Mortgage Assumption Application - Chase Bank
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Transcript of Mortgage Assumption Application - Chase Bank
Mortgage Assumption Application
Please complete and include this Cover Sheet with your documents
Date ______ ______ _________________
Loan number __________________________________________________
Applicant name _________________________________________________
Phone1 ( ______ ) ______ - _____________
1 When you give us your mobile phone number we have your permission to contact you at that number about all your Chase or JP Morgan accounts Your consent allows us to use text messaging artificial or prerecorded voice messages and automatic dialing technology for informational and account service calls but not for telemarketing or sales calls It may include contact from companies working on our behalf to service your accounts Message and data rates may apply You may contact us anytime to change these preferences
You can fax mail or email these documents to
Fax1-855-372-0605
Emailmortgageassumptionjpmchasecom
Mail Chase700 Kansas LaneMail Code LA4-6888Monroe LA 71203
COVER SHEET
99177-CS-0215
copy2021 JPMorgan Chase amp Co
This package will walk you through the mortgage assumption process provide and explain the
necessary forms and serve as a road map for you to complete your request to
bull Add a new borrower to become financially responsible for the loan
bull Release a current borrower from financial responsibility
Herersquos how the people associated with the assumption of the loan are identified on the forms included in this package
mdashThe person who will be added to the loan or the person already on the loan who will remain on the loan
mdashThe person already on the loan who will be removed from the loan
PLEASE NOTE
An assumption is a significant
decisionmdashit changes who is financially
responsible for the loan Please review
the information in this package to make
sure that an assumption is right for you
If you believe a relatively simple name
change may be your best option please
call us at 1-866-299-6752
99177-LAG-0215
Remember wersquore available to answer your questions
mdash call us at 1-866-299-6752 (1-800-582-0542 TTY)
Si tiene alguna pregunta por favor llame al 1-855-280-4198
Pay stubs from the past 30 days or if self-employed personal and business
returns from the past two years
Previous two years of W-2 forms (if applicable)
Previous two years of 1099 forms (if applicable)
Previous two months of bank statements (all pages)
Most recent quarterly 401(k) statement (all pages)
Final divorce decree or court-approved settlement agreement (if applicable)
Sales contract (if applicable)
Copy of death certificatewill (if applicable)
THE DOCUMENTS YOUrsquoLL NEED TO SEND US
Anyone who will be remaining on or added to the existing loan will need to return the following
information with the assumption applicationmdashwe canrsquot proceed with the application until wersquove
received all of the documents listed below
Please note that we may have also enclosed additional documents that are required for your situation that
arenrsquot listed below If applicable please review and sign these documents and return them to us with the
completed documents listed below
Please complete these enclosed forms and return them to us in the provided prepaid envelope
Uniform Residential Loan Application (Freddie Mac Form 65Fannie Mae Form 1003)
General Authorization for a Mortgage Loan Assumption
Customer Information Worksheet
IRS Form 4506-C (Request for Transcript of Tax Return)
Please gather and send us the following documents for review
Copy of current property deed evidencing a transfer (if applicable)
You can fax mail or email the application and required documents to
Fax Mail Email 1-855-372-0605 Chase mortgageassumptionjpmchasecom
700 Kansas Lane Mail Code LA4-6888 Monroe LA 71203
99177-DOCS-0215
FREQUENTLY ASKED QUESTIONS
A loan assumption lets the borrower change who is financially responsible for the loan It could
involve adding or removing borrowers or transferring the loan to someone else Please review
these questions about eligibility for and alternatives to a loan assumption
ELIGIBILITY
How do you determine eligibility
We look at the credit history assets and income of the person who wants to assume the loan from the borrower
Will my credit history be considered
Yes wersquoll review your credit score and consider your credit history
Do the borrower and the person who assumes the loan have to be related
In some cases yes Wersquoll review your eligibility after we receive all the documents we need
What if the purpose of the property will change for example from a primary residence to an investment property
We may allow a change in the propertyrsquos purpose but in many cases we wonrsquot allow a change in occupancy
Can my loan be assumed if I completed a loan modification
We usually require that you wait one to four years after a modification before applying for an assumption
Can I have a previous bankruptcy or foreclosure in my credit history
We require that you wait four years after a bankruptcy and six years after a foreclosure before applying for an assumption
Can I still apply for mortgage assistance
Yes but assuming the loan may limit the assistance options yoursquore eligible for
FEES
Are there costs associated with an assumption
There are closing costs for completing an assumption These costs usually total about $1500 for every $100000 of the unpaid loan amount
Can closing costs be included in the loan amount
No All closing costs must be paid at the time of closing We canrsquot increase the amount owed on an existing loan as we can with a refinanced loan
GENERAL
Is it better to refinance the loan or assume responsibility for the existing loan
The rates and terms for refinancing could be better than the current loan terms visit chasecom for our rates When you refinance you can roll the closing costs into the loan amount In an assumption we canrsquot modify the existing loan terms
How long does an assumption take
Usually 70 to 90 days
Why do I have to qualify for the assumed loan if Irsquom on the current one
We need to make sure that you can afford the loan under the new circumstances
If I own the property will an assumption change that
An assumption by itself doesnrsquot change ownership of the property but ownership may change at the same time We recommend getting independent legal advice or consulting with a title company
ID 3188620 FM201
IN THE EVENT OF A DEATH
Is an assumption my only option
You may have the option to be added to the loan as a successor in interest
You wonrsquot be responsible for repaying the loan but will get access to account information and statements There are no fees to be added as a successor in interest
If you assume the loan yoursquoll be financially responsible for repaying it and wersquoll report your payment information to the credit reporting agencies
IN CASES OF DIVORCE
Should I wait until my divorce or separation is final before applying for an assumption
Yes we require a separation or divorce agreement that shows who will retain rights to the property
My divorce agreement shows that my spouse is now responsible for the mortgage Why do I have to go through an assumption
We still need to review the income credit and assets of the person maintaining ownership to ensure that they qualify for the loan under the new circumstances
IN CASES OF MARRIAGE
Do I need to complete an assumption to add my spouse to the loan
Not necessarily
If you conveyed an interest in the property to your spouse they can be added to the loan as a successor in interest They wouldnrsquot be responsible for repaying the loan but would get access to account information and statements We donrsquot charge a fee to add a successor in interest
With an assumption your spouse would be financially responsible for repaying the loan and wersquoll report their payment information to the credit reporting agencies
Were here to answer all your questions and will work with you to make sure you get the assistance you needmdashcall us at 1-866-299-6752 we accept operator relay calls
ID 3188620 FM201
[ ][ ][ ]
[ ]
[ ]
[ ]
[ ]
[ ][ ][ ]
( )
( )
( )
[ ] [ ] [ ]
[ ] [ ] [ ] [ ]
[ ]
[ ]
[ ]
( )
( )
( )
( )
( )
( )
[ ] [ ] [ ]
[ ] [ ] [ ]
[ ]
[ ]
[ ]
[ ]
ytra
P ytra
PCustomer Information Worksheet
Loan number
Address of property to be assumed
Reason for assumption ( heck one) [ ]
Divorce Death of original owner Existing owners are selling the home Other
[ ][ ][ ] ___________________________
[ [ [ [
] Spouse Child Parent Other
] ] ] ____________________________
relationship to owners (check one)
Parties to the assumption In the sections below please identify the parties associated with the assumption of the loan This includes
Individuals who will be added to the loan Individuals who are already on the loan and who will remain on the loan Individuals who are already on the loan and who will be removed from the loan
If more than three parties are associated with the assumption please provide the requested information on a separate page and attach it to this worksheet
Name
Par
ty
Current address
Check one Check one New to the loan (being added) Already on the loan and will remain Already on the loan and will be removed
Day phone
Evening phone
Cell phone
Active-duty military Military veteran Neither
Available hours
Available hours
Available hours
Name Current address
Check one Check one New to the loan (being added) Already on the loan and will remain Already on the loan and will be removed Day phone
Evening phone
Cell phone
Active-duty military Military veteran Neither
Available hours
Available hours
Available hours
Name Current address
Check one Check one New to the loan (being added)
Already on the loan and will be removed
Evening phone
Cell phone
Active-duty military Military veteran Neither
Already on the loan and will remain
Day phone Available hours
Available hours
Available hours
Esta comunicacioacuten contiene informacioacuten importante acerca de la cuenta Si tiene alguna pregunta o necesita ayuda para traducirla comuniacutequese con nosotros llamando al 1-855-280-4198
FM142
Uniform Residential Loan ApplicationVerify and complete the information onthis applicationIf you are applying for this loan with others each additional Borrower must provide
information as directed by your Lender
Section 1 Borrower Informationthis section asks about yourpersonal information and your income fromemploymentandother sources such as retirement that you want considered to qualify for this loan
1a Personal Information
Name(First Middle Last Suffix) Social Security Number - -
(orIndividual TaxpayerIdentification Number)
Alternate Names- List any namesby which you are known or any namesunderwhich credit was previously received (First Middle Last Suffix)
Date ofBirth Citizenship(mmddyyyy) USCitizen
copy PermanentResidentAliencopy Non-PermanentResidentAlien
Type of Credit List Name(s) of Other Borrower(s) Applying for this Loan
copy lamapplyingforindividual credit (First Middle Last Suffix) - Use a separator between names
copy |am applyingfor joint credit Total Numberof Borrowers_
Each Borrowerintendsto applyfor joint credit Yourinitials
Marital Status Dependents(notlisted by another Borrower) Contact Information
O Married Number __ Home Phone ( ) -
s SeparatedUnmarried
Ages CellPhone ( ) _7
(Single Divorced Widowed Civil Union Domestic Partnership Registered Work Phone (0) Ext
Reciprocal Beneficiary Relationship) Email
Current Address
Street Unit
City State ZIP Country
How Long at Current Address Years mdashMonths Housing O Noprimary housing expense copy) Own copy Rent($ month)
If at Current Addressfor LESS than 2 yearslist Former Address LC Does not apply
Street Unit
City State ZIP Country
How Long at Former Address Years mdashMonths Housing No primary housing expense Own Rent($ month)
Mailing Address- ifdifferent from CurrentAddress (| Does not apply
Street Unit
City State ZIP Country
easeaoemir ] Does not apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base $_mdashmdashmdashmdash__mdashmonth
City State ZIP Country Overtime =$_________monthBonus $ month
Position orTitle Checkif this statementapplies Commission $ month[] am employedby a family member
propertyseller real estate agent or otherparty to the transaction
TTStartDate0__mdashsmmddyy) MilitaryHow long in this line of work Years mdash_ Months Entitlements $_mdashsmontth
Other $ monthCheckif you are the Business () | have an ownershipshare of less than 25 Monthly Income(or Loss) mdashmdash_mdashOwnerorSelf-Employed O I have an ownership share of 25 or more sect TOTALS__000month
Uniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
1c IF APPLICABLE Complete Information for Additional EmploymentSelf-Employment and Income
Doesnot apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base $ month
City State ZIP Country Overtime mdash$ monthBonus $ month
Position orTitle Checkif this statementapplies Commission $ month| am employedby a family memberproperty seller real estate agent or otherparty to the transaction
Start Date mdash_mdashAA(mmddyyyy) Military
EntitlementsHow long in this line of work lsquoYears mdash_ Months $ month
7 7 Other $ monthCheckif you are the BusinessOwnerorSelf-Employed
| have an ownershipshare ofless than 25 Monthly Income(or Loss)| have an ownership share of 25 or more $ TOTAL $ 000month
PlMeNeeeMeeCee ti)LeeseteUeLimet Does not apply
Provideatleast 2 years of current and previous employment and income
Employeror Business Name Previous Gross Monthly
Street Unit Income $ month
City State ZIP Country
Position orTitleStart Date (mmddyyyy) Checkif you were the Business
Owneror Self-Employedmdash_ mdashEnd Date (mmddyyyy)
WCBeelcaTy Does not apply
Include incomefrom other sources below Under IncomeSource choosefrom the sourceslisted hereraquo Alimony+ Automobile Allowance Boarder Income
+ Capital Gains
Child Support+ Disabilitylaquo Foster Care
laquo Housing or Parsonage
+ Interest and Dividendslaquo Mortgage Credit Certificateraquo MortgageDifferential
Payments
raquo Notes Receivable+ Public Assistance- Retirement
(eg Pension IRA)
laquo Royalty Payments Separate Maintenance+ Social Security
+ Trust
laquo UnemploymentBenefits
laquo VA Compensation
cent Other
NOTEReveal alimony child support separate maintenance or other income ONLYIFyou wantit considered in determining yourqualification
for this loan
IncomeSource -mdash uselist above Monthly Income
$
$
$
Provide TOTAL AmountHere $ 000
Borrower Name
Uniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 2 Financial Information mdash Assets andLiabilities this section asks about things you ownthatare worth moneyand that you wantconsidered to qualify for this loan It then asks about your liabilities (or debts) that you pay
each month suchas credit cards alimony or other expenses
rNcee stLeVaalemities eitimeeecm dellaLC-
Include all accounts below Under Account Typechoosefrom the typeslisted here
laquo Checkinglaquo Savingsraquo Money Market
+ Certificate of Depositlaquo Mutual Fund+ Stocks
laquo Stock Optionslaquo Bonds+raquo Retirement(eg 407k IRA)
laquo Bridge Loan ProceedslaquoIndividual DevelopmentAccount
Trust Account- Cash Value ofLife Insurance(usedfor the transaction)
AccountType- use list above FinancialInstitution Account Number Cash or MarketValue
$
$
$
$
$
$ 000Provide TOTAL AmountHere|
Includeall other assets and credits below UnderAsset or Credit Type choose from the typeslisted here
Assets Credits- Proceeds from Real EstateProperty to be sold on orbefore closing
laquo Proceeds from Sale ofNon-Real Estate Asset
- Secured Borrowed Funds
cent Unsecured Borrowed Funds Other
raquo Earnest MoneylaquoEmployer Assistance- Lot Equity
Relocation Funds_raquo Rent Credit
laquo Sweat Equity+ Trade Equity
Assetor Credit Type mdash uselist above Cash or Market Value
$
$
$
$
$ 000Provide TOTAL AmountHere
2c Liabilities - Credit Cards Other Debts and Leases that You Owe C Does not apply
List all liabilities below (except real estate) and include deferred payments Under Account Type choose from thetypeslisted herelaquoRevolving (eg credit cards) +Installment (eg car student personal loans) Open 30-Day (balance paid monthly) + Lease (not realestate) +Other
Account Type mdashuse list above
To be paid offator before closingCompany Name Account Number Unpaid Balance Monthly Payment
$ $
$ $
$ $
$ $
$ $
2d OtherLiabilities and Expenses Does not apply
Includeall otherliabilities and expenses below Choose from the typeslisted here
+ Alimony Child Support -Separate Maintenance +JobRelatedExpenses +Other Monthly Payment
$
$
$
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 3 Financial Information mdash Real Estatethis section asks youtolist all properties you currently ownand what you owe onthem donot own anyreal estate
3a Property You Own If you are refinancinglist the property you are refinancing FIRST
Address Street Unit
City State ZIP Country
Sol Intended Occupancyinvestment PrimaryResidence SecondHome Other
Monthly InsuranceTaxesAssociation Duesetcifnot included in MonthlyMortgage Payment
For 2-4 Unit Primary or Investment PropertyStatus SoldPending Saleor Retained
=Monthly RentalIncomeProperty Value
$ $ $
Mortgage Loanson this Property Does not apply
MonthlyMortgagePayment
Type FHA VAConventionalUSDA-RD Other|
To be paid offator before closing
Credit Limit(ifapplicable)Creditor Name Account Number Unpaid Balance
$ $ $
$ $ $
3b IF APPLICABLE Complete Information for Additional Property Does not apply
Address Street Unit
City State ZIP Country
ldquoSold Intended Occupancyinvestment PrimaryResidence SecondHome Other
Monthly Insurance TaxesAssociation Duesetcifnot included in MonthlyMortgage Payment
For 2-4 Unit Primary or Investment PropertyStatus SoldPendingSaleor Retained
Monthly RentalIncomeProperty Value
$ $ $
Mortgage Loanson this Property Does not apply
Monthly
Mortgage
Payment
Type FHA VA
Conventional
USDA-RD Other|
To be paid offat
or before closing
Credit Limit
(ifapplicable)Creditor Name Account Number Unpaid Balance
$ $ $
$ $ $
$ $ $
$ $ $
$ $ $
3c IF APPLICABLE Complete Information for Additional Property Does not apply
Address Street Unit
City State ZIP Country
Intended Occupancyinvestment PrimaryResidence SecondHome Other
Monthly Insurance TaxesAssociation Duesetcifnot included in MonthlyMortgage Payment
For 2-4 Unit Primary or Investment PropertyStatus SoldPending Saleor Retained
Monthly RentalIncomeProperty Value
Mortgage Loanson this Property Does not apply
MonthlyMortgagePayment
Type FHA VAConventionalUSDA-RD Other|
To be paid offator before closing
Credit Limit(ifapplicable)Creditor Name Account Number Unpaid Balance
Borrower Name
Uniform Residential Loan Application
Freddie Mac Form 65 +raquo Fannie Mae Form 1003
Effective 12021
Section 4 Loan and Property Informationthis section asks about the loanrsquos purpose and the property youwantto purchase orrefinance
4a Loan and Property Information
LoanAmount $ Loan Purpose Purchase efinance Other(specify)
Property Address Street Unit
City State ZIP County
Numberof Units Property Value $
Occupancy Primary Residence Second Home InvestmentProperty FHA Secondary Residence
1 Mixed-Use PropertyIf you will occupy the propertywill you set aside space within the property to operate
your ownbusiness(eg daycare facility medicaloffice beautybarber shop)NO YES
2 Manufactured HomeIs the property a manufactured home(eg a factory built dwelling built on a permanentchassis) NO YES
4b Other New Mortgage Loansonthe Property Youare Buying or Refinancing Does not apply
LoanAmountAmountto be Drawn
Credit Limit(ifapplicable)Creditor Name Lien Type Monthly Payment
First Lien Subordinate Lien $ $ $
$ $ $First Lien SubordinateLien
4c Rental Income on the Property You Wantto Purchase For Purchase Only Does not apply
Completeif the property is a 2-4 Unit Primary Residence or an Investment Property Amount
Expected Monthly Rental Income $
Doesnot apply4d Gifts or Grants You Have Been GivenorWill Receive for this Loan
Includeall gifts and grants below Under Source choose from the sourceslisted here
Community Nonprofitlaquo Employer
raquo Federal Agencyraquo Local Agency
- Relative+ Religious Nonprofit
+ State Agency+ Unmarried Partner
raquo Lender Other
Asset TypeCash Gift Gift of Equity Grant DepositedNot Deposited Source - uselist above Cash or Market Value
Deposited Not Deposited $
$Deposited Not Deposited
Borrower Name
Uniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 5 DeclarationsThis section asks youspecific questions about the property your funding and yourpastfinancial history
5aAboutthis Property and Your Moneyfor this Loan
A Will you occupy the property as your primary residence
If YES have you had an ownershipinterest 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 investmentproperty(IP)
(2) How did you holdtitle to the property by yourself (S) jointly with your spouse(SP) or jointly with another person (O)
YESYES
B If this is a Purchase Transaction Do you have a family relationship or businessaffiliation with the seller of the property NO YES
C Are you borrowing any moneyforthis real estate transaction (eg money foryour closing costs or down payment) orobtaining any moneyfrom anotherparty such astheseller or realtor that you have notdisclosed on this loan application NO YES
If YES what is the amountof this money $
D 1 Have you orwill you be applying for a mortgage loan on anotherproperty (not the property securing this loan) on or
before closing this transaction that is not disclosed on this loan application
NO YES
2 Have you orwill you be applying for any newcredit (eg installment loan credit card etc) on or before closing this loan that
is not disclosed on this application
No YES
E Will this property be subject to a lien that could take priority over the first mortgagelien such as a clean energylien paid
through yourproperty taxes(eg the PropertyAssessed Clean Energy Program)NO YES
5b About YourFinances
F Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application NO YES
G Are there any outstanding judgments against you No YES
H Areyou currently delinquentor in default on a Federal debt No YES
I Areyou a party to a lawsuit in which you potentially have any personalfinancialliability NO YES
J Have you conveyedtitle to any property in lieu of foreclosure in the past 7 years NO YES
K Within the past 7 years have you completed a pre-foreclosure sale or short sale whereby the property wassold to a
third party and the Lenderagreed to acceptless than the outstanding mortgage balance due
NO YES
L Have you hadproperty foreclosed uponin thelast 7 years NO YES
M Have you declared bankruptcy within the past 7 years ONO YESIf YES identify the type(s) of bankruptcy Chapter7 Chapter11 Chapter12 Chapter 13
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 6 Acknowledgments and AgreementsThis section tells you about yourlegal obligations whenyousign this application
Acknowledgments and Agreements
Definitions- Lenderincludes the Lenderrsquos agents service providers and any oftheir successors andassigns
Other Loan Participantsrdquo includes(i) any actual or potential owners of
a loan resulting from this application (the ldquoLoanrsquo)(ii) acquirers ofany beneficial or other interest in the Loan(iii) any mortgageinsurer(iv) any guarantor (v) any servicer of the Loan and (vi) any of theseparties service providers successors or assigns
I agree to acknowledgeand representthe following
(1) The Complete Informationfor this Application- The information | have providedin this application is true accurate
and completeas of the date | signed this application
laquo If the information | submitted changesor | have new information
before closing of the Loan | must change and supplementthis
application including providing any updatedsupplementedrealestate sales contract
- For purchase transactions The terms and conditionsof anyrealestate sales contract signed by mein connection with this application
are true accurate and complete to the best of my knowledge andbelief | have not entered into any other agreement written ororal inconnection withthis real estate transaction
- The Lender and OtherLoan Participants mayrely on the informationcontainedin the application before and after closing of the Loan
- Any intentional or negligent misrepresentation of information may
result in the impositionof(a) civil liability on me including monetary damagesif a
person suffers any loss because the person relied on anymisrepresentation that | have made onthis application andor
(b) criminal penalties on me including but not limited to fine orimprisonment or both underthe provisions of Federal law(18 USC sectsect 1001 et seq)
(2) The Propertyrsquos SecurityThe Loan | have applied for in this application will be secured by
a mortgage or deedoftrust which provides the Lendera security
interest in the property described in this application
(3) The Propertys Appraisal Value and Condition- Any appraisal or value of the property obtained by the Lenderis
for use by the Lender and OtherLoanParticipantslaquoThe Lender and OtherLoan Participants have not made anyrepresentation or warranty express or implied to me about the
propertyits conditionorits value
(4) Electronic Records and Signatures- The Lender and OtherLoan Participants may keep any paper record
andorelectronic record of this application whether or not the Loan
is approved
BorrowerSignature
- If this application is created as (or converted into) an ldquoelectronicapplicationrdquo | consent to the use of ldquoelectronic recordsrdquo and
ldquoelectronic signaturesrdquo as the termsare defined in and governed byapplicable Federal andorstate electronic transactions laws
| intend to sign and have signedthis application either using my(a) electronic signature or(b) a written signature and agreethatif a paper version ofthis
application is converted into an electronic application theapplication will be an electronic record and the representationof my written signature on this application will be my binding
electronic signature- | agree that the applicationif delivered or transmitted to the Lenderor Other Loan Participants as an electronic record with myelectronicsignaturewill be as effective and enforceable as a paperapplicationsigned by mein writing
(5) Delinquencylaquo The Lender and OtherLoan Participants may report information about
my accountto credit bureaus Late payments missed paymentsorother defaults on my account maybereflected in my credit report andwill likely affect my credit score
- If | have trouble making my payments | understand that | may contacta HUD-approved housing counseling organization for advice about
actions I can take to meet my mortgageobligations
(6) Authorization for Use and Sharing of InformationBy signing belowin addition to the representations and agreementsmade above| expressly authorize the Lender and Other LoanParticipants to obtain use and share with each other(i) the loan
application and related loan information and documentation(ii) aconsumercredit report on me and(iii) my tax return information asnecessary to perform theactionslisted belowfor so long as they havean interest in my loanorits servicing
(a) process and underwrite myloan(b) verify any data contained in my consumercredit 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 analysisandreviews
(e) perform analysis and modeling for risk assessments(f) monitor the accountfor this loan for potential delinquencies and
determineanyassistance that may beavailable to me and
(g) other actions permissible under applicable law
Date (mmddyyyy)
Additional Borrower Signature Date (mmddyyyy)
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 7 Military ServiceThis section asks questions about your(or your deceased spouses) military service
Military Service of Borrower
Military Service mdash Did you (or your deceased spouse) everserve or are you currently serving in the United States Armed Forces NO YES
If YES check allthat apply Currently serving on active duty with projected expiration date of servicetour (mmddyyyy)
Currently retired discharged or separated from service
Only period of service was as a non-activated memberof the Reserve or National GuardSurviving spouse
Section 8 Demographic InformationThis section asks about your ethnicity sex and race
Demographic Information of Borrower
The purposeofcollecting this informationis to help ensure thatall applicants are treated fairly and that the housing needs of communities
and neighborhoodsare beingfulfilled 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 mayselect one or more designationsfor
Ethnicity and one or more designationsfor Race The law provides that we maynotdiscriminate on the basis of this information or onwhetheryou chooseto provideit However if you choose not to provide the information and you have madethis application in person Federal
regulations require us to note your ethnicity sex and race on thebasis of visual observation or surname Thelaw also provides that we may notdiscriminate on the basis of age or marital status information you providein this application If you do not wish to provide someorall of this
information please check below
Ethnicity Check one or more Race Check one or moreHispanic or Latino AmericanIndian or Alaska Native - Print nameofenrolled
or principaltribe Mexican PuertoRican CubanOther Hispanic or Latino - Print origin Asian
Asian Indian Chinese Filipino
Japanese Korean Vietnamese
OtherAsian mdash Print race
For example Hmong Laotian Thai Pakistani Cambodian and so on
Black or African American
Native Hawaiian or OtherPacific Islander
Native Hawaiian GuamanianorChamorro Samoan
For exampleArgentinean Colombian Dominican Nicaraguan
Salvadoran Spaniard andso on
Not Hispanic or Latino
| do not wish to providethis information
5Female OtherPacific Islander mdash Print race
Male For example Fijian Tongan and so on| do not wish to providethis information white
| do not wish to providethis information
Wasthe ethnicity of the Borrowercollected on the basis of visual observation or surname )NO YESWasthe sex of the Borrowercollected on the basis of visual observation or surname NO YESWastherace of the Borrowercollected on the basis of visual observation or surname NO YES
Face-to-Face Interview (includes Electronic Media w Video Component) TelephoneInterview Faxor Mail Email or Internet
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
ReelTemCrCL
Loan Originator Organization Name
Address
Loan Originator Organization NMLSR ID State License ID
Loan Originator Name
Loan Originator NMLSR ID State License ID
Date (mmddyyyy)
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Uniform Residential Loan Application mdash Additional BorrowerVerify and complete the information onthis application as directed by your Lender
Section 1 Borrower Informationthis section asks about yourpersonal information and your income fromemploymentandother sources such as retirement that you want considered to qualify for this loan
1a Personal Information
Name(First Middle Last Suffix)
Alternate Names - List any namesby which you are known or any namesunder which credit was previously received (First Middle Last Suffix)
Social Security Number - -(or Individual TaxpayerIdentification Number)
Dateof Birth Citizenship(mmddyyyy)
USCitizenPermanentResidentAlienNon-Permanent ResidentAlien
Type ofCredit| am applying for individualcredit
lam applying forjoint credit Total Number of Borrowers
Each Borrowerintendsto applyfor joint credit Your initials
List Name(s) of Other Borrower(s) Applying for this Loan
(First Middle Last Suffix) - Use a separator between names
Marital Status Dependents(notlisted by another Borrower)
Contact Information
Married Number _ Home Phone ( ) -
( ) _
( ) -mdash_ mdash_
Separated Ages CellPhone
Unmarried ens Work Phone Ext(Single Divorced WidowedCivil Union Domestic Partnership Registered
Reciprocal Beneficiary Relationship)lsquol
Emal
Current Address
Street Unit
City State ZIP Country
How Long at Current Address=Years mdashMonths Housing Noprimary housing expense Own Rent($ month)
If at Current Address for LESS than 2 yearslist Former Address Does not apply
Street Unit
City State ZIP Country
How Long at Former Address Years mdashMonths Housing Noprimary housing expense Own month)
Mailing Address- ifdifferent from CurrentAddress Does not apply
Street Unit
City State ZIP Country
eeeeCeeteiChuraleCme Doesnot apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base S$month
City State ZIP Country Overtime =$_____monthBonus $ month
Position orTitle Checkif this statementapplies Commission sect month| am employedby a family memberpropertyseller real estate agent or otherparty to the transaction
TTStart Date ____ (mmddyy) Military
Entitlements$_How longin this line of work Years =Months mdash monthSS
Other $ monthCheckif you are the BusinessOwnerorSelf-Employed
| have an ownershipshare ofless than 25 Monthly Income(or Loss) mdashmdash| have an ownership share of 25 or more $ TOTAL $ 000month
Uniform Residential Loan Application mdash Additional Borrower
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
CoeeeMCMCmeticlm tu)Comiteteilteeilelie mieit
Does not apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base
OvertimeBonus
Commission
MilitaryEntitlements
Other
$ month
$ month$ month
$ month
$ month
$ month
City State ZIP Country
Position orTitle ose if this statement applieslam employed by a family memberpropertyseller real estate agent or otherparty to the transaction
Start Date (mmddyy)How long in this line of work Years =Months
Checkif you are the Business
Owneror Self-Employed| have an ownershipshare of less than 25 Monthly Income(or Loss)
Ihave an ownership share of 25 or more $ TOTAL$ 000month
CPONMeeeMummaTestetiersdeere lire miret Does not apply
Provideat least 2 years of current and previous employment and income
Employeror Business Name Previous Gross MonthlyStreet Unit Income s month
City State ZIP Country
Position or Title
Start Date
End Date
Checkif you were the BusinessOwneror Self-Employed
(mmddyyyy)
(mmddyyyy) 1e Income from Other Sources Does not apply
Include incomefrom other sources below Under Income Source choose from the sourceslisted herelaquo Alimonylaquo Automobile Allowanceraquo Boarder Incomelaquo Capital Gains
Child Support+ Disability+ Foster Care Housing or Parsonage
+ Interest and DividendslaquoMortgage Credit Certificate Mortgage DifferentialPayments
laquo Notes Receivable+ Public Assistancelaquo Retirement(eg Pension IRA)
+raquo Royalty Payments Separate Maintenance
+ Social Security
raquo Trust
+ UnemploymentBenefits
laquo VA Compensation
laquo Other
NOTE Revealalimony child support separate maintenance or other income ONLYIFyou wantit considered in determining yourqualification
for this loan
Income Source - uselist above Monthly Income
$
$
$
$ 000Provide TOTAL AmountHere|
Section 2 Financial Information mdash Assets andLiabilities
Myinformation for Section 2 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 3 Financial Information mdash Real Estate
Myinformation for Section 3 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 4 Loan and Property Information
Myinformation for Section 4 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 5 DeclarationsThis section asks you specific questions about the property your funding and your past
financial history
5aAboutthis Property and Your Moneyforthis Loan
A Will you occupy the property as your primary residence NO YES
If YES have you had an ownershipinterest in another property in the last three years NO YES
If YES complete (1) and (2) below
(1)What type of property did you ownprimary residence (PR) FHA secondary residence (SR) second home(SH)
or investmentproperty (IP)
(2) How did you holdtitle to the property by yourself (S) jointly with your spouse(SP) or jointly with another person (O)
B If this is a Purchase Transaction Do you have a family relationship or businessaffiliation with the seller of the property NO YES Cc Are you borrowing any moneyforthis real estate transaction (eg money foryour closing costs or down payment) or
obtaining any moneyfrom anotherparty suchastheselleror realtor that you have not disclosed on this loan application NO YES
If YES whatis the amountof this money $
D 1 Have youorwill you be applying for a mortgage loan on anotherproperty (not the property securing this loan) on orbefore closing this transaction that is not disclosed on this loan application
NO YES
2 Have you orwill you be applying for any newcredit (eg installment loan credit card etc) on or before closing this loan that wsis not disclosed on this application
NO YES
E Will this property be subject to a lien that could take priority over thefirst mortgagelien such as a clean energylien paid
through yourproperty taxes(eg the PropertyAssessed Clean Energy Program)No YES
EK) Veli ellim ait
F Areyou a co-signer or guarantor on any debtor loan thatis not disclosed on this application NO ES
G Are there any outstanding judgments against you NO YES
H Are you currently delinquentor in default on a Federal debt NO YES
I Are you a party to a lawsuit in which you potentially have any personalfinancialliability NO YES
J Have you conveyedtitle to any property in lieu of foreclosure in the past 7 years NO YES
K Within the past 7 years have you completed a pre-foreclosure sale or short sale whereby the property wassold to a
third party and the Lender agreed to acceptless than the outstanding mortgage balance due
No YES
L Have you had property foreclosed uponin thelast 7 years NO YES
M Have you declared bankruptcy within the past 7 years no vESIf YES identify the type(s) of bankruptcy Chapter 7 Chapter11 Chapter12 Chapter 13
Section 6 Acknowledgements and AgreementsMy signature for Section 6 is on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 7 Military Service This section asks questions about your(or your deceased spouses) military service
Military Service of Borrower
Military Service mdash Did you (or your deceased spouse)everserve or are you currently serving in the United States Armed Forces NO YES
IfYES check allthat apply Currently serving on active duty with projected expiration date of servicetour (mmddyyyy)
Currently retired discharged or separated from service nnOnly period of service was as a non-activated memberofthe Reserve or National GuardSurviving spouse
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 8 Demographic InformationThis section asks about your ethnicity sex and race
Demographic Information of Borrower
The purposeofcollecting this information is to help ensure thatall applicants are treated fairly and that the housing needs of communities
and neighborhoodsare beingfulfilled 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 providethis information but are encouraged to do so You mayselect one or more designationsfor
Ethnicity and one or more designationsfor Race The law provides that we maynotdiscriminate onthe basis of this information or onwhetheryou chooseto provideit However if you choose notto provide the information and you have madethis application in person Federal
regulations require us to note yourethnicity sex and race on the basis of visual observation or surname The law also provides that we may notdiscriminate on the basis of age or marital status information you providein this application If you do not wish to provide someorall of this
information please check below
Ethnicity Check one or more Race Check one or moreHispanic or Latino AmericanIndian or Alaska Native - Print nameofenrolled
or principaltribeMexican PuertoRican Cuban
OtherHispanic or Latino - Printorigin siansian Indian Chinese Filipino
For exampleArgentinean Colombian Dominican NicaraguanSalvadoran Spaniard andso on
Japanese Korean VietnameseOtherAsian - Print race Forexample Hmong Laotian Thai Pakistani Cambodian andso on
Black or African American
Native Hawaiian or OtherPacific Islander
Native Hawaiian GuamanianorChamorro Samoan
OtherPacific Islander mdash Print race
Not Hispanic or Latino
| do not wish to providethis information
Sex
Female
Male
| do not wish to providethis informationFor example Fijian Tongan and so on
White
| do not wish to providethis information
Wasthe ethnicity of the Borrowercollected on thebasis of visual observation or surnameWasthesex of the Borrowercollected on the basis of visual observation or surnameWastherace of the Borrowercollected on the basis of visual observation or surname
)NO YESNO YESNO YES
Face-to-Face Interview (includes Electronic Media w Video Component) Telephone Interview Faxor Mail Email or Internet
Loan Originator Organization Name
Address
Loan Originator Organization NMLSR ID State License ID
Loan Originator Name
Loan Originator NMLSR ID State License ID
Email Phone (
Signature Date (mmddyyyy)
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Pe)aae-emeet)
Community Property State
At least one borrowerlives in a community propertystateThe property is in a community property state
Transaction DetailConversion of Contract for Deed or Land ContractRenovationConstruction-ConversionConstruction-to-Permanent
Single-Closing Two-ClosingConstructionImprovementCosts $
LotAcquired Date
Original Cost of Lot $(mmddyyyy)
Refinance Program
Full DocumentationInterest Rate ReductionStreamlined without Appraisal
Other
Refinance Type
NoCash OutLimited Cash OutCash Out
Energy Improvement
Mortgageloanwill finance energy-related improvements
Propertyis currently subject to a lien that could take priority ovethe first mortgagelien such as a clean energylien paid for througproperty taxes(eg the PropertyAssessed Clean Energyprogram)
Project Type Condominium Cooperative Planned Unit Development (PUD) Propertyis notlocatedin a project
Peiwlivcestetece)a)
Title to the Property Will be Held in What Name(s)
For RefinanceTitle to the Property is Currently Held in What Name(s
Trust Information
tle Will be Held byan Inter Vivos (Living) Trust
Title Will be Held by a Land TrustLeasehold Expiration Date
Mannerin WhichTitle Will be Held Indian Country Land Tenure
Sole OwnershipLife EstateTenancy in Common
Joint Tenancywith Right of Survivorship]Tenancybythe EntiretyOther
Fee Simple Ona ReservationIndividualTrust Land (AllottedRestricted)Tribal Trust Land On a ReservationTribal Trust Land Off ReservationAlaska Native Corporation Land
Estate Will be Held in
Fee Simple(mmddyyyy)
3 Mortgage LoanInformation
Termsof Loan
Note Rate
Loan Term (months)
MortgageLien Type
First LienSubordinate Lien
Mortgage Type Applied For
Conventional USDA-RDFHA VA Other
Amortization Type
Fixed RateAdjustable Rate
If Adjustable Rate
Initial Period Prior to First Adjustment
Subsequent AdjustmentPeriod
Proposed Monthly Paymentfor Property
First Mortgage (P amp I) $
Subordinate Lien(s) (P amp |) $
Other(explain)
Homeowners Insurance $(months)
(months)
Loan Features Property Taxes $
Balloon Balloon Term (months)
Interest Only Interest OnlyTermNegative AmortizationPrepaymentPenalty Prepayment Penalty Term (months) Other
Temporary Interest Rate BuydownInitial Buydown Rate TOTALOther(explain)
Mortgage Insurance $
AssociationProject Dues (Condo Co-Op PUD) $
Supplemental Property Insurance $
(months)
Borrower Name(s)Uniform Residential Loan Application mdash LenderLoan Information
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
L4 Qualifying the Borrower - Minimum Required Funds or Cash Back
DUEFROM BORROWER(S)
A Sales Contract Price
B Improvements Renovations and Repairs
C Land(ifacquired separately)
D For Refinance Balance of Mortgage Loanson the Propertyto be paid off in the Transaction
(See Table 3a Property You Own)
E Credit Cards and Other Debts Paid Off
(See Table 2c Liabilities mdash Credit Cards Other Debts and Leases that You Owe)
F BorrowerClosing Costs (including Prepaid andInitial Escrow Payments)
G Discount Points
HTOTAL DUE FROM BORROWER(s)(Total of A thru G)
TOTALMORTGAGE LOANS
Loan Amount
Loan AmountExcluding Financed Mortgage Insurance (or Mortgage Insurance Equivalent) $
Financed Mortgage Insurance (or Mortgage Insurance Equivalent) Amount $
Other New Mortgage Loanson the Property the Borrower(s) is Buying or Refinancing(See Table 4b Other New MortgageLoanson the Property You are Buying or Refinancing)
KTOTAL MORTGAGELOANS(Totalof| and J)
TOTALCREDITS
L Seller Credits (Enter the amountofBorrower(s) costs paid by the property seller)
MOtherCredits (Enter the sum ofall other credits mdash BorrowerPaid Fees Earnest Money EmployerAssistedHousing Lease Purchase Fund Lot Equity Relocation Funds Sweat Equity Trade Equity Other)
NTOTAL CREDITS(Total of L and M)
CALCULATION
TOTAL DUE FROM BORROWER(s)(Line H)
LESSTOTAL MORTGAGELOANS(Line K) AND TOTAL CREDITS(Line N)
Cash FromTothe Borrower(Line H minusLine K and Line N)NOTE This amountdoesnotinclude reservesor other funds that may be required by the Lenderto be verified
Borrower Name(s)Uniform Residential Loan Application mdash LenderLoan Information
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
Uniform Residential Loan Application mdash Unmarried Addendum
eeCeceetatimC elitleeComeLy
Lenders Instructions for Using the Unmarried Addendum
The Lender may use the Unmarried Addendum only when a Borrowerselected ldquoUnmarriedrdquoin Section 1 and the information collected is
necessary to determine howState property lawsdirectly or indirectly affecting creditworthiness apply including ensuring clear title
For example the Lender may use the Unmarried Addendum whentheBorrowerresides in a State that recognizescivil unions domestic
partnerships or registered reciprocal beneficiary relationships or when the property is located in such a State ldquoStaterdquo meansanystate the
District of Columbia the Commonwealth of Puerto Rico or anyterritory or possession of the United States
Ifyou selected ldquoUnmarriedrdquoin Section 1 is there a person whois not your legal spouse but whocurrently has real property rights similar to
those of a legal spouse +=) NOQ YES
If YES indicate the type of relationship and the State in which the relationship was formed For example indicate if you are in a
civil union domestic partnership registered reciprocal beneficiary relationship or other relationship recognized by the State in which you
currently reside or where the property is located
O Civil Union copy Domestic Partnership copy Registered Reciprocal Beneficiary Relationship copy) Other(explain)
Statea]
Borrower NameUniform Residential Loan Application mdash Unmarried Addendum
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Uniform Residential Loan Application mdash Continuation Sheet
Use this continuation sheet if you need more space to complete the Uniform Residential Loan Application
Borrower Name(First Middle Last Suffix )
Additional Information
Additional Borrower Name(First Middle Last Suffix )
Additional Information
IWefully understand thatit is a federal crime punishable by fine or imprisonment or both to knowingly make anyfalse statements concerningany of the abovefacts as applicable underthe provisions of federal law (18 USC sectsect 1001 et seq)
BorrowerSignature Date (mmddyyyy)
Additional Borrower Signature Date (mmddyyyy)
Uniform Residential Loan Application mdash Continuation SheetFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
INSTRUCTIONS FOR COMPLETING THE UNIFORM RESIDENTIAL LOAN APPLICATION
Use the instructions below to complete the enclosed Uniform Residential Loan Application (Freddie Mac Form 65Fannie Mae Form 1003) To avoid any delays in your application review please provide all of the requested information
If you need to make a correction on the application draw a line through the incorrect text and mark your initials beside the change Donrsquot use correction tape or fluid The application must be completed signed and dated in ink
The Uniform Residential Loan Application (URLA)
The URLA contains the following sections Section 1 Borrower Information Please provide your personal information income and employment
Section 2 Financial Information ndash Assets and Liabilities Please provide information about your financial assets personal financial obligations and debts you owe
Section 3 Financial Information ndash Real Estate Please provide information about property you own and the debts and expenses related to the property
Section 4 Loan and Property Information Please provide information about the loan purpose and the property you are buying or refinancing
Section 5 Declarations Please answer questions about the property how the property will be financed and your past financial history
Section 6 Acknowledgments and Agreements Informs you of your legal obligations related to the mortgage application and asks that you acknowledge certain information will be obtained used and shared
Section 7 Military Service Please provide information about your (or your deceased spousersquos) military service
Section 8 Demographic Information Requests information the Lender is required by law to ask you
Section 9 Loan Originator Information Will be completed by Chase
Uniform Residential Loan Application ndash Additional Borrower
The URLA ndash Additional Borrower contains the following sections Section 1 Borrower Information This is the same as the Borrower Information section of the URLA
Section 2 Financial Information ndash Assets and Liabilities Contains only the following statement for the additional Borrower to complete ldquoMy information for Section 2 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo The name of the other borrower is entered here
Complete a separate URLA for each BorrowermiddotThree or more Borrowers ndash Use any combination of URLA and URLA-Additional Borrower forms in accordance with the above examples
Section 3 Financial Information ndash Real Estate Contains only the following statement for the additional borrower to complete ldquoMy information for Section 3 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 4 Loan and Property Information Contains only the following statement for the additional borrower to complete ldquoMy information for Section 4 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 5 Declarations This is the same as the Declarations section of the URLA
Section 6 Acknowledgments and Agreements Contains only the following statement for the additional borrower to complete ldquoMy signature for Section 6 is on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 7 Military Service This is the same as the Military Service section of the URLA
Section 8 Demographic Information This is the same as the Demographic Information section on the URLA
Section 9 Loan Originator Information This is the same as the Loan Originator Information section of the URLA
Using the URLA and URLA ndash Additional Borrower Together The URLA and the URLA ndash Additional Borrower are used together to collect information for two Borrowers who have joint assets liabilities andor real estate information The URLA and URLA ndash Additional Borrower can also be used for Borrowers who do not have joint information but wish to combine their information on the URLA for ease of use Here are examples of how to use the URLA and URLA ndash Additional Borrower
For one borrower Complete the URLA
