain)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

c. Land (if acquired separately)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

d. Refinance (include debts to be paid off)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

e. Estimated prepaid items

 

 

 

 

 

 

m. Loan amount (exclude PMI, MIP,

 

 

 

 

 

 

 

 

 

 

 

 

Funding Fee financed)

 

 

 

 

 

f. Estimated closing costs

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

g. PMI, MIP, Funding Fee

 

 

 

 

 

 

n. PMI, MIP, Funding Fee financed

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

h. Discount (if Applicant will pay)

 

 

 

 

 

o. Loan amount (add m & n)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

i. Total costs (add items a through h)

 

 

 

 

 

p. Cash from/to Applicant

 

 

 

 

 

 

 

 

 

 

 

 

 

(subtract j, k, l & o from i)

 

 

 

 

 

j. Subordinate financing

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

For Lender's Use

 

 

 

 

 

 

Lender's Initial Lien Position

First Lien Holder's Name & Address (if any)

Second Lien Holder's Name & Address (if any)

l First Lien

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

l Second Lien

 

 

 

 

 

 

 

 

 

 

 

 

 

 

l Subordinate Lien

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Loan No.

 

 

 

 

 

Loan No.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date Application Received

Received By

 

 

 

 

 

Amount Requested

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Decision

 

Decision Date

 

 

 

 

 

Decision By

 

 

 

 

 

l Approved

l Denied

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HMDA Reportable

 

Amount Approved

 

Initial Advance (if applicable)

Funding Date

 

 

l Yes

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Refinancing

 

Rescindable

 

Early Disclosures Given

High Cost Mortgage

l Yes

l Yes l Cash Out

l Yes

 

 

 

l Yes, on

 

High Priced Mortgage l Yes

Universal Credit Application-Real Estate

 

 

 

 

 

 

 

 

 

 

 

UCA-RE 11/1/2010

VMP , Bankers Systems* MDF. ETXUCARE

 

 

 

 

 

 

 

 

 

 

 

VMPC148R

(1011).00

Wolters Kluwer Financial Services - 2009, 2010

 

 

 

 

 

 

 

 

 

 

 

 

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