For two borrowers with joint financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you dont need to duplicate them on more than one URLA or o In cases where Borrowers are not collaborating when completing the loan application
joint assets liabilities and real estate may be duplicated on each URLA bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you do not need to duplicate them on more than one URLA or
o In cases where Borrowers are not collaborating when completing the loan application joint assets liabilities and real estate may be duplicated on each URLA
For two borrowers with separate financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower Report the assets liabilities and
real estate for the additional Borrower on the URLA or bull Complete a separate URLA for each Borrower
For three or more borrowers use any combination of URLA and URLA ndash Additional Borrower forms described for two borrowers
Uniform Residential Loan Application ndash Unmarried Addendum If any borrower listed on the URLA or URLA ndash Additional Borrower form selects Unmarried in Section 1 (Personal Information) the lender will complete this optional form
The information must be collected to determine how to apply state property laws that directly or indirectly affect creditworthiness including ensuring clear title
Uniform Residential Loan Application ndash Continuation Sheet Use the URLA ndash Continuation Sheet if you need more space to complete either the URLA or URLA ndash Additional Borrower forms
99177-URLAI-0215
HUD Addendum to Uniform Residential Loan Application OMB Approval No HUD 2502-0059 (exp )
Part I - Identifying Information HUDFHA Application for Insurance under the National Housing Act and Borrower Certification
FHA Case No (include any suffix) Mortgagee Case No
Mortgagee ID Sponsor ID Agent ID
Mortgagee Name Address (include ZIP Code) and Telephone Number
Type or print all entries clearly
Name and Address of Sponsor Name and Address of Agent
Borrowers Name amp Present Address (include ZIP Code) Property Address (include name of subdivision lot amp block no amp ZIP Code)
Sponsored Originations
Name of Third-Party Originator NMLS ID of Third-Party Originator
Part II - Borrower Consent for Social Security Administration to Verify Social Security Number I authorize the Social Security Administration (SSA) to verify my Social Security Number (SSN) to the Mortgagee and HUDFHA I authorize SSA to provide explanatory
information to HUDFHA in the event of a discrepancy This consent is valid for 180 days from the date signed unless indicated otherwise by the individual(s) named in this
loan application
Signature(s) of Borrower(s) - Read consent carefully Review accuracy of Social Security Number(s) provided on this application
Borrowerrsquos NameDate of BirthSocial Security Number
Co-Borrowerrsquos Name Date of BirthSocial Security Number
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
Part III - Borrower Notices Information and Acknowledgment Public Reporting Burden
Public reporting burden for this collection of information is estimated to average 10 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 conduct or sponsor and a person is not
required to respond to a collection of information unless that collection displays a valid OMB control number which can be located on the OMB Internet page at
httpwwwreginfogovpublicdoPRAMain
Privacy Act Information
The information requested on the Uniform Residential Loan Application and this Addendum is authorized by the National Housing Act of 1934 12 USC sect 1701 et seq The Debt
Collection Act of 1982 Pub L 97-365 and HUDrsquos Housing and Community Development Act of 1987 42 USC sect 3543 require persons applying for a federally insured loan to
furnish their SSN You must provide all the requested information including your SSN HUD may conduct a computer match to verify the information you provide HUD may
disclose certain information to Federal State and local agencies when relevant to civil criminal or regulatory investigations and prosecutions It will not otherwise be disclosed or
released outside of HUD except as required and permitted by law The information will be used to determine whether you qualify as a mortgagor Failure to provide any of the
requested information including SSN may result in disapproval of your loan application This is notice to you as required by the Right to Financial Privacy Act of 1978 that
HUDFHA has a right of access to financial records held by financial institutions in connection with the consideration or administration of assistance to you Financial records
involving your transaction will be available to HUDFHA without further notice or authorization but will not be disclosed or released by the institution to another Government Agency
or Department without your consent except as required or permitted by law
WARNING This warning applies to all certifications made in this document Anyone who knowingly submits a false claim or makes false statements is subject to criminal and civil penalties including confinement for up to 5 years fines and civil penalties 18 USC sectsect 287 1001 and 31 USC sect 3729
orm HUD-92900-A ( ) Page 1
Borrower Name ____________________________ FHA Case No __________________
Caution Delinquencies Defaults Foreclosures and Abuses Delinquencies defaults foreclosures and abuses of mortgage loans involving programs of the Federal Government can be costly and detrimental to your credit now and in the future The Mortgagee in this transaction its agents and assigns as well as the Federal Government its agencies agents and assigns are authorized to take any and all of the following actions in the event loan payments become delinquent on the mortgage loan described in the attached application (1) Report your name and account information to a credit bureau (2) Assess additional interest and penalty charges for the period of time that payment is not made (3) Assess charges to cover additional administrative costs incurred by the Federal Government to service your account (4) Offset amounts owed to you
under other Federal programs (5) Refer your account to a private attorney collection agency or mortgage servicing agency to collect the amount due foreclose
the mortgage sell the property and seek judgment against you for any deficiency (6) Refer your account to the Department of Justice (DOJ) for litigation in the
courts (7) If you are a current or retired Federal employee take action to offset your salary or civil service retirement benefits (8) Refer your debt to the Internal
Revenue Service for offset against any amount owed to you as an income tax refund and (9) Report any resulting written off debt of yours to the Internal Revenue Service as your taxable income All of these actions may be used to recover any debts owed when it is determined to be in the interest of the Mortgagee or Federal Government or both
As a mortgage loan borrower you will be legally obligated to make the mortgage payments called for by your mortgage loan contract The fact that you dispose of your property after the loan has been made will not relieve you of liability for making these payments Payment of the loan in full is ordinarily the way liability on a mortgage note is ended Some home buyers have the mistaken impression that if they sell their homes when they move to another locality or dispose of it for any other reasons they are no longer liable for the mortgage payments and that liability for these payments is solely that of the new owners Even though the new owners may agree in writing to assume liability for your mortgage payments this assumption agreement will not relieve you from liability to the holder of the note which you signed when you obtained the loan to buy the property Unless you are able to sell the property to a buyer who is acceptable to HUDFHA who will assume the payment of your obligation to the lender you will not be relieved from liability to repay any claim which HUDFHA may be required to pay your lender on account of default in your loan payments The amount of any such claim payment may be a debt owed by you to the Federal Government and subject to established collection procedures
Fair Housing Act I and anyone acting on my behalf are and will remain in compliance with the Fair Housing Act 42 USC sect 3604 et seq with respect to the dwelling or property covered by the loan and in the provision of services or facilities in connection therewith I recognize that any restrictive covenant on this property related to race color religion sex disability familial status or national origin is unlawful under the Fair Housing Act and unenforceable I further recognize that in addition to administrative action by HUD a civil action may be brought by the DOJ in any appropriate US court against any person responsible for a violation of the
applicable law
Certification and Acknowledgment All information in this application is given for the purpose of obtaining a loan to be insured under the National Housing Act and the information in the Uniform Residential Loan Application and this Addendum is true and complete to the best of my knowledge and belief Verification may be obtained from any source named herein I have read and understand the foregoing concerning my liability on the loan and Part III Borrower Notices Information and Acknowledgment
Signature(s) of Borrower(s) - Do not sign unless this application is fully completed Read the certification carefully and review accuracy of this application
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
orm HUD-92900-A ( Page 2
___________________________________
______________________________________________________
______________________________________________________________
- - - - - - - - - - - - - - - - - - - - - - -
Borrower Name ____________________________ FHA Case No __________________
Part IV - Direct Endorsement Approval for a HUD FHA-Insured Mortgage A Underwriting the Borrower
Date Mortgage Approved ______________________________ Date Approval Expires ______________________
For mortgages rated as an ldquoacceptrdquo or ldquoapproverdquo by FHAs TOTAL Mortgage Scorecard
The information submitted to TOTAL was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA4e Final Underwriting Decision (TOTAL) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee Representative Signature
Printed Name
Title
OR
For mortgages rated as a ldquoreferrdquo by FHAs TOTAL Mortgage Scorecard or manually underwritten by a Direct Endorsement underwriter I have personally reviewed and underwritten the borrowerrsquos credit application The information used to underwrite the borrower was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA5d Final Underwriting Decision (Manual) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
B Underwriting the Property
For all mortgages where FHA requires an appraisal I have personally reviewed and underwritten the appraisal according to FHA requirements I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
orm HUD-92900-A ( ) Page 3
Borrower Name ____________________________ FHA Case No __________________
Part V Mortgagees Certification
I have personally reviewed the mortgage documents and the application for insurance endorsement and This mortgage complies with SF Handbook 40001 Section IIA7 Post-Closing and Endorsement to the extent that no defect exists that would have changed the decision to endorse or submit the mortgage for insurance
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee
Name of Mortgageersquos Representative
Title of Mortgageersquos Representative
Signature of the Mortgageersquos Representative Date
orm HUD-92900-A ( ) Page 4
GENERAL AUTHORIZATION FOR A MORTGAGE LOAN ASSUMPTION
Applicant name(s)
Loan number
NOTICES AND DISCLOSURES
Non-discriminatory underwriting guidelines Anyone who inquires about the availability of credit from us has the right to receive a copy of our non-discriminatory underwriting guidelines To request a copy of these guidelines contact your Loan Processor
Attorney note Itrsquos the responsibility of our attorneys to protect our interest You may at your expense request an attorney to represent your interest
Notice to HUDFHA applicants As required by the Right to Financial Privacy Act of 1978 this notice is to inform you that the US Department of Housing and Urban Development (HUD)Federal Housing Administration (FHA) has a right of access to financial records held by financial institutions related to a request for assistance Financial records involving your assumption will be available to HUDFHA without further notice or authorization but wonrsquot be disclosed or released by us to another government agency or department without your consent except as required or permitted by law
Borrower consent to the use of tax return information I understand acknowledge and agree that the Lender and Other Loan Participants can obtain use and share tax return information for purposes of (i) providing an offer (ii) originating maintaining managing monitoring servicing selling insuring and securitizing a loan (iii) marketing or (iv) as otherwise permitted by applicable laws including state and federal privacy and data security laws The Lender includes the Lenderrsquos affiliates agents service providers and any of aforementioned partiesrsquo successors and assigns The Other Loan Participants includes any actual or potential owners of a loan resulting from your loan application or acquirers of any beneficial or other interest in the loan and mortgage insurer guarantor any servicers or service providers for these parties and any of aforementioned partiesrsquo successors and assigns
CERTIFICATION AND AUTHORIZATION
Environmental certification By signing below I represent and warrant that Irsquom not aware of any substances materials or products that may be an environmental hazard such as but not limited to asbestos formaldehyde radon gas lead-based paint fuel or chemical storage tanks (above or below ground) and contaminated soil or water on the property I acknowledge that Chase is relying on this representation and warranty as a material part of its loan application process I also am not aware of any landfill on any portion of the property
Exceptions to the above I further acknowledge (1) receipt of applicable disclosures from the seller in purchase transactions (2) that lead-based paint may exist in housing constructed prior to 1978 (3) that Chase performs no environmental investigation on my behalf and isnrsquot responsible for identifying lead-based paint or any other environmental conditions that might impact the property or its residents and (4) that it is my sole obligation to investigate for potential impact to the property from environmental conditions
Certifications I certify by signing below that (1) all of the loan application information provided is true and complete (2) I understand any intentional or negligent misrepresentation(s) of the information provided in conjunction with my application may result in civil liability andor 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 Chase its agents successors and assigns insurers and any other person who may suffer any loss due to reliance upon any misrepresentation that I have made on the application and (3) any significant change from the information provided at the time of application until the final loan application is signed may have a bearing on the approval of my application for a home loan
Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union
This question is asked because of state laws that extend the same or similar rights benefits and protections of spouses in a marriage to persons who are members of a partnership or union recognized under state law You should consult with your own legal advisor for advice regarding the rights protections benefits responsibilities obligations and duties of those who are registered domestic partners civil union partners or members of other unions recognized under applicable law
CREDIT AUTHORIZATION RELEASE
By signing below I authorize Chase andor my mortgage insurer (if any) to verify my past and present employment earnings records (including information contained in income tax returns that have been filed with the IRS) bank accounts stock holdings and any other information that it finds necessary to process my mortgage loan application or to review it for quality-control purposes I understand that a credit report will be ordered from a credit reporting agency for verification prior to loan closing as part of the application process and may be ordered after closing as part of the Lenderrsquos quality-control program A credit report may also be completed as part of the Lenderrsquos servicing or collection of the loan or in consideration of any other product or service that the Lender may consider offering me in the future and at any time throughout the life of the loan I understand that use of a photocopy of this form may be necessary to verify one or more of my credit references I understand that a photocopy or fax copy of this form will also serve as authorization
By signing below each applicant acknowledges (1) making the above certifications and authorizations and (2) that each applicant has received and understands the above notices and disclosures
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
You do not have to give us this information but if you donrsquot your application for approval as a borrower may be delayed or rejected The information requested in this form is authorized by Title 38 USC Chapter 37 (if VA) by 12 USC Section 1701 et seq (if HUDFHA) by 42 USC Section 1452b (if HUDCPD) and Title 42 USC 1471 et seq or 7 USC 1921 et seq (if USDA FHA)
Updated December 2021 99177-GA-0215
1b
2b
Form 4506-C (September 2020)
Department of the Treasury - Internal Revenue Service
IVES Request for Transcript of Tax Return OMB Number
1545-1872
Do not sign this form unless all applicable lines have been completed Request may be rejected if the form is incomplete or illegible
For more information about Form 4506-C visit wwwirsgov and search IVES
1a Name shown on tax return (if a joint return enter the name shown first)
First social security number on tax return individual taxpayer identification number or employer identification number (see instructions)
2a If a joint return enter spousersquos name shown on tax return Second social security number or individual taxpayer identification number if joint tax return
3 Current name address (including apt room or suite no) city state and ZIP code (see instructions)
4 Previous address shown on the last return filed if different from line 3 (see instructions)
5a IVES participant name address and SOR mailbox ID
DataVerify 875 Greentree Rd 8 Parkway Center Pittsburgh PA 15220
5b Customer file number (if applicable) (see instructions)
Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing (see instructions)
6 Transcript requested Enter the tax form number here (1040 1065 1120 etc) and check the appropriate box below Enter only one tax form number per request 1040
a Return Transcript which includes most of the line items of a tax return as filed with the IRS A tax return transcript does not reflect changes made to the account after the return is processed Transcripts are only available for the following returns Form 1040 series Form 1065 Form 1120 Form 1120-A Form 1120-H Form 1120-L and Form 1120S Return transcripts are available for the current year and returns processed during the prior 3 processing years
b Account Transcript which contains information on the financial status of the account such as payments made on the account penalty assessments and adjustments made by you or the IRS after the return was filed Return information is limited to items such as tax liability and estimated tax payments Account transcripts are available for most returns
c Record of Account which provides the most detailed information as it is a combination of the Return Transcript and the Account Transcript Available for current year and 3 prior tax years
7 Form W-2 Form 1099 series Form 1098 series or Form 5498 series transcript The IRS can provide a transcript that includes data from these information returns State or local information is not included with the Form W-2 information The IRS may be able to provide this transcript information for up to 10 years Information for the current year is generally not available until the year after it is filed with the IRS For example W-2 information for 2016 filed in 2017 will likely not be available from the IRS until 2018 If you need W-2 information for retirement purposes you should contact the Social Security Administration at 1-800-772-1213
Caution If you need a copy of Form W-2 or Form 1099 you should first contact the payer To get a copy of the Form W-2 or Form 1099 filed with your return you must use Form 4506 and request a copy of your return which includes all attachments
8 Year or period requested Enter the ending date of the tax year or period using the mmddyyyy format (see instructions)
12 31 2020 12 31 2019 12 31 2018 Caution Do not sign this form unless all applicable lines have been completed
Signature of taxpayer(s) I declare that I am either the taxpayer whose name is shown on line 1a or 2a or a person authorized to obtain the tax information requested If the request applies to a joint return at least one spouse must sign If signed by a corporate officer 1 percent or more shareholder partner managing member guardian tax matters partner executor receiver administrator trustee or party other than the taxpayer I certify that I have the authority to execute Form 4506-C on behalf of the taxpayer Note This form must be received by IRS within 120 days of the signature date
Signatory attests that heshe has read the attestation clause and upon so reading declares that heshe has the authority to sign the Form 4506-C See instructions
Sign Here
Signature (see instructions) Date Phone number of taxpayer on line 1a or 2a
PrintType name
Title (if line 1a above is a corporation partnership estate or trust)
Spousersquos signature Date
PrintType name
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020) For Privacy Act and Paperwork Reduction Act Notice see page 2
Instructions for Form 4506-C IVES Request for Transcript of Tax Return
Section references are to the Internal Revenue Code unless otherwise noted
Future Developments
For the latest information about Form 4506-C and its instructions go to wwwirsgov and search IVES Information about any recent developments affecting Form 4506-C (such as legislation enacted after we released it) will be posted on that page
Whats New Form 4506-C was created to be utilized by authorized IVES participants to order tax transcripts with the consent of the taxpayer
General Instructions
Caution Do not sign this form unless all applicable lines have been completed
Designated Recipient Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information received pursuant to the taxpayerrsquos consent and holds the recipient subject to penalties for any unauthorized access other use or redisclosure without the taxpayerrsquos express permission or request
Taxpayer Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information provided pursuant to your consent and holds the recipient subject to penalties brought by private right of action for any unauthorized access other use or redisclosure without your express permission or request
Purpose of form Use Form 4506-C to request tax return information through an authorized IVES participant You will designate an IVES participant to receive the information on line 5a
Note If you are unsure of which type of transcript you need check with the party requesting your tax information
Where to file The IVES participant will fax Form 4506-C with the approved IVES cover sheet to their assigned Service Center
Chart for ordering transcripts
If your assigned Service Center is
Fax the requests with the approved coversheet to
Austin Submission Processing Center
Austin IVES Team
844-249-6238
Fresno Submission Processing Center
Fresno IVES Team
844-249-6239
Kansas City Submission Processing Center
Kansas City IVES Team
844-249-8128
Ogden Submission Processing Center
Ogden IVES Team
844-249-8129
Specific Instructions
Line 1b Enter the social security number (SSN) or individual taxpayer identification number (ITIN) for the individual listed on line 1a or enter the employer identification number (EIN) for the business listed on line 1a
Line 3 Enter your current address If you use a PO box include it on this line
Line 4 Enter the address shown on the last return filed if different from the address entered on line 3
Note If the addresses on lines 3 and 4 are different and you have not changed your address with the IRS file Form 8822 Change of Address or Form 8822-BChange of Address or Responsible Party mdash Business with Form 4506-C
Line 5b Enter up to 10 numeric characters to create a unique customer file number that will appear on the transcript The customer file number cannot contain an SSN ITIN or EIN Completion of this line is not required
Note If you use an SSN name or combination of both we will not input the information and the customer file number will reflect a generic entry of 9999999999 on the transcript
Line 8 Enter the end date of the tax year or period requested in mmddyyyy format This may be a calendar year fiscal year or quarter Enter each quarter requested for quarterly returns Example Enter 12312018 for a calendar year 2018 Form 1040 transcript
Signature and date Form 4506-C must be signed and dated by the taxpayer listed on line 1a or 2a The IRS must receive Form 4506-C within 120 days of the date signed by the taxpayer or it will be rejected Ensure that all applicable lines including lines 5a through 8 are completed before signing
You must check the box in the signature area to acknowledge you have the authority to sign and request the information The form will not be processed if unchecked
Individuals Transcripts listed on on line 6 may be furnished to either spouse if jointly filed Only one signature is required Sign Form 4506-C exactly as your name appeared on the original return If you changed your name also sign your current name
Corporations Generally Form 4506-C can be signed by
(1) an officer having legal authority to bind the corporation (2) any person designated by the board of directors or other governing body or (3) any officer or employee on written request by any principal officer and attested to by the secretary or other officer A bona fide shareholder of record owning 1 percent or more of the outstanding stock of the corporation may submit a Form 4506-C but must provide documentation to support the requesters right to receive the information
Partnerships Generally Form 4506-C can be signed by any person who was a member of the partnership during any part of the tax period requested on line 8
All others See section 6103(e) if the taxpayer has died is insolvent is a dissolved corporation or if a trustee guardian executor receiver or administrator is acting for the taxpayer
Note If you are Heir at law Next of kin or Beneficiary you must be able to establish a material interest in the estate or trust
Documentation For entities other than individuals you must attach the authorization document For example this could be the letter from the principal officer authorizing an employee of the corporation or the letters testamentary authorizing an individual to act for an estate
Signature by a representative A representative can sign Form 4506-C for a taxpayer only if the taxpayer has specifically delegated this authority to the representative on Form 2848 line 5 The representative must attach Form 2848 showing the delegation to sign Form 4506-C
Privacy Act and Paperwork Reduction Act Notice We ask for the information on this form to establish your right to gain access to the requested tax information under the Internal Revenue Code We need this information to properly identify the tax information and respond to your request You are not required to request any transcript if you do request a transcript sections 6103 and 6109 and their regulations require you to provide this information including your SSN or EIN If you do not provide this information we may not be able to process your request Providing false or fraudulent information may subject you to penalties
Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and cities states the District of Columbia and US commonwealths and possessions for use in administering their tax laws We may also disclose this information to other countries under a tax treaty to federal and state agencies to enforce federal nontax criminal laws or to federal law enforcement and intelligence agencies to combat terrorism
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law Generally tax returns and return information are confidential as required by section 6103
The time needed to complete and file Form 4506-C will vary depending on individual circumstances The estimated average time is
Learning about the law or the form 10 min Preparing the form 12 min Copying assembling and sending the form to the IRS 20 min
If you have comments concerning the accuracy of these time estimates or suggestions for making Form 4506-C simpler we would be happy to hear from you You can write to
Internal Revenue Service Tax Forms and Publications Division 1111 Constitution Ave NW IR-6526 Washington DC 20224
Do not send the form to this address Instead see Where to file on this page
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020)
Rev April 2021 CHASEO Facts What does Chase do with your personal information
Why Financial companies choose how they share your personal information Federal law gives consumers the right to limit some but not all sharing Federal law also requires us to tell you how we collect share and protect your personal information Please read this notice carefully to understand what we do
What The types of personal information we collect and share depend on the product or service you have with us This information can include bull Social Security number and income bull account balances and transaction history bull credit history and payment history
How All financial companies need to share customers personal information to run their everyday business In the section below we list the reasons financial companies can share their customers personal information the reasons Chase chooses to share and whether you can limit this sharing
Reasons we can share your personal information Does Chase share
Can you limit this sharing
For our everyday business purposes - such as to process your transactions maintain your account(s) respond to court orders and legal investigations or report to credit bureaus
Yes No
For our marketing purposes - to offer our products and services to you
Yes No
For joint marketing with other financial companies Yes No
For our affiliates everyday business purposes - information about your transactions and experiences
Yes No
For our affiliates everyday business purposes - information about your creditworthiness
Yes Yes
For our affiliates to market to you Yes Yes
For nonaffiliates to market to you Yes Yes
a
0
To limit our sharing
bull Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
bull Visit us online chasecomprivacypreferences
Please note If you are a new customer we can begin sharing your information 30 days from the date we sent this notice When you are no longer our customer we continue to share your information as described in this notice However you can contact us at any time to limit our sharing
Questions
Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
PAGE 2
Who we are
Who is providing this notice The US consumer financial companies within the JPMorgan Chase amp Co family including JPMorgan Chase Bank NA Chase Insurance Agency Inc and JP Morgan Securities LLC
What we do
How does Chase protect my To protect your personal information from unauthorized access and use we personal information use security measures that comply with federal law These measures include
computer safeguards and secured files and buildings We authorize our employees to get your information only when they need it to do their work and we require companies that work for us to protect your information
How does Chase collect my We collect your personal information for example when you personal information bull open an account or make deposits or withdrawals from your account
bull pay your bills or apply for a loan bull use your credit or debit card We also collect your personal information from others such as credit bureaus affiliates or other companies
Why cant I limit all sharing Federal law gives you the right to limit only bull sharing for affiliates everyday business purposes - information about your
creditworthiness bull affiliates from using your information to market to you bull sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing See below for more on your rights under state law
What happens when I limit sharing for an account I hold jointly with someone else
Your choices will apply to everyone on your account
Definitions
Affiliates Companies related by common ownership or control They can be financial and non financial companies bull Our affiliates include companies with a Chase or JP Morgan name and financial companies such asjP Morgan Securities LLC
Nonaffiliates Companies not related by common ownership or control They can be financial and non financial companies bull Nonaffiliates we share with can include companies such as retailers auto dealers auto makers and membership clubs
Joint marketing A formal agreement between nonaffiliated financial companies that together market financial products or services to you bull Our joint marketing partners include categories of companies such as insurance companies
Other important information
VT Accounts with a Vermont mailing address are automatically treated as if they have limited the sharing as described on page 1 For joint marketing we will only disclose your name contact information and information about your transactions
NV We are providing you this notice pursuant to Nevada law If you prefer not to receive marketing calls from us you may be placed on our Internal Do Not Call List by calling 1-800-945-9470 or by writing to us at PO Box 734007 Dallas TX 75373-4007
For more information contact us at the address above or email PrivacylnfoJPMChasecom with Nevada Annual Notice in the subject line You may also contact the Nevada Attorney Generals office Bureau of Consumer Protection Office of the Nevada Attorney General 555 E Washington St Suite 3900 Las Vegas NV 89101 telephone number 1-702-486-3132 email BCPINFOagstatenvus
CA Accounts with a California mailing address are automatically treated as if they have limited the sharing with nonaffiliates as described on page 1 CA residents are provided a CA notice for additional choices
CHASE O
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
The following disclosure is required by the USA PATRIOT Act
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 opens an account
What this means to you When you 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 drivers
license or other identifying documents
99177-PAT-0215
VETERAN STATEMENT When this loan was opened the US Department of Veterans Affairs (VA) used the veteran borrowerrsquos entitlement which is a set amount the VA promises to repay a lender if the borrower defaults on the mortgage An assumption will modify who is obligated to pay the existing mortgage loan but all loan termsmdashincluding the entitlementmdashwill remain the same If the veteran borrower is being removed from the loan the entitlement would remain with whoever is assuming the loan because the loan will continue to be serviced by the VA If the applicant is also a veteran and can substitute his or her entitlement for the current entitlement then the current borrowerrsquos entitlement can be released
Please review the following questions and answer as appropriate This form requires completion by both the applicant(s) and current borrower(s)
1 Applicant to Complete
Are you (the applicant) currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the reverse side)
Yes (If yes please provide the information requested below answer the question in section 3 and sign and date this form at the bottom of the reverse side)
Name of applicant(s) who answered ldquoyesrdquo to the above question
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Are you receiving VA disability benefts
Applicant
Yes
No
Co-Applicant
Yes
No
Are you entitled to receive VA disability benefts Yes No Yes No
Have you received VA disability benefts in the past Yes No Yes No
Are you a surviving spouse of a veteran who died on active duty or as the result of a service-related disability
Yes No Yes No
Do you have any VA loans Yes No Yes No
2 Current Borrower to Complete
Is the current borrowerco-borrower currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the page)
Yes (If yes please answer the question in section 3 and sign and date this form at the bottom of the page)
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
________________________________________________________________________________________________
3 Applicant and Current Borrower to Complete
If the answer to the questions in section 1 and 2 are both yes please answer the following question After yoursquove reviewed and completed this entire form please sign and date at the bottom
Applicant Current Borrower
Do you want to apply for a substitution of entitlement Yes Yes No No
In order to complete a substitution of entitlement the veteran applicant must have suffcient entitlement to substitute for that of the current borrower Contact the VA Offce of Jurisdiction for your area for more information Also before the veteran applicant can substitute entitlement on a VA loan heshe must certify that the property securing the loan will be occupied as hisher primary residence Both the applicantrsquos and current borrowerrsquos original certifcate of eligibility will be required If your sales contract is contingent upon the restoration of entitlement please contact your VA Offce of Jurisdiction for complete procedures Otherwise the substitution will be completed after the loan has been approved and closed
Date Applicant printed name Applicant signature
Date Applicant printed name Applicant signature
Date Current Borrower printed name Current Borrower signature
Date Current Borrower printed name Current Borrower signature
Forms completed by Mail Phone
For Chase use only
Interviewer signature Date
99177-VS-0215
- Assumption Application Package_41521-noscannedpages-update-4pdf
-
- 1 FM203 Cover Pagepdf
- 2 FM202 Mortgage Assumption Application Package pagepdf
- 3 The Documents Youll need to Send Uspdf
- 4 FM201 FAQpdf
- 5 FM142 CIWpdf
- 6 FM126 URLApdf
- 7 FM130 URLA Instpdf
-
- Blank Page
-
- 8 92900a Addednum to Loan Applicationpdf
- 9 FM462 Gen Authpdf
- 10 FM220 4506-Cpdf
- 11 FM153 Chase Federal Privacy Noticepdf
- 12 FM144 Info on Opening a New Accountpdf
- 13 FM152 Veteran Statementpdf
-
- Date
- Loan number
- Applicant name
- Phone1
- Loan number 1
- Loan number 2
- Other
- Other_2
- 1
- 2
- undefined_7
- Available hours
- Available hours_2
- undefined_8
- Available hours_3
- undefined_9
- Current address 1
- Neither
- Available hours_4
- Available hours_5
- undefined_10
- Available hours_6
- 1_2
- 2_2
- undefined_11
- Available hours_7
- Available hours_8
- undefined_12
- Available hours_9
- FHA Case No include any suffix
- Mortgagee Case No
- Mortgagee ID
- Sponsor ID
- Agent ID
- Name and Address of Sponsor Name and Address of Agent
- Borrowers Name Present Address include ZIP Code Property Address
- include name of subdivision lot block no ZIP Code
- Name of ThirdParty Originator
- NMLS ID of ThirdParty Originator
- s application
- ty Number
- ty Number_2
- Date Signed_2
- Date Mortgage Approved
- Date Approval Expires
- Printed Name
- Title 1
- DEs ID Number
- DEs ID Number_2
- Mortgagee
- Name of Mortgagees Representative
- Title of Mortgagees Representative
- Signature of the Mortgagees Representative
- Date_2
- Applicant names 1
- Applicant names 2
- Applicant names 3
- Loan number_2
- Date_3
- Applicant printed name
- Social Security number
- Date_4
- Applicant printed name_2
- Social Security number_2
- Date_5
- Applicant printed name_3
- Social Security number_3
- Date_6
- Applicant printed name_4
- Social Security number_4
- 1a Name shown on tax return if a joint return enter the name shown first
- 1b First social security number on tax return individual taxpayer identification number or employer identification number see instructions
- 2a If a joint return enter spouses name shown on tax return
- 2b Second social security number or individual taxpayer identification number if joint tax return
- 4 Previous address shown on the last return filed if different from line 3 see instructions
- 5a IVES participant name address and SOR mailbox ID
- Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing see instructions
- Signature see instructions
- Date_7
- Phone number of taxpayer on line 1a or 2a
- PrintType name
- Here
- Spouses signature
- Date_8
- PrintType name_2
- Name
- Date of birth
- Service number
- Name_2
- Date of birth_2
- Service number_2
- Date_9
- Applicant printed name_5
- Date_10
- Applicant printed name_6
- Date_11
- Current Borrower printed name
- Date_12
- Current Borrower printed name_2
- Date_13
- Text3
- Text10
- undefined_13
- Text15
- undefined_14
- undefined_15
- undefined_16
- undefined_17
- undefined_18
- undefined_19
- undefined_20
- undefined_21
- undefined_23
- Reason for assumption Off
- Requestors relationship to owners Off
- Check one Off
- Check one1 Off
- Day1
- Evening
- Cell phone
- Check one2 Off
- Check one3 Off
- Check one4 Off
- Check one5 Off
- Text2-1
- Text2-2
- Text2-3
- Text2-4
- Text2-5
- Text2-6
- Text3-1
- Text3-2
- Text3-3
- Text3-4
- Text3-6
- Text3-7
- Text3-8
- Text3-9
- Text3-10
- Text3-11
- Text3-12
- Text3-13
- Text3-14
- Text3-15
- Text3-16
- Text3-17
- Text3-18
- Text3-19
- Text3-20
- Text3-21
- Text3-22
- Text3-23
- Text3-24
- Text3-25
- Text3-26
- Text3-27
- Text3-28
- Text3-29
- Text3-30
- Text3-31
- Text3-32
- Text3-33
- Text3-34
- Text3-35
- Text3-36
- Text3-37
- Text3-38
- Text3-39
- Text3-40
- Text3-41
- Text3-42
- Text3-43
- Text3-44
- Text3-45
- Text3-46
- Text3-47
- Text3-48
- Text3-49
- Text3-50
- Text3-51
- Text3-52
- Text3-53
- Text3-5
- Text3-54
- Text3-55
- Text3-56
- Citizenship Off
- Type of credit Off
- Marital Status Off
- Housing Off
- Housing1 Off
- ownership Off
- DNA1 Off
- DNA2 Off
- DNA3 Off
- family Off
- BO Off
- Total
- Text31
- Text32
- Text33
- Text34
- Text35
- Text36
- Text37
- Text38
- Text39
- Text310
- Text311
- Text312
- Text313
- Text314
- Text315
- Text316
- Text317
- Text318
- Text319
- ownership1 Off
- Total1
- Total1-2
- Check Box4-1 Off
- Text320
- Text321
- Text322
- Text323
- Text324
- Text325
- Text326
- Text327
- Text328
- Text329
- Check Box4-2 Off
- Check Box4-3 Off
- Check Box4-4 Off
- Check Box4-8 Off
- Check Box4-9 Off
- Text330
- Text331
- Text332
- Text333
- Text334
- Text335
- Text1-1
- Text1-2
- Text1-3
- Text1-4
- Text1-5
- Text1-6
- Text1-7
- Text1-8
- Text1-9
- Text1-10
- Text1-11
- Text1-12
- Text1-13
- Text1-14
- Text1-15
- Text1-16
- Text1-17
- Text1-18
- Text1-19
- Text1-20
- Text1-21
- Text1-22
- Text1-23
- Text1-24
- Text1-25
- Text1-26
- Text1-27
- Text1-28
- Text1-29
- Text1-30
- Text1-31
- Text1-32
- Text1-33
- Text1-34
- Text1-35
- Check Box3-2 Off
- Check Box2-1 Off
- Check Box2-2 Off
- Check Box2-3 Off
- Check Box2-4 Off
- Check Box2-5 Off
- Text1-36
- Text1-37
- Text1-38
- Text1-39
- Text1-40
- Text1-41
- Text1-42
- Text1-43
- Text1-44
- Text1-45
- Text1-46
- Text1-47
- Text1-48
- Text1-49
- Text1-50
- Text1-51
- Text1-52
- Text1-53
- Text1-54
- Text1-55
- Text1-56
- Text1-57
- Text1-58
- Text1-59
- Text1-60
- Text1-61
- Check Box3-11 Off
- A1
- A2
- A3
- A4
- A5
- A6
- A7
- A8
- A9
- A10
- A11
- A12
- Check Box3-1 Off
- Check Box30-1 Off
- Check Box30-2 Off
- Check Box30-4 Off
- Check Box30-5 Off
- Check Box30-7 Off
- Check Box30-8 Off
- Check Box30-9 Off
- Check Box30-10 Off
- Check Box30-11 Off
- Check Box30-12 Off
- A13
- A14
- A15
- A16
- A17 Off
- A18
- A19
- A20
- A21
- A22
- A23
- A24
- A25
- A26
- A27
- A28
- A29
- A30
- A31
- A32
- A33
- A34
- A35
- A36
- A37
- A38 Off
- A39
- A40
- A41
- A42
- A43
- A44
- A45
- A46
- A47
- A48
- A49
- A50
- A51
- A52
- A53
- A54
- A55
- A56
- A57
- A58
- A59
- A60
- A61
- A62
- A63
- A64
- A65
- A66
- A67
- A68
- A69
- A70
- A71
- A72
- A73
- A74
- Loan Purpose Off
- occupancy1 Off
- lien type Off
- lientype Off
- mixed use Off
- manufactured home Off
- deposit1 Off
- deposit2 Off
- B1
- B2
- B3
- B4
- B5
- B6
- B7
- B8
- B9
- B10
- fha Off
- Check Box51 Off
- B11
- B12
- B13
- B14
- B15
- B16
- B17
- B18
- B19 Off
- B20
- B21
- B22 Off
- B23
- B24
- B25
- B26
- B27
- B28
- A
-
- Will you occupy the property as your primary residence Off
- Will you occupy the property as your primary residence1 Off
-
- If yes have you had an ownership interest in another property in the last three years Off
- Text9-2
- B
-
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property Off
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property1 Off
-
- 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 Off
- 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 application1 Off
-
- 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 Off
- 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 application1 Off
-
- new credit Off
- 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) Off
- the Property Assessed Clean Energy Program)1 Off
-
- F
-
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application Off
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application1 Off
-
- G
-
- Are there any outstanding judgments against you Off
- Are there any outstanding judgments against you1 Off
-
- H
-
- Are you currently delinquent or in default on a Federal debt Off
- Are you currently delinquent or in default on a Federal debt1 Off
-
- I
-
- Are you a party to a lawsuit in which you potentially have any personal financial liability Off
- Are you a party to a lawsuit in which you potentially have any personal financial liability1 Off
-
- J
-
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years Off
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years1 Off
-
- 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 Off
- 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 due1 Off
-
- L
-
- Have you had property foreclosed upon in the last 7 years Off
- Have you had property foreclosed upon in the last 7 years1 Off
-
- M
-
- Have you declared bankruptcy within the past 7 years Off
- Have you declared bankruptcy within the past 7 years1 Off
-
- Check Box8-2 Off
- Check Box8-3 Off
- Check Box8-4 Off
- Text9-3
- Text9-5
- Text9-6
- Text97
- military Off
- ethnicity Off
- sex Off
- race Off
- demo Off
- Text12-1
- Check Box11-1 Off
- Check Box11-2 Off
- Check Box11-3 Off
- Check Box11-4 Off
- Check Box11-5 Off
- Check Box11-6 Off
- Check Box11-7 Off
- Check Box11-8 Off
- Check Box11-9 Off
- Text12-2
- Check Box11-10 Off
- Check Box11-11 Off
- Check Box11-12 Off
- Check Box11-13 Off
- Check Box11-14 Off
- Check Box11-15 Off
- Text12-3
- Check Box11-16 Off
- Check Box11-17 Off
- Check Box11-18 Off
- Check Box11-19 Off
- Check Box11-20 Off
- Check Box11-21 Off
- Check Box11-22 Off
- Check Box11-23 Off
- Text12-4
- Check Box11-24 Off
- Check Box11-25 Off
- Check Box11-26 Off
- Check Box11-27 Off
- Check Box11-28 Off
- Check Box11-29 Off
- Text12-5
- Check Box11-30 Off
- Check Box11-31 Off
- citizen Off
- credit Off
- marital status1 Off
- housing-1 Off
- housing-2 Off
- own Off
- C1
- C2
- C3
- C6
- C7
- C8
- C9
- C10
- C11
- C12
- C13
- C14
- C15
- C16
- C17
- C18
- C19
- C20
- C21
- C22
- C23
- C24
- C25
- C26
- C27
- C28
- C29
- C30
- C31
- C32
- C33
- C34
- C35
- Check Box-2 Off
- C36
- C37
- C38
- C39
- C4
- C40
- C41
- C42
- C43
- C44
- C45
- C46
- C47
- Check Box-3 Off
- Check Box-4 Off
- C48
- C49
- C5
- C50
- C51
- C52
- C53
- C54
- C55
- Check Box-1-1 Off
- own1 Off
- Check Box-1 Off
- D1 Off
- D2
- D3
- D4
- D5
- D6
- D7
- D8
- D9
- D10
- D11
- D12
- D13
- D14 Off
- D15 Off
- D16
- D17
- D18
- D19
- D20
- D21
- D22
- D23
- D24 Off
- D25
- D26
- D27
- D28
- D29
- D30
- D31
- D32
- D33
- D34
- D35 Off
- D36
- D37 Off
- D38
- D39
- D40
- D41
- D42
- D43
- D44
- D45
- D46
- D47
- If yes have you had an ownership interest in another property in the last three years1 Off
- new credit1 Off
- Check Box8-1 Off
- Check Box8-1-2 Off
- Check Box8-1-1 Off
- Check Box8-1-3 Off
- Check Box8-1-4 Off
- Military Service mdash Did you (or your deceased spouse) ever serve or are you currently serving in the United States Armed Forces 1 Off
- Check1 Off
- Text9-1-1
- Check2 Off
- Check3 Off
- Check4 Off
- Text9-1
- E1
- E2
- E3
- Was the ethnicity of the Borrower collected on the basis of visual observation or surname1 Off
- Was the sex of the Borrower collected on the basis of visual observation or surname1 Off
- Was the race of the Borrower collected on the basis of visual observation or surname1 Off
- The Demographic Information was provided through1 Off
- F1 Off
- F2 Off
- F3 Off
- F4 Off
- F5 Off
- F6
- F7 Off
- F8 Off
- F9 Off
- F10 Off
- F11 Off
- F12 Off
- F13
- F14 Off
- F15 Off
- F16 Off
- F17 Off
- F18 Off
- F19 Off
- F20 Off
- F21 Off
- F22
- F23 Off
- F24 Off
- F25 Off
- F26 Off
- F27 Off
- F28 Off
- F29
- F30 Off
- F31 Off
- undefined_13-1
- undefined_13-2
- undefined_14-1
- undefined_15-1
- undefined_16-1
- undefined_17-1
- undefined_18-1
- undefined_19-1
- undefined_21-1
- undefined_20-1
- undefined_23-1
- undefined_13_1
- Single-Two Off
- Refi type Off
- refi program Off
- Estate Off
- Title held Off
- Trust Information Off
- Indian Country Land Tenure Off
- Mortgage Type Applied For Off
- Mortgage Lien Type Off
- Amortization Type Off
- G1 Off
- G2 Off
- G3 Off
- G4 Off
- G5 Off
- G6
- G7
- G8
- G9
- G10 Off
- G11 Off
- G12 Off
- G13 Off
- G14 Off
- G15 Off
- G16
- G17
- G18
- G19
- G20
- G21
- G22
- G23 Off
- G24
- G25 Off
- G26
- G27 Off
- G28 Off
- G29
- G30 Off
- G31
- G32 Off
- G33
- G34
- G35
- G36
- G37
- G38
- G39
- G40
- G41
- G42
- Property Held
- refi
- Text18-1
- Text18-2
- Text18-3
- Text18-4
- Text18-5
- Text18-6
- Text18-7
- Text18-8
- Text18-9
- Text18-10
- Text18-11
- Text18-12
- Text18-13
- Text18-14
- Text18-15
- Text18-16
- Text18-17
- Text18-18
- Text18-19
- Lender
- case no
- If you selected ldquoUnmarriedrdquo in Section 1 is there a person who is not your legal spouse but who currently has real property rights similar to those of a legal spouse Off
- Relationship and State Off
- Other-5
- Text19-1
- BName
- Additional Information
- ABN
- Additional Information1
- BSign
- BSDate
- ABSign
- ABDate
- MortageeNameAddress
- NAmeAddress
- Bname1
- DOB1
- DOB2
- SignOfBorr1
- SignOfBorr
- Date Signed
- SignOfBorr2
- SignOfBorr3
- Date Signed3
- Date Signed4
- MortgageeRepSign
- DirectSign
- DirectSign1
- Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union Off
- AppSign
- AppSign1
- AppSign2
- AppSign3
- Nopage38 Off
- Yespage38 Off
- Yes1 Off
- No1 Off
- Yes2 Off
- Yes3 Off
- Yes4 Off
- Yes5 Off
- Yes6 Off
- Yes7 Off
- Yes8 Off
- Yes9 Off
- Yes10 Off
- No2 Off
- No3 Off
- No4 Off
- No5 Off
- No6 Off
- No7 Off
- No8 Off
- No9 Off
- No10 Off
- BorrowerNo Off
- BorrowerYes Off
- AppSignature
- AppSignature1
- CurrentSign
- CurrentSign1
- InterviewSign
- Yes_1 Off
- No_1 Off
- Yes_2 Off
- No_2 Off
- Mail Off
- Phone Off
copy2021 JPMorgan Chase amp Co
This package will walk you through the mortgage assumption process provide and explain the
necessary forms and serve as a road map for you to complete your request to
bull Add a new borrower to become financially responsible for the loan
bull Release a current borrower from financial responsibility
Herersquos how the people associated with the assumption of the loan are identified on the forms included in this package
mdashThe person who will be added to the loan or the person already on the loan who will remain on the loan
mdashThe person already on the loan who will be removed from the loan
PLEASE NOTE
An assumption is a significant
decisionmdashit changes who is financially
responsible for the loan Please review
the information in this package to make
sure that an assumption is right for you
If you believe a relatively simple name
change may be your best option please
call us at 1-866-299-6752
99177-LAG-0215
Remember wersquore available to answer your questions
mdash call us at 1-866-299-6752 (1-800-582-0542 TTY)
Si tiene alguna pregunta por favor llame al 1-855-280-4198
Pay stubs from the past 30 days or if self-employed personal and business
returns from the past two years
Previous two years of W-2 forms (if applicable)
Previous two years of 1099 forms (if applicable)
Previous two months of bank statements (all pages)
Most recent quarterly 401(k) statement (all pages)
Final divorce decree or court-approved settlement agreement (if applicable)
Sales contract (if applicable)
Copy of death certificatewill (if applicable)
THE DOCUMENTS YOUrsquoLL NEED TO SEND US
Anyone who will be remaining on or added to the existing loan will need to return the following
information with the assumption applicationmdashwe canrsquot proceed with the application until wersquove
received all of the documents listed below
Please note that we may have also enclosed additional documents that are required for your situation that
arenrsquot listed below If applicable please review and sign these documents and return them to us with the
completed documents listed below
Please complete these enclosed forms and return them to us in the provided prepaid envelope
Uniform Residential Loan Application (Freddie Mac Form 65Fannie Mae Form 1003)
General Authorization for a Mortgage Loan Assumption
Customer Information Worksheet
IRS Form 4506-C (Request for Transcript of Tax Return)
Please gather and send us the following documents for review
Copy of current property deed evidencing a transfer (if applicable)
You can fax mail or email the application and required documents to
Fax Mail Email 1-855-372-0605 Chase mortgageassumptionjpmchasecom
700 Kansas Lane Mail Code LA4-6888 Monroe LA 71203
99177-DOCS-0215
FREQUENTLY ASKED QUESTIONS
A loan assumption lets the borrower change who is financially responsible for the loan It could
involve adding or removing borrowers or transferring the loan to someone else Please review
these questions about eligibility for and alternatives to a loan assumption
ELIGIBILITY
How do you determine eligibility
We look at the credit history assets and income of the person who wants to assume the loan from the borrower
Will my credit history be considered
Yes wersquoll review your credit score and consider your credit history
Do the borrower and the person who assumes the loan have to be related
In some cases yes Wersquoll review your eligibility after we receive all the documents we need
What if the purpose of the property will change for example from a primary residence to an investment property
We may allow a change in the propertyrsquos purpose but in many cases we wonrsquot allow a change in occupancy
Can my loan be assumed if I completed a loan modification
We usually require that you wait one to four years after a modification before applying for an assumption
Can I have a previous bankruptcy or foreclosure in my credit history
We require that you wait four years after a bankruptcy and six years after a foreclosure before applying for an assumption
Can I still apply for mortgage assistance
Yes but assuming the loan may limit the assistance options yoursquore eligible for
FEES
Are there costs associated with an assumption
There are closing costs for completing an assumption These costs usually total about $1500 for every $100000 of the unpaid loan amount
Can closing costs be included in the loan amount
No All closing costs must be paid at the time of closing We canrsquot increase the amount owed on an existing loan as we can with a refinanced loan
GENERAL
Is it better to refinance the loan or assume responsibility for the existing loan
The rates and terms for refinancing could be better than the current loan terms visit chasecom for our rates When you refinance you can roll the closing costs into the loan amount In an assumption we canrsquot modify the existing loan terms
How long does an assumption take
Usually 70 to 90 days
Why do I have to qualify for the assumed loan if Irsquom on the current one
We need to make sure that you can afford the loan under the new circumstances
If I own the property will an assumption change that
An assumption by itself doesnrsquot change ownership of the property but ownership may change at the same time We recommend getting independent legal advice or consulting with a title company
ID 3188620 FM201
IN THE EVENT OF A DEATH
Is an assumption my only option
You may have the option to be added to the loan as a successor in interest
You wonrsquot be responsible for repaying the loan but will get access to account information and statements There are no fees to be added as a successor in interest
If you assume the loan yoursquoll be financially responsible for repaying it and wersquoll report your payment information to the credit reporting agencies
IN CASES OF DIVORCE
Should I wait until my divorce or separation is final before applying for an assumption
Yes we require a separation or divorce agreement that shows who will retain rights to the property
My divorce agreement shows that my spouse is now responsible for the mortgage Why do I have to go through an assumption
We still need to review the income credit and assets of the person maintaining ownership to ensure that they qualify for the loan under the new circumstances
IN CASES OF MARRIAGE
Do I need to complete an assumption to add my spouse to the loan
Not necessarily
If you conveyed an interest in the property to your spouse they can be added to the loan as a successor in interest They wouldnrsquot be responsible for repaying the loan but would get access to account information and statements We donrsquot charge a fee to add a successor in interest
With an assumption your spouse would be financially responsible for repaying the loan and wersquoll report their payment information to the credit reporting agencies
Were here to answer all your questions and will work with you to make sure you get the assistance you needmdashcall us at 1-866-299-6752 we accept operator relay calls
ID 3188620 FM201
[ ][ ][ ]
[ ]
[ ]
[ ]
[ ]
[ ][ ][ ]
( )
( )
( )
[ ] [ ] [ ]
[ ] [ ] [ ] [ ]
[ ]
[ ]
[ ]
( )
( )
( )
( )
( )
( )
[ ] [ ] [ ]
[ ] [ ] [ ]
[ ]
[ ]
[ ]
[ ]
ytra
P ytra
PCustomer Information Worksheet
Loan number
Address of property to be assumed
Reason for assumption ( heck one) [ ]
Divorce Death of original owner Existing owners are selling the home Other
[ ][ ][ ] ___________________________
[ [ [ [
] Spouse Child Parent Other
] ] ] ____________________________
relationship to owners (check one)
Parties to the assumption In the sections below please identify the parties associated with the assumption of the loan This includes
Individuals who will be added to the loan Individuals who are already on the loan and who will remain on the loan Individuals who are already on the loan and who will be removed from the loan
If more than three parties are associated with the assumption please provide the requested information on a separate page and attach it to this worksheet
Name
Par
ty
Current address
Check one Check one New to the loan (being added) Already on the loan and will remain Already on the loan and will be removed
Day phone
Evening phone
Cell phone
Active-duty military Military veteran Neither
Available hours
Available hours
Available hours
Name Current address
Check one Check one New to the loan (being added) Already on the loan and will remain Already on the loan and will be removed Day phone
Evening phone
Cell phone
Active-duty military Military veteran Neither
Available hours
Available hours
Available hours
Name Current address
Check one Check one New to the loan (being added)
Already on the loan and will be removed
Evening phone
Cell phone
Active-duty military Military veteran Neither
Already on the loan and will remain
Day phone Available hours
Available hours
Available hours
Esta comunicacioacuten contiene informacioacuten importante acerca de la cuenta Si tiene alguna pregunta o necesita ayuda para traducirla comuniacutequese con nosotros llamando al 1-855-280-4198
FM142
Uniform Residential Loan ApplicationVerify and complete the information onthis applicationIf you are applying for this loan with others each additional Borrower must provide
information as directed by your Lender
Section 1 Borrower Informationthis section asks about yourpersonal information and your income fromemploymentandother sources such as retirement that you want considered to qualify for this loan
1a Personal Information
Name(First Middle Last Suffix) Social Security Number - -
(orIndividual TaxpayerIdentification Number)
Alternate Names- List any namesby which you are known or any namesunderwhich credit was previously received (First Middle Last Suffix)
Date ofBirth Citizenship(mmddyyyy) USCitizen
copy PermanentResidentAliencopy Non-PermanentResidentAlien
Type of Credit List Name(s) of Other Borrower(s) Applying for this Loan
copy lamapplyingforindividual credit (First Middle Last Suffix) - Use a separator between names
copy |am applyingfor joint credit Total Numberof Borrowers_
Each Borrowerintendsto applyfor joint credit Yourinitials
Marital Status Dependents(notlisted by another Borrower) Contact Information
O Married Number __ Home Phone ( ) -
s SeparatedUnmarried
Ages CellPhone ( ) _7
(Single Divorced Widowed Civil Union Domestic Partnership Registered Work Phone (0) Ext
Reciprocal Beneficiary Relationship) Email
Current Address
Street Unit
City State ZIP Country
How Long at Current Address Years mdashMonths Housing O Noprimary housing expense copy) Own copy Rent($ month)
If at Current Addressfor LESS than 2 yearslist Former Address LC Does not apply
Street Unit
City State ZIP Country
How Long at Former Address Years mdashMonths Housing No primary housing expense Own Rent($ month)
Mailing Address- ifdifferent from CurrentAddress (| Does not apply
Street Unit
City State ZIP Country
easeaoemir ] Does not apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base $_mdashmdashmdashmdash__mdashmonth
City State ZIP Country Overtime =$_________monthBonus $ month
Position orTitle Checkif this statementapplies Commission $ month[] am employedby a family member
propertyseller real estate agent or otherparty to the transaction
TTStartDate0__mdashsmmddyy) MilitaryHow long in this line of work Years mdash_ Months Entitlements $_mdashsmontth
Other $ monthCheckif you are the Business () | have an ownershipshare of less than 25 Monthly Income(or Loss) mdashmdash_mdashOwnerorSelf-Employed O I have an ownership share of 25 or more sect TOTALS__000month
Uniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
1c IF APPLICABLE Complete Information for Additional EmploymentSelf-Employment and Income
Doesnot apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base $ month
City State ZIP Country Overtime mdash$ monthBonus $ month
Position orTitle Checkif this statementapplies Commission $ month| am employedby a family memberproperty seller real estate agent or otherparty to the transaction
Start Date mdash_mdashAA(mmddyyyy) Military
EntitlementsHow long in this line of work lsquoYears mdash_ Months $ month
7 7 Other $ monthCheckif you are the BusinessOwnerorSelf-Employed
| have an ownershipshare ofless than 25 Monthly Income(or Loss)| have an ownership share of 25 or more $ TOTAL $ 000month
PlMeNeeeMeeCee ti)LeeseteUeLimet Does not apply
Provideatleast 2 years of current and previous employment and income
Employeror Business Name Previous Gross Monthly
Street Unit Income $ month
City State ZIP Country
Position orTitleStart Date (mmddyyyy) Checkif you were the Business
Owneror Self-Employedmdash_ mdashEnd Date (mmddyyyy)
WCBeelcaTy Does not apply
Include incomefrom other sources below Under IncomeSource choosefrom the sourceslisted hereraquo Alimony+ Automobile Allowance Boarder Income
+ Capital Gains
Child Support+ Disabilitylaquo Foster Care
laquo Housing or Parsonage
+ Interest and Dividendslaquo Mortgage Credit Certificateraquo MortgageDifferential
Payments
raquo Notes Receivable+ Public Assistance- Retirement
(eg Pension IRA)
laquo Royalty Payments Separate Maintenance+ Social Security
+ Trust
laquo UnemploymentBenefits
laquo VA Compensation
cent Other
NOTEReveal alimony child support separate maintenance or other income ONLYIFyou wantit considered in determining yourqualification
for this loan
IncomeSource -mdash uselist above Monthly Income
$
$
$
Provide TOTAL AmountHere $ 000
Borrower Name
Uniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 2 Financial Information mdash Assets andLiabilities this section asks about things you ownthatare worth moneyand that you wantconsidered to qualify for this loan It then asks about your liabilities (or debts) that you pay
each month suchas credit cards alimony or other expenses
rNcee stLeVaalemities eitimeeecm dellaLC-
Include all accounts below Under Account Typechoosefrom the typeslisted here
laquo Checkinglaquo Savingsraquo Money Market
+ Certificate of Depositlaquo Mutual Fund+ Stocks
laquo Stock Optionslaquo Bonds+raquo Retirement(eg 407k IRA)
laquo Bridge Loan ProceedslaquoIndividual DevelopmentAccount
Trust Account- Cash Value ofLife Insurance(usedfor the transaction)
AccountType- use list above FinancialInstitution Account Number Cash or MarketValue
$
$
$
$
$
$ 000Provide TOTAL AmountHere|
Includeall other assets and credits below UnderAsset or Credit Type choose from the typeslisted here
Assets Credits- Proceeds from Real EstateProperty to be sold on orbefore closing
laquo Proceeds from Sale ofNon-Real Estate Asset
- Secured Borrowed Funds
cent Unsecured Borrowed Funds Other
raquo Earnest MoneylaquoEmployer Assistance- Lot Equity
Relocation Funds_raquo Rent Credit
laquo Sweat Equity+ Trade Equity
Assetor Credit Type mdash uselist above Cash or Market Value
$
$
$
$
$ 000Provide TOTAL AmountHere
2c Liabilities - Credit Cards Other Debts and Leases that You Owe C Does not apply
List all liabilities below (except real estate) and include deferred payments Under Account Type choose from thetypeslisted herelaquoRevolving (eg credit cards) +Installment (eg car student personal loans) Open 30-Day (balance paid monthly) + Lease (not realestate) +Other
Account Type mdashuse list above
To be paid offator before closingCompany Name Account Number Unpaid Balance Monthly Payment
$ $
$ $
$ $
$ $
$ $
2d OtherLiabilities and Expenses Does not apply
Includeall otherliabilities and expenses below Choose from the typeslisted here
+ Alimony Child Support -Separate Maintenance +JobRelatedExpenses +Other Monthly Payment
$
$
$
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 3 Financial Information mdash Real Estatethis section asks youtolist all properties you currently ownand what you owe onthem donot own anyreal estate
3a Property You Own If you are refinancinglist the property you are refinancing FIRST
Address Street Unit
City State ZIP Country
Sol Intended Occupancyinvestment PrimaryResidence SecondHome Other
Monthly InsuranceTaxesAssociation Duesetcifnot included in MonthlyMortgage Payment
For 2-4 Unit Primary or Investment PropertyStatus SoldPending Saleor Retained
=Monthly RentalIncomeProperty Value
$ $ $
Mortgage Loanson this Property Does not apply
MonthlyMortgagePayment
Type FHA VAConventionalUSDA-RD Other|
To be paid offator before closing
Credit Limit(ifapplicable)Creditor Name Account Number Unpaid Balance
$ $ $
$ $ $
3b IF APPLICABLE Complete Information for Additional Property Does not apply
Address Street Unit
City State ZIP Country
ldquoSold Intended Occupancyinvestment PrimaryResidence SecondHome Other
Monthly Insurance TaxesAssociation Duesetcifnot included in MonthlyMortgage Payment
For 2-4 Unit Primary or Investment PropertyStatus SoldPendingSaleor Retained
Monthly RentalIncomeProperty Value
$ $ $
Mortgage Loanson this Property Does not apply
Monthly
Mortgage
Payment
Type FHA VA
Conventional
USDA-RD Other|
To be paid offat
or before closing
Credit Limit
(ifapplicable)Creditor Name Account Number Unpaid Balance
$ $ $
$ $ $
$ $ $
$ $ $
$ $ $
3c IF APPLICABLE Complete Information for Additional Property Does not apply
Address Street Unit
City State ZIP Country
Intended Occupancyinvestment PrimaryResidence SecondHome Other
Monthly Insurance TaxesAssociation Duesetcifnot included in MonthlyMortgage Payment
For 2-4 Unit Primary or Investment PropertyStatus SoldPending Saleor Retained
Monthly RentalIncomeProperty Value
Mortgage Loanson this Property Does not apply
MonthlyMortgagePayment
Type FHA VAConventionalUSDA-RD Other|
To be paid offator before closing
Credit Limit(ifapplicable)Creditor Name Account Number Unpaid Balance
Borrower Name
Uniform Residential Loan Application
Freddie Mac Form 65 +raquo Fannie Mae Form 1003
Effective 12021
Section 4 Loan and Property Informationthis section asks about the loanrsquos purpose and the property youwantto purchase orrefinance
4a Loan and Property Information
LoanAmount $ Loan Purpose Purchase efinance Other(specify)
Property Address Street Unit
City State ZIP County
Numberof Units Property Value $
Occupancy Primary Residence Second Home InvestmentProperty FHA Secondary Residence
1 Mixed-Use PropertyIf you will occupy the propertywill you set aside space within the property to operate
your ownbusiness(eg daycare facility medicaloffice beautybarber shop)NO YES
2 Manufactured HomeIs the property a manufactured home(eg a factory built dwelling built on a permanentchassis) NO YES
4b Other New Mortgage Loansonthe Property Youare Buying or Refinancing Does not apply
LoanAmountAmountto be Drawn
Credit Limit(ifapplicable)Creditor Name Lien Type Monthly Payment
First Lien Subordinate Lien $ $ $
$ $ $First Lien SubordinateLien
4c Rental Income on the Property You Wantto Purchase For Purchase Only Does not apply
Completeif the property is a 2-4 Unit Primary Residence or an Investment Property Amount
Expected Monthly Rental Income $
Doesnot apply4d Gifts or Grants You Have Been GivenorWill Receive for this Loan
Includeall gifts and grants below Under Source choose from the sourceslisted here
Community Nonprofitlaquo Employer
raquo Federal Agencyraquo Local Agency
- Relative+ Religious Nonprofit
+ State Agency+ Unmarried Partner
raquo Lender Other
Asset TypeCash Gift Gift of Equity Grant DepositedNot Deposited Source - uselist above Cash or Market Value
Deposited Not Deposited $
$Deposited Not Deposited
Borrower Name
Uniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 5 DeclarationsThis section asks youspecific questions about the property your funding and yourpastfinancial history
5aAboutthis Property and Your Moneyfor this Loan
A Will you occupy the property as your primary residence
If YES have you had an ownershipinterest 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 investmentproperty(IP)
(2) How did you holdtitle to the property by yourself (S) jointly with your spouse(SP) or jointly with another person (O)
YESYES
B If this is a Purchase Transaction Do you have a family relationship or businessaffiliation with the seller of the property NO YES
C Are you borrowing any moneyforthis real estate transaction (eg money foryour closing costs or down payment) orobtaining any moneyfrom anotherparty such astheseller or realtor that you have notdisclosed on this loan application NO YES
If YES what is the amountof this money $
D 1 Have you orwill you be applying for a mortgage loan on anotherproperty (not the property securing this loan) on or
before closing this transaction that is not disclosed on this loan application
NO YES
2 Have you orwill you be applying for any newcredit (eg installment loan credit card etc) on or before closing this loan that
is not disclosed on this application
No YES
E Will this property be subject to a lien that could take priority over the first mortgagelien such as a clean energylien paid
through yourproperty taxes(eg the PropertyAssessed Clean Energy Program)NO YES
5b About YourFinances
F Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application NO YES
G Are there any outstanding judgments against you No YES
H Areyou currently delinquentor in default on a Federal debt No YES
I Areyou a party to a lawsuit in which you potentially have any personalfinancialliability NO YES
J Have you conveyedtitle to any property in lieu of foreclosure in the past 7 years NO YES
K Within the past 7 years have you completed a pre-foreclosure sale or short sale whereby the property wassold to a
third party and the Lenderagreed to acceptless than the outstanding mortgage balance due
NO YES
L Have you hadproperty foreclosed uponin thelast 7 years NO YES
M Have you declared bankruptcy within the past 7 years ONO YESIf YES identify the type(s) of bankruptcy Chapter7 Chapter11 Chapter12 Chapter 13
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 6 Acknowledgments and AgreementsThis section tells you about yourlegal obligations whenyousign this application
Acknowledgments and Agreements
Definitions- Lenderincludes the Lenderrsquos agents service providers and any oftheir successors andassigns
Other Loan Participantsrdquo includes(i) any actual or potential owners of
a loan resulting from this application (the ldquoLoanrsquo)(ii) acquirers ofany beneficial or other interest in the Loan(iii) any mortgageinsurer(iv) any guarantor (v) any servicer of the Loan and (vi) any of theseparties service providers successors or assigns
I agree to acknowledgeand representthe following
(1) The Complete Informationfor this Application- The information | have providedin this application is true accurate
and completeas of the date | signed this application
laquo If the information | submitted changesor | have new information
before closing of the Loan | must change and supplementthis
application including providing any updatedsupplementedrealestate sales contract
- For purchase transactions The terms and conditionsof anyrealestate sales contract signed by mein connection with this application
are true accurate and complete to the best of my knowledge andbelief | have not entered into any other agreement written ororal inconnection withthis real estate transaction
- The Lender and OtherLoan Participants mayrely on the informationcontainedin the application before and after closing of the Loan
- Any intentional or negligent misrepresentation of information may
result in the impositionof(a) civil liability on me including monetary damagesif a
person suffers any loss because the person relied on anymisrepresentation that | have made onthis application andor
(b) criminal penalties on me including but not limited to fine orimprisonment or both underthe provisions of Federal law(18 USC sectsect 1001 et seq)
(2) The Propertyrsquos SecurityThe Loan | have applied for in this application will be secured by
a mortgage or deedoftrust which provides the Lendera security
interest in the property described in this application
(3) The Propertys Appraisal Value and Condition- Any appraisal or value of the property obtained by the Lenderis
for use by the Lender and OtherLoanParticipantslaquoThe Lender and OtherLoan Participants have not made anyrepresentation or warranty express or implied to me about the
propertyits conditionorits value
(4) Electronic Records and Signatures- The Lender and OtherLoan Participants may keep any paper record
andorelectronic record of this application whether or not the Loan
is approved
BorrowerSignature
- If this application is created as (or converted into) an ldquoelectronicapplicationrdquo | consent to the use of ldquoelectronic recordsrdquo and
ldquoelectronic signaturesrdquo as the termsare defined in and governed byapplicable Federal andorstate electronic transactions laws
| intend to sign and have signedthis application either using my(a) electronic signature or(b) a written signature and agreethatif a paper version ofthis
application is converted into an electronic application theapplication will be an electronic record and the representationof my written signature on this application will be my binding
electronic signature- | agree that the applicationif delivered or transmitted to the Lenderor Other Loan Participants as an electronic record with myelectronicsignaturewill be as effective and enforceable as a paperapplicationsigned by mein writing
(5) Delinquencylaquo The Lender and OtherLoan Participants may report information about
my accountto credit bureaus Late payments missed paymentsorother defaults on my account maybereflected in my credit report andwill likely affect my credit score
- If | have trouble making my payments | understand that | may contacta HUD-approved housing counseling organization for advice about
actions I can take to meet my mortgageobligations
(6) Authorization for Use and Sharing of InformationBy signing belowin addition to the representations and agreementsmade above| expressly authorize the Lender and Other LoanParticipants to obtain use and share with each other(i) the loan
application and related loan information and documentation(ii) aconsumercredit report on me and(iii) my tax return information asnecessary to perform theactionslisted belowfor so long as they havean interest in my loanorits servicing
(a) process and underwrite myloan(b) verify any data contained in my consumercredit 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 analysisandreviews
(e) perform analysis and modeling for risk assessments(f) monitor the accountfor this loan for potential delinquencies and
determineanyassistance that may beavailable to me and
(g) other actions permissible under applicable law
Date (mmddyyyy)
Additional Borrower Signature Date (mmddyyyy)
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 7 Military ServiceThis section asks questions about your(or your deceased spouses) military service
Military Service of Borrower
Military Service mdash Did you (or your deceased spouse) everserve or are you currently serving in the United States Armed Forces NO YES
If YES check allthat apply Currently serving on active duty with projected expiration date of servicetour (mmddyyyy)
Currently retired discharged or separated from service
Only period of service was as a non-activated memberof the Reserve or National GuardSurviving spouse
Section 8 Demographic InformationThis section asks about your ethnicity sex and race
Demographic Information of Borrower
The purposeofcollecting this informationis to help ensure thatall applicants are treated fairly and that the housing needs of communities
and neighborhoodsare beingfulfilled 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 mayselect one or more designationsfor
Ethnicity and one or more designationsfor Race The law provides that we maynotdiscriminate on the basis of this information or onwhetheryou chooseto provideit However if you choose not to provide the information and you have madethis application in person Federal
regulations require us to note your ethnicity sex and race on thebasis of visual observation or surname Thelaw also provides that we may notdiscriminate on the basis of age or marital status information you providein this application If you do not wish to provide someorall of this
information please check below
Ethnicity Check one or more Race Check one or moreHispanic or Latino AmericanIndian or Alaska Native - Print nameofenrolled
or principaltribe Mexican PuertoRican CubanOther Hispanic or Latino - Print origin Asian
Asian Indian Chinese Filipino
Japanese Korean Vietnamese
OtherAsian mdash Print race
For example Hmong Laotian Thai Pakistani Cambodian and so on
Black or African American
Native Hawaiian or OtherPacific Islander
Native Hawaiian GuamanianorChamorro Samoan
For exampleArgentinean Colombian Dominican Nicaraguan
Salvadoran Spaniard andso on
Not Hispanic or Latino
| do not wish to providethis information
5Female OtherPacific Islander mdash Print race
Male For example Fijian Tongan and so on| do not wish to providethis information white
| do not wish to providethis information
Wasthe ethnicity of the Borrowercollected on the basis of visual observation or surname )NO YESWasthe sex of the Borrowercollected on the basis of visual observation or surname NO YESWastherace of the Borrowercollected on the basis of visual observation or surname NO YES
Face-to-Face Interview (includes Electronic Media w Video Component) TelephoneInterview Faxor Mail Email or Internet
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
ReelTemCrCL
Loan Originator Organization Name
Address
Loan Originator Organization NMLSR ID State License ID
Loan Originator Name
Loan Originator NMLSR ID State License ID
Date (mmddyyyy)
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Uniform Residential Loan Application mdash Additional BorrowerVerify and complete the information onthis application as directed by your Lender
Section 1 Borrower Informationthis section asks about yourpersonal information and your income fromemploymentandother sources such as retirement that you want considered to qualify for this loan
1a Personal Information
Name(First Middle Last Suffix)
Alternate Names - List any namesby which you are known or any namesunder which credit was previously received (First Middle Last Suffix)
Social Security Number - -(or Individual TaxpayerIdentification Number)
Dateof Birth Citizenship(mmddyyyy)
USCitizenPermanentResidentAlienNon-Permanent ResidentAlien
Type ofCredit| am applying for individualcredit
lam applying forjoint credit Total Number of Borrowers
Each Borrowerintendsto applyfor joint credit Your initials
List Name(s) of Other Borrower(s) Applying for this Loan
(First Middle Last Suffix) - Use a separator between names
Marital Status Dependents(notlisted by another Borrower)
Contact Information
Married Number _ Home Phone ( ) -
( ) _
( ) -mdash_ mdash_
Separated Ages CellPhone
Unmarried ens Work Phone Ext(Single Divorced WidowedCivil Union Domestic Partnership Registered
Reciprocal Beneficiary Relationship)lsquol
Emal
Current Address
Street Unit
City State ZIP Country
How Long at Current Address=Years mdashMonths Housing Noprimary housing expense Own Rent($ month)
If at Current Address for LESS than 2 yearslist Former Address Does not apply
Street Unit
City State ZIP Country
How Long at Former Address Years mdashMonths Housing Noprimary housing expense Own month)
Mailing Address- ifdifferent from CurrentAddress Does not apply
Street Unit
City State ZIP Country
eeeeCeeteiChuraleCme Doesnot apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base S$month
City State ZIP Country Overtime =$_____monthBonus $ month
Position orTitle Checkif this statementapplies Commission sect month| am employedby a family memberpropertyseller real estate agent or otherparty to the transaction
TTStart Date ____ (mmddyy) Military
Entitlements$_How longin this line of work Years =Months mdash monthSS
Other $ monthCheckif you are the BusinessOwnerorSelf-Employed
| have an ownershipshare ofless than 25 Monthly Income(or Loss) mdashmdash| have an ownership share of 25 or more $ TOTAL $ 000month
Uniform Residential Loan Application mdash Additional Borrower
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
CoeeeMCMCmeticlm tu)Comiteteilteeilelie mieit
Does not apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base
OvertimeBonus
Commission
MilitaryEntitlements
Other
$ month
$ month$ month
$ month
$ month
$ month
City State ZIP Country
Position orTitle ose if this statement applieslam employed by a family memberpropertyseller real estate agent or otherparty to the transaction
Start Date (mmddyy)How long in this line of work Years =Months
Checkif you are the Business
Owneror Self-Employed| have an ownershipshare of less than 25 Monthly Income(or Loss)
Ihave an ownership share of 25 or more $ TOTAL$ 000month
CPONMeeeMummaTestetiersdeere lire miret Does not apply
Provideat least 2 years of current and previous employment and income
Employeror Business Name Previous Gross MonthlyStreet Unit Income s month
City State ZIP Country
Position or Title
Start Date
End Date
Checkif you were the BusinessOwneror Self-Employed
(mmddyyyy)
(mmddyyyy) 1e Income from Other Sources Does not apply
Include incomefrom other sources below Under Income Source choose from the sourceslisted herelaquo Alimonylaquo Automobile Allowanceraquo Boarder Incomelaquo Capital Gains
Child Support+ Disability+ Foster Care Housing or Parsonage
+ Interest and DividendslaquoMortgage Credit Certificate Mortgage DifferentialPayments
laquo Notes Receivable+ Public Assistancelaquo Retirement(eg Pension IRA)
+raquo Royalty Payments Separate Maintenance
+ Social Security
raquo Trust
+ UnemploymentBenefits
laquo VA Compensation
laquo Other
NOTE Revealalimony child support separate maintenance or other income ONLYIFyou wantit considered in determining yourqualification
for this loan
Income Source - uselist above Monthly Income
$
$
$
$ 000Provide TOTAL AmountHere|
Section 2 Financial Information mdash Assets andLiabilities
Myinformation for Section 2 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 3 Financial Information mdash Real Estate
Myinformation for Section 3 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 4 Loan and Property Information
Myinformation for Section 4 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 5 DeclarationsThis section asks you specific questions about the property your funding and your past
financial history
5aAboutthis Property and Your Moneyforthis Loan
A Will you occupy the property as your primary residence NO YES
If YES have you had an ownershipinterest in another property in the last three years NO YES
If YES complete (1) and (2) below
(1)What type of property did you ownprimary residence (PR) FHA secondary residence (SR) second home(SH)
or investmentproperty (IP)
(2) How did you holdtitle to the property by yourself (S) jointly with your spouse(SP) or jointly with another person (O)
B If this is a Purchase Transaction Do you have a family relationship or businessaffiliation with the seller of the property NO YES Cc Are you borrowing any moneyforthis real estate transaction (eg money foryour closing costs or down payment) or
obtaining any moneyfrom anotherparty suchastheselleror realtor that you have not disclosed on this loan application NO YES
If YES whatis the amountof this money $
D 1 Have youorwill you be applying for a mortgage loan on anotherproperty (not the property securing this loan) on orbefore closing this transaction that is not disclosed on this loan application
NO YES
2 Have you orwill you be applying for any newcredit (eg installment loan credit card etc) on or before closing this loan that wsis not disclosed on this application
NO YES
E Will this property be subject to a lien that could take priority over thefirst mortgagelien such as a clean energylien paid
through yourproperty taxes(eg the PropertyAssessed Clean Energy Program)No YES
EK) Veli ellim ait
F Areyou a co-signer or guarantor on any debtor loan thatis not disclosed on this application NO ES
G Are there any outstanding judgments against you NO YES
H Are you currently delinquentor in default on a Federal debt NO YES
I Are you a party to a lawsuit in which you potentially have any personalfinancialliability NO YES
J Have you conveyedtitle to any property in lieu of foreclosure in the past 7 years NO YES
K Within the past 7 years have you completed a pre-foreclosure sale or short sale whereby the property wassold to a
third party and the Lender agreed to acceptless than the outstanding mortgage balance due
No YES
L Have you had property foreclosed uponin thelast 7 years NO YES
M Have you declared bankruptcy within the past 7 years no vESIf YES identify the type(s) of bankruptcy Chapter 7 Chapter11 Chapter12 Chapter 13
Section 6 Acknowledgements and AgreementsMy signature for Section 6 is on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 7 Military Service This section asks questions about your(or your deceased spouses) military service
Military Service of Borrower
Military Service mdash Did you (or your deceased spouse)everserve or are you currently serving in the United States Armed Forces NO YES
IfYES check allthat apply Currently serving on active duty with projected expiration date of servicetour (mmddyyyy)
Currently retired discharged or separated from service nnOnly period of service was as a non-activated memberofthe Reserve or National GuardSurviving spouse
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 8 Demographic InformationThis section asks about your ethnicity sex and race
Demographic Information of Borrower
The purposeofcollecting this information is to help ensure thatall applicants are treated fairly and that the housing needs of communities
and neighborhoodsare beingfulfilled 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 providethis information but are encouraged to do so You mayselect one or more designationsfor
Ethnicity and one or more designationsfor Race The law provides that we maynotdiscriminate onthe basis of this information or onwhetheryou chooseto provideit However if you choose notto provide the information and you have madethis application in person Federal
regulations require us to note yourethnicity sex and race on the basis of visual observation or surname The law also provides that we may notdiscriminate on the basis of age or marital status information you providein this application If you do not wish to provide someorall of this
information please check below
Ethnicity Check one or more Race Check one or moreHispanic or Latino AmericanIndian or Alaska Native - Print nameofenrolled
or principaltribeMexican PuertoRican Cuban
OtherHispanic or Latino - Printorigin siansian Indian Chinese Filipino
For exampleArgentinean Colombian Dominican NicaraguanSalvadoran Spaniard andso on
Japanese Korean VietnameseOtherAsian - Print race Forexample Hmong Laotian Thai Pakistani Cambodian andso on
Black or African American
Native Hawaiian or OtherPacific Islander
Native Hawaiian GuamanianorChamorro Samoan
OtherPacific Islander mdash Print race
Not Hispanic or Latino
| do not wish to providethis information
Sex
Female
Male
| do not wish to providethis informationFor example Fijian Tongan and so on
White
| do not wish to providethis information
Wasthe ethnicity of the Borrowercollected on thebasis of visual observation or surnameWasthesex of the Borrowercollected on the basis of visual observation or surnameWastherace of the Borrowercollected on the basis of visual observation or surname
)NO YESNO YESNO YES
Face-to-Face Interview (includes Electronic Media w Video Component) Telephone Interview Faxor Mail Email or Internet
Loan Originator Organization Name
Address
Loan Originator Organization NMLSR ID State License ID
Loan Originator Name
Loan Originator NMLSR ID State License ID
Email Phone (
Signature Date (mmddyyyy)
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Pe)aae-emeet)
Community Property State
At least one borrowerlives in a community propertystateThe property is in a community property state
Transaction DetailConversion of Contract for Deed or Land ContractRenovationConstruction-ConversionConstruction-to-Permanent
Single-Closing Two-ClosingConstructionImprovementCosts $
LotAcquired Date
Original Cost of Lot $(mmddyyyy)
Refinance Program
Full DocumentationInterest Rate ReductionStreamlined without Appraisal
Other
Refinance Type
NoCash OutLimited Cash OutCash Out
Energy Improvement
Mortgageloanwill finance energy-related improvements
Propertyis currently subject to a lien that could take priority ovethe first mortgagelien such as a clean energylien paid for througproperty taxes(eg the PropertyAssessed Clean Energyprogram)
Project Type Condominium Cooperative Planned Unit Development (PUD) Propertyis notlocatedin a project
Peiwlivcestetece)a)
Title to the Property Will be Held in What Name(s)
For RefinanceTitle to the Property is Currently Held in What Name(s
Trust Information
tle Will be Held byan Inter Vivos (Living) Trust
Title Will be Held by a Land TrustLeasehold Expiration Date
Mannerin WhichTitle Will be Held Indian Country Land Tenure
Sole OwnershipLife EstateTenancy in Common
Joint Tenancywith Right of Survivorship]Tenancybythe EntiretyOther
Fee Simple Ona ReservationIndividualTrust Land (AllottedRestricted)Tribal Trust Land On a ReservationTribal Trust Land Off ReservationAlaska Native Corporation Land
Estate Will be Held in
Fee Simple(mmddyyyy)
3 Mortgage LoanInformation
Termsof Loan
Note Rate
Loan Term (months)
MortgageLien Type
First LienSubordinate Lien
Mortgage Type Applied For
Conventional USDA-RDFHA VA Other
Amortization Type
Fixed RateAdjustable Rate
If Adjustable Rate
Initial Period Prior to First Adjustment
Subsequent AdjustmentPeriod
Proposed Monthly Paymentfor Property
First Mortgage (P amp I) $
Subordinate Lien(s) (P amp |) $
Other(explain)
Homeowners Insurance $(months)
(months)
Loan Features Property Taxes $
Balloon Balloon Term (months)
Interest Only Interest OnlyTermNegative AmortizationPrepaymentPenalty Prepayment Penalty Term (months) Other
Temporary Interest Rate BuydownInitial Buydown Rate TOTALOther(explain)
Mortgage Insurance $
AssociationProject Dues (Condo Co-Op PUD) $
Supplemental Property Insurance $
(months)
Borrower Name(s)Uniform Residential Loan Application mdash LenderLoan Information
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
L4 Qualifying the Borrower - Minimum Required Funds or Cash Back
DUEFROM BORROWER(S)
A Sales Contract Price
B Improvements Renovations and Repairs
C Land(ifacquired separately)
D For Refinance Balance of Mortgage Loanson the Propertyto be paid off in the Transaction
(See Table 3a Property You Own)
E Credit Cards and Other Debts Paid Off
(See Table 2c Liabilities mdash Credit Cards Other Debts and Leases that You Owe)
F BorrowerClosing Costs (including Prepaid andInitial Escrow Payments)
G Discount Points
HTOTAL DUE FROM BORROWER(s)(Total of A thru G)
TOTALMORTGAGE LOANS
Loan Amount
Loan AmountExcluding Financed Mortgage Insurance (or Mortgage Insurance Equivalent) $
Financed Mortgage Insurance (or Mortgage Insurance Equivalent) Amount $
Other New Mortgage Loanson the Property the Borrower(s) is Buying or Refinancing(See Table 4b Other New MortgageLoanson the Property You are Buying or Refinancing)
KTOTAL MORTGAGELOANS(Totalof| and J)
TOTALCREDITS
L Seller Credits (Enter the amountofBorrower(s) costs paid by the property seller)
MOtherCredits (Enter the sum ofall other credits mdash BorrowerPaid Fees Earnest Money EmployerAssistedHousing Lease Purchase Fund Lot Equity Relocation Funds Sweat Equity Trade Equity Other)
NTOTAL CREDITS(Total of L and M)
CALCULATION
TOTAL DUE FROM BORROWER(s)(Line H)
LESSTOTAL MORTGAGELOANS(Line K) AND TOTAL CREDITS(Line N)
Cash FromTothe Borrower(Line H minusLine K and Line N)NOTE This amountdoesnotinclude reservesor other funds that may be required by the Lenderto be verified
Borrower Name(s)Uniform Residential Loan Application mdash LenderLoan Information
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
Uniform Residential Loan Application mdash Unmarried Addendum
eeCeceetatimC elitleeComeLy
Lenders Instructions for Using the Unmarried Addendum
The Lender may use the Unmarried Addendum only when a Borrowerselected ldquoUnmarriedrdquoin Section 1 and the information collected is
necessary to determine howState property lawsdirectly or indirectly affecting creditworthiness apply including ensuring clear title
For example the Lender may use the Unmarried Addendum whentheBorrowerresides in a State that recognizescivil unions domestic
partnerships or registered reciprocal beneficiary relationships or when the property is located in such a State ldquoStaterdquo meansanystate the
District of Columbia the Commonwealth of Puerto Rico or anyterritory or possession of the United States
Ifyou selected ldquoUnmarriedrdquoin Section 1 is there a person whois not your legal spouse but whocurrently has real property rights similar to
those of a legal spouse +=) NOQ YES
If YES indicate the type of relationship and the State in which the relationship was formed For example indicate if you are in a
civil union domestic partnership registered reciprocal beneficiary relationship or other relationship recognized by the State in which you
currently reside or where the property is located
O Civil Union copy Domestic Partnership copy Registered Reciprocal Beneficiary Relationship copy) Other(explain)
Statea]
Borrower NameUniform Residential Loan Application mdash Unmarried Addendum
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Uniform Residential Loan Application mdash Continuation Sheet
Use this continuation sheet if you need more space to complete the Uniform Residential Loan Application
Borrower Name(First Middle Last Suffix )
Additional Information
Additional Borrower Name(First Middle Last Suffix )
Additional Information
IWefully understand thatit is a federal crime punishable by fine or imprisonment or both to knowingly make anyfalse statements concerningany of the abovefacts as applicable underthe provisions of federal law (18 USC sectsect 1001 et seq)
BorrowerSignature Date (mmddyyyy)
Additional Borrower Signature Date (mmddyyyy)
Uniform Residential Loan Application mdash Continuation SheetFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
INSTRUCTIONS FOR COMPLETING THE UNIFORM RESIDENTIAL LOAN APPLICATION
Use the instructions below to complete the enclosed Uniform Residential Loan Application (Freddie Mac Form 65Fannie Mae Form 1003) To avoid any delays in your application review please provide all of the requested information
If you need to make a correction on the application draw a line through the incorrect text and mark your initials beside the change Donrsquot use correction tape or fluid The application must be completed signed and dated in ink
The Uniform Residential Loan Application (URLA)
The URLA contains the following sections Section 1 Borrower Information Please provide your personal information income and employment
Section 2 Financial Information ndash Assets and Liabilities Please provide information about your financial assets personal financial obligations and debts you owe
Section 3 Financial Information ndash Real Estate Please provide information about property you own and the debts and expenses related to the property
Section 4 Loan and Property Information Please provide information about the loan purpose and the property you are buying or refinancing
Section 5 Declarations Please answer questions about the property how the property will be financed and your past financial history
Section 6 Acknowledgments and Agreements Informs you of your legal obligations related to the mortgage application and asks that you acknowledge certain information will be obtained used and shared
Section 7 Military Service Please provide information about your (or your deceased spousersquos) military service
Section 8 Demographic Information Requests information the Lender is required by law to ask you
Section 9 Loan Originator Information Will be completed by Chase
Uniform Residential Loan Application ndash Additional Borrower
The URLA ndash Additional Borrower contains the following sections Section 1 Borrower Information This is the same as the Borrower Information section of the URLA
Section 2 Financial Information ndash Assets and Liabilities Contains only the following statement for the additional Borrower to complete ldquoMy information for Section 2 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo The name of the other borrower is entered here
Complete a separate URLA for each BorrowermiddotThree or more Borrowers ndash Use any combination of URLA and URLA-Additional Borrower forms in accordance with the above examples
Section 3 Financial Information ndash Real Estate Contains only the following statement for the additional borrower to complete ldquoMy information for Section 3 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 4 Loan and Property Information Contains only the following statement for the additional borrower to complete ldquoMy information for Section 4 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 5 Declarations This is the same as the Declarations section of the URLA
Section 6 Acknowledgments and Agreements Contains only the following statement for the additional borrower to complete ldquoMy signature for Section 6 is on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 7 Military Service This is the same as the Military Service section of the URLA
Section 8 Demographic Information This is the same as the Demographic Information section on the URLA
Section 9 Loan Originator Information This is the same as the Loan Originator Information section of the URLA
Using the URLA and URLA ndash Additional Borrower Together The URLA and the URLA ndash Additional Borrower are used together to collect information for two Borrowers who have joint assets liabilities andor real estate information The URLA and URLA ndash Additional Borrower can also be used for Borrowers who do not have joint information but wish to combine their information on the URLA for ease of use Here are examples of how to use the URLA and URLA ndash Additional Borrower
For one borrower Complete the URLA
For two borrowers with joint financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you dont need to duplicate them on more than one URLA or o In cases where Borrowers are not collaborating when completing the loan application
joint assets liabilities and real estate may be duplicated on each URLA bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you do not need to duplicate them on more than one URLA or
o In cases where Borrowers are not collaborating when completing the loan application joint assets liabilities and real estate may be duplicated on each URLA
For two borrowers with separate financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower Report the assets liabilities and
real estate for the additional Borrower on the URLA or bull Complete a separate URLA for each Borrower
For three or more borrowers use any combination of URLA and URLA ndash Additional Borrower forms described for two borrowers
Uniform Residential Loan Application ndash Unmarried Addendum If any borrower listed on the URLA or URLA ndash Additional Borrower form selects Unmarried in Section 1 (Personal Information) the lender will complete this optional form
The information must be collected to determine how to apply state property laws that directly or indirectly affect creditworthiness including ensuring clear title
Uniform Residential Loan Application ndash Continuation Sheet Use the URLA ndash Continuation Sheet if you need more space to complete either the URLA or URLA ndash Additional Borrower forms
99177-URLAI-0215
HUD Addendum to Uniform Residential Loan Application OMB Approval No HUD 2502-0059 (exp )
Part I - Identifying Information HUDFHA Application for Insurance under the National Housing Act and Borrower Certification
FHA Case No (include any suffix) Mortgagee Case No
Mortgagee ID Sponsor ID Agent ID
Mortgagee Name Address (include ZIP Code) and Telephone Number
Type or print all entries clearly
Name and Address of Sponsor Name and Address of Agent
Borrowers Name amp Present Address (include ZIP Code) Property Address (include name of subdivision lot amp block no amp ZIP Code)
Sponsored Originations
Name of Third-Party Originator NMLS ID of Third-Party Originator
Part II - Borrower Consent for Social Security Administration to Verify Social Security Number I authorize the Social Security Administration (SSA) to verify my Social Security Number (SSN) to the Mortgagee and HUDFHA I authorize SSA to provide explanatory
information to HUDFHA in the event of a discrepancy This consent is valid for 180 days from the date signed unless indicated otherwise by the individual(s) named in this
loan application
Signature(s) of Borrower(s) - Read consent carefully Review accuracy of Social Security Number(s) provided on this application
Borrowerrsquos NameDate of BirthSocial Security Number
Co-Borrowerrsquos Name Date of BirthSocial Security Number
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
Part III - Borrower Notices Information and Acknowledgment Public Reporting Burden
Public reporting burden for this collection of information is estimated to average 10 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 conduct or sponsor and a person is not
required to respond to a collection of information unless that collection displays a valid OMB control number which can be located on the OMB Internet page at
httpwwwreginfogovpublicdoPRAMain
Privacy Act Information
The information requested on the Uniform Residential Loan Application and this Addendum is authorized by the National Housing Act of 1934 12 USC sect 1701 et seq The Debt
Collection Act of 1982 Pub L 97-365 and HUDrsquos Housing and Community Development Act of 1987 42 USC sect 3543 require persons applying for a federally insured loan to
furnish their SSN You must provide all the requested information including your SSN HUD may conduct a computer match to verify the information you provide HUD may
disclose certain information to Federal State and local agencies when relevant to civil criminal or regulatory investigations and prosecutions It will not otherwise be disclosed or
released outside of HUD except as required and permitted by law The information will be used to determine whether you qualify as a mortgagor Failure to provide any of the
requested information including SSN may result in disapproval of your loan application This is notice to you as required by the Right to Financial Privacy Act of 1978 that
HUDFHA has a right of access to financial records held by financial institutions in connection with the consideration or administration of assistance to you Financial records
involving your transaction will be available to HUDFHA without further notice or authorization but will not be disclosed or released by the institution to another Government Agency
or Department without your consent except as required or permitted by law
WARNING This warning applies to all certifications made in this document Anyone who knowingly submits a false claim or makes false statements is subject to criminal and civil penalties including confinement for up to 5 years fines and civil penalties 18 USC sectsect 287 1001 and 31 USC sect 3729
orm HUD-92900-A ( ) Page 1
Borrower Name ____________________________ FHA Case No __________________
Caution Delinquencies Defaults Foreclosures and Abuses Delinquencies defaults foreclosures and abuses of mortgage loans involving programs of the Federal Government can be costly and detrimental to your credit now and in the future The Mortgagee in this transaction its agents and assigns as well as the Federal Government its agencies agents and assigns are authorized to take any and all of the following actions in the event loan payments become delinquent on the mortgage loan described in the attached application (1) Report your name and account information to a credit bureau (2) Assess additional interest and penalty charges for the period of time that payment is not made (3) Assess charges to cover additional administrative costs incurred by the Federal Government to service your account (4) Offset amounts owed to you
under other Federal programs (5) Refer your account to a private attorney collection agency or mortgage servicing agency to collect the amount due foreclose
the mortgage sell the property and seek judgment against you for any deficiency (6) Refer your account to the Department of Justice (DOJ) for litigation in the
courts (7) If you are a current or retired Federal employee take action to offset your salary or civil service retirement benefits (8) Refer your debt to the Internal
Revenue Service for offset against any amount owed to you as an income tax refund and (9) Report any resulting written off debt of yours to the Internal Revenue Service as your taxable income All of these actions may be used to recover any debts owed when it is determined to be in the interest of the Mortgagee or Federal Government or both
As a mortgage loan borrower you will be legally obligated to make the mortgage payments called for by your mortgage loan contract The fact that you dispose of your property after the loan has been made will not relieve you of liability for making these payments Payment of the loan in full is ordinarily the way liability on a mortgage note is ended Some home buyers have the mistaken impression that if they sell their homes when they move to another locality or dispose of it for any other reasons they are no longer liable for the mortgage payments and that liability for these payments is solely that of the new owners Even though the new owners may agree in writing to assume liability for your mortgage payments this assumption agreement will not relieve you from liability to the holder of the note which you signed when you obtained the loan to buy the property Unless you are able to sell the property to a buyer who is acceptable to HUDFHA who will assume the payment of your obligation to the lender you will not be relieved from liability to repay any claim which HUDFHA may be required to pay your lender on account of default in your loan payments The amount of any such claim payment may be a debt owed by you to the Federal Government and subject to established collection procedures
Fair Housing Act I and anyone acting on my behalf are and will remain in compliance with the Fair Housing Act 42 USC sect 3604 et seq with respect to the dwelling or property covered by the loan and in the provision of services or facilities in connection therewith I recognize that any restrictive covenant on this property related to race color religion sex disability familial status or national origin is unlawful under the Fair Housing Act and unenforceable I further recognize that in addition to administrative action by HUD a civil action may be brought by the DOJ in any appropriate US court against any person responsible for a violation of the
applicable law
Certification and Acknowledgment All information in this application is given for the purpose of obtaining a loan to be insured under the National Housing Act and the information in the Uniform Residential Loan Application and this Addendum is true and complete to the best of my knowledge and belief Verification may be obtained from any source named herein I have read and understand the foregoing concerning my liability on the loan and Part III Borrower Notices Information and Acknowledgment
Signature(s) of Borrower(s) - Do not sign unless this application is fully completed Read the certification carefully and review accuracy of this application
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
orm HUD-92900-A ( Page 2
___________________________________
______________________________________________________
______________________________________________________________
- - - - - - - - - - - - - - - - - - - - - - -
Borrower Name ____________________________ FHA Case No __________________
Part IV - Direct Endorsement Approval for a HUD FHA-Insured Mortgage A Underwriting the Borrower
Date Mortgage Approved ______________________________ Date Approval Expires ______________________
For mortgages rated as an ldquoacceptrdquo or ldquoapproverdquo by FHAs TOTAL Mortgage Scorecard
The information submitted to TOTAL was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA4e Final Underwriting Decision (TOTAL) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee Representative Signature
Printed Name
Title
OR
For mortgages rated as a ldquoreferrdquo by FHAs TOTAL Mortgage Scorecard or manually underwritten by a Direct Endorsement underwriter I have personally reviewed and underwritten the borrowerrsquos credit application The information used to underwrite the borrower was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA5d Final Underwriting Decision (Manual) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
B Underwriting the Property
For all mortgages where FHA requires an appraisal I have personally reviewed and underwritten the appraisal according to FHA requirements I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
orm HUD-92900-A ( ) Page 3
Borrower Name ____________________________ FHA Case No __________________
Part V Mortgagees Certification
I have personally reviewed the mortgage documents and the application for insurance endorsement and This mortgage complies with SF Handbook 40001 Section IIA7 Post-Closing and Endorsement to the extent that no defect exists that would have changed the decision to endorse or submit the mortgage for insurance
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee
Name of Mortgageersquos Representative
Title of Mortgageersquos Representative
Signature of the Mortgageersquos Representative Date
orm HUD-92900-A ( ) Page 4
GENERAL AUTHORIZATION FOR A MORTGAGE LOAN ASSUMPTION
Applicant name(s)
Loan number
NOTICES AND DISCLOSURES
Non-discriminatory underwriting guidelines Anyone who inquires about the availability of credit from us has the right to receive a copy of our non-discriminatory underwriting guidelines To request a copy of these guidelines contact your Loan Processor
Attorney note Itrsquos the responsibility of our attorneys to protect our interest You may at your expense request an attorney to represent your interest
Notice to HUDFHA applicants As required by the Right to Financial Privacy Act of 1978 this notice is to inform you that the US Department of Housing and Urban Development (HUD)Federal Housing Administration (FHA) has a right of access to financial records held by financial institutions related to a request for assistance Financial records involving your assumption will be available to HUDFHA without further notice or authorization but wonrsquot be disclosed or released by us to another government agency or department without your consent except as required or permitted by law
Borrower consent to the use of tax return information I understand acknowledge and agree that the Lender and Other Loan Participants can obtain use and share tax return information for purposes of (i) providing an offer (ii) originating maintaining managing monitoring servicing selling insuring and securitizing a loan (iii) marketing or (iv) as otherwise permitted by applicable laws including state and federal privacy and data security laws The Lender includes the Lenderrsquos affiliates agents service providers and any of aforementioned partiesrsquo successors and assigns The Other Loan Participants includes any actual or potential owners of a loan resulting from your loan application or acquirers of any beneficial or other interest in the loan and mortgage insurer guarantor any servicers or service providers for these parties and any of aforementioned partiesrsquo successors and assigns
CERTIFICATION AND AUTHORIZATION
Environmental certification By signing below I represent and warrant that Irsquom not aware of any substances materials or products that may be an environmental hazard such as but not limited to asbestos formaldehyde radon gas lead-based paint fuel or chemical storage tanks (above or below ground) and contaminated soil or water on the property I acknowledge that Chase is relying on this representation and warranty as a material part of its loan application process I also am not aware of any landfill on any portion of the property
Exceptions to the above I further acknowledge (1) receipt of applicable disclosures from the seller in purchase transactions (2) that lead-based paint may exist in housing constructed prior to 1978 (3) that Chase performs no environmental investigation on my behalf and isnrsquot responsible for identifying lead-based paint or any other environmental conditions that might impact the property or its residents and (4) that it is my sole obligation to investigate for potential impact to the property from environmental conditions
Certifications I certify by signing below that (1) all of the loan application information provided is true and complete (2) I understand any intentional or negligent misrepresentation(s) of the information provided in conjunction with my application may result in civil liability andor 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 Chase its agents successors and assigns insurers and any other person who may suffer any loss due to reliance upon any misrepresentation that I have made on the application and (3) any significant change from the information provided at the time of application until the final loan application is signed may have a bearing on the approval of my application for a home loan
Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union
This question is asked because of state laws that extend the same or similar rights benefits and protections of spouses in a marriage to persons who are members of a partnership or union recognized under state law You should consult with your own legal advisor for advice regarding the rights protections benefits responsibilities obligations and duties of those who are registered domestic partners civil union partners or members of other unions recognized under applicable law
CREDIT AUTHORIZATION RELEASE
By signing below I authorize Chase andor my mortgage insurer (if any) to verify my past and present employment earnings records (including information contained in income tax returns that have been filed with the IRS) bank accounts stock holdings and any other information that it finds necessary to process my mortgage loan application or to review it for quality-control purposes I understand that a credit report will be ordered from a credit reporting agency for verification prior to loan closing as part of the application process and may be ordered after closing as part of the Lenderrsquos quality-control program A credit report may also be completed as part of the Lenderrsquos servicing or collection of the loan or in consideration of any other product or service that the Lender may consider offering me in the future and at any time throughout the life of the loan I understand that use of a photocopy of this form may be necessary to verify one or more of my credit references I understand that a photocopy or fax copy of this form will also serve as authorization
By signing below each applicant acknowledges (1) making the above certifications and authorizations and (2) that each applicant has received and understands the above notices and disclosures
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
You do not have to give us this information but if you donrsquot your application for approval as a borrower may be delayed or rejected The information requested in this form is authorized by Title 38 USC Chapter 37 (if VA) by 12 USC Section 1701 et seq (if HUDFHA) by 42 USC Section 1452b (if HUDCPD) and Title 42 USC 1471 et seq or 7 USC 1921 et seq (if USDA FHA)
Updated December 2021 99177-GA-0215
1b
2b
Form 4506-C (September 2020)
Department of the Treasury - Internal Revenue Service
IVES Request for Transcript of Tax Return OMB Number
1545-1872
Do not sign this form unless all applicable lines have been completed Request may be rejected if the form is incomplete or illegible
For more information about Form 4506-C visit wwwirsgov and search IVES
1a Name shown on tax return (if a joint return enter the name shown first)
First social security number on tax return individual taxpayer identification number or employer identification number (see instructions)
2a If a joint return enter spousersquos name shown on tax return Second social security number or individual taxpayer identification number if joint tax return
3 Current name address (including apt room or suite no) city state and ZIP code (see instructions)
4 Previous address shown on the last return filed if different from line 3 (see instructions)
5a IVES participant name address and SOR mailbox ID
DataVerify 875 Greentree Rd 8 Parkway Center Pittsburgh PA 15220
5b Customer file number (if applicable) (see instructions)
Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing (see instructions)
6 Transcript requested Enter the tax form number here (1040 1065 1120 etc) and check the appropriate box below Enter only one tax form number per request 1040
a Return Transcript which includes most of the line items of a tax return as filed with the IRS A tax return transcript does not reflect changes made to the account after the return is processed Transcripts are only available for the following returns Form 1040 series Form 1065 Form 1120 Form 1120-A Form 1120-H Form 1120-L and Form 1120S Return transcripts are available for the current year and returns processed during the prior 3 processing years
b Account Transcript which contains information on the financial status of the account such as payments made on the account penalty assessments and adjustments made by you or the IRS after the return was filed Return information is limited to items such as tax liability and estimated tax payments Account transcripts are available for most returns
c Record of Account which provides the most detailed information as it is a combination of the Return Transcript and the Account Transcript Available for current year and 3 prior tax years
7 Form W-2 Form 1099 series Form 1098 series or Form 5498 series transcript The IRS can provide a transcript that includes data from these information returns State or local information is not included with the Form W-2 information The IRS may be able to provide this transcript information for up to 10 years Information for the current year is generally not available until the year after it is filed with the IRS For example W-2 information for 2016 filed in 2017 will likely not be available from the IRS until 2018 If you need W-2 information for retirement purposes you should contact the Social Security Administration at 1-800-772-1213
Caution If you need a copy of Form W-2 or Form 1099 you should first contact the payer To get a copy of the Form W-2 or Form 1099 filed with your return you must use Form 4506 and request a copy of your return which includes all attachments
8 Year or period requested Enter the ending date of the tax year or period using the mmddyyyy format (see instructions)
12 31 2020 12 31 2019 12 31 2018 Caution Do not sign this form unless all applicable lines have been completed
Signature of taxpayer(s) I declare that I am either the taxpayer whose name is shown on line 1a or 2a or a person authorized to obtain the tax information requested If the request applies to a joint return at least one spouse must sign If signed by a corporate officer 1 percent or more shareholder partner managing member guardian tax matters partner executor receiver administrator trustee or party other than the taxpayer I certify that I have the authority to execute Form 4506-C on behalf of the taxpayer Note This form must be received by IRS within 120 days of the signature date
Signatory attests that heshe has read the attestation clause and upon so reading declares that heshe has the authority to sign the Form 4506-C See instructions
Sign Here
Signature (see instructions) Date Phone number of taxpayer on line 1a or 2a
PrintType name
Title (if line 1a above is a corporation partnership estate or trust)
Spousersquos signature Date
PrintType name
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020) For Privacy Act and Paperwork Reduction Act Notice see page 2
Instructions for Form 4506-C IVES Request for Transcript of Tax Return
Section references are to the Internal Revenue Code unless otherwise noted
Future Developments
For the latest information about Form 4506-C and its instructions go to wwwirsgov and search IVES Information about any recent developments affecting Form 4506-C (such as legislation enacted after we released it) will be posted on that page
Whats New Form 4506-C was created to be utilized by authorized IVES participants to order tax transcripts with the consent of the taxpayer
General Instructions
Caution Do not sign this form unless all applicable lines have been completed
Designated Recipient Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information received pursuant to the taxpayerrsquos consent and holds the recipient subject to penalties for any unauthorized access other use or redisclosure without the taxpayerrsquos express permission or request
Taxpayer Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information provided pursuant to your consent and holds the recipient subject to penalties brought by private right of action for any unauthorized access other use or redisclosure without your express permission or request
Purpose of form Use Form 4506-C to request tax return information through an authorized IVES participant You will designate an IVES participant to receive the information on line 5a
Note If you are unsure of which type of transcript you need check with the party requesting your tax information
Where to file The IVES participant will fax Form 4506-C with the approved IVES cover sheet to their assigned Service Center
Chart for ordering transcripts
If your assigned Service Center is
Fax the requests with the approved coversheet to
Austin Submission Processing Center
Austin IVES Team
844-249-6238
Fresno Submission Processing Center
Fresno IVES Team
844-249-6239
Kansas City Submission Processing Center
Kansas City IVES Team
844-249-8128
Ogden Submission Processing Center
Ogden IVES Team
844-249-8129
Specific Instructions
Line 1b Enter the social security number (SSN) or individual taxpayer identification number (ITIN) for the individual listed on line 1a or enter the employer identification number (EIN) for the business listed on line 1a
Line 3 Enter your current address If you use a PO box include it on this line
Line 4 Enter the address shown on the last return filed if different from the address entered on line 3
Note If the addresses on lines 3 and 4 are different and you have not changed your address with the IRS file Form 8822 Change of Address or Form 8822-BChange of Address or Responsible Party mdash Business with Form 4506-C
Line 5b Enter up to 10 numeric characters to create a unique customer file number that will appear on the transcript The customer file number cannot contain an SSN ITIN or EIN Completion of this line is not required
Note If you use an SSN name or combination of both we will not input the information and the customer file number will reflect a generic entry of 9999999999 on the transcript
Line 8 Enter the end date of the tax year or period requested in mmddyyyy format This may be a calendar year fiscal year or quarter Enter each quarter requested for quarterly returns Example Enter 12312018 for a calendar year 2018 Form 1040 transcript
Signature and date Form 4506-C must be signed and dated by the taxpayer listed on line 1a or 2a The IRS must receive Form 4506-C within 120 days of the date signed by the taxpayer or it will be rejected Ensure that all applicable lines including lines 5a through 8 are completed before signing
You must check the box in the signature area to acknowledge you have the authority to sign and request the information The form will not be processed if unchecked
Individuals Transcripts listed on on line 6 may be furnished to either spouse if jointly filed Only one signature is required Sign Form 4506-C exactly as your name appeared on the original return If you changed your name also sign your current name
Corporations Generally Form 4506-C can be signed by
(1) an officer having legal authority to bind the corporation (2) any person designated by the board of directors or other governing body or (3) any officer or employee on written request by any principal officer and attested to by the secretary or other officer A bona fide shareholder of record owning 1 percent or more of the outstanding stock of the corporation may submit a Form 4506-C but must provide documentation to support the requesters right to receive the information
Partnerships Generally Form 4506-C can be signed by any person who was a member of the partnership during any part of the tax period requested on line 8
All others See section 6103(e) if the taxpayer has died is insolvent is a dissolved corporation or if a trustee guardian executor receiver or administrator is acting for the taxpayer
Note If you are Heir at law Next of kin or Beneficiary you must be able to establish a material interest in the estate or trust
Documentation For entities other than individuals you must attach the authorization document For example this could be the letter from the principal officer authorizing an employee of the corporation or the letters testamentary authorizing an individual to act for an estate
Signature by a representative A representative can sign Form 4506-C for a taxpayer only if the taxpayer has specifically delegated this authority to the representative on Form 2848 line 5 The representative must attach Form 2848 showing the delegation to sign Form 4506-C
Privacy Act and Paperwork Reduction Act Notice We ask for the information on this form to establish your right to gain access to the requested tax information under the Internal Revenue Code We need this information to properly identify the tax information and respond to your request You are not required to request any transcript if you do request a transcript sections 6103 and 6109 and their regulations require you to provide this information including your SSN or EIN If you do not provide this information we may not be able to process your request Providing false or fraudulent information may subject you to penalties
Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and cities states the District of Columbia and US commonwealths and possessions for use in administering their tax laws We may also disclose this information to other countries under a tax treaty to federal and state agencies to enforce federal nontax criminal laws or to federal law enforcement and intelligence agencies to combat terrorism
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law Generally tax returns and return information are confidential as required by section 6103
The time needed to complete and file Form 4506-C will vary depending on individual circumstances The estimated average time is
Learning about the law or the form 10 min Preparing the form 12 min Copying assembling and sending the form to the IRS 20 min
If you have comments concerning the accuracy of these time estimates or suggestions for making Form 4506-C simpler we would be happy to hear from you You can write to
Internal Revenue Service Tax Forms and Publications Division 1111 Constitution Ave NW IR-6526 Washington DC 20224
Do not send the form to this address Instead see Where to file on this page
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020)
Rev April 2021 CHASEO Facts What does Chase do with your personal information
Why Financial companies choose how they share your personal information Federal law gives consumers the right to limit some but not all sharing Federal law also requires us to tell you how we collect share and protect your personal information Please read this notice carefully to understand what we do
What The types of personal information we collect and share depend on the product or service you have with us This information can include bull Social Security number and income bull account balances and transaction history bull credit history and payment history
How All financial companies need to share customers personal information to run their everyday business In the section below we list the reasons financial companies can share their customers personal information the reasons Chase chooses to share and whether you can limit this sharing
Reasons we can share your personal information Does Chase share
Can you limit this sharing
For our everyday business purposes - such as to process your transactions maintain your account(s) respond to court orders and legal investigations or report to credit bureaus
Yes No
For our marketing purposes - to offer our products and services to you
Yes No
For joint marketing with other financial companies Yes No
For our affiliates everyday business purposes - information about your transactions and experiences
Yes No
For our affiliates everyday business purposes - information about your creditworthiness
Yes Yes
For our affiliates to market to you Yes Yes
For nonaffiliates to market to you Yes Yes
a
0
To limit our sharing
bull Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
bull Visit us online chasecomprivacypreferences
Please note If you are a new customer we can begin sharing your information 30 days from the date we sent this notice When you are no longer our customer we continue to share your information as described in this notice However you can contact us at any time to limit our sharing
Questions
Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
PAGE 2
Who we are
Who is providing this notice The US consumer financial companies within the JPMorgan Chase amp Co family including JPMorgan Chase Bank NA Chase Insurance Agency Inc and JP Morgan Securities LLC
What we do
How does Chase protect my To protect your personal information from unauthorized access and use we personal information use security measures that comply with federal law These measures include
computer safeguards and secured files and buildings We authorize our employees to get your information only when they need it to do their work and we require companies that work for us to protect your information
How does Chase collect my We collect your personal information for example when you personal information bull open an account or make deposits or withdrawals from your account
bull pay your bills or apply for a loan bull use your credit or debit card We also collect your personal information from others such as credit bureaus affiliates or other companies
Why cant I limit all sharing Federal law gives you the right to limit only bull sharing for affiliates everyday business purposes - information about your
creditworthiness bull affiliates from using your information to market to you bull sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing See below for more on your rights under state law
What happens when I limit sharing for an account I hold jointly with someone else
Your choices will apply to everyone on your account
Definitions
Affiliates Companies related by common ownership or control They can be financial and non financial companies bull Our affiliates include companies with a Chase or JP Morgan name and financial companies such asjP Morgan Securities LLC
Nonaffiliates Companies not related by common ownership or control They can be financial and non financial companies bull Nonaffiliates we share with can include companies such as retailers auto dealers auto makers and membership clubs
Joint marketing A formal agreement between nonaffiliated financial companies that together market financial products or services to you bull Our joint marketing partners include categories of companies such as insurance companies
Other important information
VT Accounts with a Vermont mailing address are automatically treated as if they have limited the sharing as described on page 1 For joint marketing we will only disclose your name contact information and information about your transactions
NV We are providing you this notice pursuant to Nevada law If you prefer not to receive marketing calls from us you may be placed on our Internal Do Not Call List by calling 1-800-945-9470 or by writing to us at PO Box 734007 Dallas TX 75373-4007
For more information contact us at the address above or email PrivacylnfoJPMChasecom with Nevada Annual Notice in the subject line You may also contact the Nevada Attorney Generals office Bureau of Consumer Protection Office of the Nevada Attorney General 555 E Washington St Suite 3900 Las Vegas NV 89101 telephone number 1-702-486-3132 email BCPINFOagstatenvus
CA Accounts with a California mailing address are automatically treated as if they have limited the sharing with nonaffiliates as described on page 1 CA residents are provided a CA notice for additional choices
CHASE O
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
The following disclosure is required by the USA PATRIOT Act
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 opens an account
What this means to you When you 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 drivers
license or other identifying documents
99177-PAT-0215
VETERAN STATEMENT When this loan was opened the US Department of Veterans Affairs (VA) used the veteran borrowerrsquos entitlement which is a set amount the VA promises to repay a lender if the borrower defaults on the mortgage An assumption will modify who is obligated to pay the existing mortgage loan but all loan termsmdashincluding the entitlementmdashwill remain the same If the veteran borrower is being removed from the loan the entitlement would remain with whoever is assuming the loan because the loan will continue to be serviced by the VA If the applicant is also a veteran and can substitute his or her entitlement for the current entitlement then the current borrowerrsquos entitlement can be released
Please review the following questions and answer as appropriate This form requires completion by both the applicant(s) and current borrower(s)
1 Applicant to Complete
Are you (the applicant) currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the reverse side)
Yes (If yes please provide the information requested below answer the question in section 3 and sign and date this form at the bottom of the reverse side)
Name of applicant(s) who answered ldquoyesrdquo to the above question
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Are you receiving VA disability benefts
Applicant
Yes
No
Co-Applicant
Yes
No
Are you entitled to receive VA disability benefts Yes No Yes No
Have you received VA disability benefts in the past Yes No Yes No
Are you a surviving spouse of a veteran who died on active duty or as the result of a service-related disability
Yes No Yes No
Do you have any VA loans Yes No Yes No
2 Current Borrower to Complete
Is the current borrowerco-borrower currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the page)
Yes (If yes please answer the question in section 3 and sign and date this form at the bottom of the page)
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
________________________________________________________________________________________________
3 Applicant and Current Borrower to Complete
If the answer to the questions in section 1 and 2 are both yes please answer the following question After yoursquove reviewed and completed this entire form please sign and date at the bottom
Applicant Current Borrower
Do you want to apply for a substitution of entitlement Yes Yes No No
In order to complete a substitution of entitlement the veteran applicant must have suffcient entitlement to substitute for that of the current borrower Contact the VA Offce of Jurisdiction for your area for more information Also before the veteran applicant can substitute entitlement on a VA loan heshe must certify that the property securing the loan will be occupied as hisher primary residence Both the applicantrsquos and current borrowerrsquos original certifcate of eligibility will be required If your sales contract is contingent upon the restoration of entitlement please contact your VA Offce of Jurisdiction for complete procedures Otherwise the substitution will be completed after the loan has been approved and closed
Date Applicant printed name Applicant signature
Date Applicant printed name Applicant signature
Date Current Borrower printed name Current Borrower signature
Date Current Borrower printed name Current Borrower signature
Forms completed by Mail Phone
For Chase use only
Interviewer signature Date
99177-VS-0215
- Assumption Application Package_41521-noscannedpages-update-4pdf
-
- 1 FM203 Cover Pagepdf
- 2 FM202 Mortgage Assumption Application Package pagepdf
- 3 The Documents Youll need to Send Uspdf
- 4 FM201 FAQpdf
- 5 FM142 CIWpdf
- 6 FM126 URLApdf
- 7 FM130 URLA Instpdf
-
- Blank Page
-
- 8 92900a Addednum to Loan Applicationpdf
- 9 FM462 Gen Authpdf
- 10 FM220 4506-Cpdf
- 11 FM153 Chase Federal Privacy Noticepdf
- 12 FM144 Info on Opening a New Accountpdf
- 13 FM152 Veteran Statementpdf
-
- Date
- Loan number
- Applicant name
- Phone1
- Loan number 1
- Loan number 2
- Other
- Other_2
- 1
- 2
- undefined_7
- Available hours
- Available hours_2
- undefined_8
- Available hours_3
- undefined_9
- Current address 1
- Neither
- Available hours_4
- Available hours_5
- undefined_10
- Available hours_6
- 1_2
- 2_2
- undefined_11
- Available hours_7
- Available hours_8
- undefined_12
- Available hours_9
- FHA Case No include any suffix
- Mortgagee Case No
- Mortgagee ID
- Sponsor ID
- Agent ID
- Name and Address of Sponsor Name and Address of Agent
- Borrowers Name Present Address include ZIP Code Property Address
- include name of subdivision lot block no ZIP Code
- Name of ThirdParty Originator
- NMLS ID of ThirdParty Originator
- s application
- ty Number
- ty Number_2
- Date Signed_2
- Date Mortgage Approved
- Date Approval Expires
- Printed Name
- Title 1
- DEs ID Number
- DEs ID Number_2
- Mortgagee
- Name of Mortgagees Representative
- Title of Mortgagees Representative
- Signature of the Mortgagees Representative
- Date_2
- Applicant names 1
- Applicant names 2
- Applicant names 3
- Loan number_2
- Date_3
- Applicant printed name
- Social Security number
- Date_4
- Applicant printed name_2
- Social Security number_2
- Date_5
- Applicant printed name_3
- Social Security number_3
- Date_6
- Applicant printed name_4
- Social Security number_4
- 1a Name shown on tax return if a joint return enter the name shown first
- 1b First social security number on tax return individual taxpayer identification number or employer identification number see instructions
- 2a If a joint return enter spouses name shown on tax return
- 2b Second social security number or individual taxpayer identification number if joint tax return
- 4 Previous address shown on the last return filed if different from line 3 see instructions
- 5a IVES participant name address and SOR mailbox ID
- Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing see instructions
- Signature see instructions
- Date_7
- Phone number of taxpayer on line 1a or 2a
- PrintType name
- Here
- Spouses signature
- Date_8
- PrintType name_2
- Name
- Date of birth
- Service number
- Name_2
- Date of birth_2
- Service number_2
- Date_9
- Applicant printed name_5
- Date_10
- Applicant printed name_6
- Date_11
- Current Borrower printed name
- Date_12
- Current Borrower printed name_2
- Date_13
- Text3
- Text10
- undefined_13
- Text15
- undefined_14
- undefined_15
- undefined_16
- undefined_17
- undefined_18
- undefined_19
- undefined_20
- undefined_21
- undefined_23
- Reason for assumption Off
- Requestors relationship to owners Off
- Check one Off
- Check one1 Off
- Day1
- Evening
- Cell phone
- Check one2 Off
- Check one3 Off
- Check one4 Off
- Check one5 Off
- Text2-1
- Text2-2
- Text2-3
- Text2-4
- Text2-5
- Text2-6
- Text3-1
- Text3-2
- Text3-3
- Text3-4
- Text3-6
- Text3-7
- Text3-8
- Text3-9
- Text3-10
- Text3-11
- Text3-12
- Text3-13
- Text3-14
- Text3-15
- Text3-16
- Text3-17
- Text3-18
- Text3-19
- Text3-20
- Text3-21
- Text3-22
- Text3-23
- Text3-24
- Text3-25
- Text3-26
- Text3-27
- Text3-28
- Text3-29
- Text3-30
- Text3-31
- Text3-32
- Text3-33
- Text3-34
- Text3-35
- Text3-36
- Text3-37
- Text3-38
- Text3-39
- Text3-40
- Text3-41
- Text3-42
- Text3-43
- Text3-44
- Text3-45
- Text3-46
- Text3-47
- Text3-48
- Text3-49
- Text3-50
- Text3-51
- Text3-52
- Text3-53
- Text3-5
- Text3-54
- Text3-55
- Text3-56
- Citizenship Off
- Type of credit Off
- Marital Status Off
- Housing Off
- Housing1 Off
- ownership Off
- DNA1 Off
- DNA2 Off
- DNA3 Off
- family Off
- BO Off
- Total
- Text31
- Text32
- Text33
- Text34
- Text35
- Text36
- Text37
- Text38
- Text39
- Text310
- Text311
- Text312
- Text313
- Text314
- Text315
- Text316
- Text317
- Text318
- Text319
- ownership1 Off
- Total1
- Total1-2
- Check Box4-1 Off
- Text320
- Text321
- Text322
- Text323
- Text324
- Text325
- Text326
- Text327
- Text328
- Text329
- Check Box4-2 Off
- Check Box4-3 Off
- Check Box4-4 Off
- Check Box4-8 Off
- Check Box4-9 Off
- Text330
- Text331
- Text332
- Text333
- Text334
- Text335
- Text1-1
- Text1-2
- Text1-3
- Text1-4
- Text1-5
- Text1-6
- Text1-7
- Text1-8
- Text1-9
- Text1-10
- Text1-11
- Text1-12
- Text1-13
- Text1-14
- Text1-15
- Text1-16
- Text1-17
- Text1-18
- Text1-19
- Text1-20
- Text1-21
- Text1-22
- Text1-23
- Text1-24
- Text1-25
- Text1-26
- Text1-27
- Text1-28
- Text1-29
- Text1-30
- Text1-31
- Text1-32
- Text1-33
- Text1-34
- Text1-35
- Check Box3-2 Off
- Check Box2-1 Off
- Check Box2-2 Off
- Check Box2-3 Off
- Check Box2-4 Off
- Check Box2-5 Off
- Text1-36
- Text1-37
- Text1-38
- Text1-39
- Text1-40
- Text1-41
- Text1-42
- Text1-43
- Text1-44
- Text1-45
- Text1-46
- Text1-47
- Text1-48
- Text1-49
- Text1-50
- Text1-51
- Text1-52
- Text1-53
- Text1-54
- Text1-55
- Text1-56
- Text1-57
- Text1-58
- Text1-59
- Text1-60
- Text1-61
- Check Box3-11 Off
- A1
- A2
- A3
- A4
- A5
- A6
- A7
- A8
- A9
- A10
- A11
- A12
- Check Box3-1 Off
- Check Box30-1 Off
- Check Box30-2 Off
- Check Box30-4 Off
- Check Box30-5 Off
- Check Box30-7 Off
- Check Box30-8 Off
- Check Box30-9 Off
- Check Box30-10 Off
- Check Box30-11 Off
- Check Box30-12 Off
- A13
- A14
- A15
- A16
- A17 Off
- A18
- A19
- A20
- A21
- A22
- A23
- A24
- A25
- A26
- A27
- A28
- A29
- A30
- A31
- A32
- A33
- A34
- A35
- A36
- A37
- A38 Off
- A39
- A40
- A41
- A42
- A43
- A44
- A45
- A46
- A47
- A48
- A49
- A50
- A51
- A52
- A53
- A54
- A55
- A56
- A57
- A58
- A59
- A60
- A61
- A62
- A63
- A64
- A65
- A66
- A67
- A68
- A69
- A70
- A71
- A72
- A73
- A74
- Loan Purpose Off
- occupancy1 Off
- lien type Off
- lientype Off
- mixed use Off
- manufactured home Off
- deposit1 Off
- deposit2 Off
- B1
- B2
- B3
- B4
- B5
- B6
- B7
- B8
- B9
- B10
- fha Off
- Check Box51 Off
- B11
- B12
- B13
- B14
- B15
- B16
- B17
- B18
- B19 Off
- B20
- B21
- B22 Off
- B23
- B24
- B25
- B26
- B27
- B28
- A
-
- Will you occupy the property as your primary residence Off
- Will you occupy the property as your primary residence1 Off
-
- If yes have you had an ownership interest in another property in the last three years Off
- Text9-2
- B
-
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property Off
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property1 Off
-
- 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 Off
- 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 application1 Off
-
- 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 Off
- 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 application1 Off
-
- new credit Off
- 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) Off
- the Property Assessed Clean Energy Program)1 Off
-
- F
-
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application Off
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application1 Off
-
- G
-
- Are there any outstanding judgments against you Off
- Are there any outstanding judgments against you1 Off
-
- H
-
- Are you currently delinquent or in default on a Federal debt Off
- Are you currently delinquent or in default on a Federal debt1 Off
-
- I
-
- Are you a party to a lawsuit in which you potentially have any personal financial liability Off
- Are you a party to a lawsuit in which you potentially have any personal financial liability1 Off
-
- J
-
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years Off
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years1 Off
-
- 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 Off
- 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 due1 Off
-
- L
-
- Have you had property foreclosed upon in the last 7 years Off
- Have you had property foreclosed upon in the last 7 years1 Off
-
- M
-
- Have you declared bankruptcy within the past 7 years Off
- Have you declared bankruptcy within the past 7 years1 Off
-
- Check Box8-2 Off
- Check Box8-3 Off
- Check Box8-4 Off
- Text9-3
- Text9-5
- Text9-6
- Text97
- military Off
- ethnicity Off
- sex Off
- race Off
- demo Off
- Text12-1
- Check Box11-1 Off
- Check Box11-2 Off
- Check Box11-3 Off
- Check Box11-4 Off
- Check Box11-5 Off
- Check Box11-6 Off
- Check Box11-7 Off
- Check Box11-8 Off
- Check Box11-9 Off
- Text12-2
- Check Box11-10 Off
- Check Box11-11 Off
- Check Box11-12 Off
- Check Box11-13 Off
- Check Box11-14 Off
- Check Box11-15 Off
- Text12-3
- Check Box11-16 Off
- Check Box11-17 Off
- Check Box11-18 Off
- Check Box11-19 Off
- Check Box11-20 Off
- Check Box11-21 Off
- Check Box11-22 Off
- Check Box11-23 Off
- Text12-4
- Check Box11-24 Off
- Check Box11-25 Off
- Check Box11-26 Off
- Check Box11-27 Off
- Check Box11-28 Off
- Check Box11-29 Off
- Text12-5
- Check Box11-30 Off
- Check Box11-31 Off
- citizen Off
- credit Off
- marital status1 Off
- housing-1 Off
- housing-2 Off
- own Off
- C1
- C2
- C3
- C6
- C7
- C8
- C9
- C10
- C11
- C12
- C13
- C14
- C15
- C16
- C17
- C18
- C19
- C20
- C21
- C22
- C23
- C24
- C25
- C26
- C27
- C28
- C29
- C30
- C31
- C32
- C33
- C34
- C35
- Check Box-2 Off
- C36
- C37
- C38
- C39
- C4
- C40
- C41
- C42
- C43
- C44
- C45
- C46
- C47
- Check Box-3 Off
- Check Box-4 Off
- C48
- C49
- C5
- C50
- C51
- C52
- C53
- C54
- C55
- Check Box-1-1 Off
- own1 Off
- Check Box-1 Off
- D1 Off
- D2
- D3
- D4
- D5
- D6
- D7
- D8
- D9
- D10
- D11
- D12
- D13
- D14 Off
- D15 Off
- D16
- D17
- D18
- D19
- D20
- D21
- D22
- D23
- D24 Off
- D25
- D26
- D27
- D28
- D29
- D30
- D31
- D32
- D33
- D34
- D35 Off
- D36
- D37 Off
- D38
- D39
- D40
- D41
- D42
- D43
- D44
- D45
- D46
- D47
- If yes have you had an ownership interest in another property in the last three years1 Off
- new credit1 Off
- Check Box8-1 Off
- Check Box8-1-2 Off
- Check Box8-1-1 Off
- Check Box8-1-3 Off
- Check Box8-1-4 Off
- Military Service mdash Did you (or your deceased spouse) ever serve or are you currently serving in the United States Armed Forces 1 Off
- Check1 Off
- Text9-1-1
- Check2 Off
- Check3 Off
- Check4 Off
- Text9-1
- E1
- E2
- E3
- Was the ethnicity of the Borrower collected on the basis of visual observation or surname1 Off
- Was the sex of the Borrower collected on the basis of visual observation or surname1 Off
- Was the race of the Borrower collected on the basis of visual observation or surname1 Off
- The Demographic Information was provided through1 Off
- F1 Off
- F2 Off
- F3 Off
- F4 Off
- F5 Off
- F6
- F7 Off
- F8 Off
- F9 Off
- F10 Off
- F11 Off
- F12 Off
- F13
- F14 Off
- F15 Off
- F16 Off
- F17 Off
- F18 Off
- F19 Off
- F20 Off
- F21 Off
- F22
- F23 Off
- F24 Off
- F25 Off
- F26 Off
- F27 Off
- F28 Off
- F29
- F30 Off
- F31 Off
- undefined_13-1
- undefined_13-2
- undefined_14-1
- undefined_15-1
- undefined_16-1
- undefined_17-1
- undefined_18-1
- undefined_19-1
- undefined_21-1
- undefined_20-1
- undefined_23-1
- undefined_13_1
- Single-Two Off
- Refi type Off
- refi program Off
- Estate Off
- Title held Off
- Trust Information Off
- Indian Country Land Tenure Off
- Mortgage Type Applied For Off
- Mortgage Lien Type Off
- Amortization Type Off
- G1 Off
- G2 Off
- G3 Off
- G4 Off
- G5 Off
- G6
- G7
- G8
- G9
- G10 Off
- G11 Off
- G12 Off
- G13 Off
- G14 Off
- G15 Off
- G16
- G17
- G18
- G19
- G20
- G21
- G22
- G23 Off
- G24
- G25 Off
- G26
- G27 Off
- G28 Off
- G29
- G30 Off
- G31
- G32 Off
- G33
- G34
- G35
- G36
- G37
- G38
- G39
- G40
- G41
- G42
- Property Held
- refi
- Text18-1
- Text18-2
- Text18-3
- Text18-4
- Text18-5
- Text18-6
- Text18-7
- Text18-8
- Text18-9
- Text18-10
- Text18-11
- Text18-12
- Text18-13
- Text18-14
- Text18-15
- Text18-16
- Text18-17
- Text18-18
- Text18-19
- Lender
- case no
- If you selected ldquoUnmarriedrdquo in Section 1 is there a person who is not your legal spouse but who currently has real property rights similar to those of a legal spouse Off
- Relationship and State Off
- Other-5
- Text19-1
- BName
- Additional Information
- ABN
- Additional Information1
- BSign
- BSDate
- ABSign
- ABDate
- MortageeNameAddress
- NAmeAddress
- Bname1
- DOB1
- DOB2
- SignOfBorr1
- SignOfBorr
- Date Signed
- SignOfBorr2
- SignOfBorr3
- Date Signed3
- Date Signed4
- MortgageeRepSign
- DirectSign
- DirectSign1
- Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union Off
- AppSign
- AppSign1
- AppSign2
- AppSign3
- Nopage38 Off
- Yespage38 Off
- Yes1 Off
- No1 Off
- Yes2 Off
- Yes3 Off
- Yes4 Off
- Yes5 Off
- Yes6 Off
- Yes7 Off
- Yes8 Off
- Yes9 Off
- Yes10 Off
- No2 Off
- No3 Off
- No4 Off
- No5 Off
- No6 Off
- No7 Off
- No8 Off
- No9 Off
- No10 Off
- BorrowerNo Off
- BorrowerYes Off
- AppSignature
- AppSignature1
- CurrentSign
- CurrentSign1
- InterviewSign
- Yes_1 Off
- No_1 Off
- Yes_2 Off
- No_2 Off
- Mail Off
- Phone Off
Pay stubs from the past 30 days or if self-employed personal and business
returns from the past two years
Previous two years of W-2 forms (if applicable)
Previous two years of 1099 forms (if applicable)
Previous two months of bank statements (all pages)
Most recent quarterly 401(k) statement (all pages)
Final divorce decree or court-approved settlement agreement (if applicable)
Sales contract (if applicable)
Copy of death certificatewill (if applicable)
THE DOCUMENTS YOUrsquoLL NEED TO SEND US
Anyone who will be remaining on or added to the existing loan will need to return the following
information with the assumption applicationmdashwe canrsquot proceed with the application until wersquove
received all of the documents listed below
Please note that we may have also enclosed additional documents that are required for your situation that
arenrsquot listed below If applicable please review and sign these documents and return them to us with the
completed documents listed below
Please complete these enclosed forms and return them to us in the provided prepaid envelope
Uniform Residential Loan Application (Freddie Mac Form 65Fannie Mae Form 1003)
General Authorization for a Mortgage Loan Assumption
Customer Information Worksheet
IRS Form 4506-C (Request for Transcript of Tax Return)
Please gather and send us the following documents for review
Copy of current property deed evidencing a transfer (if applicable)
You can fax mail or email the application and required documents to
Fax Mail Email 1-855-372-0605 Chase mortgageassumptionjpmchasecom
700 Kansas Lane Mail Code LA4-6888 Monroe LA 71203
99177-DOCS-0215
FREQUENTLY ASKED QUESTIONS
A loan assumption lets the borrower change who is financially responsible for the loan It could
involve adding or removing borrowers or transferring the loan to someone else Please review
these questions about eligibility for and alternatives to a loan assumption
ELIGIBILITY
How do you determine eligibility
We look at the credit history assets and income of the person who wants to assume the loan from the borrower
Will my credit history be considered
Yes wersquoll review your credit score and consider your credit history
Do the borrower and the person who assumes the loan have to be related
In some cases yes Wersquoll review your eligibility after we receive all the documents we need
What if the purpose of the property will change for example from a primary residence to an investment property
We may allow a change in the propertyrsquos purpose but in many cases we wonrsquot allow a change in occupancy
Can my loan be assumed if I completed a loan modification
We usually require that you wait one to four years after a modification before applying for an assumption
Can I have a previous bankruptcy or foreclosure in my credit history
We require that you wait four years after a bankruptcy and six years after a foreclosure before applying for an assumption
Can I still apply for mortgage assistance
Yes but assuming the loan may limit the assistance options yoursquore eligible for
FEES
Are there costs associated with an assumption
There are closing costs for completing an assumption These costs usually total about $1500 for every $100000 of the unpaid loan amount
Can closing costs be included in the loan amount
No All closing costs must be paid at the time of closing We canrsquot increase the amount owed on an existing loan as we can with a refinanced loan
GENERAL
Is it better to refinance the loan or assume responsibility for the existing loan
The rates and terms for refinancing could be better than the current loan terms visit chasecom for our rates When you refinance you can roll the closing costs into the loan amount In an assumption we canrsquot modify the existing loan terms
How long does an assumption take
Usually 70 to 90 days
Why do I have to qualify for the assumed loan if Irsquom on the current one
We need to make sure that you can afford the loan under the new circumstances
If I own the property will an assumption change that
An assumption by itself doesnrsquot change ownership of the property but ownership may change at the same time We recommend getting independent legal advice or consulting with a title company
ID 3188620 FM201
IN THE EVENT OF A DEATH
Is an assumption my only option
You may have the option to be added to the loan as a successor in interest
You wonrsquot be responsible for repaying the loan but will get access to account information and statements There are no fees to be added as a successor in interest
If you assume the loan yoursquoll be financially responsible for repaying it and wersquoll report your payment information to the credit reporting agencies
IN CASES OF DIVORCE
Should I wait until my divorce or separation is final before applying for an assumption
Yes we require a separation or divorce agreement that shows who will retain rights to the property
My divorce agreement shows that my spouse is now responsible for the mortgage Why do I have to go through an assumption
We still need to review the income credit and assets of the person maintaining ownership to ensure that they qualify for the loan under the new circumstances
IN CASES OF MARRIAGE
Do I need to complete an assumption to add my spouse to the loan
Not necessarily
If you conveyed an interest in the property to your spouse they can be added to the loan as a successor in interest They wouldnrsquot be responsible for repaying the loan but would get access to account information and statements We donrsquot charge a fee to add a successor in interest
With an assumption your spouse would be financially responsible for repaying the loan and wersquoll report their payment information to the credit reporting agencies
Were here to answer all your questions and will work with you to make sure you get the assistance you needmdashcall us at 1-866-299-6752 we accept operator relay calls
ID 3188620 FM201
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[ ]
[ ]
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[ ][ ][ ]
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( )
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[ ] [ ] [ ]
[ ] [ ] [ ] [ ]
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[ ]
[ ]
ytra
P ytra
PCustomer Information Worksheet
Loan number
Address of property to be assumed
Reason for assumption ( heck one) [ ]
Divorce Death of original owner Existing owners are selling the home Other
[ ][ ][ ] ___________________________
[ [ [ [
] Spouse Child Parent Other
] ] ] ____________________________
relationship to owners (check one)
Parties to the assumption In the sections below please identify the parties associated with the assumption of the loan This includes
Individuals who will be added to the loan Individuals who are already on the loan and who will remain on the loan Individuals who are already on the loan and who will be removed from the loan
If more than three parties are associated with the assumption please provide the requested information on a separate page and attach it to this worksheet
Name
Par
ty
Current address
Check one Check one New to the loan (being added) Already on the loan and will remain Already on the loan and will be removed
Day phone
Evening phone
Cell phone
Active-duty military Military veteran Neither
Available hours
Available hours
Available hours
Name Current address
Check one Check one New to the loan (being added) Already on the loan and will remain Already on the loan and will be removed Day phone
Evening phone
Cell phone
Active-duty military Military veteran Neither
Available hours
Available hours
Available hours
Name Current address
Check one Check one New to the loan (being added)
Already on the loan and will be removed
Evening phone
Cell phone
Active-duty military Military veteran Neither
Already on the loan and will remain
Day phone Available hours
Available hours
Available hours
Esta comunicacioacuten contiene informacioacuten importante acerca de la cuenta Si tiene alguna pregunta o necesita ayuda para traducirla comuniacutequese con nosotros llamando al 1-855-280-4198
FM142
Uniform Residential Loan ApplicationVerify and complete the information onthis applicationIf you are applying for this loan with others each additional Borrower must provide
information as directed by your Lender
Section 1 Borrower Informationthis section asks about yourpersonal information and your income fromemploymentandother sources such as retirement that you want considered to qualify for this loan
1a Personal Information
Name(First Middle Last Suffix) Social Security Number - -
(orIndividual TaxpayerIdentification Number)
Alternate Names- List any namesby which you are known or any namesunderwhich credit was previously received (First Middle Last Suffix)
Date ofBirth Citizenship(mmddyyyy) USCitizen
copy PermanentResidentAliencopy Non-PermanentResidentAlien
Type of Credit List Name(s) of Other Borrower(s) Applying for this Loan
copy lamapplyingforindividual credit (First Middle Last Suffix) - Use a separator between names
copy |am applyingfor joint credit Total Numberof Borrowers_
Each Borrowerintendsto applyfor joint credit Yourinitials
Marital Status Dependents(notlisted by another Borrower) Contact Information
O Married Number __ Home Phone ( ) -
s SeparatedUnmarried
Ages CellPhone ( ) _7
(Single Divorced Widowed Civil Union Domestic Partnership Registered Work Phone (0) Ext
Reciprocal Beneficiary Relationship) Email
Current Address
Street Unit
City State ZIP Country
How Long at Current Address Years mdashMonths Housing O Noprimary housing expense copy) Own copy Rent($ month)
If at Current Addressfor LESS than 2 yearslist Former Address LC Does not apply
Street Unit
City State ZIP Country
How Long at Former Address Years mdashMonths Housing No primary housing expense Own Rent($ month)
Mailing Address- ifdifferent from CurrentAddress (| Does not apply
Street Unit
City State ZIP Country
easeaoemir ] Does not apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base $_mdashmdashmdashmdash__mdashmonth
City State ZIP Country Overtime =$_________monthBonus $ month
Position orTitle Checkif this statementapplies Commission $ month[] am employedby a family member
propertyseller real estate agent or otherparty to the transaction
TTStartDate0__mdashsmmddyy) MilitaryHow long in this line of work Years mdash_ Months Entitlements $_mdashsmontth
Other $ monthCheckif you are the Business () | have an ownershipshare of less than 25 Monthly Income(or Loss) mdashmdash_mdashOwnerorSelf-Employed O I have an ownership share of 25 or more sect TOTALS__000month
Uniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
1c IF APPLICABLE Complete Information for Additional EmploymentSelf-Employment and Income
Doesnot apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base $ month
City State ZIP Country Overtime mdash$ monthBonus $ month
Position orTitle Checkif this statementapplies Commission $ month| am employedby a family memberproperty seller real estate agent or otherparty to the transaction
Start Date mdash_mdashAA(mmddyyyy) Military
EntitlementsHow long in this line of work lsquoYears mdash_ Months $ month
7 7 Other $ monthCheckif you are the BusinessOwnerorSelf-Employed
| have an ownershipshare ofless than 25 Monthly Income(or Loss)| have an ownership share of 25 or more $ TOTAL $ 000month
PlMeNeeeMeeCee ti)LeeseteUeLimet Does not apply
Provideatleast 2 years of current and previous employment and income
Employeror Business Name Previous Gross Monthly
Street Unit Income $ month
City State ZIP Country
Position orTitleStart Date (mmddyyyy) Checkif you were the Business
Owneror Self-Employedmdash_ mdashEnd Date (mmddyyyy)
WCBeelcaTy Does not apply
Include incomefrom other sources below Under IncomeSource choosefrom the sourceslisted hereraquo Alimony+ Automobile Allowance Boarder Income
+ Capital Gains
Child Support+ Disabilitylaquo Foster Care
laquo Housing or Parsonage
+ Interest and Dividendslaquo Mortgage Credit Certificateraquo MortgageDifferential
Payments
raquo Notes Receivable+ Public Assistance- Retirement
(eg Pension IRA)
laquo Royalty Payments Separate Maintenance+ Social Security
+ Trust
laquo UnemploymentBenefits
laquo VA Compensation
cent Other
NOTEReveal alimony child support separate maintenance or other income ONLYIFyou wantit considered in determining yourqualification
for this loan
IncomeSource -mdash uselist above Monthly Income
$
$
$
Provide TOTAL AmountHere $ 000
Borrower Name
Uniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 2 Financial Information mdash Assets andLiabilities this section asks about things you ownthatare worth moneyand that you wantconsidered to qualify for this loan It then asks about your liabilities (or debts) that you pay
each month suchas credit cards alimony or other expenses
rNcee stLeVaalemities eitimeeecm dellaLC-
Include all accounts below Under Account Typechoosefrom the typeslisted here
laquo Checkinglaquo Savingsraquo Money Market
+ Certificate of Depositlaquo Mutual Fund+ Stocks
laquo Stock Optionslaquo Bonds+raquo Retirement(eg 407k IRA)
laquo Bridge Loan ProceedslaquoIndividual DevelopmentAccount
Trust Account- Cash Value ofLife Insurance(usedfor the transaction)
AccountType- use list above FinancialInstitution Account Number Cash or MarketValue
$
$
$
$
$
$ 000Provide TOTAL AmountHere|
Includeall other assets and credits below UnderAsset or Credit Type choose from the typeslisted here
Assets Credits- Proceeds from Real EstateProperty to be sold on orbefore closing
laquo Proceeds from Sale ofNon-Real Estate Asset
- Secured Borrowed Funds
cent Unsecured Borrowed Funds Other
raquo Earnest MoneylaquoEmployer Assistance- Lot Equity
Relocation Funds_raquo Rent Credit
laquo Sweat Equity+ Trade Equity
Assetor Credit Type mdash uselist above Cash or Market Value
$
$
$
$
$ 000Provide TOTAL AmountHere
2c Liabilities - Credit Cards Other Debts and Leases that You Owe C Does not apply
List all liabilities below (except real estate) and include deferred payments Under Account Type choose from thetypeslisted herelaquoRevolving (eg credit cards) +Installment (eg car student personal loans) Open 30-Day (balance paid monthly) + Lease (not realestate) +Other
Account Type mdashuse list above
To be paid offator before closingCompany Name Account Number Unpaid Balance Monthly Payment
$ $
$ $
$ $
$ $
$ $
2d OtherLiabilities and Expenses Does not apply
Includeall otherliabilities and expenses below Choose from the typeslisted here
+ Alimony Child Support -Separate Maintenance +JobRelatedExpenses +Other Monthly Payment
$
$
$
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 3 Financial Information mdash Real Estatethis section asks youtolist all properties you currently ownand what you owe onthem donot own anyreal estate
3a Property You Own If you are refinancinglist the property you are refinancing FIRST
Address Street Unit
City State ZIP Country
Sol Intended Occupancyinvestment PrimaryResidence SecondHome Other
Monthly InsuranceTaxesAssociation Duesetcifnot included in MonthlyMortgage Payment
For 2-4 Unit Primary or Investment PropertyStatus SoldPending Saleor Retained
=Monthly RentalIncomeProperty Value
$ $ $
Mortgage Loanson this Property Does not apply
MonthlyMortgagePayment
Type FHA VAConventionalUSDA-RD Other|
To be paid offator before closing
Credit Limit(ifapplicable)Creditor Name Account Number Unpaid Balance
$ $ $
$ $ $
3b IF APPLICABLE Complete Information for Additional Property Does not apply
Address Street Unit
City State ZIP Country
ldquoSold Intended Occupancyinvestment PrimaryResidence SecondHome Other
Monthly Insurance TaxesAssociation Duesetcifnot included in MonthlyMortgage Payment
For 2-4 Unit Primary or Investment PropertyStatus SoldPendingSaleor Retained
Monthly RentalIncomeProperty Value
$ $ $
Mortgage Loanson this Property Does not apply
Monthly
Mortgage
Payment
Type FHA VA
Conventional
USDA-RD Other|
To be paid offat
or before closing
Credit Limit
(ifapplicable)Creditor Name Account Number Unpaid Balance
$ $ $
$ $ $
$ $ $
$ $ $
$ $ $
3c IF APPLICABLE Complete Information for Additional Property Does not apply
Address Street Unit
City State ZIP Country
Intended Occupancyinvestment PrimaryResidence SecondHome Other
Monthly Insurance TaxesAssociation Duesetcifnot included in MonthlyMortgage Payment
For 2-4 Unit Primary or Investment PropertyStatus SoldPending Saleor Retained
Monthly RentalIncomeProperty Value
Mortgage Loanson this Property Does not apply
MonthlyMortgagePayment
Type FHA VAConventionalUSDA-RD Other|
To be paid offator before closing
Credit Limit(ifapplicable)Creditor Name Account Number Unpaid Balance
Borrower Name
Uniform Residential Loan Application
Freddie Mac Form 65 +raquo Fannie Mae Form 1003
Effective 12021
Section 4 Loan and Property Informationthis section asks about the loanrsquos purpose and the property youwantto purchase orrefinance
4a Loan and Property Information
LoanAmount $ Loan Purpose Purchase efinance Other(specify)
Property Address Street Unit
City State ZIP County
Numberof Units Property Value $
Occupancy Primary Residence Second Home InvestmentProperty FHA Secondary Residence
1 Mixed-Use PropertyIf you will occupy the propertywill you set aside space within the property to operate
your ownbusiness(eg daycare facility medicaloffice beautybarber shop)NO YES
2 Manufactured HomeIs the property a manufactured home(eg a factory built dwelling built on a permanentchassis) NO YES
4b Other New Mortgage Loansonthe Property Youare Buying or Refinancing Does not apply
LoanAmountAmountto be Drawn
Credit Limit(ifapplicable)Creditor Name Lien Type Monthly Payment
First Lien Subordinate Lien $ $ $
$ $ $First Lien SubordinateLien
4c Rental Income on the Property You Wantto Purchase For Purchase Only Does not apply
Completeif the property is a 2-4 Unit Primary Residence or an Investment Property Amount
Expected Monthly Rental Income $
Doesnot apply4d Gifts or Grants You Have Been GivenorWill Receive for this Loan
Includeall gifts and grants below Under Source choose from the sourceslisted here
Community Nonprofitlaquo Employer
raquo Federal Agencyraquo Local Agency
- Relative+ Religious Nonprofit
+ State Agency+ Unmarried Partner
raquo Lender Other
Asset TypeCash Gift Gift of Equity Grant DepositedNot Deposited Source - uselist above Cash or Market Value
Deposited Not Deposited $
$Deposited Not Deposited
Borrower Name
Uniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 5 DeclarationsThis section asks youspecific questions about the property your funding and yourpastfinancial history
5aAboutthis Property and Your Moneyfor this Loan
A Will you occupy the property as your primary residence
If YES have you had an ownershipinterest 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 investmentproperty(IP)
(2) How did you holdtitle to the property by yourself (S) jointly with your spouse(SP) or jointly with another person (O)
YESYES
B If this is a Purchase Transaction Do you have a family relationship or businessaffiliation with the seller of the property NO YES
C Are you borrowing any moneyforthis real estate transaction (eg money foryour closing costs or down payment) orobtaining any moneyfrom anotherparty such astheseller or realtor that you have notdisclosed on this loan application NO YES
If YES what is the amountof this money $
D 1 Have you orwill you be applying for a mortgage loan on anotherproperty (not the property securing this loan) on or
before closing this transaction that is not disclosed on this loan application
NO YES
2 Have you orwill you be applying for any newcredit (eg installment loan credit card etc) on or before closing this loan that
is not disclosed on this application
No YES
E Will this property be subject to a lien that could take priority over the first mortgagelien such as a clean energylien paid
through yourproperty taxes(eg the PropertyAssessed Clean Energy Program)NO YES
5b About YourFinances
F Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application NO YES
G Are there any outstanding judgments against you No YES
H Areyou currently delinquentor in default on a Federal debt No YES
I Areyou a party to a lawsuit in which you potentially have any personalfinancialliability NO YES
J Have you conveyedtitle to any property in lieu of foreclosure in the past 7 years NO YES
K Within the past 7 years have you completed a pre-foreclosure sale or short sale whereby the property wassold to a
third party and the Lenderagreed to acceptless than the outstanding mortgage balance due
NO YES
L Have you hadproperty foreclosed uponin thelast 7 years NO YES
M Have you declared bankruptcy within the past 7 years ONO YESIf YES identify the type(s) of bankruptcy Chapter7 Chapter11 Chapter12 Chapter 13
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 6 Acknowledgments and AgreementsThis section tells you about yourlegal obligations whenyousign this application
Acknowledgments and Agreements
Definitions- Lenderincludes the Lenderrsquos agents service providers and any oftheir successors andassigns
Other Loan Participantsrdquo includes(i) any actual or potential owners of
a loan resulting from this application (the ldquoLoanrsquo)(ii) acquirers ofany beneficial or other interest in the Loan(iii) any mortgageinsurer(iv) any guarantor (v) any servicer of the Loan and (vi) any of theseparties service providers successors or assigns
I agree to acknowledgeand representthe following
(1) The Complete Informationfor this Application- The information | have providedin this application is true accurate
and completeas of the date | signed this application
laquo If the information | submitted changesor | have new information
before closing of the Loan | must change and supplementthis
application including providing any updatedsupplementedrealestate sales contract
- For purchase transactions The terms and conditionsof anyrealestate sales contract signed by mein connection with this application
are true accurate and complete to the best of my knowledge andbelief | have not entered into any other agreement written ororal inconnection withthis real estate transaction
- The Lender and OtherLoan Participants mayrely on the informationcontainedin the application before and after closing of the Loan
- Any intentional or negligent misrepresentation of information may
result in the impositionof(a) civil liability on me including monetary damagesif a
person suffers any loss because the person relied on anymisrepresentation that | have made onthis application andor
(b) criminal penalties on me including but not limited to fine orimprisonment or both underthe provisions of Federal law(18 USC sectsect 1001 et seq)
(2) The Propertyrsquos SecurityThe Loan | have applied for in this application will be secured by
a mortgage or deedoftrust which provides the Lendera security
interest in the property described in this application
(3) The Propertys Appraisal Value and Condition- Any appraisal or value of the property obtained by the Lenderis
for use by the Lender and OtherLoanParticipantslaquoThe Lender and OtherLoan Participants have not made anyrepresentation or warranty express or implied to me about the
propertyits conditionorits value
(4) Electronic Records and Signatures- The Lender and OtherLoan Participants may keep any paper record
andorelectronic record of this application whether or not the Loan
is approved
BorrowerSignature
- If this application is created as (or converted into) an ldquoelectronicapplicationrdquo | consent to the use of ldquoelectronic recordsrdquo and
ldquoelectronic signaturesrdquo as the termsare defined in and governed byapplicable Federal andorstate electronic transactions laws
| intend to sign and have signedthis application either using my(a) electronic signature or(b) a written signature and agreethatif a paper version ofthis
application is converted into an electronic application theapplication will be an electronic record and the representationof my written signature on this application will be my binding
electronic signature- | agree that the applicationif delivered or transmitted to the Lenderor Other Loan Participants as an electronic record with myelectronicsignaturewill be as effective and enforceable as a paperapplicationsigned by mein writing
(5) Delinquencylaquo The Lender and OtherLoan Participants may report information about
my accountto credit bureaus Late payments missed paymentsorother defaults on my account maybereflected in my credit report andwill likely affect my credit score
- If | have trouble making my payments | understand that | may contacta HUD-approved housing counseling organization for advice about
actions I can take to meet my mortgageobligations
(6) Authorization for Use and Sharing of InformationBy signing belowin addition to the representations and agreementsmade above| expressly authorize the Lender and Other LoanParticipants to obtain use and share with each other(i) the loan
application and related loan information and documentation(ii) aconsumercredit report on me and(iii) my tax return information asnecessary to perform theactionslisted belowfor so long as they havean interest in my loanorits servicing
(a) process and underwrite myloan(b) verify any data contained in my consumercredit 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 analysisandreviews
(e) perform analysis and modeling for risk assessments(f) monitor the accountfor this loan for potential delinquencies and
determineanyassistance that may beavailable to me and
(g) other actions permissible under applicable law
Date (mmddyyyy)
Additional Borrower Signature Date (mmddyyyy)
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 7 Military ServiceThis section asks questions about your(or your deceased spouses) military service
Military Service of Borrower
Military Service mdash Did you (or your deceased spouse) everserve or are you currently serving in the United States Armed Forces NO YES
If YES check allthat apply Currently serving on active duty with projected expiration date of servicetour (mmddyyyy)
Currently retired discharged or separated from service
Only period of service was as a non-activated memberof the Reserve or National GuardSurviving spouse
Section 8 Demographic InformationThis section asks about your ethnicity sex and race
Demographic Information of Borrower
The purposeofcollecting this informationis to help ensure thatall applicants are treated fairly and that the housing needs of communities
and neighborhoodsare beingfulfilled 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 mayselect one or more designationsfor
Ethnicity and one or more designationsfor Race The law provides that we maynotdiscriminate on the basis of this information or onwhetheryou chooseto provideit However if you choose not to provide the information and you have madethis application in person Federal
regulations require us to note your ethnicity sex and race on thebasis of visual observation or surname Thelaw also provides that we may notdiscriminate on the basis of age or marital status information you providein this application If you do not wish to provide someorall of this
information please check below
Ethnicity Check one or more Race Check one or moreHispanic or Latino AmericanIndian or Alaska Native - Print nameofenrolled
or principaltribe Mexican PuertoRican CubanOther Hispanic or Latino - Print origin Asian
Asian Indian Chinese Filipino
Japanese Korean Vietnamese
OtherAsian mdash Print race
For example Hmong Laotian Thai Pakistani Cambodian and so on
Black or African American
Native Hawaiian or OtherPacific Islander
Native Hawaiian GuamanianorChamorro Samoan
For exampleArgentinean Colombian Dominican Nicaraguan
Salvadoran Spaniard andso on
Not Hispanic or Latino
| do not wish to providethis information
5Female OtherPacific Islander mdash Print race
Male For example Fijian Tongan and so on| do not wish to providethis information white
| do not wish to providethis information
Wasthe ethnicity of the Borrowercollected on the basis of visual observation or surname )NO YESWasthe sex of the Borrowercollected on the basis of visual observation or surname NO YESWastherace of the Borrowercollected on the basis of visual observation or surname NO YES
Face-to-Face Interview (includes Electronic Media w Video Component) TelephoneInterview Faxor Mail Email or Internet
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
ReelTemCrCL
Loan Originator Organization Name
Address
Loan Originator Organization NMLSR ID State License ID
Loan Originator Name
Loan Originator NMLSR ID State License ID
Date (mmddyyyy)
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Uniform Residential Loan Application mdash Additional BorrowerVerify and complete the information onthis application as directed by your Lender
Section 1 Borrower Informationthis section asks about yourpersonal information and your income fromemploymentandother sources such as retirement that you want considered to qualify for this loan
1a Personal Information
Name(First Middle Last Suffix)
Alternate Names - List any namesby which you are known or any namesunder which credit was previously received (First Middle Last Suffix)
Social Security Number - -(or Individual TaxpayerIdentification Number)
Dateof Birth Citizenship(mmddyyyy)
USCitizenPermanentResidentAlienNon-Permanent ResidentAlien
Type ofCredit| am applying for individualcredit
lam applying forjoint credit Total Number of Borrowers
Each Borrowerintendsto applyfor joint credit Your initials
List Name(s) of Other Borrower(s) Applying for this Loan
(First Middle Last Suffix) - Use a separator between names
Marital Status Dependents(notlisted by another Borrower)
Contact Information
Married Number _ Home Phone ( ) -
( ) _
( ) -mdash_ mdash_
Separated Ages CellPhone
Unmarried ens Work Phone Ext(Single Divorced WidowedCivil Union Domestic Partnership Registered
Reciprocal Beneficiary Relationship)lsquol
Emal
Current Address
Street Unit
City State ZIP Country
How Long at Current Address=Years mdashMonths Housing Noprimary housing expense Own Rent($ month)
If at Current Address for LESS than 2 yearslist Former Address Does not apply
Street Unit
City State ZIP Country
How Long at Former Address Years mdashMonths Housing Noprimary housing expense Own month)
Mailing Address- ifdifferent from CurrentAddress Does not apply
Street Unit
City State ZIP Country
eeeeCeeteiChuraleCme Doesnot apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base S$month
City State ZIP Country Overtime =$_____monthBonus $ month
Position orTitle Checkif this statementapplies Commission sect month| am employedby a family memberpropertyseller real estate agent or otherparty to the transaction
TTStart Date ____ (mmddyy) Military
Entitlements$_How longin this line of work Years =Months mdash monthSS
Other $ monthCheckif you are the BusinessOwnerorSelf-Employed
| have an ownershipshare ofless than 25 Monthly Income(or Loss) mdashmdash| have an ownership share of 25 or more $ TOTAL $ 000month
Uniform Residential Loan Application mdash Additional Borrower
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
CoeeeMCMCmeticlm tu)Comiteteilteeilelie mieit
Does not apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base
OvertimeBonus
Commission
MilitaryEntitlements
Other
$ month
$ month$ month
$ month
$ month
$ month
City State ZIP Country
Position orTitle ose if this statement applieslam employed by a family memberpropertyseller real estate agent or otherparty to the transaction
Start Date (mmddyy)How long in this line of work Years =Months
Checkif you are the Business
Owneror Self-Employed| have an ownershipshare of less than 25 Monthly Income(or Loss)
Ihave an ownership share of 25 or more $ TOTAL$ 000month
CPONMeeeMummaTestetiersdeere lire miret Does not apply
Provideat least 2 years of current and previous employment and income
Employeror Business Name Previous Gross MonthlyStreet Unit Income s month
City State ZIP Country
Position or Title
Start Date
End Date
Checkif you were the BusinessOwneror Self-Employed
(mmddyyyy)
(mmddyyyy) 1e Income from Other Sources Does not apply
Include incomefrom other sources below Under Income Source choose from the sourceslisted herelaquo Alimonylaquo Automobile Allowanceraquo Boarder Incomelaquo Capital Gains
Child Support+ Disability+ Foster Care Housing or Parsonage
+ Interest and DividendslaquoMortgage Credit Certificate Mortgage DifferentialPayments
laquo Notes Receivable+ Public Assistancelaquo Retirement(eg Pension IRA)
+raquo Royalty Payments Separate Maintenance
+ Social Security
raquo Trust
+ UnemploymentBenefits
laquo VA Compensation
laquo Other
NOTE Revealalimony child support separate maintenance or other income ONLYIFyou wantit considered in determining yourqualification
for this loan
Income Source - uselist above Monthly Income
$
$
$
$ 000Provide TOTAL AmountHere|
Section 2 Financial Information mdash Assets andLiabilities
Myinformation for Section 2 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 3 Financial Information mdash Real Estate
Myinformation for Section 3 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 4 Loan and Property Information
Myinformation for Section 4 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 5 DeclarationsThis section asks you specific questions about the property your funding and your past
financial history
5aAboutthis Property and Your Moneyforthis Loan
A Will you occupy the property as your primary residence NO YES
If YES have you had an ownershipinterest in another property in the last three years NO YES
If YES complete (1) and (2) below
(1)What type of property did you ownprimary residence (PR) FHA secondary residence (SR) second home(SH)
or investmentproperty (IP)
(2) How did you holdtitle to the property by yourself (S) jointly with your spouse(SP) or jointly with another person (O)
B If this is a Purchase Transaction Do you have a family relationship or businessaffiliation with the seller of the property NO YES Cc Are you borrowing any moneyforthis real estate transaction (eg money foryour closing costs or down payment) or
obtaining any moneyfrom anotherparty suchastheselleror realtor that you have not disclosed on this loan application NO YES
If YES whatis the amountof this money $
D 1 Have youorwill you be applying for a mortgage loan on anotherproperty (not the property securing this loan) on orbefore closing this transaction that is not disclosed on this loan application
NO YES
2 Have you orwill you be applying for any newcredit (eg installment loan credit card etc) on or before closing this loan that wsis not disclosed on this application
NO YES
E Will this property be subject to a lien that could take priority over thefirst mortgagelien such as a clean energylien paid
through yourproperty taxes(eg the PropertyAssessed Clean Energy Program)No YES
EK) Veli ellim ait
F Areyou a co-signer or guarantor on any debtor loan thatis not disclosed on this application NO ES
G Are there any outstanding judgments against you NO YES
H Are you currently delinquentor in default on a Federal debt NO YES
I Are you a party to a lawsuit in which you potentially have any personalfinancialliability NO YES
J Have you conveyedtitle to any property in lieu of foreclosure in the past 7 years NO YES
K Within the past 7 years have you completed a pre-foreclosure sale or short sale whereby the property wassold to a
third party and the Lender agreed to acceptless than the outstanding mortgage balance due
No YES
L Have you had property foreclosed uponin thelast 7 years NO YES
M Have you declared bankruptcy within the past 7 years no vESIf YES identify the type(s) of bankruptcy Chapter 7 Chapter11 Chapter12 Chapter 13
Section 6 Acknowledgements and AgreementsMy signature for Section 6 is on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 7 Military Service This section asks questions about your(or your deceased spouses) military service
Military Service of Borrower
Military Service mdash Did you (or your deceased spouse)everserve or are you currently serving in the United States Armed Forces NO YES
IfYES check allthat apply Currently serving on active duty with projected expiration date of servicetour (mmddyyyy)
Currently retired discharged or separated from service nnOnly period of service was as a non-activated memberofthe Reserve or National GuardSurviving spouse
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 8 Demographic InformationThis section asks about your ethnicity sex and race
Demographic Information of Borrower
The purposeofcollecting this information is to help ensure thatall applicants are treated fairly and that the housing needs of communities
and neighborhoodsare beingfulfilled 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 providethis information but are encouraged to do so You mayselect one or more designationsfor
Ethnicity and one or more designationsfor Race The law provides that we maynotdiscriminate onthe basis of this information or onwhetheryou chooseto provideit However if you choose notto provide the information and you have madethis application in person Federal
regulations require us to note yourethnicity sex and race on the basis of visual observation or surname The law also provides that we may notdiscriminate on the basis of age or marital status information you providein this application If you do not wish to provide someorall of this
information please check below
Ethnicity Check one or more Race Check one or moreHispanic or Latino AmericanIndian or Alaska Native - Print nameofenrolled
or principaltribeMexican PuertoRican Cuban
OtherHispanic or Latino - Printorigin siansian Indian Chinese Filipino
For exampleArgentinean Colombian Dominican NicaraguanSalvadoran Spaniard andso on
Japanese Korean VietnameseOtherAsian - Print race Forexample Hmong Laotian Thai Pakistani Cambodian andso on
Black or African American
Native Hawaiian or OtherPacific Islander
Native Hawaiian GuamanianorChamorro Samoan
OtherPacific Islander mdash Print race
Not Hispanic or Latino
| do not wish to providethis information
Sex
Female
Male
| do not wish to providethis informationFor example Fijian Tongan and so on
White
| do not wish to providethis information
Wasthe ethnicity of the Borrowercollected on thebasis of visual observation or surnameWasthesex of the Borrowercollected on the basis of visual observation or surnameWastherace of the Borrowercollected on the basis of visual observation or surname
)NO YESNO YESNO YES
Face-to-Face Interview (includes Electronic Media w Video Component) Telephone Interview Faxor Mail Email or Internet
Loan Originator Organization Name
Address
Loan Originator Organization NMLSR ID State License ID
Loan Originator Name
Loan Originator NMLSR ID State License ID
Email Phone (
Signature Date (mmddyyyy)
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Pe)aae-emeet)
Community Property State
At least one borrowerlives in a community propertystateThe property is in a community property state
Transaction DetailConversion of Contract for Deed or Land ContractRenovationConstruction-ConversionConstruction-to-Permanent
Single-Closing Two-ClosingConstructionImprovementCosts $
LotAcquired Date
Original Cost of Lot $(mmddyyyy)
Refinance Program
Full DocumentationInterest Rate ReductionStreamlined without Appraisal
Other
Refinance Type
NoCash OutLimited Cash OutCash Out
Energy Improvement
Mortgageloanwill finance energy-related improvements
Propertyis currently subject to a lien that could take priority ovethe first mortgagelien such as a clean energylien paid for througproperty taxes(eg the PropertyAssessed Clean Energyprogram)
Project Type Condominium Cooperative Planned Unit Development (PUD) Propertyis notlocatedin a project
Peiwlivcestetece)a)
Title to the Property Will be Held in What Name(s)
For RefinanceTitle to the Property is Currently Held in What Name(s
Trust Information
tle Will be Held byan Inter Vivos (Living) Trust
Title Will be Held by a Land TrustLeasehold Expiration Date
Mannerin WhichTitle Will be Held Indian Country Land Tenure
Sole OwnershipLife EstateTenancy in Common
Joint Tenancywith Right of Survivorship]Tenancybythe EntiretyOther
Fee Simple Ona ReservationIndividualTrust Land (AllottedRestricted)Tribal Trust Land On a ReservationTribal Trust Land Off ReservationAlaska Native Corporation Land
Estate Will be Held in
Fee Simple(mmddyyyy)
3 Mortgage LoanInformation
Termsof Loan
Note Rate
Loan Term (months)
MortgageLien Type
First LienSubordinate Lien
Mortgage Type Applied For
Conventional USDA-RDFHA VA Other
Amortization Type
Fixed RateAdjustable Rate
If Adjustable Rate
Initial Period Prior to First Adjustment
Subsequent AdjustmentPeriod
Proposed Monthly Paymentfor Property
First Mortgage (P amp I) $
Subordinate Lien(s) (P amp |) $
Other(explain)
Homeowners Insurance $(months)
(months)
Loan Features Property Taxes $
Balloon Balloon Term (months)
Interest Only Interest OnlyTermNegative AmortizationPrepaymentPenalty Prepayment Penalty Term (months) Other
Temporary Interest Rate BuydownInitial Buydown Rate TOTALOther(explain)
Mortgage Insurance $
AssociationProject Dues (Condo Co-Op PUD) $
Supplemental Property Insurance $
(months)
Borrower Name(s)Uniform Residential Loan Application mdash LenderLoan Information
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
L4 Qualifying the Borrower - Minimum Required Funds or Cash Back
DUEFROM BORROWER(S)
A Sales Contract Price
B Improvements Renovations and Repairs
C Land(ifacquired separately)
D For Refinance Balance of Mortgage Loanson the Propertyto be paid off in the Transaction
(See Table 3a Property You Own)
E Credit Cards and Other Debts Paid Off
(See Table 2c Liabilities mdash Credit Cards Other Debts and Leases that You Owe)
F BorrowerClosing Costs (including Prepaid andInitial Escrow Payments)
G Discount Points
HTOTAL DUE FROM BORROWER(s)(Total of A thru G)
TOTALMORTGAGE LOANS
Loan Amount
Loan AmountExcluding Financed Mortgage Insurance (or Mortgage Insurance Equivalent) $
Financed Mortgage Insurance (or Mortgage Insurance Equivalent) Amount $
Other New Mortgage Loanson the Property the Borrower(s) is Buying or Refinancing(See Table 4b Other New MortgageLoanson the Property You are Buying or Refinancing)
KTOTAL MORTGAGELOANS(Totalof| and J)
TOTALCREDITS
L Seller Credits (Enter the amountofBorrower(s) costs paid by the property seller)
MOtherCredits (Enter the sum ofall other credits mdash BorrowerPaid Fees Earnest Money EmployerAssistedHousing Lease Purchase Fund Lot Equity Relocation Funds Sweat Equity Trade Equity Other)
NTOTAL CREDITS(Total of L and M)
CALCULATION
TOTAL DUE FROM BORROWER(s)(Line H)
LESSTOTAL MORTGAGELOANS(Line K) AND TOTAL CREDITS(Line N)
Cash FromTothe Borrower(Line H minusLine K and Line N)NOTE This amountdoesnotinclude reservesor other funds that may be required by the Lenderto be verified
Borrower Name(s)Uniform Residential Loan Application mdash LenderLoan Information
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
Uniform Residential Loan Application mdash Unmarried Addendum
eeCeceetatimC elitleeComeLy
Lenders Instructions for Using the Unmarried Addendum
The Lender may use the Unmarried Addendum only when a Borrowerselected ldquoUnmarriedrdquoin Section 1 and the information collected is
necessary to determine howState property lawsdirectly or indirectly affecting creditworthiness apply including ensuring clear title
For example the Lender may use the Unmarried Addendum whentheBorrowerresides in a State that recognizescivil unions domestic
partnerships or registered reciprocal beneficiary relationships or when the property is located in such a State ldquoStaterdquo meansanystate the
District of Columbia the Commonwealth of Puerto Rico or anyterritory or possession of the United States
Ifyou selected ldquoUnmarriedrdquoin Section 1 is there a person whois not your legal spouse but whocurrently has real property rights similar to
those of a legal spouse +=) NOQ YES
If YES indicate the type of relationship and the State in which the relationship was formed For example indicate if you are in a
civil union domestic partnership registered reciprocal beneficiary relationship or other relationship recognized by the State in which you
currently reside or where the property is located
O Civil Union copy Domestic Partnership copy Registered Reciprocal Beneficiary Relationship copy) Other(explain)
Statea]
Borrower NameUniform Residential Loan Application mdash Unmarried Addendum
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Uniform Residential Loan Application mdash Continuation Sheet
Use this continuation sheet if you need more space to complete the Uniform Residential Loan Application
Borrower Name(First Middle Last Suffix )
Additional Information
Additional Borrower Name(First Middle Last Suffix )
Additional Information
IWefully understand thatit is a federal crime punishable by fine or imprisonment or both to knowingly make anyfalse statements concerningany of the abovefacts as applicable underthe provisions of federal law (18 USC sectsect 1001 et seq)
BorrowerSignature Date (mmddyyyy)
Additional Borrower Signature Date (mmddyyyy)
Uniform Residential Loan Application mdash Continuation SheetFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
INSTRUCTIONS FOR COMPLETING THE UNIFORM RESIDENTIAL LOAN APPLICATION
Use the instructions below to complete the enclosed Uniform Residential Loan Application (Freddie Mac Form 65Fannie Mae Form 1003) To avoid any delays in your application review please provide all of the requested information
If you need to make a correction on the application draw a line through the incorrect text and mark your initials beside the change Donrsquot use correction tape or fluid The application must be completed signed and dated in ink
The Uniform Residential Loan Application (URLA)
The URLA contains the following sections Section 1 Borrower Information Please provide your personal information income and employment
Section 2 Financial Information ndash Assets and Liabilities Please provide information about your financial assets personal financial obligations and debts you owe
Section 3 Financial Information ndash Real Estate Please provide information about property you own and the debts and expenses related to the property
Section 4 Loan and Property Information Please provide information about the loan purpose and the property you are buying or refinancing
Section 5 Declarations Please answer questions about the property how the property will be financed and your past financial history
Section 6 Acknowledgments and Agreements Informs you of your legal obligations related to the mortgage application and asks that you acknowledge certain information will be obtained used and shared
Section 7 Military Service Please provide information about your (or your deceased spousersquos) military service
Section 8 Demographic Information Requests information the Lender is required by law to ask you
Section 9 Loan Originator Information Will be completed by Chase
Uniform Residential Loan Application ndash Additional Borrower
The URLA ndash Additional Borrower contains the following sections Section 1 Borrower Information This is the same as the Borrower Information section of the URLA
Section 2 Financial Information ndash Assets and Liabilities Contains only the following statement for the additional Borrower to complete ldquoMy information for Section 2 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo The name of the other borrower is entered here
Complete a separate URLA for each BorrowermiddotThree or more Borrowers ndash Use any combination of URLA and URLA-Additional Borrower forms in accordance with the above examples
Section 3 Financial Information ndash Real Estate Contains only the following statement for the additional borrower to complete ldquoMy information for Section 3 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 4 Loan and Property Information Contains only the following statement for the additional borrower to complete ldquoMy information for Section 4 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 5 Declarations This is the same as the Declarations section of the URLA
Section 6 Acknowledgments and Agreements Contains only the following statement for the additional borrower to complete ldquoMy signature for Section 6 is on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 7 Military Service This is the same as the Military Service section of the URLA
Section 8 Demographic Information This is the same as the Demographic Information section on the URLA
Section 9 Loan Originator Information This is the same as the Loan Originator Information section of the URLA
Using the URLA and URLA ndash Additional Borrower Together The URLA and the URLA ndash Additional Borrower are used together to collect information for two Borrowers who have joint assets liabilities andor real estate information The URLA and URLA ndash Additional Borrower can also be used for Borrowers who do not have joint information but wish to combine their information on the URLA for ease of use Here are examples of how to use the URLA and URLA ndash Additional Borrower
For one borrower Complete the URLA
For two borrowers with joint financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you dont need to duplicate them on more than one URLA or o In cases where Borrowers are not collaborating when completing the loan application
joint assets liabilities and real estate may be duplicated on each URLA bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you do not need to duplicate them on more than one URLA or
o In cases where Borrowers are not collaborating when completing the loan application joint assets liabilities and real estate may be duplicated on each URLA
For two borrowers with separate financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower Report the assets liabilities and
real estate for the additional Borrower on the URLA or bull Complete a separate URLA for each Borrower
For three or more borrowers use any combination of URLA and URLA ndash Additional Borrower forms described for two borrowers
Uniform Residential Loan Application ndash Unmarried Addendum If any borrower listed on the URLA or URLA ndash Additional Borrower form selects Unmarried in Section 1 (Personal Information) the lender will complete this optional form
The information must be collected to determine how to apply state property laws that directly or indirectly affect creditworthiness including ensuring clear title
Uniform Residential Loan Application ndash Continuation Sheet Use the URLA ndash Continuation Sheet if you need more space to complete either the URLA or URLA ndash Additional Borrower forms
99177-URLAI-0215
HUD Addendum to Uniform Residential Loan Application OMB Approval No HUD 2502-0059 (exp )
Part I - Identifying Information HUDFHA Application for Insurance under the National Housing Act and Borrower Certification
FHA Case No (include any suffix) Mortgagee Case No
Mortgagee ID Sponsor ID Agent ID
Mortgagee Name Address (include ZIP Code) and Telephone Number
Type or print all entries clearly
Name and Address of Sponsor Name and Address of Agent
Borrowers Name amp Present Address (include ZIP Code) Property Address (include name of subdivision lot amp block no amp ZIP Code)
Sponsored Originations
Name of Third-Party Originator NMLS ID of Third-Party Originator
Part II - Borrower Consent for Social Security Administration to Verify Social Security Number I authorize the Social Security Administration (SSA) to verify my Social Security Number (SSN) to the Mortgagee and HUDFHA I authorize SSA to provide explanatory
information to HUDFHA in the event of a discrepancy This consent is valid for 180 days from the date signed unless indicated otherwise by the individual(s) named in this
loan application
Signature(s) of Borrower(s) - Read consent carefully Review accuracy of Social Security Number(s) provided on this application
Borrowerrsquos NameDate of BirthSocial Security Number
Co-Borrowerrsquos Name Date of BirthSocial Security Number
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
Part III - Borrower Notices Information and Acknowledgment Public Reporting Burden
Public reporting burden for this collection of information is estimated to average 10 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 conduct or sponsor and a person is not
required to respond to a collection of information unless that collection displays a valid OMB control number which can be located on the OMB Internet page at
httpwwwreginfogovpublicdoPRAMain
Privacy Act Information
The information requested on the Uniform Residential Loan Application and this Addendum is authorized by the National Housing Act of 1934 12 USC sect 1701 et seq The Debt
Collection Act of 1982 Pub L 97-365 and HUDrsquos Housing and Community Development Act of 1987 42 USC sect 3543 require persons applying for a federally insured loan to
furnish their SSN You must provide all the requested information including your SSN HUD may conduct a computer match to verify the information you provide HUD may
disclose certain information to Federal State and local agencies when relevant to civil criminal or regulatory investigations and prosecutions It will not otherwise be disclosed or
released outside of HUD except as required and permitted by law The information will be used to determine whether you qualify as a mortgagor Failure to provide any of the
requested information including SSN may result in disapproval of your loan application This is notice to you as required by the Right to Financial Privacy Act of 1978 that
HUDFHA has a right of access to financial records held by financial institutions in connection with the consideration or administration of assistance to you Financial records
involving your transaction will be available to HUDFHA without further notice or authorization but will not be disclosed or released by the institution to another Government Agency
or Department without your consent except as required or permitted by law
WARNING This warning applies to all certifications made in this document Anyone who knowingly submits a false claim or makes false statements is subject to criminal and civil penalties including confinement for up to 5 years fines and civil penalties 18 USC sectsect 287 1001 and 31 USC sect 3729
orm HUD-92900-A ( ) Page 1
Borrower Name ____________________________ FHA Case No __________________
Caution Delinquencies Defaults Foreclosures and Abuses Delinquencies defaults foreclosures and abuses of mortgage loans involving programs of the Federal Government can be costly and detrimental to your credit now and in the future The Mortgagee in this transaction its agents and assigns as well as the Federal Government its agencies agents and assigns are authorized to take any and all of the following actions in the event loan payments become delinquent on the mortgage loan described in the attached application (1) Report your name and account information to a credit bureau (2) Assess additional interest and penalty charges for the period of time that payment is not made (3) Assess charges to cover additional administrative costs incurred by the Federal Government to service your account (4) Offset amounts owed to you
under other Federal programs (5) Refer your account to a private attorney collection agency or mortgage servicing agency to collect the amount due foreclose
the mortgage sell the property and seek judgment against you for any deficiency (6) Refer your account to the Department of Justice (DOJ) for litigation in the
courts (7) If you are a current or retired Federal employee take action to offset your salary or civil service retirement benefits (8) Refer your debt to the Internal
Revenue Service for offset against any amount owed to you as an income tax refund and (9) Report any resulting written off debt of yours to the Internal Revenue Service as your taxable income All of these actions may be used to recover any debts owed when it is determined to be in the interest of the Mortgagee or Federal Government or both
As a mortgage loan borrower you will be legally obligated to make the mortgage payments called for by your mortgage loan contract The fact that you dispose of your property after the loan has been made will not relieve you of liability for making these payments Payment of the loan in full is ordinarily the way liability on a mortgage note is ended Some home buyers have the mistaken impression that if they sell their homes when they move to another locality or dispose of it for any other reasons they are no longer liable for the mortgage payments and that liability for these payments is solely that of the new owners Even though the new owners may agree in writing to assume liability for your mortgage payments this assumption agreement will not relieve you from liability to the holder of the note which you signed when you obtained the loan to buy the property Unless you are able to sell the property to a buyer who is acceptable to HUDFHA who will assume the payment of your obligation to the lender you will not be relieved from liability to repay any claim which HUDFHA may be required to pay your lender on account of default in your loan payments The amount of any such claim payment may be a debt owed by you to the Federal Government and subject to established collection procedures
Fair Housing Act I and anyone acting on my behalf are and will remain in compliance with the Fair Housing Act 42 USC sect 3604 et seq with respect to the dwelling or property covered by the loan and in the provision of services or facilities in connection therewith I recognize that any restrictive covenant on this property related to race color religion sex disability familial status or national origin is unlawful under the Fair Housing Act and unenforceable I further recognize that in addition to administrative action by HUD a civil action may be brought by the DOJ in any appropriate US court against any person responsible for a violation of the
applicable law
Certification and Acknowledgment All information in this application is given for the purpose of obtaining a loan to be insured under the National Housing Act and the information in the Uniform Residential Loan Application and this Addendum is true and complete to the best of my knowledge and belief Verification may be obtained from any source named herein I have read and understand the foregoing concerning my liability on the loan and Part III Borrower Notices Information and Acknowledgment
Signature(s) of Borrower(s) - Do not sign unless this application is fully completed Read the certification carefully and review accuracy of this application
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
orm HUD-92900-A ( Page 2
___________________________________
______________________________________________________
______________________________________________________________
- - - - - - - - - - - - - - - - - - - - - - -
Borrower Name ____________________________ FHA Case No __________________
Part IV - Direct Endorsement Approval for a HUD FHA-Insured Mortgage A Underwriting the Borrower
Date Mortgage Approved ______________________________ Date Approval Expires ______________________
For mortgages rated as an ldquoacceptrdquo or ldquoapproverdquo by FHAs TOTAL Mortgage Scorecard
The information submitted to TOTAL was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA4e Final Underwriting Decision (TOTAL) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee Representative Signature
Printed Name
Title
OR
For mortgages rated as a ldquoreferrdquo by FHAs TOTAL Mortgage Scorecard or manually underwritten by a Direct Endorsement underwriter I have personally reviewed and underwritten the borrowerrsquos credit application The information used to underwrite the borrower was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA5d Final Underwriting Decision (Manual) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
B Underwriting the Property
For all mortgages where FHA requires an appraisal I have personally reviewed and underwritten the appraisal according to FHA requirements I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
orm HUD-92900-A ( ) Page 3
Borrower Name ____________________________ FHA Case No __________________
Part V Mortgagees Certification
I have personally reviewed the mortgage documents and the application for insurance endorsement and This mortgage complies with SF Handbook 40001 Section IIA7 Post-Closing and Endorsement to the extent that no defect exists that would have changed the decision to endorse or submit the mortgage for insurance
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee
Name of Mortgageersquos Representative
Title of Mortgageersquos Representative
Signature of the Mortgageersquos Representative Date
orm HUD-92900-A ( ) Page 4
GENERAL AUTHORIZATION FOR A MORTGAGE LOAN ASSUMPTION
Applicant name(s)
Loan number
NOTICES AND DISCLOSURES
Non-discriminatory underwriting guidelines Anyone who inquires about the availability of credit from us has the right to receive a copy of our non-discriminatory underwriting guidelines To request a copy of these guidelines contact your Loan Processor
Attorney note Itrsquos the responsibility of our attorneys to protect our interest You may at your expense request an attorney to represent your interest
Notice to HUDFHA applicants As required by the Right to Financial Privacy Act of 1978 this notice is to inform you that the US Department of Housing and Urban Development (HUD)Federal Housing Administration (FHA) has a right of access to financial records held by financial institutions related to a request for assistance Financial records involving your assumption will be available to HUDFHA without further notice or authorization but wonrsquot be disclosed or released by us to another government agency or department without your consent except as required or permitted by law
Borrower consent to the use of tax return information I understand acknowledge and agree that the Lender and Other Loan Participants can obtain use and share tax return information for purposes of (i) providing an offer (ii) originating maintaining managing monitoring servicing selling insuring and securitizing a loan (iii) marketing or (iv) as otherwise permitted by applicable laws including state and federal privacy and data security laws The Lender includes the Lenderrsquos affiliates agents service providers and any of aforementioned partiesrsquo successors and assigns The Other Loan Participants includes any actual or potential owners of a loan resulting from your loan application or acquirers of any beneficial or other interest in the loan and mortgage insurer guarantor any servicers or service providers for these parties and any of aforementioned partiesrsquo successors and assigns
CERTIFICATION AND AUTHORIZATION
Environmental certification By signing below I represent and warrant that Irsquom not aware of any substances materials or products that may be an environmental hazard such as but not limited to asbestos formaldehyde radon gas lead-based paint fuel or chemical storage tanks (above or below ground) and contaminated soil or water on the property I acknowledge that Chase is relying on this representation and warranty as a material part of its loan application process I also am not aware of any landfill on any portion of the property
Exceptions to the above I further acknowledge (1) receipt of applicable disclosures from the seller in purchase transactions (2) that lead-based paint may exist in housing constructed prior to 1978 (3) that Chase performs no environmental investigation on my behalf and isnrsquot responsible for identifying lead-based paint or any other environmental conditions that might impact the property or its residents and (4) that it is my sole obligation to investigate for potential impact to the property from environmental conditions
Certifications I certify by signing below that (1) all of the loan application information provided is true and complete (2) I understand any intentional or negligent misrepresentation(s) of the information provided in conjunction with my application may result in civil liability andor 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 Chase its agents successors and assigns insurers and any other person who may suffer any loss due to reliance upon any misrepresentation that I have made on the application and (3) any significant change from the information provided at the time of application until the final loan application is signed may have a bearing on the approval of my application for a home loan
Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union
This question is asked because of state laws that extend the same or similar rights benefits and protections of spouses in a marriage to persons who are members of a partnership or union recognized under state law You should consult with your own legal advisor for advice regarding the rights protections benefits responsibilities obligations and duties of those who are registered domestic partners civil union partners or members of other unions recognized under applicable law
CREDIT AUTHORIZATION RELEASE
By signing below I authorize Chase andor my mortgage insurer (if any) to verify my past and present employment earnings records (including information contained in income tax returns that have been filed with the IRS) bank accounts stock holdings and any other information that it finds necessary to process my mortgage loan application or to review it for quality-control purposes I understand that a credit report will be ordered from a credit reporting agency for verification prior to loan closing as part of the application process and may be ordered after closing as part of the Lenderrsquos quality-control program A credit report may also be completed as part of the Lenderrsquos servicing or collection of the loan or in consideration of any other product or service that the Lender may consider offering me in the future and at any time throughout the life of the loan I understand that use of a photocopy of this form may be necessary to verify one or more of my credit references I understand that a photocopy or fax copy of this form will also serve as authorization
By signing below each applicant acknowledges (1) making the above certifications and authorizations and (2) that each applicant has received and understands the above notices and disclosures
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
You do not have to give us this information but if you donrsquot your application for approval as a borrower may be delayed or rejected The information requested in this form is authorized by Title 38 USC Chapter 37 (if VA) by 12 USC Section 1701 et seq (if HUDFHA) by 42 USC Section 1452b (if HUDCPD) and Title 42 USC 1471 et seq or 7 USC 1921 et seq (if USDA FHA)
Updated December 2021 99177-GA-0215
1b
2b
Form 4506-C (September 2020)
Department of the Treasury - Internal Revenue Service
IVES Request for Transcript of Tax Return OMB Number
1545-1872
Do not sign this form unless all applicable lines have been completed Request may be rejected if the form is incomplete or illegible
For more information about Form 4506-C visit wwwirsgov and search IVES
1a Name shown on tax return (if a joint return enter the name shown first)
First social security number on tax return individual taxpayer identification number or employer identification number (see instructions)
2a If a joint return enter spousersquos name shown on tax return Second social security number or individual taxpayer identification number if joint tax return
3 Current name address (including apt room or suite no) city state and ZIP code (see instructions)
4 Previous address shown on the last return filed if different from line 3 (see instructions)
5a IVES participant name address and SOR mailbox ID
DataVerify 875 Greentree Rd 8 Parkway Center Pittsburgh PA 15220
5b Customer file number (if applicable) (see instructions)
Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing (see instructions)
6 Transcript requested Enter the tax form number here (1040 1065 1120 etc) and check the appropriate box below Enter only one tax form number per request 1040
a Return Transcript which includes most of the line items of a tax return as filed with the IRS A tax return transcript does not reflect changes made to the account after the return is processed Transcripts are only available for the following returns Form 1040 series Form 1065 Form 1120 Form 1120-A Form 1120-H Form 1120-L and Form 1120S Return transcripts are available for the current year and returns processed during the prior 3 processing years
b Account Transcript which contains information on the financial status of the account such as payments made on the account penalty assessments and adjustments made by you or the IRS after the return was filed Return information is limited to items such as tax liability and estimated tax payments Account transcripts are available for most returns
c Record of Account which provides the most detailed information as it is a combination of the Return Transcript and the Account Transcript Available for current year and 3 prior tax years
7 Form W-2 Form 1099 series Form 1098 series or Form 5498 series transcript The IRS can provide a transcript that includes data from these information returns State or local information is not included with the Form W-2 information The IRS may be able to provide this transcript information for up to 10 years Information for the current year is generally not available until the year after it is filed with the IRS For example W-2 information for 2016 filed in 2017 will likely not be available from the IRS until 2018 If you need W-2 information for retirement purposes you should contact the Social Security Administration at 1-800-772-1213
Caution If you need a copy of Form W-2 or Form 1099 you should first contact the payer To get a copy of the Form W-2 or Form 1099 filed with your return you must use Form 4506 and request a copy of your return which includes all attachments
8 Year or period requested Enter the ending date of the tax year or period using the mmddyyyy format (see instructions)
12 31 2020 12 31 2019 12 31 2018 Caution Do not sign this form unless all applicable lines have been completed
Signature of taxpayer(s) I declare that I am either the taxpayer whose name is shown on line 1a or 2a or a person authorized to obtain the tax information requested If the request applies to a joint return at least one spouse must sign If signed by a corporate officer 1 percent or more shareholder partner managing member guardian tax matters partner executor receiver administrator trustee or party other than the taxpayer I certify that I have the authority to execute Form 4506-C on behalf of the taxpayer Note This form must be received by IRS within 120 days of the signature date
Signatory attests that heshe has read the attestation clause and upon so reading declares that heshe has the authority to sign the Form 4506-C See instructions
Sign Here
Signature (see instructions) Date Phone number of taxpayer on line 1a or 2a
PrintType name
Title (if line 1a above is a corporation partnership estate or trust)
Spousersquos signature Date
PrintType name
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020) For Privacy Act and Paperwork Reduction Act Notice see page 2
Instructions for Form 4506-C IVES Request for Transcript of Tax Return
Section references are to the Internal Revenue Code unless otherwise noted
Future Developments
For the latest information about Form 4506-C and its instructions go to wwwirsgov and search IVES Information about any recent developments affecting Form 4506-C (such as legislation enacted after we released it) will be posted on that page
Whats New Form 4506-C was created to be utilized by authorized IVES participants to order tax transcripts with the consent of the taxpayer
General Instructions
Caution Do not sign this form unless all applicable lines have been completed
Designated Recipient Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information received pursuant to the taxpayerrsquos consent and holds the recipient subject to penalties for any unauthorized access other use or redisclosure without the taxpayerrsquos express permission or request
Taxpayer Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information provided pursuant to your consent and holds the recipient subject to penalties brought by private right of action for any unauthorized access other use or redisclosure without your express permission or request
Purpose of form Use Form 4506-C to request tax return information through an authorized IVES participant You will designate an IVES participant to receive the information on line 5a
Note If you are unsure of which type of transcript you need check with the party requesting your tax information
Where to file The IVES participant will fax Form 4506-C with the approved IVES cover sheet to their assigned Service Center
Chart for ordering transcripts
If your assigned Service Center is
Fax the requests with the approved coversheet to
Austin Submission Processing Center
Austin IVES Team
844-249-6238
Fresno Submission Processing Center
Fresno IVES Team
844-249-6239
Kansas City Submission Processing Center
Kansas City IVES Team
844-249-8128
Ogden Submission Processing Center
Ogden IVES Team
844-249-8129
Specific Instructions
Line 1b Enter the social security number (SSN) or individual taxpayer identification number (ITIN) for the individual listed on line 1a or enter the employer identification number (EIN) for the business listed on line 1a
Line 3 Enter your current address If you use a PO box include it on this line
Line 4 Enter the address shown on the last return filed if different from the address entered on line 3
Note If the addresses on lines 3 and 4 are different and you have not changed your address with the IRS file Form 8822 Change of Address or Form 8822-BChange of Address or Responsible Party mdash Business with Form 4506-C
Line 5b Enter up to 10 numeric characters to create a unique customer file number that will appear on the transcript The customer file number cannot contain an SSN ITIN or EIN Completion of this line is not required
Note If you use an SSN name or combination of both we will not input the information and the customer file number will reflect a generic entry of 9999999999 on the transcript
Line 8 Enter the end date of the tax year or period requested in mmddyyyy format This may be a calendar year fiscal year or quarter Enter each quarter requested for quarterly returns Example Enter 12312018 for a calendar year 2018 Form 1040 transcript
Signature and date Form 4506-C must be signed and dated by the taxpayer listed on line 1a or 2a The IRS must receive Form 4506-C within 120 days of the date signed by the taxpayer or it will be rejected Ensure that all applicable lines including lines 5a through 8 are completed before signing
You must check the box in the signature area to acknowledge you have the authority to sign and request the information The form will not be processed if unchecked
Individuals Transcripts listed on on line 6 may be furnished to either spouse if jointly filed Only one signature is required Sign Form 4506-C exactly as your name appeared on the original return If you changed your name also sign your current name
Corporations Generally Form 4506-C can be signed by
(1) an officer having legal authority to bind the corporation (2) any person designated by the board of directors or other governing body or (3) any officer or employee on written request by any principal officer and attested to by the secretary or other officer A bona fide shareholder of record owning 1 percent or more of the outstanding stock of the corporation may submit a Form 4506-C but must provide documentation to support the requesters right to receive the information
Partnerships Generally Form 4506-C can be signed by any person who was a member of the partnership during any part of the tax period requested on line 8
All others See section 6103(e) if the taxpayer has died is insolvent is a dissolved corporation or if a trustee guardian executor receiver or administrator is acting for the taxpayer
Note If you are Heir at law Next of kin or Beneficiary you must be able to establish a material interest in the estate or trust
Documentation For entities other than individuals you must attach the authorization document For example this could be the letter from the principal officer authorizing an employee of the corporation or the letters testamentary authorizing an individual to act for an estate
Signature by a representative A representative can sign Form 4506-C for a taxpayer only if the taxpayer has specifically delegated this authority to the representative on Form 2848 line 5 The representative must attach Form 2848 showing the delegation to sign Form 4506-C
Privacy Act and Paperwork Reduction Act Notice We ask for the information on this form to establish your right to gain access to the requested tax information under the Internal Revenue Code We need this information to properly identify the tax information and respond to your request You are not required to request any transcript if you do request a transcript sections 6103 and 6109 and their regulations require you to provide this information including your SSN or EIN If you do not provide this information we may not be able to process your request Providing false or fraudulent information may subject you to penalties
Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and cities states the District of Columbia and US commonwealths and possessions for use in administering their tax laws We may also disclose this information to other countries under a tax treaty to federal and state agencies to enforce federal nontax criminal laws or to federal law enforcement and intelligence agencies to combat terrorism
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law Generally tax returns and return information are confidential as required by section 6103
The time needed to complete and file Form 4506-C will vary depending on individual circumstances The estimated average time is
Learning about the law or the form 10 min Preparing the form 12 min Copying assembling and sending the form to the IRS 20 min
If you have comments concerning the accuracy of these time estimates or suggestions for making Form 4506-C simpler we would be happy to hear from you You can write to
Internal Revenue Service Tax Forms and Publications Division 1111 Constitution Ave NW IR-6526 Washington DC 20224
Do not send the form to this address Instead see Where to file on this page
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020)
Rev April 2021 CHASEO Facts What does Chase do with your personal information
Why Financial companies choose how they share your personal information Federal law gives consumers the right to limit some but not all sharing Federal law also requires us to tell you how we collect share and protect your personal information Please read this notice carefully to understand what we do
What The types of personal information we collect and share depend on the product or service you have with us This information can include bull Social Security number and income bull account balances and transaction history bull credit history and payment history
How All financial companies need to share customers personal information to run their everyday business In the section below we list the reasons financial companies can share their customers personal information the reasons Chase chooses to share and whether you can limit this sharing
Reasons we can share your personal information Does Chase share
Can you limit this sharing
For our everyday business purposes - such as to process your transactions maintain your account(s) respond to court orders and legal investigations or report to credit bureaus
Yes No
For our marketing purposes - to offer our products and services to you
Yes No
For joint marketing with other financial companies Yes No
For our affiliates everyday business purposes - information about your transactions and experiences
Yes No
For our affiliates everyday business purposes - information about your creditworthiness
Yes Yes
For our affiliates to market to you Yes Yes
For nonaffiliates to market to you Yes Yes
a
0
To limit our sharing
bull Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
bull Visit us online chasecomprivacypreferences
Please note If you are a new customer we can begin sharing your information 30 days from the date we sent this notice When you are no longer our customer we continue to share your information as described in this notice However you can contact us at any time to limit our sharing
Questions
Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
PAGE 2
Who we are
Who is providing this notice The US consumer financial companies within the JPMorgan Chase amp Co family including JPMorgan Chase Bank NA Chase Insurance Agency Inc and JP Morgan Securities LLC
What we do
How does Chase protect my To protect your personal information from unauthorized access and use we personal information use security measures that comply with federal law These measures include
computer safeguards and secured files and buildings We authorize our employees to get your information only when they need it to do their work and we require companies that work for us to protect your information
How does Chase collect my We collect your personal information for example when you personal information bull open an account or make deposits or withdrawals from your account
bull pay your bills or apply for a loan bull use your credit or debit card We also collect your personal information from others such as credit bureaus affiliates or other companies
Why cant I limit all sharing Federal law gives you the right to limit only bull sharing for affiliates everyday business purposes - information about your
creditworthiness bull affiliates from using your information to market to you bull sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing See below for more on your rights under state law
What happens when I limit sharing for an account I hold jointly with someone else
Your choices will apply to everyone on your account
Definitions
Affiliates Companies related by common ownership or control They can be financial and non financial companies bull Our affiliates include companies with a Chase or JP Morgan name and financial companies such asjP Morgan Securities LLC
Nonaffiliates Companies not related by common ownership or control They can be financial and non financial companies bull Nonaffiliates we share with can include companies such as retailers auto dealers auto makers and membership clubs
Joint marketing A formal agreement between nonaffiliated financial companies that together market financial products or services to you bull Our joint marketing partners include categories of companies such as insurance companies
Other important information
VT Accounts with a Vermont mailing address are automatically treated as if they have limited the sharing as described on page 1 For joint marketing we will only disclose your name contact information and information about your transactions
NV We are providing you this notice pursuant to Nevada law If you prefer not to receive marketing calls from us you may be placed on our Internal Do Not Call List by calling 1-800-945-9470 or by writing to us at PO Box 734007 Dallas TX 75373-4007
For more information contact us at the address above or email PrivacylnfoJPMChasecom with Nevada Annual Notice in the subject line You may also contact the Nevada Attorney Generals office Bureau of Consumer Protection Office of the Nevada Attorney General 555 E Washington St Suite 3900 Las Vegas NV 89101 telephone number 1-702-486-3132 email BCPINFOagstatenvus
CA Accounts with a California mailing address are automatically treated as if they have limited the sharing with nonaffiliates as described on page 1 CA residents are provided a CA notice for additional choices
CHASE O
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
The following disclosure is required by the USA PATRIOT Act
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 opens an account
What this means to you When you 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 drivers
license or other identifying documents
99177-PAT-0215
VETERAN STATEMENT When this loan was opened the US Department of Veterans Affairs (VA) used the veteran borrowerrsquos entitlement which is a set amount the VA promises to repay a lender if the borrower defaults on the mortgage An assumption will modify who is obligated to pay the existing mortgage loan but all loan termsmdashincluding the entitlementmdashwill remain the same If the veteran borrower is being removed from the loan the entitlement would remain with whoever is assuming the loan because the loan will continue to be serviced by the VA If the applicant is also a veteran and can substitute his or her entitlement for the current entitlement then the current borrowerrsquos entitlement can be released
Please review the following questions and answer as appropriate This form requires completion by both the applicant(s) and current borrower(s)
1 Applicant to Complete
Are you (the applicant) currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the reverse side)
Yes (If yes please provide the information requested below answer the question in section 3 and sign and date this form at the bottom of the reverse side)
Name of applicant(s) who answered ldquoyesrdquo to the above question
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Are you receiving VA disability benefts
Applicant
Yes
No
Co-Applicant
Yes
No
Are you entitled to receive VA disability benefts Yes No Yes No
Have you received VA disability benefts in the past Yes No Yes No
Are you a surviving spouse of a veteran who died on active duty or as the result of a service-related disability
Yes No Yes No
Do you have any VA loans Yes No Yes No
2 Current Borrower to Complete
Is the current borrowerco-borrower currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the page)
Yes (If yes please answer the question in section 3 and sign and date this form at the bottom of the page)
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
________________________________________________________________________________________________
3 Applicant and Current Borrower to Complete
If the answer to the questions in section 1 and 2 are both yes please answer the following question After yoursquove reviewed and completed this entire form please sign and date at the bottom
Applicant Current Borrower
Do you want to apply for a substitution of entitlement Yes Yes No No
In order to complete a substitution of entitlement the veteran applicant must have suffcient entitlement to substitute for that of the current borrower Contact the VA Offce of Jurisdiction for your area for more information Also before the veteran applicant can substitute entitlement on a VA loan heshe must certify that the property securing the loan will be occupied as hisher primary residence Both the applicantrsquos and current borrowerrsquos original certifcate of eligibility will be required If your sales contract is contingent upon the restoration of entitlement please contact your VA Offce of Jurisdiction for complete procedures Otherwise the substitution will be completed after the loan has been approved and closed
Date Applicant printed name Applicant signature
Date Applicant printed name Applicant signature
Date Current Borrower printed name Current Borrower signature
Date Current Borrower printed name Current Borrower signature
Forms completed by Mail Phone
For Chase use only
Interviewer signature Date
99177-VS-0215
- Assumption Application Package_41521-noscannedpages-update-4pdf
-
- 1 FM203 Cover Pagepdf
- 2 FM202 Mortgage Assumption Application Package pagepdf
- 3 The Documents Youll need to Send Uspdf
- 4 FM201 FAQpdf
- 5 FM142 CIWpdf
- 6 FM126 URLApdf
- 7 FM130 URLA Instpdf
-
- Blank Page
-
- 8 92900a Addednum to Loan Applicationpdf
- 9 FM462 Gen Authpdf
- 10 FM220 4506-Cpdf
- 11 FM153 Chase Federal Privacy Noticepdf
- 12 FM144 Info on Opening a New Accountpdf
- 13 FM152 Veteran Statementpdf
-
- Date
- Loan number
- Applicant name
- Phone1
- Loan number 1
- Loan number 2
- Other
- Other_2
- 1
- 2
- undefined_7
- Available hours
- Available hours_2
- undefined_8
- Available hours_3
- undefined_9
- Current address 1
- Neither
- Available hours_4
- Available hours_5
- undefined_10
- Available hours_6
- 1_2
- 2_2
- undefined_11
- Available hours_7
- Available hours_8
- undefined_12
- Available hours_9
- FHA Case No include any suffix
- Mortgagee Case No
- Mortgagee ID
- Sponsor ID
- Agent ID
- Name and Address of Sponsor Name and Address of Agent
- Borrowers Name Present Address include ZIP Code Property Address
- include name of subdivision lot block no ZIP Code
- Name of ThirdParty Originator
- NMLS ID of ThirdParty Originator
- s application
- ty Number
- ty Number_2
- Date Signed_2
- Date Mortgage Approved
- Date Approval Expires
- Printed Name
- Title 1
- DEs ID Number
- DEs ID Number_2
- Mortgagee
- Name of Mortgagees Representative
- Title of Mortgagees Representative
- Signature of the Mortgagees Representative
- Date_2
- Applicant names 1
- Applicant names 2
- Applicant names 3
- Loan number_2
- Date_3
- Applicant printed name
- Social Security number
- Date_4
- Applicant printed name_2
- Social Security number_2
- Date_5
- Applicant printed name_3
- Social Security number_3
- Date_6
- Applicant printed name_4
- Social Security number_4
- 1a Name shown on tax return if a joint return enter the name shown first
- 1b First social security number on tax return individual taxpayer identification number or employer identification number see instructions
- 2a If a joint return enter spouses name shown on tax return
- 2b Second social security number or individual taxpayer identification number if joint tax return
- 4 Previous address shown on the last return filed if different from line 3 see instructions
- 5a IVES participant name address and SOR mailbox ID
- Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing see instructions
- Signature see instructions
- Date_7
- Phone number of taxpayer on line 1a or 2a
- PrintType name
- Here
- Spouses signature
- Date_8
- PrintType name_2
- Name
- Date of birth
- Service number
- Name_2
- Date of birth_2
- Service number_2
- Date_9
- Applicant printed name_5
- Date_10
- Applicant printed name_6
- Date_11
- Current Borrower printed name
- Date_12
- Current Borrower printed name_2
- Date_13
- Text3
- Text10
- undefined_13
- Text15
- undefined_14
- undefined_15
- undefined_16
- undefined_17
- undefined_18
- undefined_19
- undefined_20
- undefined_21
- undefined_23
- Reason for assumption Off
- Requestors relationship to owners Off
- Check one Off
- Check one1 Off
- Day1
- Evening
- Cell phone
- Check one2 Off
- Check one3 Off
- Check one4 Off
- Check one5 Off
- Text2-1
- Text2-2
- Text2-3
- Text2-4
- Text2-5
- Text2-6
- Text3-1
- Text3-2
- Text3-3
- Text3-4
- Text3-6
- Text3-7
- Text3-8
- Text3-9
- Text3-10
- Text3-11
- Text3-12
- Text3-13
- Text3-14
- Text3-15
- Text3-16
- Text3-17
- Text3-18
- Text3-19
- Text3-20
- Text3-21
- Text3-22
- Text3-23
- Text3-24
- Text3-25
- Text3-26
- Text3-27
- Text3-28
- Text3-29
- Text3-30
- Text3-31
- Text3-32
- Text3-33
- Text3-34
- Text3-35
- Text3-36
- Text3-37
- Text3-38
- Text3-39
- Text3-40
- Text3-41
- Text3-42
- Text3-43
- Text3-44
- Text3-45
- Text3-46
- Text3-47
- Text3-48
- Text3-49
- Text3-50
- Text3-51
- Text3-52
- Text3-53
- Text3-5
- Text3-54
- Text3-55
- Text3-56
- Citizenship Off
- Type of credit Off
- Marital Status Off
- Housing Off
- Housing1 Off
- ownership Off
- DNA1 Off
- DNA2 Off
- DNA3 Off
- family Off
- BO Off
- Total
- Text31
- Text32
- Text33
- Text34
- Text35
- Text36
- Text37
- Text38
- Text39
- Text310
- Text311
- Text312
- Text313
- Text314
- Text315
- Text316
- Text317
- Text318
- Text319
- ownership1 Off
- Total1
- Total1-2
- Check Box4-1 Off
- Text320
- Text321
- Text322
- Text323
- Text324
- Text325
- Text326
- Text327
- Text328
- Text329
- Check Box4-2 Off
- Check Box4-3 Off
- Check Box4-4 Off
- Check Box4-8 Off
- Check Box4-9 Off
- Text330
- Text331
- Text332
- Text333
- Text334
- Text335
- Text1-1
- Text1-2
- Text1-3
- Text1-4
- Text1-5
- Text1-6
- Text1-7
- Text1-8
- Text1-9
- Text1-10
- Text1-11
- Text1-12
- Text1-13
- Text1-14
- Text1-15
- Text1-16
- Text1-17
- Text1-18
- Text1-19
- Text1-20
- Text1-21
- Text1-22
- Text1-23
- Text1-24
- Text1-25
- Text1-26
- Text1-27
- Text1-28
- Text1-29
- Text1-30
- Text1-31
- Text1-32
- Text1-33
- Text1-34
- Text1-35
- Check Box3-2 Off
- Check Box2-1 Off
- Check Box2-2 Off
- Check Box2-3 Off
- Check Box2-4 Off
- Check Box2-5 Off
- Text1-36
- Text1-37
- Text1-38
- Text1-39
- Text1-40
- Text1-41
- Text1-42
- Text1-43
- Text1-44
- Text1-45
- Text1-46
- Text1-47
- Text1-48
- Text1-49
- Text1-50
- Text1-51
- Text1-52
- Text1-53
- Text1-54
- Text1-55
- Text1-56
- Text1-57
- Text1-58
- Text1-59
- Text1-60
- Text1-61
- Check Box3-11 Off
- A1
- A2
- A3
- A4
- A5
- A6
- A7
- A8
- A9
- A10
- A11
- A12
- Check Box3-1 Off
- Check Box30-1 Off
- Check Box30-2 Off
- Check Box30-4 Off
- Check Box30-5 Off
- Check Box30-7 Off
- Check Box30-8 Off
- Check Box30-9 Off
- Check Box30-10 Off
- Check Box30-11 Off
- Check Box30-12 Off
- A13
- A14
- A15
- A16
- A17 Off
- A18
- A19
- A20
- A21
- A22
- A23
- A24
- A25
- A26
- A27
- A28
- A29
- A30
- A31
- A32
- A33
- A34
- A35
- A36
- A37
- A38 Off
- A39
- A40
- A41
- A42
- A43
- A44
- A45
- A46
- A47
- A48
- A49
- A50
- A51
- A52
- A53
- A54
- A55
- A56
- A57
- A58
- A59
- A60
- A61
- A62
- A63
- A64
- A65
- A66
- A67
- A68
- A69
- A70
- A71
- A72
- A73
- A74
- Loan Purpose Off
- occupancy1 Off
- lien type Off
- lientype Off
- mixed use Off
- manufactured home Off
- deposit1 Off
- deposit2 Off
- B1
- B2
- B3
- B4
- B5
- B6
- B7
- B8
- B9
- B10
- fha Off
- Check Box51 Off
- B11
- B12
- B13
- B14
- B15
- B16
- B17
- B18
- B19 Off
- B20
- B21
- B22 Off
- B23
- B24
- B25
- B26
- B27
- B28
- A
-
- Will you occupy the property as your primary residence Off
- Will you occupy the property as your primary residence1 Off
-
- If yes have you had an ownership interest in another property in the last three years Off
- Text9-2
- B
-
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property Off
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property1 Off
-
- 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 Off
- 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 application1 Off
-
- 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 Off
- 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 application1 Off
-
- new credit Off
- 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) Off
- the Property Assessed Clean Energy Program)1 Off
-
- F
-
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application Off
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application1 Off
-
- G
-
- Are there any outstanding judgments against you Off
- Are there any outstanding judgments against you1 Off
-
- H
-
- Are you currently delinquent or in default on a Federal debt Off
- Are you currently delinquent or in default on a Federal debt1 Off
-
- I
-
- Are you a party to a lawsuit in which you potentially have any personal financial liability Off
- Are you a party to a lawsuit in which you potentially have any personal financial liability1 Off
-
- J
-
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years Off
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years1 Off
-
- 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 Off
- 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 due1 Off
-
- L
-
- Have you had property foreclosed upon in the last 7 years Off
- Have you had property foreclosed upon in the last 7 years1 Off
-
- M
-
- Have you declared bankruptcy within the past 7 years Off
- Have you declared bankruptcy within the past 7 years1 Off
-
- Check Box8-2 Off
- Check Box8-3 Off
- Check Box8-4 Off
- Text9-3
- Text9-5
- Text9-6
- Text97
- military Off
- ethnicity Off
- sex Off
- race Off
- demo Off
- Text12-1
- Check Box11-1 Off
- Check Box11-2 Off
- Check Box11-3 Off
- Check Box11-4 Off
- Check Box11-5 Off
- Check Box11-6 Off
- Check Box11-7 Off
- Check Box11-8 Off
- Check Box11-9 Off
- Text12-2
- Check Box11-10 Off
- Check Box11-11 Off
- Check Box11-12 Off
- Check Box11-13 Off
- Check Box11-14 Off
- Check Box11-15 Off
- Text12-3
- Check Box11-16 Off
- Check Box11-17 Off
- Check Box11-18 Off
- Check Box11-19 Off
- Check Box11-20 Off
- Check Box11-21 Off
- Check Box11-22 Off
- Check Box11-23 Off
- Text12-4
- Check Box11-24 Off
- Check Box11-25 Off
- Check Box11-26 Off
- Check Box11-27 Off
- Check Box11-28 Off
- Check Box11-29 Off
- Text12-5
- Check Box11-30 Off
- Check Box11-31 Off
- citizen Off
- credit Off
- marital status1 Off
- housing-1 Off
- housing-2 Off
- own Off
- C1
- C2
- C3
- C6
- C7
- C8
- C9
- C10
- C11
- C12
- C13
- C14
- C15
- C16
- C17
- C18
- C19
- C20
- C21
- C22
- C23
- C24
- C25
- C26
- C27
- C28
- C29
- C30
- C31
- C32
- C33
- C34
- C35
- Check Box-2 Off
- C36
- C37
- C38
- C39
- C4
- C40
- C41
- C42
- C43
- C44
- C45
- C46
- C47
- Check Box-3 Off
- Check Box-4 Off
- C48
- C49
- C5
- C50
- C51
- C52
- C53
- C54
- C55
- Check Box-1-1 Off
- own1 Off
- Check Box-1 Off
- D1 Off
- D2
- D3
- D4
- D5
- D6
- D7
- D8
- D9
- D10
- D11
- D12
- D13
- D14 Off
- D15 Off
- D16
- D17
- D18
- D19
- D20
- D21
- D22
- D23
- D24 Off
- D25
- D26
- D27
- D28
- D29
- D30
- D31
- D32
- D33
- D34
- D35 Off
- D36
- D37 Off
- D38
- D39
- D40
- D41
- D42
- D43
- D44
- D45
- D46
- D47
- If yes have you had an ownership interest in another property in the last three years1 Off
- new credit1 Off
- Check Box8-1 Off
- Check Box8-1-2 Off
- Check Box8-1-1 Off
- Check Box8-1-3 Off
- Check Box8-1-4 Off
- Military Service mdash Did you (or your deceased spouse) ever serve or are you currently serving in the United States Armed Forces 1 Off
- Check1 Off
- Text9-1-1
- Check2 Off
- Check3 Off
- Check4 Off
- Text9-1
- E1
- E2
- E3
- Was the ethnicity of the Borrower collected on the basis of visual observation or surname1 Off
- Was the sex of the Borrower collected on the basis of visual observation or surname1 Off
- Was the race of the Borrower collected on the basis of visual observation or surname1 Off
- The Demographic Information was provided through1 Off
- F1 Off
- F2 Off
- F3 Off
- F4 Off
- F5 Off
- F6
- F7 Off
- F8 Off
- F9 Off
- F10 Off
- F11 Off
- F12 Off
- F13
- F14 Off
- F15 Off
- F16 Off
- F17 Off
- F18 Off
- F19 Off
- F20 Off
- F21 Off
- F22
- F23 Off
- F24 Off
- F25 Off
- F26 Off
- F27 Off
- F28 Off
- F29
- F30 Off
- F31 Off
- undefined_13-1
- undefined_13-2
- undefined_14-1
- undefined_15-1
- undefined_16-1
- undefined_17-1
- undefined_18-1
- undefined_19-1
- undefined_21-1
- undefined_20-1
- undefined_23-1
- undefined_13_1
- Single-Two Off
- Refi type Off
- refi program Off
- Estate Off
- Title held Off
- Trust Information Off
- Indian Country Land Tenure Off
- Mortgage Type Applied For Off
- Mortgage Lien Type Off
- Amortization Type Off
- G1 Off
- G2 Off
- G3 Off
- G4 Off
- G5 Off
- G6
- G7
- G8
- G9
- G10 Off
- G11 Off
- G12 Off
- G13 Off
- G14 Off
- G15 Off
- G16
- G17
- G18
- G19
- G20
- G21
- G22
- G23 Off
- G24
- G25 Off
- G26
- G27 Off
- G28 Off
- G29
- G30 Off
- G31
- G32 Off
- G33
- G34
- G35
- G36
- G37
- G38
- G39
- G40
- G41
- G42
- Property Held
- refi
- Text18-1
- Text18-2
- Text18-3
- Text18-4
- Text18-5
- Text18-6
- Text18-7
- Text18-8
- Text18-9
- Text18-10
- Text18-11
- Text18-12
- Text18-13
- Text18-14
- Text18-15
- Text18-16
- Text18-17
- Text18-18
- Text18-19
- Lender
- case no
- If you selected ldquoUnmarriedrdquo in Section 1 is there a person who is not your legal spouse but who currently has real property rights similar to those of a legal spouse Off
- Relationship and State Off
- Other-5
- Text19-1
- BName
- Additional Information
- ABN
- Additional Information1
- BSign
- BSDate
- ABSign
- ABDate
- MortageeNameAddress
- NAmeAddress
- Bname1
- DOB1
- DOB2
- SignOfBorr1
- SignOfBorr
- Date Signed
- SignOfBorr2
- SignOfBorr3
- Date Signed3
- Date Signed4
- MortgageeRepSign
- DirectSign
- DirectSign1
- Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union Off
- AppSign
- AppSign1
- AppSign2
- AppSign3
- Nopage38 Off
- Yespage38 Off
- Yes1 Off
- No1 Off
- Yes2 Off
- Yes3 Off
- Yes4 Off
- Yes5 Off
- Yes6 Off
- Yes7 Off
- Yes8 Off
- Yes9 Off
- Yes10 Off
- No2 Off
- No3 Off
- No4 Off
- No5 Off
- No6 Off
- No7 Off
- No8 Off
- No9 Off
- No10 Off
- BorrowerNo Off
- BorrowerYes Off
- AppSignature
- AppSignature1
- CurrentSign
- CurrentSign1
- InterviewSign
- Yes_1 Off
- No_1 Off
- Yes_2 Off
- No_2 Off
- Mail Off
- Phone Off
FREQUENTLY ASKED QUESTIONS
A loan assumption lets the borrower change who is financially responsible for the loan It could
involve adding or removing borrowers or transferring the loan to someone else Please review
these questions about eligibility for and alternatives to a loan assumption
ELIGIBILITY
How do you determine eligibility
We look at the credit history assets and income of the person who wants to assume the loan from the borrower
Will my credit history be considered
Yes wersquoll review your credit score and consider your credit history
Do the borrower and the person who assumes the loan have to be related
In some cases yes Wersquoll review your eligibility after we receive all the documents we need
What if the purpose of the property will change for example from a primary residence to an investment property
We may allow a change in the propertyrsquos purpose but in many cases we wonrsquot allow a change in occupancy
Can my loan be assumed if I completed a loan modification
We usually require that you wait one to four years after a modification before applying for an assumption
Can I have a previous bankruptcy or foreclosure in my credit history
We require that you wait four years after a bankruptcy and six years after a foreclosure before applying for an assumption
Can I still apply for mortgage assistance
Yes but assuming the loan may limit the assistance options yoursquore eligible for
FEES
Are there costs associated with an assumption
There are closing costs for completing an assumption These costs usually total about $1500 for every $100000 of the unpaid loan amount
Can closing costs be included in the loan amount
No All closing costs must be paid at the time of closing We canrsquot increase the amount owed on an existing loan as we can with a refinanced loan
GENERAL
Is it better to refinance the loan or assume responsibility for the existing loan
The rates and terms for refinancing could be better than the current loan terms visit chasecom for our rates When you refinance you can roll the closing costs into the loan amount In an assumption we canrsquot modify the existing loan terms
How long does an assumption take
Usually 70 to 90 days
Why do I have to qualify for the assumed loan if Irsquom on the current one
We need to make sure that you can afford the loan under the new circumstances
If I own the property will an assumption change that
An assumption by itself doesnrsquot change ownership of the property but ownership may change at the same time We recommend getting independent legal advice or consulting with a title company
ID 3188620 FM201
IN THE EVENT OF A DEATH
Is an assumption my only option
You may have the option to be added to the loan as a successor in interest
You wonrsquot be responsible for repaying the loan but will get access to account information and statements There are no fees to be added as a successor in interest
If you assume the loan yoursquoll be financially responsible for repaying it and wersquoll report your payment information to the credit reporting agencies
IN CASES OF DIVORCE
Should I wait until my divorce or separation is final before applying for an assumption
Yes we require a separation or divorce agreement that shows who will retain rights to the property
My divorce agreement shows that my spouse is now responsible for the mortgage Why do I have to go through an assumption
We still need to review the income credit and assets of the person maintaining ownership to ensure that they qualify for the loan under the new circumstances
IN CASES OF MARRIAGE
Do I need to complete an assumption to add my spouse to the loan
Not necessarily
If you conveyed an interest in the property to your spouse they can be added to the loan as a successor in interest They wouldnrsquot be responsible for repaying the loan but would get access to account information and statements We donrsquot charge a fee to add a successor in interest
With an assumption your spouse would be financially responsible for repaying the loan and wersquoll report their payment information to the credit reporting agencies
Were here to answer all your questions and will work with you to make sure you get the assistance you needmdashcall us at 1-866-299-6752 we accept operator relay calls
ID 3188620 FM201
[ ][ ][ ]
[ ]
[ ]
[ ]
[ ]
[ ][ ][ ]
( )
( )
( )
[ ] [ ] [ ]
[ ] [ ] [ ] [ ]
[ ]
[ ]
[ ]
( )
( )
( )
( )
( )
( )
[ ] [ ] [ ]
[ ] [ ] [ ]
[ ]
[ ]
[ ]
[ ]
ytra
P ytra
PCustomer Information Worksheet
Loan number
Address of property to be assumed
Reason for assumption ( heck one) [ ]
Divorce Death of original owner Existing owners are selling the home Other
[ ][ ][ ] ___________________________
[ [ [ [
] Spouse Child Parent Other
] ] ] ____________________________
relationship to owners (check one)
Parties to the assumption In the sections below please identify the parties associated with the assumption of the loan This includes
Individuals who will be added to the loan Individuals who are already on the loan and who will remain on the loan Individuals who are already on the loan and who will be removed from the loan
If more than three parties are associated with the assumption please provide the requested information on a separate page and attach it to this worksheet
Name
Par
ty
Current address
Check one Check one New to the loan (being added) Already on the loan and will remain Already on the loan and will be removed
Day phone
Evening phone
Cell phone
Active-duty military Military veteran Neither
Available hours
Available hours
Available hours
Name Current address
Check one Check one New to the loan (being added) Already on the loan and will remain Already on the loan and will be removed Day phone
Evening phone
Cell phone
Active-duty military Military veteran Neither
Available hours
Available hours
Available hours
Name Current address
Check one Check one New to the loan (being added)
Already on the loan and will be removed
Evening phone
Cell phone
Active-duty military Military veteran Neither
Already on the loan and will remain
Day phone Available hours
Available hours
Available hours
Esta comunicacioacuten contiene informacioacuten importante acerca de la cuenta Si tiene alguna pregunta o necesita ayuda para traducirla comuniacutequese con nosotros llamando al 1-855-280-4198
FM142
Uniform Residential Loan ApplicationVerify and complete the information onthis applicationIf you are applying for this loan with others each additional Borrower must provide
information as directed by your Lender
Section 1 Borrower Informationthis section asks about yourpersonal information and your income fromemploymentandother sources such as retirement that you want considered to qualify for this loan
1a Personal Information
Name(First Middle Last Suffix) Social Security Number - -
(orIndividual TaxpayerIdentification Number)
Alternate Names- List any namesby which you are known or any namesunderwhich credit was previously received (First Middle Last Suffix)
Date ofBirth Citizenship(mmddyyyy) USCitizen
copy PermanentResidentAliencopy Non-PermanentResidentAlien
Type of Credit List Name(s) of Other Borrower(s) Applying for this Loan
copy lamapplyingforindividual credit (First Middle Last Suffix) - Use a separator between names
copy |am applyingfor joint credit Total Numberof Borrowers_
Each Borrowerintendsto applyfor joint credit Yourinitials
Marital Status Dependents(notlisted by another Borrower) Contact Information
O Married Number __ Home Phone ( ) -
s SeparatedUnmarried
Ages CellPhone ( ) _7
(Single Divorced Widowed Civil Union Domestic Partnership Registered Work Phone (0) Ext
Reciprocal Beneficiary Relationship) Email
Current Address
Street Unit
City State ZIP Country
How Long at Current Address Years mdashMonths Housing O Noprimary housing expense copy) Own copy Rent($ month)
If at Current Addressfor LESS than 2 yearslist Former Address LC Does not apply
Street Unit
City State ZIP Country
How Long at Former Address Years mdashMonths Housing No primary housing expense Own Rent($ month)
Mailing Address- ifdifferent from CurrentAddress (| Does not apply
Street Unit
City State ZIP Country
easeaoemir ] Does not apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base $_mdashmdashmdashmdash__mdashmonth
City State ZIP Country Overtime =$_________monthBonus $ month
Position orTitle Checkif this statementapplies Commission $ month[] am employedby a family member
propertyseller real estate agent or otherparty to the transaction
TTStartDate0__mdashsmmddyy) MilitaryHow long in this line of work Years mdash_ Months Entitlements $_mdashsmontth
Other $ monthCheckif you are the Business () | have an ownershipshare of less than 25 Monthly Income(or Loss) mdashmdash_mdashOwnerorSelf-Employed O I have an ownership share of 25 or more sect TOTALS__000month
Uniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
1c IF APPLICABLE Complete Information for Additional EmploymentSelf-Employment and Income
Doesnot apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base $ month
City State ZIP Country Overtime mdash$ monthBonus $ month
Position orTitle Checkif this statementapplies Commission $ month| am employedby a family memberproperty seller real estate agent or otherparty to the transaction
Start Date mdash_mdashAA(mmddyyyy) Military
EntitlementsHow long in this line of work lsquoYears mdash_ Months $ month
7 7 Other $ monthCheckif you are the BusinessOwnerorSelf-Employed
| have an ownershipshare ofless than 25 Monthly Income(or Loss)| have an ownership share of 25 or more $ TOTAL $ 000month
PlMeNeeeMeeCee ti)LeeseteUeLimet Does not apply
Provideatleast 2 years of current and previous employment and income
Employeror Business Name Previous Gross Monthly
Street Unit Income $ month
City State ZIP Country
Position orTitleStart Date (mmddyyyy) Checkif you were the Business
Owneror Self-Employedmdash_ mdashEnd Date (mmddyyyy)
WCBeelcaTy Does not apply
Include incomefrom other sources below Under IncomeSource choosefrom the sourceslisted hereraquo Alimony+ Automobile Allowance Boarder Income
+ Capital Gains
Child Support+ Disabilitylaquo Foster Care
laquo Housing or Parsonage
+ Interest and Dividendslaquo Mortgage Credit Certificateraquo MortgageDifferential
Payments
raquo Notes Receivable+ Public Assistance- Retirement
(eg Pension IRA)
laquo Royalty Payments Separate Maintenance+ Social Security
+ Trust
laquo UnemploymentBenefits
laquo VA Compensation
cent Other
NOTEReveal alimony child support separate maintenance or other income ONLYIFyou wantit considered in determining yourqualification
for this loan
IncomeSource -mdash uselist above Monthly Income
$
$
$
Provide TOTAL AmountHere $ 000
Borrower Name
Uniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 2 Financial Information mdash Assets andLiabilities this section asks about things you ownthatare worth moneyand that you wantconsidered to qualify for this loan It then asks about your liabilities (or debts) that you pay
each month suchas credit cards alimony or other expenses
rNcee stLeVaalemities eitimeeecm dellaLC-
Include all accounts below Under Account Typechoosefrom the typeslisted here
laquo Checkinglaquo Savingsraquo Money Market
+ Certificate of Depositlaquo Mutual Fund+ Stocks
laquo Stock Optionslaquo Bonds+raquo Retirement(eg 407k IRA)
laquo Bridge Loan ProceedslaquoIndividual DevelopmentAccount
Trust Account- Cash Value ofLife Insurance(usedfor the transaction)
AccountType- use list above FinancialInstitution Account Number Cash or MarketValue
$
$
$
$
$
$ 000Provide TOTAL AmountHere|
Includeall other assets and credits below UnderAsset or Credit Type choose from the typeslisted here
Assets Credits- Proceeds from Real EstateProperty to be sold on orbefore closing
laquo Proceeds from Sale ofNon-Real Estate Asset
- Secured Borrowed Funds
cent Unsecured Borrowed Funds Other
raquo Earnest MoneylaquoEmployer Assistance- Lot Equity
Relocation Funds_raquo Rent Credit
laquo Sweat Equity+ Trade Equity
Assetor Credit Type mdash uselist above Cash or Market Value
$
$
$
$
$ 000Provide TOTAL AmountHere
2c Liabilities - Credit Cards Other Debts and Leases that You Owe C Does not apply
List all liabilities below (except real estate) and include deferred payments Under Account Type choose from thetypeslisted herelaquoRevolving (eg credit cards) +Installment (eg car student personal loans) Open 30-Day (balance paid monthly) + Lease (not realestate) +Other
Account Type mdashuse list above
To be paid offator before closingCompany Name Account Number Unpaid Balance Monthly Payment
$ $
$ $
$ $
$ $
$ $
2d OtherLiabilities and Expenses Does not apply
Includeall otherliabilities and expenses below Choose from the typeslisted here
+ Alimony Child Support -Separate Maintenance +JobRelatedExpenses +Other Monthly Payment
$
$
$
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 3 Financial Information mdash Real Estatethis section asks youtolist all properties you currently ownand what you owe onthem donot own anyreal estate
3a Property You Own If you are refinancinglist the property you are refinancing FIRST
Address Street Unit
City State ZIP Country
Sol Intended Occupancyinvestment PrimaryResidence SecondHome Other
Monthly InsuranceTaxesAssociation Duesetcifnot included in MonthlyMortgage Payment
For 2-4 Unit Primary or Investment PropertyStatus SoldPending Saleor Retained
=Monthly RentalIncomeProperty Value
$ $ $
Mortgage Loanson this Property Does not apply
MonthlyMortgagePayment
Type FHA VAConventionalUSDA-RD Other|
To be paid offator before closing
Credit Limit(ifapplicable)Creditor Name Account Number Unpaid Balance
$ $ $
$ $ $
3b IF APPLICABLE Complete Information for Additional Property Does not apply
Address Street Unit
City State ZIP Country
ldquoSold Intended Occupancyinvestment PrimaryResidence SecondHome Other
Monthly Insurance TaxesAssociation Duesetcifnot included in MonthlyMortgage Payment
For 2-4 Unit Primary or Investment PropertyStatus SoldPendingSaleor Retained
Monthly RentalIncomeProperty Value
$ $ $
Mortgage Loanson this Property Does not apply
Monthly
Mortgage
Payment
Type FHA VA
Conventional
USDA-RD Other|
To be paid offat
or before closing
Credit Limit
(ifapplicable)Creditor Name Account Number Unpaid Balance
$ $ $
$ $ $
$ $ $
$ $ $
$ $ $
3c IF APPLICABLE Complete Information for Additional Property Does not apply
Address Street Unit
City State ZIP Country
Intended Occupancyinvestment PrimaryResidence SecondHome Other
Monthly Insurance TaxesAssociation Duesetcifnot included in MonthlyMortgage Payment
For 2-4 Unit Primary or Investment PropertyStatus SoldPending Saleor Retained
Monthly RentalIncomeProperty Value
Mortgage Loanson this Property Does not apply
MonthlyMortgagePayment
Type FHA VAConventionalUSDA-RD Other|
To be paid offator before closing
Credit Limit(ifapplicable)Creditor Name Account Number Unpaid Balance
Borrower Name
Uniform Residential Loan Application
Freddie Mac Form 65 +raquo Fannie Mae Form 1003
Effective 12021
Section 4 Loan and Property Informationthis section asks about the loanrsquos purpose and the property youwantto purchase orrefinance
4a Loan and Property Information
LoanAmount $ Loan Purpose Purchase efinance Other(specify)
Property Address Street Unit
City State ZIP County
Numberof Units Property Value $
Occupancy Primary Residence Second Home InvestmentProperty FHA Secondary Residence
1 Mixed-Use PropertyIf you will occupy the propertywill you set aside space within the property to operate
your ownbusiness(eg daycare facility medicaloffice beautybarber shop)NO YES
2 Manufactured HomeIs the property a manufactured home(eg a factory built dwelling built on a permanentchassis) NO YES
4b Other New Mortgage Loansonthe Property Youare Buying or Refinancing Does not apply
LoanAmountAmountto be Drawn
Credit Limit(ifapplicable)Creditor Name Lien Type Monthly Payment
First Lien Subordinate Lien $ $ $
$ $ $First Lien SubordinateLien
4c Rental Income on the Property You Wantto Purchase For Purchase Only Does not apply
Completeif the property is a 2-4 Unit Primary Residence or an Investment Property Amount
Expected Monthly Rental Income $
Doesnot apply4d Gifts or Grants You Have Been GivenorWill Receive for this Loan
Includeall gifts and grants below Under Source choose from the sourceslisted here
Community Nonprofitlaquo Employer
raquo Federal Agencyraquo Local Agency
- Relative+ Religious Nonprofit
+ State Agency+ Unmarried Partner
raquo Lender Other
Asset TypeCash Gift Gift of Equity Grant DepositedNot Deposited Source - uselist above Cash or Market Value
Deposited Not Deposited $
$Deposited Not Deposited
Borrower Name
Uniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 5 DeclarationsThis section asks youspecific questions about the property your funding and yourpastfinancial history
5aAboutthis Property and Your Moneyfor this Loan
A Will you occupy the property as your primary residence
If YES have you had an ownershipinterest 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 investmentproperty(IP)
(2) How did you holdtitle to the property by yourself (S) jointly with your spouse(SP) or jointly with another person (O)
YESYES
B If this is a Purchase Transaction Do you have a family relationship or businessaffiliation with the seller of the property NO YES
C Are you borrowing any moneyforthis real estate transaction (eg money foryour closing costs or down payment) orobtaining any moneyfrom anotherparty such astheseller or realtor that you have notdisclosed on this loan application NO YES
If YES what is the amountof this money $
D 1 Have you orwill you be applying for a mortgage loan on anotherproperty (not the property securing this loan) on or
before closing this transaction that is not disclosed on this loan application
NO YES
2 Have you orwill you be applying for any newcredit (eg installment loan credit card etc) on or before closing this loan that
is not disclosed on this application
No YES
E Will this property be subject to a lien that could take priority over the first mortgagelien such as a clean energylien paid
through yourproperty taxes(eg the PropertyAssessed Clean Energy Program)NO YES
5b About YourFinances
F Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application NO YES
G Are there any outstanding judgments against you No YES
H Areyou currently delinquentor in default on a Federal debt No YES
I Areyou a party to a lawsuit in which you potentially have any personalfinancialliability NO YES
J Have you conveyedtitle to any property in lieu of foreclosure in the past 7 years NO YES
K Within the past 7 years have you completed a pre-foreclosure sale or short sale whereby the property wassold to a
third party and the Lenderagreed to acceptless than the outstanding mortgage balance due
NO YES
L Have you hadproperty foreclosed uponin thelast 7 years NO YES
M Have you declared bankruptcy within the past 7 years ONO YESIf YES identify the type(s) of bankruptcy Chapter7 Chapter11 Chapter12 Chapter 13
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 6 Acknowledgments and AgreementsThis section tells you about yourlegal obligations whenyousign this application
Acknowledgments and Agreements
Definitions- Lenderincludes the Lenderrsquos agents service providers and any oftheir successors andassigns
Other Loan Participantsrdquo includes(i) any actual or potential owners of
a loan resulting from this application (the ldquoLoanrsquo)(ii) acquirers ofany beneficial or other interest in the Loan(iii) any mortgageinsurer(iv) any guarantor (v) any servicer of the Loan and (vi) any of theseparties service providers successors or assigns
I agree to acknowledgeand representthe following
(1) The Complete Informationfor this Application- The information | have providedin this application is true accurate
and completeas of the date | signed this application
laquo If the information | submitted changesor | have new information
before closing of the Loan | must change and supplementthis
application including providing any updatedsupplementedrealestate sales contract
- For purchase transactions The terms and conditionsof anyrealestate sales contract signed by mein connection with this application
are true accurate and complete to the best of my knowledge andbelief | have not entered into any other agreement written ororal inconnection withthis real estate transaction
- The Lender and OtherLoan Participants mayrely on the informationcontainedin the application before and after closing of the Loan
- Any intentional or negligent misrepresentation of information may
result in the impositionof(a) civil liability on me including monetary damagesif a
person suffers any loss because the person relied on anymisrepresentation that | have made onthis application andor
(b) criminal penalties on me including but not limited to fine orimprisonment or both underthe provisions of Federal law(18 USC sectsect 1001 et seq)
(2) The Propertyrsquos SecurityThe Loan | have applied for in this application will be secured by
a mortgage or deedoftrust which provides the Lendera security
interest in the property described in this application
(3) The Propertys Appraisal Value and Condition- Any appraisal or value of the property obtained by the Lenderis
for use by the Lender and OtherLoanParticipantslaquoThe Lender and OtherLoan Participants have not made anyrepresentation or warranty express or implied to me about the
propertyits conditionorits value
(4) Electronic Records and Signatures- The Lender and OtherLoan Participants may keep any paper record
andorelectronic record of this application whether or not the Loan
is approved
BorrowerSignature
- If this application is created as (or converted into) an ldquoelectronicapplicationrdquo | consent to the use of ldquoelectronic recordsrdquo and
ldquoelectronic signaturesrdquo as the termsare defined in and governed byapplicable Federal andorstate electronic transactions laws
| intend to sign and have signedthis application either using my(a) electronic signature or(b) a written signature and agreethatif a paper version ofthis
application is converted into an electronic application theapplication will be an electronic record and the representationof my written signature on this application will be my binding
electronic signature- | agree that the applicationif delivered or transmitted to the Lenderor Other Loan Participants as an electronic record with myelectronicsignaturewill be as effective and enforceable as a paperapplicationsigned by mein writing
(5) Delinquencylaquo The Lender and OtherLoan Participants may report information about
my accountto credit bureaus Late payments missed paymentsorother defaults on my account maybereflected in my credit report andwill likely affect my credit score
- If | have trouble making my payments | understand that | may contacta HUD-approved housing counseling organization for advice about
actions I can take to meet my mortgageobligations
(6) Authorization for Use and Sharing of InformationBy signing belowin addition to the representations and agreementsmade above| expressly authorize the Lender and Other LoanParticipants to obtain use and share with each other(i) the loan
application and related loan information and documentation(ii) aconsumercredit report on me and(iii) my tax return information asnecessary to perform theactionslisted belowfor so long as they havean interest in my loanorits servicing
(a) process and underwrite myloan(b) verify any data contained in my consumercredit 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 analysisandreviews
(e) perform analysis and modeling for risk assessments(f) monitor the accountfor this loan for potential delinquencies and
determineanyassistance that may beavailable to me and
(g) other actions permissible under applicable law
Date (mmddyyyy)
Additional Borrower Signature Date (mmddyyyy)
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 7 Military ServiceThis section asks questions about your(or your deceased spouses) military service
Military Service of Borrower
Military Service mdash Did you (or your deceased spouse) everserve or are you currently serving in the United States Armed Forces NO YES
If YES check allthat apply Currently serving on active duty with projected expiration date of servicetour (mmddyyyy)
Currently retired discharged or separated from service
Only period of service was as a non-activated memberof the Reserve or National GuardSurviving spouse
Section 8 Demographic InformationThis section asks about your ethnicity sex and race
Demographic Information of Borrower
The purposeofcollecting this informationis to help ensure thatall applicants are treated fairly and that the housing needs of communities
and neighborhoodsare beingfulfilled 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 mayselect one or more designationsfor
Ethnicity and one or more designationsfor Race The law provides that we maynotdiscriminate on the basis of this information or onwhetheryou chooseto provideit However if you choose not to provide the information and you have madethis application in person Federal
regulations require us to note your ethnicity sex and race on thebasis of visual observation or surname Thelaw also provides that we may notdiscriminate on the basis of age or marital status information you providein this application If you do not wish to provide someorall of this
information please check below
Ethnicity Check one or more Race Check one or moreHispanic or Latino AmericanIndian or Alaska Native - Print nameofenrolled
or principaltribe Mexican PuertoRican CubanOther Hispanic or Latino - Print origin Asian
Asian Indian Chinese Filipino
Japanese Korean Vietnamese
OtherAsian mdash Print race
For example Hmong Laotian Thai Pakistani Cambodian and so on
Black or African American
Native Hawaiian or OtherPacific Islander
Native Hawaiian GuamanianorChamorro Samoan
For exampleArgentinean Colombian Dominican Nicaraguan
Salvadoran Spaniard andso on
Not Hispanic or Latino
| do not wish to providethis information
5Female OtherPacific Islander mdash Print race
Male For example Fijian Tongan and so on| do not wish to providethis information white
| do not wish to providethis information
Wasthe ethnicity of the Borrowercollected on the basis of visual observation or surname )NO YESWasthe sex of the Borrowercollected on the basis of visual observation or surname NO YESWastherace of the Borrowercollected on the basis of visual observation or surname NO YES
Face-to-Face Interview (includes Electronic Media w Video Component) TelephoneInterview Faxor Mail Email or Internet
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
ReelTemCrCL
Loan Originator Organization Name
Address
Loan Originator Organization NMLSR ID State License ID
Loan Originator Name
Loan Originator NMLSR ID State License ID
Date (mmddyyyy)
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Uniform Residential Loan Application mdash Additional BorrowerVerify and complete the information onthis application as directed by your Lender
Section 1 Borrower Informationthis section asks about yourpersonal information and your income fromemploymentandother sources such as retirement that you want considered to qualify for this loan
1a Personal Information
Name(First Middle Last Suffix)
Alternate Names - List any namesby which you are known or any namesunder which credit was previously received (First Middle Last Suffix)
Social Security Number - -(or Individual TaxpayerIdentification Number)
Dateof Birth Citizenship(mmddyyyy)
USCitizenPermanentResidentAlienNon-Permanent ResidentAlien
Type ofCredit| am applying for individualcredit
lam applying forjoint credit Total Number of Borrowers
Each Borrowerintendsto applyfor joint credit Your initials
List Name(s) of Other Borrower(s) Applying for this Loan
(First Middle Last Suffix) - Use a separator between names
Marital Status Dependents(notlisted by another Borrower)
Contact Information
Married Number _ Home Phone ( ) -
( ) _
( ) -mdash_ mdash_
Separated Ages CellPhone
Unmarried ens Work Phone Ext(Single Divorced WidowedCivil Union Domestic Partnership Registered
Reciprocal Beneficiary Relationship)lsquol
Emal
Current Address
Street Unit
City State ZIP Country
How Long at Current Address=Years mdashMonths Housing Noprimary housing expense Own Rent($ month)
If at Current Address for LESS than 2 yearslist Former Address Does not apply
Street Unit
City State ZIP Country
How Long at Former Address Years mdashMonths Housing Noprimary housing expense Own month)
Mailing Address- ifdifferent from CurrentAddress Does not apply
Street Unit
City State ZIP Country
eeeeCeeteiChuraleCme Doesnot apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base S$month
City State ZIP Country Overtime =$_____monthBonus $ month
Position orTitle Checkif this statementapplies Commission sect month| am employedby a family memberpropertyseller real estate agent or otherparty to the transaction
TTStart Date ____ (mmddyy) Military
Entitlements$_How longin this line of work Years =Months mdash monthSS
Other $ monthCheckif you are the BusinessOwnerorSelf-Employed
| have an ownershipshare ofless than 25 Monthly Income(or Loss) mdashmdash| have an ownership share of 25 or more $ TOTAL $ 000month
Uniform Residential Loan Application mdash Additional Borrower
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
CoeeeMCMCmeticlm tu)Comiteteilteeilelie mieit
Does not apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base
OvertimeBonus
Commission
MilitaryEntitlements
Other
$ month
$ month$ month
$ month
$ month
$ month
City State ZIP Country
Position orTitle ose if this statement applieslam employed by a family memberpropertyseller real estate agent or otherparty to the transaction
Start Date (mmddyy)How long in this line of work Years =Months
Checkif you are the Business
Owneror Self-Employed| have an ownershipshare of less than 25 Monthly Income(or Loss)
Ihave an ownership share of 25 or more $ TOTAL$ 000month
CPONMeeeMummaTestetiersdeere lire miret Does not apply
Provideat least 2 years of current and previous employment and income
Employeror Business Name Previous Gross MonthlyStreet Unit Income s month
City State ZIP Country
Position or Title
Start Date
End Date
Checkif you were the BusinessOwneror Self-Employed
(mmddyyyy)
(mmddyyyy) 1e Income from Other Sources Does not apply
Include incomefrom other sources below Under Income Source choose from the sourceslisted herelaquo Alimonylaquo Automobile Allowanceraquo Boarder Incomelaquo Capital Gains
Child Support+ Disability+ Foster Care Housing or Parsonage
+ Interest and DividendslaquoMortgage Credit Certificate Mortgage DifferentialPayments
laquo Notes Receivable+ Public Assistancelaquo Retirement(eg Pension IRA)
+raquo Royalty Payments Separate Maintenance
+ Social Security
raquo Trust
+ UnemploymentBenefits
laquo VA Compensation
laquo Other
NOTE Revealalimony child support separate maintenance or other income ONLYIFyou wantit considered in determining yourqualification
for this loan
Income Source - uselist above Monthly Income
$
$
$
$ 000Provide TOTAL AmountHere|
Section 2 Financial Information mdash Assets andLiabilities
Myinformation for Section 2 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 3 Financial Information mdash Real Estate
Myinformation for Section 3 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 4 Loan and Property Information
Myinformation for Section 4 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 5 DeclarationsThis section asks you specific questions about the property your funding and your past
financial history
5aAboutthis Property and Your Moneyforthis Loan
A Will you occupy the property as your primary residence NO YES
If YES have you had an ownershipinterest in another property in the last three years NO YES
If YES complete (1) and (2) below
(1)What type of property did you ownprimary residence (PR) FHA secondary residence (SR) second home(SH)
or investmentproperty (IP)
(2) How did you holdtitle to the property by yourself (S) jointly with your spouse(SP) or jointly with another person (O)
B If this is a Purchase Transaction Do you have a family relationship or businessaffiliation with the seller of the property NO YES Cc Are you borrowing any moneyforthis real estate transaction (eg money foryour closing costs or down payment) or
obtaining any moneyfrom anotherparty suchastheselleror realtor that you have not disclosed on this loan application NO YES
If YES whatis the amountof this money $
D 1 Have youorwill you be applying for a mortgage loan on anotherproperty (not the property securing this loan) on orbefore closing this transaction that is not disclosed on this loan application
NO YES
2 Have you orwill you be applying for any newcredit (eg installment loan credit card etc) on or before closing this loan that wsis not disclosed on this application
NO YES
E Will this property be subject to a lien that could take priority over thefirst mortgagelien such as a clean energylien paid
through yourproperty taxes(eg the PropertyAssessed Clean Energy Program)No YES
EK) Veli ellim ait
F Areyou a co-signer or guarantor on any debtor loan thatis not disclosed on this application NO ES
G Are there any outstanding judgments against you NO YES
H Are you currently delinquentor in default on a Federal debt NO YES
I Are you a party to a lawsuit in which you potentially have any personalfinancialliability NO YES
J Have you conveyedtitle to any property in lieu of foreclosure in the past 7 years NO YES
K Within the past 7 years have you completed a pre-foreclosure sale or short sale whereby the property wassold to a
third party and the Lender agreed to acceptless than the outstanding mortgage balance due
No YES
L Have you had property foreclosed uponin thelast 7 years NO YES
M Have you declared bankruptcy within the past 7 years no vESIf YES identify the type(s) of bankruptcy Chapter 7 Chapter11 Chapter12 Chapter 13
Section 6 Acknowledgements and AgreementsMy signature for Section 6 is on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 7 Military Service This section asks questions about your(or your deceased spouses) military service
Military Service of Borrower
Military Service mdash Did you (or your deceased spouse)everserve or are you currently serving in the United States Armed Forces NO YES
IfYES check allthat apply Currently serving on active duty with projected expiration date of servicetour (mmddyyyy)
Currently retired discharged or separated from service nnOnly period of service was as a non-activated memberofthe Reserve or National GuardSurviving spouse
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 8 Demographic InformationThis section asks about your ethnicity sex and race
Demographic Information of Borrower
The purposeofcollecting this information is to help ensure thatall applicants are treated fairly and that the housing needs of communities
and neighborhoodsare beingfulfilled 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 providethis information but are encouraged to do so You mayselect one or more designationsfor
Ethnicity and one or more designationsfor Race The law provides that we maynotdiscriminate onthe basis of this information or onwhetheryou chooseto provideit However if you choose notto provide the information and you have madethis application in person Federal
regulations require us to note yourethnicity sex and race on the basis of visual observation or surname The law also provides that we may notdiscriminate on the basis of age or marital status information you providein this application If you do not wish to provide someorall of this
information please check below
Ethnicity Check one or more Race Check one or moreHispanic or Latino AmericanIndian or Alaska Native - Print nameofenrolled
or principaltribeMexican PuertoRican Cuban
OtherHispanic or Latino - Printorigin siansian Indian Chinese Filipino
For exampleArgentinean Colombian Dominican NicaraguanSalvadoran Spaniard andso on
Japanese Korean VietnameseOtherAsian - Print race Forexample Hmong Laotian Thai Pakistani Cambodian andso on
Black or African American
Native Hawaiian or OtherPacific Islander
Native Hawaiian GuamanianorChamorro Samoan
OtherPacific Islander mdash Print race
Not Hispanic or Latino
| do not wish to providethis information
Sex
Female
Male
| do not wish to providethis informationFor example Fijian Tongan and so on
White
| do not wish to providethis information
Wasthe ethnicity of the Borrowercollected on thebasis of visual observation or surnameWasthesex of the Borrowercollected on the basis of visual observation or surnameWastherace of the Borrowercollected on the basis of visual observation or surname
)NO YESNO YESNO YES
Face-to-Face Interview (includes Electronic Media w Video Component) Telephone Interview Faxor Mail Email or Internet
Loan Originator Organization Name
Address
Loan Originator Organization NMLSR ID State License ID
Loan Originator Name
Loan Originator NMLSR ID State License ID
Email Phone (
Signature Date (mmddyyyy)
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Pe)aae-emeet)
Community Property State
At least one borrowerlives in a community propertystateThe property is in a community property state
Transaction DetailConversion of Contract for Deed or Land ContractRenovationConstruction-ConversionConstruction-to-Permanent
Single-Closing Two-ClosingConstructionImprovementCosts $
LotAcquired Date
Original Cost of Lot $(mmddyyyy)
Refinance Program
Full DocumentationInterest Rate ReductionStreamlined without Appraisal
Other
Refinance Type
NoCash OutLimited Cash OutCash Out
Energy Improvement
Mortgageloanwill finance energy-related improvements
Propertyis currently subject to a lien that could take priority ovethe first mortgagelien such as a clean energylien paid for througproperty taxes(eg the PropertyAssessed Clean Energyprogram)
Project Type Condominium Cooperative Planned Unit Development (PUD) Propertyis notlocatedin a project
Peiwlivcestetece)a)
Title to the Property Will be Held in What Name(s)
For RefinanceTitle to the Property is Currently Held in What Name(s
Trust Information
tle Will be Held byan Inter Vivos (Living) Trust
Title Will be Held by a Land TrustLeasehold Expiration Date
Mannerin WhichTitle Will be Held Indian Country Land Tenure
Sole OwnershipLife EstateTenancy in Common
Joint Tenancywith Right of Survivorship]Tenancybythe EntiretyOther
Fee Simple Ona ReservationIndividualTrust Land (AllottedRestricted)Tribal Trust Land On a ReservationTribal Trust Land Off ReservationAlaska Native Corporation Land
Estate Will be Held in
Fee Simple(mmddyyyy)
3 Mortgage LoanInformation
Termsof Loan
Note Rate
Loan Term (months)
MortgageLien Type
First LienSubordinate Lien
Mortgage Type Applied For
Conventional USDA-RDFHA VA Other
Amortization Type
Fixed RateAdjustable Rate
If Adjustable Rate
Initial Period Prior to First Adjustment
Subsequent AdjustmentPeriod
Proposed Monthly Paymentfor Property
First Mortgage (P amp I) $
Subordinate Lien(s) (P amp |) $
Other(explain)
Homeowners Insurance $(months)
(months)
Loan Features Property Taxes $
Balloon Balloon Term (months)
Interest Only Interest OnlyTermNegative AmortizationPrepaymentPenalty Prepayment Penalty Term (months) Other
Temporary Interest Rate BuydownInitial Buydown Rate TOTALOther(explain)
Mortgage Insurance $
AssociationProject Dues (Condo Co-Op PUD) $
Supplemental Property Insurance $
(months)
Borrower Name(s)Uniform Residential Loan Application mdash LenderLoan Information
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
L4 Qualifying the Borrower - Minimum Required Funds or Cash Back
DUEFROM BORROWER(S)
A Sales Contract Price
B Improvements Renovations and Repairs
C Land(ifacquired separately)
D For Refinance Balance of Mortgage Loanson the Propertyto be paid off in the Transaction
(See Table 3a Property You Own)
E Credit Cards and Other Debts Paid Off
(See Table 2c Liabilities mdash Credit Cards Other Debts and Leases that You Owe)
F BorrowerClosing Costs (including Prepaid andInitial Escrow Payments)
G Discount Points
HTOTAL DUE FROM BORROWER(s)(Total of A thru G)
TOTALMORTGAGE LOANS
Loan Amount
Loan AmountExcluding Financed Mortgage Insurance (or Mortgage Insurance Equivalent) $
Financed Mortgage Insurance (or Mortgage Insurance Equivalent) Amount $
Other New Mortgage Loanson the Property the Borrower(s) is Buying or Refinancing(See Table 4b Other New MortgageLoanson the Property You are Buying or Refinancing)
KTOTAL MORTGAGELOANS(Totalof| and J)
TOTALCREDITS
L Seller Credits (Enter the amountofBorrower(s) costs paid by the property seller)
MOtherCredits (Enter the sum ofall other credits mdash BorrowerPaid Fees Earnest Money EmployerAssistedHousing Lease Purchase Fund Lot Equity Relocation Funds Sweat Equity Trade Equity Other)
NTOTAL CREDITS(Total of L and M)
CALCULATION
TOTAL DUE FROM BORROWER(s)(Line H)
LESSTOTAL MORTGAGELOANS(Line K) AND TOTAL CREDITS(Line N)
Cash FromTothe Borrower(Line H minusLine K and Line N)NOTE This amountdoesnotinclude reservesor other funds that may be required by the Lenderto be verified
Borrower Name(s)Uniform Residential Loan Application mdash LenderLoan Information
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
Uniform Residential Loan Application mdash Unmarried Addendum
eeCeceetatimC elitleeComeLy
Lenders Instructions for Using the Unmarried Addendum
The Lender may use the Unmarried Addendum only when a Borrowerselected ldquoUnmarriedrdquoin Section 1 and the information collected is
necessary to determine howState property lawsdirectly or indirectly affecting creditworthiness apply including ensuring clear title
For example the Lender may use the Unmarried Addendum whentheBorrowerresides in a State that recognizescivil unions domestic
partnerships or registered reciprocal beneficiary relationships or when the property is located in such a State ldquoStaterdquo meansanystate the
District of Columbia the Commonwealth of Puerto Rico or anyterritory or possession of the United States
Ifyou selected ldquoUnmarriedrdquoin Section 1 is there a person whois not your legal spouse but whocurrently has real property rights similar to
those of a legal spouse +=) NOQ YES
If YES indicate the type of relationship and the State in which the relationship was formed For example indicate if you are in a
civil union domestic partnership registered reciprocal beneficiary relationship or other relationship recognized by the State in which you
currently reside or where the property is located
O Civil Union copy Domestic Partnership copy Registered Reciprocal Beneficiary Relationship copy) Other(explain)
Statea]
Borrower NameUniform Residential Loan Application mdash Unmarried Addendum
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Uniform Residential Loan Application mdash Continuation Sheet
Use this continuation sheet if you need more space to complete the Uniform Residential Loan Application
Borrower Name(First Middle Last Suffix )
Additional Information
Additional Borrower Name(First Middle Last Suffix )
Additional Information
IWefully understand thatit is a federal crime punishable by fine or imprisonment or both to knowingly make anyfalse statements concerningany of the abovefacts as applicable underthe provisions of federal law (18 USC sectsect 1001 et seq)
BorrowerSignature Date (mmddyyyy)
Additional Borrower Signature Date (mmddyyyy)
Uniform Residential Loan Application mdash Continuation SheetFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
INSTRUCTIONS FOR COMPLETING THE UNIFORM RESIDENTIAL LOAN APPLICATION
Use the instructions below to complete the enclosed Uniform Residential Loan Application (Freddie Mac Form 65Fannie Mae Form 1003) To avoid any delays in your application review please provide all of the requested information
If you need to make a correction on the application draw a line through the incorrect text and mark your initials beside the change Donrsquot use correction tape or fluid The application must be completed signed and dated in ink
The Uniform Residential Loan Application (URLA)
The URLA contains the following sections Section 1 Borrower Information Please provide your personal information income and employment
Section 2 Financial Information ndash Assets and Liabilities Please provide information about your financial assets personal financial obligations and debts you owe
Section 3 Financial Information ndash Real Estate Please provide information about property you own and the debts and expenses related to the property
Section 4 Loan and Property Information Please provide information about the loan purpose and the property you are buying or refinancing
Section 5 Declarations Please answer questions about the property how the property will be financed and your past financial history
Section 6 Acknowledgments and Agreements Informs you of your legal obligations related to the mortgage application and asks that you acknowledge certain information will be obtained used and shared
Section 7 Military Service Please provide information about your (or your deceased spousersquos) military service
Section 8 Demographic Information Requests information the Lender is required by law to ask you
Section 9 Loan Originator Information Will be completed by Chase
Uniform Residential Loan Application ndash Additional Borrower
The URLA ndash Additional Borrower contains the following sections Section 1 Borrower Information This is the same as the Borrower Information section of the URLA
Section 2 Financial Information ndash Assets and Liabilities Contains only the following statement for the additional Borrower to complete ldquoMy information for Section 2 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo The name of the other borrower is entered here
Complete a separate URLA for each BorrowermiddotThree or more Borrowers ndash Use any combination of URLA and URLA-Additional Borrower forms in accordance with the above examples
Section 3 Financial Information ndash Real Estate Contains only the following statement for the additional borrower to complete ldquoMy information for Section 3 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 4 Loan and Property Information Contains only the following statement for the additional borrower to complete ldquoMy information for Section 4 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 5 Declarations This is the same as the Declarations section of the URLA
Section 6 Acknowledgments and Agreements Contains only the following statement for the additional borrower to complete ldquoMy signature for Section 6 is on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 7 Military Service This is the same as the Military Service section of the URLA
Section 8 Demographic Information This is the same as the Demographic Information section on the URLA
Section 9 Loan Originator Information This is the same as the Loan Originator Information section of the URLA
Using the URLA and URLA ndash Additional Borrower Together The URLA and the URLA ndash Additional Borrower are used together to collect information for two Borrowers who have joint assets liabilities andor real estate information The URLA and URLA ndash Additional Borrower can also be used for Borrowers who do not have joint information but wish to combine their information on the URLA for ease of use Here are examples of how to use the URLA and URLA ndash Additional Borrower
For one borrower Complete the URLA
For two borrowers with joint financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you dont need to duplicate them on more than one URLA or o In cases where Borrowers are not collaborating when completing the loan application
joint assets liabilities and real estate may be duplicated on each URLA bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you do not need to duplicate them on more than one URLA or
o In cases where Borrowers are not collaborating when completing the loan application joint assets liabilities and real estate may be duplicated on each URLA
For two borrowers with separate financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower Report the assets liabilities and
real estate for the additional Borrower on the URLA or bull Complete a separate URLA for each Borrower
For three or more borrowers use any combination of URLA and URLA ndash Additional Borrower forms described for two borrowers
Uniform Residential Loan Application ndash Unmarried Addendum If any borrower listed on the URLA or URLA ndash Additional Borrower form selects Unmarried in Section 1 (Personal Information) the lender will complete this optional form
The information must be collected to determine how to apply state property laws that directly or indirectly affect creditworthiness including ensuring clear title
Uniform Residential Loan Application ndash Continuation Sheet Use the URLA ndash Continuation Sheet if you need more space to complete either the URLA or URLA ndash Additional Borrower forms
99177-URLAI-0215
HUD Addendum to Uniform Residential Loan Application OMB Approval No HUD 2502-0059 (exp )
Part I - Identifying Information HUDFHA Application for Insurance under the National Housing Act and Borrower Certification
FHA Case No (include any suffix) Mortgagee Case No
Mortgagee ID Sponsor ID Agent ID
Mortgagee Name Address (include ZIP Code) and Telephone Number
Type or print all entries clearly
Name and Address of Sponsor Name and Address of Agent
Borrowers Name amp Present Address (include ZIP Code) Property Address (include name of subdivision lot amp block no amp ZIP Code)
Sponsored Originations
Name of Third-Party Originator NMLS ID of Third-Party Originator
Part II - Borrower Consent for Social Security Administration to Verify Social Security Number I authorize the Social Security Administration (SSA) to verify my Social Security Number (SSN) to the Mortgagee and HUDFHA I authorize SSA to provide explanatory
information to HUDFHA in the event of a discrepancy This consent is valid for 180 days from the date signed unless indicated otherwise by the individual(s) named in this
loan application
Signature(s) of Borrower(s) - Read consent carefully Review accuracy of Social Security Number(s) provided on this application
Borrowerrsquos NameDate of BirthSocial Security Number
Co-Borrowerrsquos Name Date of BirthSocial Security Number
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
Part III - Borrower Notices Information and Acknowledgment Public Reporting Burden
Public reporting burden for this collection of information is estimated to average 10 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 conduct or sponsor and a person is not
required to respond to a collection of information unless that collection displays a valid OMB control number which can be located on the OMB Internet page at
httpwwwreginfogovpublicdoPRAMain
Privacy Act Information
The information requested on the Uniform Residential Loan Application and this Addendum is authorized by the National Housing Act of 1934 12 USC sect 1701 et seq The Debt
Collection Act of 1982 Pub L 97-365 and HUDrsquos Housing and Community Development Act of 1987 42 USC sect 3543 require persons applying for a federally insured loan to
furnish their SSN You must provide all the requested information including your SSN HUD may conduct a computer match to verify the information you provide HUD may
disclose certain information to Federal State and local agencies when relevant to civil criminal or regulatory investigations and prosecutions It will not otherwise be disclosed or
released outside of HUD except as required and permitted by law The information will be used to determine whether you qualify as a mortgagor Failure to provide any of the
requested information including SSN may result in disapproval of your loan application This is notice to you as required by the Right to Financial Privacy Act of 1978 that
HUDFHA has a right of access to financial records held by financial institutions in connection with the consideration or administration of assistance to you Financial records
involving your transaction will be available to HUDFHA without further notice or authorization but will not be disclosed or released by the institution to another Government Agency
or Department without your consent except as required or permitted by law
WARNING This warning applies to all certifications made in this document Anyone who knowingly submits a false claim or makes false statements is subject to criminal and civil penalties including confinement for up to 5 years fines and civil penalties 18 USC sectsect 287 1001 and 31 USC sect 3729
orm HUD-92900-A ( ) Page 1
Borrower Name ____________________________ FHA Case No __________________
Caution Delinquencies Defaults Foreclosures and Abuses Delinquencies defaults foreclosures and abuses of mortgage loans involving programs of the Federal Government can be costly and detrimental to your credit now and in the future The Mortgagee in this transaction its agents and assigns as well as the Federal Government its agencies agents and assigns are authorized to take any and all of the following actions in the event loan payments become delinquent on the mortgage loan described in the attached application (1) Report your name and account information to a credit bureau (2) Assess additional interest and penalty charges for the period of time that payment is not made (3) Assess charges to cover additional administrative costs incurred by the Federal Government to service your account (4) Offset amounts owed to you
under other Federal programs (5) Refer your account to a private attorney collection agency or mortgage servicing agency to collect the amount due foreclose
the mortgage sell the property and seek judgment against you for any deficiency (6) Refer your account to the Department of Justice (DOJ) for litigation in the
courts (7) If you are a current or retired Federal employee take action to offset your salary or civil service retirement benefits (8) Refer your debt to the Internal
Revenue Service for offset against any amount owed to you as an income tax refund and (9) Report any resulting written off debt of yours to the Internal Revenue Service as your taxable income All of these actions may be used to recover any debts owed when it is determined to be in the interest of the Mortgagee or Federal Government or both
As a mortgage loan borrower you will be legally obligated to make the mortgage payments called for by your mortgage loan contract The fact that you dispose of your property after the loan has been made will not relieve you of liability for making these payments Payment of the loan in full is ordinarily the way liability on a mortgage note is ended Some home buyers have the mistaken impression that if they sell their homes when they move to another locality or dispose of it for any other reasons they are no longer liable for the mortgage payments and that liability for these payments is solely that of the new owners Even though the new owners may agree in writing to assume liability for your mortgage payments this assumption agreement will not relieve you from liability to the holder of the note which you signed when you obtained the loan to buy the property Unless you are able to sell the property to a buyer who is acceptable to HUDFHA who will assume the payment of your obligation to the lender you will not be relieved from liability to repay any claim which HUDFHA may be required to pay your lender on account of default in your loan payments The amount of any such claim payment may be a debt owed by you to the Federal Government and subject to established collection procedures
Fair Housing Act I and anyone acting on my behalf are and will remain in compliance with the Fair Housing Act 42 USC sect 3604 et seq with respect to the dwelling or property covered by the loan and in the provision of services or facilities in connection therewith I recognize that any restrictive covenant on this property related to race color religion sex disability familial status or national origin is unlawful under the Fair Housing Act and unenforceable I further recognize that in addition to administrative action by HUD a civil action may be brought by the DOJ in any appropriate US court against any person responsible for a violation of the
applicable law
Certification and Acknowledgment All information in this application is given for the purpose of obtaining a loan to be insured under the National Housing Act and the information in the Uniform Residential Loan Application and this Addendum is true and complete to the best of my knowledge and belief Verification may be obtained from any source named herein I have read and understand the foregoing concerning my liability on the loan and Part III Borrower Notices Information and Acknowledgment
Signature(s) of Borrower(s) - Do not sign unless this application is fully completed Read the certification carefully and review accuracy of this application
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
orm HUD-92900-A ( Page 2
___________________________________
______________________________________________________
______________________________________________________________
- - - - - - - - - - - - - - - - - - - - - - -
Borrower Name ____________________________ FHA Case No __________________
Part IV - Direct Endorsement Approval for a HUD FHA-Insured Mortgage A Underwriting the Borrower
Date Mortgage Approved ______________________________ Date Approval Expires ______________________
For mortgages rated as an ldquoacceptrdquo or ldquoapproverdquo by FHAs TOTAL Mortgage Scorecard
The information submitted to TOTAL was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA4e Final Underwriting Decision (TOTAL) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee Representative Signature
Printed Name
Title
OR
For mortgages rated as a ldquoreferrdquo by FHAs TOTAL Mortgage Scorecard or manually underwritten by a Direct Endorsement underwriter I have personally reviewed and underwritten the borrowerrsquos credit application The information used to underwrite the borrower was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA5d Final Underwriting Decision (Manual) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
B Underwriting the Property
For all mortgages where FHA requires an appraisal I have personally reviewed and underwritten the appraisal according to FHA requirements I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
orm HUD-92900-A ( ) Page 3
Borrower Name ____________________________ FHA Case No __________________
Part V Mortgagees Certification
I have personally reviewed the mortgage documents and the application for insurance endorsement and This mortgage complies with SF Handbook 40001 Section IIA7 Post-Closing and Endorsement to the extent that no defect exists that would have changed the decision to endorse or submit the mortgage for insurance
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee
Name of Mortgageersquos Representative
Title of Mortgageersquos Representative
Signature of the Mortgageersquos Representative Date
orm HUD-92900-A ( ) Page 4
GENERAL AUTHORIZATION FOR A MORTGAGE LOAN ASSUMPTION
Applicant name(s)
Loan number
NOTICES AND DISCLOSURES
Non-discriminatory underwriting guidelines Anyone who inquires about the availability of credit from us has the right to receive a copy of our non-discriminatory underwriting guidelines To request a copy of these guidelines contact your Loan Processor
Attorney note Itrsquos the responsibility of our attorneys to protect our interest You may at your expense request an attorney to represent your interest
Notice to HUDFHA applicants As required by the Right to Financial Privacy Act of 1978 this notice is to inform you that the US Department of Housing and Urban Development (HUD)Federal Housing Administration (FHA) has a right of access to financial records held by financial institutions related to a request for assistance Financial records involving your assumption will be available to HUDFHA without further notice or authorization but wonrsquot be disclosed or released by us to another government agency or department without your consent except as required or permitted by law
Borrower consent to the use of tax return information I understand acknowledge and agree that the Lender and Other Loan Participants can obtain use and share tax return information for purposes of (i) providing an offer (ii) originating maintaining managing monitoring servicing selling insuring and securitizing a loan (iii) marketing or (iv) as otherwise permitted by applicable laws including state and federal privacy and data security laws The Lender includes the Lenderrsquos affiliates agents service providers and any of aforementioned partiesrsquo successors and assigns The Other Loan Participants includes any actual or potential owners of a loan resulting from your loan application or acquirers of any beneficial or other interest in the loan and mortgage insurer guarantor any servicers or service providers for these parties and any of aforementioned partiesrsquo successors and assigns
CERTIFICATION AND AUTHORIZATION
Environmental certification By signing below I represent and warrant that Irsquom not aware of any substances materials or products that may be an environmental hazard such as but not limited to asbestos formaldehyde radon gas lead-based paint fuel or chemical storage tanks (above or below ground) and contaminated soil or water on the property I acknowledge that Chase is relying on this representation and warranty as a material part of its loan application process I also am not aware of any landfill on any portion of the property
Exceptions to the above I further acknowledge (1) receipt of applicable disclosures from the seller in purchase transactions (2) that lead-based paint may exist in housing constructed prior to 1978 (3) that Chase performs no environmental investigation on my behalf and isnrsquot responsible for identifying lead-based paint or any other environmental conditions that might impact the property or its residents and (4) that it is my sole obligation to investigate for potential impact to the property from environmental conditions
Certifications I certify by signing below that (1) all of the loan application information provided is true and complete (2) I understand any intentional or negligent misrepresentation(s) of the information provided in conjunction with my application may result in civil liability andor 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 Chase its agents successors and assigns insurers and any other person who may suffer any loss due to reliance upon any misrepresentation that I have made on the application and (3) any significant change from the information provided at the time of application until the final loan application is signed may have a bearing on the approval of my application for a home loan
Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union
This question is asked because of state laws that extend the same or similar rights benefits and protections of spouses in a marriage to persons who are members of a partnership or union recognized under state law You should consult with your own legal advisor for advice regarding the rights protections benefits responsibilities obligations and duties of those who are registered domestic partners civil union partners or members of other unions recognized under applicable law
CREDIT AUTHORIZATION RELEASE
By signing below I authorize Chase andor my mortgage insurer (if any) to verify my past and present employment earnings records (including information contained in income tax returns that have been filed with the IRS) bank accounts stock holdings and any other information that it finds necessary to process my mortgage loan application or to review it for quality-control purposes I understand that a credit report will be ordered from a credit reporting agency for verification prior to loan closing as part of the application process and may be ordered after closing as part of the Lenderrsquos quality-control program A credit report may also be completed as part of the Lenderrsquos servicing or collection of the loan or in consideration of any other product or service that the Lender may consider offering me in the future and at any time throughout the life of the loan I understand that use of a photocopy of this form may be necessary to verify one or more of my credit references I understand that a photocopy or fax copy of this form will also serve as authorization
By signing below each applicant acknowledges (1) making the above certifications and authorizations and (2) that each applicant has received and understands the above notices and disclosures
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
You do not have to give us this information but if you donrsquot your application for approval as a borrower may be delayed or rejected The information requested in this form is authorized by Title 38 USC Chapter 37 (if VA) by 12 USC Section 1701 et seq (if HUDFHA) by 42 USC Section 1452b (if HUDCPD) and Title 42 USC 1471 et seq or 7 USC 1921 et seq (if USDA FHA)
Updated December 2021 99177-GA-0215
1b
2b
Form 4506-C (September 2020)
Department of the Treasury - Internal Revenue Service
IVES Request for Transcript of Tax Return OMB Number
1545-1872
Do not sign this form unless all applicable lines have been completed Request may be rejected if the form is incomplete or illegible
For more information about Form 4506-C visit wwwirsgov and search IVES
1a Name shown on tax return (if a joint return enter the name shown first)
First social security number on tax return individual taxpayer identification number or employer identification number (see instructions)
2a If a joint return enter spousersquos name shown on tax return Second social security number or individual taxpayer identification number if joint tax return
3 Current name address (including apt room or suite no) city state and ZIP code (see instructions)
4 Previous address shown on the last return filed if different from line 3 (see instructions)
5a IVES participant name address and SOR mailbox ID
DataVerify 875 Greentree Rd 8 Parkway Center Pittsburgh PA 15220
5b Customer file number (if applicable) (see instructions)
Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing (see instructions)
6 Transcript requested Enter the tax form number here (1040 1065 1120 etc) and check the appropriate box below Enter only one tax form number per request 1040
a Return Transcript which includes most of the line items of a tax return as filed with the IRS A tax return transcript does not reflect changes made to the account after the return is processed Transcripts are only available for the following returns Form 1040 series Form 1065 Form 1120 Form 1120-A Form 1120-H Form 1120-L and Form 1120S Return transcripts are available for the current year and returns processed during the prior 3 processing years
b Account Transcript which contains information on the financial status of the account such as payments made on the account penalty assessments and adjustments made by you or the IRS after the return was filed Return information is limited to items such as tax liability and estimated tax payments Account transcripts are available for most returns
c Record of Account which provides the most detailed information as it is a combination of the Return Transcript and the Account Transcript Available for current year and 3 prior tax years
7 Form W-2 Form 1099 series Form 1098 series or Form 5498 series transcript The IRS can provide a transcript that includes data from these information returns State or local information is not included with the Form W-2 information The IRS may be able to provide this transcript information for up to 10 years Information for the current year is generally not available until the year after it is filed with the IRS For example W-2 information for 2016 filed in 2017 will likely not be available from the IRS until 2018 If you need W-2 information for retirement purposes you should contact the Social Security Administration at 1-800-772-1213
Caution If you need a copy of Form W-2 or Form 1099 you should first contact the payer To get a copy of the Form W-2 or Form 1099 filed with your return you must use Form 4506 and request a copy of your return which includes all attachments
8 Year or period requested Enter the ending date of the tax year or period using the mmddyyyy format (see instructions)
12 31 2020 12 31 2019 12 31 2018 Caution Do not sign this form unless all applicable lines have been completed
Signature of taxpayer(s) I declare that I am either the taxpayer whose name is shown on line 1a or 2a or a person authorized to obtain the tax information requested If the request applies to a joint return at least one spouse must sign If signed by a corporate officer 1 percent or more shareholder partner managing member guardian tax matters partner executor receiver administrator trustee or party other than the taxpayer I certify that I have the authority to execute Form 4506-C on behalf of the taxpayer Note This form must be received by IRS within 120 days of the signature date
Signatory attests that heshe has read the attestation clause and upon so reading declares that heshe has the authority to sign the Form 4506-C See instructions
Sign Here
Signature (see instructions) Date Phone number of taxpayer on line 1a or 2a
PrintType name
Title (if line 1a above is a corporation partnership estate or trust)
Spousersquos signature Date
PrintType name
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020) For Privacy Act and Paperwork Reduction Act Notice see page 2
Instructions for Form 4506-C IVES Request for Transcript of Tax Return
Section references are to the Internal Revenue Code unless otherwise noted
Future Developments
For the latest information about Form 4506-C and its instructions go to wwwirsgov and search IVES Information about any recent developments affecting Form 4506-C (such as legislation enacted after we released it) will be posted on that page
Whats New Form 4506-C was created to be utilized by authorized IVES participants to order tax transcripts with the consent of the taxpayer
General Instructions
Caution Do not sign this form unless all applicable lines have been completed
Designated Recipient Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information received pursuant to the taxpayerrsquos consent and holds the recipient subject to penalties for any unauthorized access other use or redisclosure without the taxpayerrsquos express permission or request
Taxpayer Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information provided pursuant to your consent and holds the recipient subject to penalties brought by private right of action for any unauthorized access other use or redisclosure without your express permission or request
Purpose of form Use Form 4506-C to request tax return information through an authorized IVES participant You will designate an IVES participant to receive the information on line 5a
Note If you are unsure of which type of transcript you need check with the party requesting your tax information
Where to file The IVES participant will fax Form 4506-C with the approved IVES cover sheet to their assigned Service Center
Chart for ordering transcripts
If your assigned Service Center is
Fax the requests with the approved coversheet to
Austin Submission Processing Center
Austin IVES Team
844-249-6238
Fresno Submission Processing Center
Fresno IVES Team
844-249-6239
Kansas City Submission Processing Center
Kansas City IVES Team
844-249-8128
Ogden Submission Processing Center
Ogden IVES Team
844-249-8129
Specific Instructions
Line 1b Enter the social security number (SSN) or individual taxpayer identification number (ITIN) for the individual listed on line 1a or enter the employer identification number (EIN) for the business listed on line 1a
Line 3 Enter your current address If you use a PO box include it on this line
Line 4 Enter the address shown on the last return filed if different from the address entered on line 3
Note If the addresses on lines 3 and 4 are different and you have not changed your address with the IRS file Form 8822 Change of Address or Form 8822-BChange of Address or Responsible Party mdash Business with Form 4506-C
Line 5b Enter up to 10 numeric characters to create a unique customer file number that will appear on the transcript The customer file number cannot contain an SSN ITIN or EIN Completion of this line is not required
Note If you use an SSN name or combination of both we will not input the information and the customer file number will reflect a generic entry of 9999999999 on the transcript
Line 8 Enter the end date of the tax year or period requested in mmddyyyy format This may be a calendar year fiscal year or quarter Enter each quarter requested for quarterly returns Example Enter 12312018 for a calendar year 2018 Form 1040 transcript
Signature and date Form 4506-C must be signed and dated by the taxpayer listed on line 1a or 2a The IRS must receive Form 4506-C within 120 days of the date signed by the taxpayer or it will be rejected Ensure that all applicable lines including lines 5a through 8 are completed before signing
You must check the box in the signature area to acknowledge you have the authority to sign and request the information The form will not be processed if unchecked
Individuals Transcripts listed on on line 6 may be furnished to either spouse if jointly filed Only one signature is required Sign Form 4506-C exactly as your name appeared on the original return If you changed your name also sign your current name
Corporations Generally Form 4506-C can be signed by
(1) an officer having legal authority to bind the corporation (2) any person designated by the board of directors or other governing body or (3) any officer or employee on written request by any principal officer and attested to by the secretary or other officer A bona fide shareholder of record owning 1 percent or more of the outstanding stock of the corporation may submit a Form 4506-C but must provide documentation to support the requesters right to receive the information
Partnerships Generally Form 4506-C can be signed by any person who was a member of the partnership during any part of the tax period requested on line 8
All others See section 6103(e) if the taxpayer has died is insolvent is a dissolved corporation or if a trustee guardian executor receiver or administrator is acting for the taxpayer
Note If you are Heir at law Next of kin or Beneficiary you must be able to establish a material interest in the estate or trust
Documentation For entities other than individuals you must attach the authorization document For example this could be the letter from the principal officer authorizing an employee of the corporation or the letters testamentary authorizing an individual to act for an estate
Signature by a representative A representative can sign Form 4506-C for a taxpayer only if the taxpayer has specifically delegated this authority to the representative on Form 2848 line 5 The representative must attach Form 2848 showing the delegation to sign Form 4506-C
Privacy Act and Paperwork Reduction Act Notice We ask for the information on this form to establish your right to gain access to the requested tax information under the Internal Revenue Code We need this information to properly identify the tax information and respond to your request You are not required to request any transcript if you do request a transcript sections 6103 and 6109 and their regulations require you to provide this information including your SSN or EIN If you do not provide this information we may not be able to process your request Providing false or fraudulent information may subject you to penalties
Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and cities states the District of Columbia and US commonwealths and possessions for use in administering their tax laws We may also disclose this information to other countries under a tax treaty to federal and state agencies to enforce federal nontax criminal laws or to federal law enforcement and intelligence agencies to combat terrorism
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law Generally tax returns and return information are confidential as required by section 6103
The time needed to complete and file Form 4506-C will vary depending on individual circumstances The estimated average time is
Learning about the law or the form 10 min Preparing the form 12 min Copying assembling and sending the form to the IRS 20 min
If you have comments concerning the accuracy of these time estimates or suggestions for making Form 4506-C simpler we would be happy to hear from you You can write to
Internal Revenue Service Tax Forms and Publications Division 1111 Constitution Ave NW IR-6526 Washington DC 20224
Do not send the form to this address Instead see Where to file on this page
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020)
Rev April 2021 CHASEO Facts What does Chase do with your personal information
Why Financial companies choose how they share your personal information Federal law gives consumers the right to limit some but not all sharing Federal law also requires us to tell you how we collect share and protect your personal information Please read this notice carefully to understand what we do
What The types of personal information we collect and share depend on the product or service you have with us This information can include bull Social Security number and income bull account balances and transaction history bull credit history and payment history
How All financial companies need to share customers personal information to run their everyday business In the section below we list the reasons financial companies can share their customers personal information the reasons Chase chooses to share and whether you can limit this sharing
Reasons we can share your personal information Does Chase share
Can you limit this sharing
For our everyday business purposes - such as to process your transactions maintain your account(s) respond to court orders and legal investigations or report to credit bureaus
Yes No
For our marketing purposes - to offer our products and services to you
Yes No
For joint marketing with other financial companies Yes No
For our affiliates everyday business purposes - information about your transactions and experiences
Yes No
For our affiliates everyday business purposes - information about your creditworthiness
Yes Yes
For our affiliates to market to you Yes Yes
For nonaffiliates to market to you Yes Yes
a
0
To limit our sharing
bull Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
bull Visit us online chasecomprivacypreferences
Please note If you are a new customer we can begin sharing your information 30 days from the date we sent this notice When you are no longer our customer we continue to share your information as described in this notice However you can contact us at any time to limit our sharing
Questions
Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
PAGE 2
Who we are
Who is providing this notice The US consumer financial companies within the JPMorgan Chase amp Co family including JPMorgan Chase Bank NA Chase Insurance Agency Inc and JP Morgan Securities LLC
What we do
How does Chase protect my To protect your personal information from unauthorized access and use we personal information use security measures that comply with federal law These measures include
computer safeguards and secured files and buildings We authorize our employees to get your information only when they need it to do their work and we require companies that work for us to protect your information
How does Chase collect my We collect your personal information for example when you personal information bull open an account or make deposits or withdrawals from your account
bull pay your bills or apply for a loan bull use your credit or debit card We also collect your personal information from others such as credit bureaus affiliates or other companies
Why cant I limit all sharing Federal law gives you the right to limit only bull sharing for affiliates everyday business purposes - information about your
creditworthiness bull affiliates from using your information to market to you bull sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing See below for more on your rights under state law
What happens when I limit sharing for an account I hold jointly with someone else
Your choices will apply to everyone on your account
Definitions
Affiliates Companies related by common ownership or control They can be financial and non financial companies bull Our affiliates include companies with a Chase or JP Morgan name and financial companies such asjP Morgan Securities LLC
Nonaffiliates Companies not related by common ownership or control They can be financial and non financial companies bull Nonaffiliates we share with can include companies such as retailers auto dealers auto makers and membership clubs
Joint marketing A formal agreement between nonaffiliated financial companies that together market financial products or services to you bull Our joint marketing partners include categories of companies such as insurance companies
Other important information
VT Accounts with a Vermont mailing address are automatically treated as if they have limited the sharing as described on page 1 For joint marketing we will only disclose your name contact information and information about your transactions
NV We are providing you this notice pursuant to Nevada law If you prefer not to receive marketing calls from us you may be placed on our Internal Do Not Call List by calling 1-800-945-9470 or by writing to us at PO Box 734007 Dallas TX 75373-4007
For more information contact us at the address above or email PrivacylnfoJPMChasecom with Nevada Annual Notice in the subject line You may also contact the Nevada Attorney Generals office Bureau of Consumer Protection Office of the Nevada Attorney General 555 E Washington St Suite 3900 Las Vegas NV 89101 telephone number 1-702-486-3132 email BCPINFOagstatenvus
CA Accounts with a California mailing address are automatically treated as if they have limited the sharing with nonaffiliates as described on page 1 CA residents are provided a CA notice for additional choices
CHASE O
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
The following disclosure is required by the USA PATRIOT Act
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 opens an account
What this means to you When you 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 drivers
license or other identifying documents
99177-PAT-0215
VETERAN STATEMENT When this loan was opened the US Department of Veterans Affairs (VA) used the veteran borrowerrsquos entitlement which is a set amount the VA promises to repay a lender if the borrower defaults on the mortgage An assumption will modify who is obligated to pay the existing mortgage loan but all loan termsmdashincluding the entitlementmdashwill remain the same If the veteran borrower is being removed from the loan the entitlement would remain with whoever is assuming the loan because the loan will continue to be serviced by the VA If the applicant is also a veteran and can substitute his or her entitlement for the current entitlement then the current borrowerrsquos entitlement can be released
Please review the following questions and answer as appropriate This form requires completion by both the applicant(s) and current borrower(s)
1 Applicant to Complete
Are you (the applicant) currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the reverse side)
Yes (If yes please provide the information requested below answer the question in section 3 and sign and date this form at the bottom of the reverse side)
Name of applicant(s) who answered ldquoyesrdquo to the above question
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Are you receiving VA disability benefts
Applicant
Yes
No
Co-Applicant
Yes
No
Are you entitled to receive VA disability benefts Yes No Yes No
Have you received VA disability benefts in the past Yes No Yes No
Are you a surviving spouse of a veteran who died on active duty or as the result of a service-related disability
Yes No Yes No
Do you have any VA loans Yes No Yes No
2 Current Borrower to Complete
Is the current borrowerco-borrower currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the page)
Yes (If yes please answer the question in section 3 and sign and date this form at the bottom of the page)
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
________________________________________________________________________________________________
3 Applicant and Current Borrower to Complete
If the answer to the questions in section 1 and 2 are both yes please answer the following question After yoursquove reviewed and completed this entire form please sign and date at the bottom
Applicant Current Borrower
Do you want to apply for a substitution of entitlement Yes Yes No No
In order to complete a substitution of entitlement the veteran applicant must have suffcient entitlement to substitute for that of the current borrower Contact the VA Offce of Jurisdiction for your area for more information Also before the veteran applicant can substitute entitlement on a VA loan heshe must certify that the property securing the loan will be occupied as hisher primary residence Both the applicantrsquos and current borrowerrsquos original certifcate of eligibility will be required If your sales contract is contingent upon the restoration of entitlement please contact your VA Offce of Jurisdiction for complete procedures Otherwise the substitution will be completed after the loan has been approved and closed
Date Applicant printed name Applicant signature
Date Applicant printed name Applicant signature
Date Current Borrower printed name Current Borrower signature
Date Current Borrower printed name Current Borrower signature
Forms completed by Mail Phone
For Chase use only
Interviewer signature Date
99177-VS-0215
- Assumption Application Package_41521-noscannedpages-update-4pdf
-
- 1 FM203 Cover Pagepdf
- 2 FM202 Mortgage Assumption Application Package pagepdf
- 3 The Documents Youll need to Send Uspdf
- 4 FM201 FAQpdf
- 5 FM142 CIWpdf
- 6 FM126 URLApdf
- 7 FM130 URLA Instpdf
-
- Blank Page
-
- 8 92900a Addednum to Loan Applicationpdf
- 9 FM462 Gen Authpdf
- 10 FM220 4506-Cpdf
- 11 FM153 Chase Federal Privacy Noticepdf
- 12 FM144 Info on Opening a New Accountpdf
- 13 FM152 Veteran Statementpdf
-
- Date
- Loan number
- Applicant name
- Phone1
- Loan number 1
- Loan number 2
- Other
- Other_2
- 1
- 2
- undefined_7
- Available hours
- Available hours_2
- undefined_8
- Available hours_3
- undefined_9
- Current address 1
- Neither
- Available hours_4
- Available hours_5
- undefined_10
- Available hours_6
- 1_2
- 2_2
- undefined_11
- Available hours_7
- Available hours_8
- undefined_12
- Available hours_9
- FHA Case No include any suffix
- Mortgagee Case No
- Mortgagee ID
- Sponsor ID
- Agent ID
- Name and Address of Sponsor Name and Address of Agent
- Borrowers Name Present Address include ZIP Code Property Address
- include name of subdivision lot block no ZIP Code
- Name of ThirdParty Originator
- NMLS ID of ThirdParty Originator
- s application
- ty Number
- ty Number_2
- Date Signed_2
- Date Mortgage Approved
- Date Approval Expires
- Printed Name
- Title 1
- DEs ID Number
- DEs ID Number_2
- Mortgagee
- Name of Mortgagees Representative
- Title of Mortgagees Representative
- Signature of the Mortgagees Representative
- Date_2
- Applicant names 1
- Applicant names 2
- Applicant names 3
- Loan number_2
- Date_3
- Applicant printed name
- Social Security number
- Date_4
- Applicant printed name_2
- Social Security number_2
- Date_5
- Applicant printed name_3
- Social Security number_3
- Date_6
- Applicant printed name_4
- Social Security number_4
- 1a Name shown on tax return if a joint return enter the name shown first
- 1b First social security number on tax return individual taxpayer identification number or employer identification number see instructions
- 2a If a joint return enter spouses name shown on tax return
- 2b Second social security number or individual taxpayer identification number if joint tax return
- 4 Previous address shown on the last return filed if different from line 3 see instructions
- 5a IVES participant name address and SOR mailbox ID
- Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing see instructions
- Signature see instructions
- Date_7
- Phone number of taxpayer on line 1a or 2a
- PrintType name
- Here
- Spouses signature
- Date_8
- PrintType name_2
- Name
- Date of birth
- Service number
- Name_2
- Date of birth_2
- Service number_2
- Date_9
- Applicant printed name_5
- Date_10
- Applicant printed name_6
- Date_11
- Current Borrower printed name
- Date_12
- Current Borrower printed name_2
- Date_13
- Text3
- Text10
- undefined_13
- Text15
- undefined_14
- undefined_15
- undefined_16
- undefined_17
- undefined_18
- undefined_19
- undefined_20
- undefined_21
- undefined_23
- Reason for assumption Off
- Requestors relationship to owners Off
- Check one Off
- Check one1 Off
- Day1
- Evening
- Cell phone
- Check one2 Off
- Check one3 Off
- Check one4 Off
- Check one5 Off
- Text2-1
- Text2-2
- Text2-3
- Text2-4
- Text2-5
- Text2-6
- Text3-1
- Text3-2
- Text3-3
- Text3-4
- Text3-6
- Text3-7
- Text3-8
- Text3-9
- Text3-10
- Text3-11
- Text3-12
- Text3-13
- Text3-14
- Text3-15
- Text3-16
- Text3-17
- Text3-18
- Text3-19
- Text3-20
- Text3-21
- Text3-22
- Text3-23
- Text3-24
- Text3-25
- Text3-26
- Text3-27
- Text3-28
- Text3-29
- Text3-30
- Text3-31
- Text3-32
- Text3-33
- Text3-34
- Text3-35
- Text3-36
- Text3-37
- Text3-38
- Text3-39
- Text3-40
- Text3-41
- Text3-42
- Text3-43
- Text3-44
- Text3-45
- Text3-46
- Text3-47
- Text3-48
- Text3-49
- Text3-50
- Text3-51
- Text3-52
- Text3-53
- Text3-5
- Text3-54
- Text3-55
- Text3-56
- Citizenship Off
- Type of credit Off
- Marital Status Off
- Housing Off
- Housing1 Off
- ownership Off
- DNA1 Off
- DNA2 Off
- DNA3 Off
- family Off
- BO Off
- Total
- Text31
- Text32
- Text33
- Text34
- Text35
- Text36
- Text37
- Text38
- Text39
- Text310
- Text311
- Text312
- Text313
- Text314
- Text315
- Text316
- Text317
- Text318
- Text319
- ownership1 Off
- Total1
- Total1-2
- Check Box4-1 Off
- Text320
- Text321
- Text322
- Text323
- Text324
- Text325
- Text326
- Text327
- Text328
- Text329
- Check Box4-2 Off
- Check Box4-3 Off
- Check Box4-4 Off
- Check Box4-8 Off
- Check Box4-9 Off
- Text330
- Text331
- Text332
- Text333
- Text334
- Text335
- Text1-1
- Text1-2
- Text1-3
- Text1-4
- Text1-5
- Text1-6
- Text1-7
- Text1-8
- Text1-9
- Text1-10
- Text1-11
- Text1-12
- Text1-13
- Text1-14
- Text1-15
- Text1-16
- Text1-17
- Text1-18
- Text1-19
- Text1-20
- Text1-21
- Text1-22
- Text1-23
- Text1-24
- Text1-25
- Text1-26
- Text1-27
- Text1-28
- Text1-29
- Text1-30
- Text1-31
- Text1-32
- Text1-33
- Text1-34
- Text1-35
- Check Box3-2 Off
- Check Box2-1 Off
- Check Box2-2 Off
- Check Box2-3 Off
- Check Box2-4 Off
- Check Box2-5 Off
- Text1-36
- Text1-37
- Text1-38
- Text1-39
- Text1-40
- Text1-41
- Text1-42
- Text1-43
- Text1-44
- Text1-45
- Text1-46
- Text1-47
- Text1-48
- Text1-49
- Text1-50
- Text1-51
- Text1-52
- Text1-53
- Text1-54
- Text1-55
- Text1-56
- Text1-57
- Text1-58
- Text1-59
- Text1-60
- Text1-61
- Check Box3-11 Off
- A1
- A2
- A3
- A4
- A5
- A6
- A7
- A8
- A9
- A10
- A11
- A12
- Check Box3-1 Off
- Check Box30-1 Off
- Check Box30-2 Off
- Check Box30-4 Off
- Check Box30-5 Off
- Check Box30-7 Off
- Check Box30-8 Off
- Check Box30-9 Off
- Check Box30-10 Off
- Check Box30-11 Off
- Check Box30-12 Off
- A13
- A14
- A15
- A16
- A17 Off
- A18
- A19
- A20
- A21
- A22
- A23
- A24
- A25
- A26
- A27
- A28
- A29
- A30
- A31
- A32
- A33
- A34
- A35
- A36
- A37
- A38 Off
- A39
- A40
- A41
- A42
- A43
- A44
- A45
- A46
- A47
- A48
- A49
- A50
- A51
- A52
- A53
- A54
- A55
- A56
- A57
- A58
- A59
- A60
- A61
- A62
- A63
- A64
- A65
- A66
- A67
- A68
- A69
- A70
- A71
- A72
- A73
- A74
- Loan Purpose Off
- occupancy1 Off
- lien type Off
- lientype Off
- mixed use Off
- manufactured home Off
- deposit1 Off
- deposit2 Off
- B1
- B2
- B3
- B4
- B5
- B6
- B7
- B8
- B9
- B10
- fha Off
- Check Box51 Off
- B11
- B12
- B13
- B14
- B15
- B16
- B17
- B18
- B19 Off
- B20
- B21
- B22 Off
- B23
- B24
- B25
- B26
- B27
- B28
- A
-
- Will you occupy the property as your primary residence Off
- Will you occupy the property as your primary residence1 Off
-
- If yes have you had an ownership interest in another property in the last three years Off
- Text9-2
- B
-
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property Off
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property1 Off
-
- 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 Off
- 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 application1 Off
-
- 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 Off
- 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 application1 Off
-
- new credit Off
- 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) Off
- the Property Assessed Clean Energy Program)1 Off
-
- F
-
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application Off
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application1 Off
-
- G
-
- Are there any outstanding judgments against you Off
- Are there any outstanding judgments against you1 Off
-
- H
-
- Are you currently delinquent or in default on a Federal debt Off
- Are you currently delinquent or in default on a Federal debt1 Off
-
- I
-
- Are you a party to a lawsuit in which you potentially have any personal financial liability Off
- Are you a party to a lawsuit in which you potentially have any personal financial liability1 Off
-
- J
-
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years Off
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years1 Off
-
- 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 Off
- 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 due1 Off
-
- L
-
- Have you had property foreclosed upon in the last 7 years Off
- Have you had property foreclosed upon in the last 7 years1 Off
-
- M
-
- Have you declared bankruptcy within the past 7 years Off
- Have you declared bankruptcy within the past 7 years1 Off
-
- Check Box8-2 Off
- Check Box8-3 Off
- Check Box8-4 Off
- Text9-3
- Text9-5
- Text9-6
- Text97
- military Off
- ethnicity Off
- sex Off
- race Off
- demo Off
- Text12-1
- Check Box11-1 Off
- Check Box11-2 Off
- Check Box11-3 Off
- Check Box11-4 Off
- Check Box11-5 Off
- Check Box11-6 Off
- Check Box11-7 Off
- Check Box11-8 Off
- Check Box11-9 Off
- Text12-2
- Check Box11-10 Off
- Check Box11-11 Off
- Check Box11-12 Off
- Check Box11-13 Off
- Check Box11-14 Off
- Check Box11-15 Off
- Text12-3
- Check Box11-16 Off
- Check Box11-17 Off
- Check Box11-18 Off
- Check Box11-19 Off
- Check Box11-20 Off
- Check Box11-21 Off
- Check Box11-22 Off
- Check Box11-23 Off
- Text12-4
- Check Box11-24 Off
- Check Box11-25 Off
- Check Box11-26 Off
- Check Box11-27 Off
- Check Box11-28 Off
- Check Box11-29 Off
- Text12-5
- Check Box11-30 Off
- Check Box11-31 Off
- citizen Off
- credit Off
- marital status1 Off
- housing-1 Off
- housing-2 Off
- own Off
- C1
- C2
- C3
- C6
- C7
- C8
- C9
- C10
- C11
- C12
- C13
- C14
- C15
- C16
- C17
- C18
- C19
- C20
- C21
- C22
- C23
- C24
- C25
- C26
- C27
- C28
- C29
- C30
- C31
- C32
- C33
- C34
- C35
- Check Box-2 Off
- C36
- C37
- C38
- C39
- C4
- C40
- C41
- C42
- C43
- C44
- C45
- C46
- C47
- Check Box-3 Off
- Check Box-4 Off
- C48
- C49
- C5
- C50
- C51
- C52
- C53
- C54
- C55
- Check Box-1-1 Off
- own1 Off
- Check Box-1 Off
- D1 Off
- D2
- D3
- D4
- D5
- D6
- D7
- D8
- D9
- D10
- D11
- D12
- D13
- D14 Off
- D15 Off
- D16
- D17
- D18
- D19
- D20
- D21
- D22
- D23
- D24 Off
- D25
- D26
- D27
- D28
- D29
- D30
- D31
- D32
- D33
- D34
- D35 Off
- D36
- D37 Off
- D38
- D39
- D40
- D41
- D42
- D43
- D44
- D45
- D46
- D47
- If yes have you had an ownership interest in another property in the last three years1 Off
- new credit1 Off
- Check Box8-1 Off
- Check Box8-1-2 Off
- Check Box8-1-1 Off
- Check Box8-1-3 Off
- Check Box8-1-4 Off
- Military Service mdash Did you (or your deceased spouse) ever serve or are you currently serving in the United States Armed Forces 1 Off
- Check1 Off
- Text9-1-1
- Check2 Off
- Check3 Off
- Check4 Off
- Text9-1
- E1
- E2
- E3
- Was the ethnicity of the Borrower collected on the basis of visual observation or surname1 Off
- Was the sex of the Borrower collected on the basis of visual observation or surname1 Off
- Was the race of the Borrower collected on the basis of visual observation or surname1 Off
- The Demographic Information was provided through1 Off
- F1 Off
- F2 Off
- F3 Off
- F4 Off
- F5 Off
- F6
- F7 Off
- F8 Off
- F9 Off
- F10 Off
- F11 Off
- F12 Off
- F13
- F14 Off
- F15 Off
- F16 Off
- F17 Off
- F18 Off
- F19 Off
- F20 Off
- F21 Off
- F22
- F23 Off
- F24 Off
- F25 Off
- F26 Off
- F27 Off
- F28 Off
- F29
- F30 Off
- F31 Off
- undefined_13-1
- undefined_13-2
- undefined_14-1
- undefined_15-1
- undefined_16-1
- undefined_17-1
- undefined_18-1
- undefined_19-1
- undefined_21-1
- undefined_20-1
- undefined_23-1
- undefined_13_1
- Single-Two Off
- Refi type Off
- refi program Off
- Estate Off
- Title held Off
- Trust Information Off
- Indian Country Land Tenure Off
- Mortgage Type Applied For Off
- Mortgage Lien Type Off
- Amortization Type Off
- G1 Off
- G2 Off
- G3 Off
- G4 Off
- G5 Off
- G6
- G7
- G8
- G9
- G10 Off
- G11 Off
- G12 Off
- G13 Off
- G14 Off
- G15 Off
- G16
- G17
- G18
- G19
- G20
- G21
- G22
- G23 Off
- G24
- G25 Off
- G26
- G27 Off
- G28 Off
- G29
- G30 Off
- G31
- G32 Off
- G33
- G34
- G35
- G36
- G37
- G38
- G39
- G40
- G41
- G42
- Property Held
- refi
- Text18-1
- Text18-2
- Text18-3
- Text18-4
- Text18-5
- Text18-6
- Text18-7
- Text18-8
- Text18-9
- Text18-10
- Text18-11
- Text18-12
- Text18-13
- Text18-14
- Text18-15
- Text18-16
- Text18-17
- Text18-18
- Text18-19
- Lender
- case no
- If you selected ldquoUnmarriedrdquo in Section 1 is there a person who is not your legal spouse but who currently has real property rights similar to those of a legal spouse Off
- Relationship and State Off
- Other-5
- Text19-1
- BName
- Additional Information
- ABN
- Additional Information1
- BSign
- BSDate
- ABSign
- ABDate
- MortageeNameAddress
- NAmeAddress
- Bname1
- DOB1
- DOB2
- SignOfBorr1
- SignOfBorr
- Date Signed
- SignOfBorr2
- SignOfBorr3
- Date Signed3
- Date Signed4
- MortgageeRepSign
- DirectSign
- DirectSign1
- Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union Off
- AppSign
- AppSign1
- AppSign2
- AppSign3
- Nopage38 Off
- Yespage38 Off
- Yes1 Off
- No1 Off
- Yes2 Off
- Yes3 Off
- Yes4 Off
- Yes5 Off
- Yes6 Off
- Yes7 Off
- Yes8 Off
- Yes9 Off
- Yes10 Off
- No2 Off
- No3 Off
- No4 Off
- No5 Off
- No6 Off
- No7 Off
- No8 Off
- No9 Off
- No10 Off
- BorrowerNo Off
- BorrowerYes Off
- AppSignature
- AppSignature1
- CurrentSign
- CurrentSign1
- InterviewSign
- Yes_1 Off
- No_1 Off
- Yes_2 Off
- No_2 Off
- Mail Off
- Phone Off
IN THE EVENT OF A DEATH
Is an assumption my only option
You may have the option to be added to the loan as a successor in interest
You wonrsquot be responsible for repaying the loan but will get access to account information and statements There are no fees to be added as a successor in interest
If you assume the loan yoursquoll be financially responsible for repaying it and wersquoll report your payment information to the credit reporting agencies
IN CASES OF DIVORCE
Should I wait until my divorce or separation is final before applying for an assumption
Yes we require a separation or divorce agreement that shows who will retain rights to the property
My divorce agreement shows that my spouse is now responsible for the mortgage Why do I have to go through an assumption
We still need to review the income credit and assets of the person maintaining ownership to ensure that they qualify for the loan under the new circumstances
IN CASES OF MARRIAGE
Do I need to complete an assumption to add my spouse to the loan
Not necessarily
If you conveyed an interest in the property to your spouse they can be added to the loan as a successor in interest They wouldnrsquot be responsible for repaying the loan but would get access to account information and statements We donrsquot charge a fee to add a successor in interest
With an assumption your spouse would be financially responsible for repaying the loan and wersquoll report their payment information to the credit reporting agencies
Were here to answer all your questions and will work with you to make sure you get the assistance you needmdashcall us at 1-866-299-6752 we accept operator relay calls
ID 3188620 FM201
[ ][ ][ ]
[ ]
[ ]
[ ]
[ ]
[ ][ ][ ]
( )
( )
( )
[ ] [ ] [ ]
[ ] [ ] [ ] [ ]
[ ]
[ ]
[ ]
( )
( )
( )
( )
( )
( )
[ ] [ ] [ ]
[ ] [ ] [ ]
[ ]
[ ]
[ ]
[ ]
ytra
P ytra
PCustomer Information Worksheet
Loan number
Address of property to be assumed
Reason for assumption ( heck one) [ ]
Divorce Death of original owner Existing owners are selling the home Other
[ ][ ][ ] ___________________________
[ [ [ [
] Spouse Child Parent Other
] ] ] ____________________________
relationship to owners (check one)
Parties to the assumption In the sections below please identify the parties associated with the assumption of the loan This includes
Individuals who will be added to the loan Individuals who are already on the loan and who will remain on the loan Individuals who are already on the loan and who will be removed from the loan
If more than three parties are associated with the assumption please provide the requested information on a separate page and attach it to this worksheet
Name
Par
ty
Current address
Check one Check one New to the loan (being added) Already on the loan and will remain Already on the loan and will be removed
Day phone
Evening phone
Cell phone
Active-duty military Military veteran Neither
Available hours
Available hours
Available hours
Name Current address
Check one Check one New to the loan (being added) Already on the loan and will remain Already on the loan and will be removed Day phone
Evening phone
Cell phone
Active-duty military Military veteran Neither
Available hours
Available hours
Available hours
Name Current address
Check one Check one New to the loan (being added)
Already on the loan and will be removed
Evening phone
Cell phone
Active-duty military Military veteran Neither
Already on the loan and will remain
Day phone Available hours
Available hours
Available hours
Esta comunicacioacuten contiene informacioacuten importante acerca de la cuenta Si tiene alguna pregunta o necesita ayuda para traducirla comuniacutequese con nosotros llamando al 1-855-280-4198
FM142
Uniform Residential Loan ApplicationVerify and complete the information onthis applicationIf you are applying for this loan with others each additional Borrower must provide
information as directed by your Lender
Section 1 Borrower Informationthis section asks about yourpersonal information and your income fromemploymentandother sources such as retirement that you want considered to qualify for this loan
1a Personal Information
Name(First Middle Last Suffix) Social Security Number - -
(orIndividual TaxpayerIdentification Number)
Alternate Names- List any namesby which you are known or any namesunderwhich credit was previously received (First Middle Last Suffix)
Date ofBirth Citizenship(mmddyyyy) USCitizen
copy PermanentResidentAliencopy Non-PermanentResidentAlien
Type of Credit List Name(s) of Other Borrower(s) Applying for this Loan
copy lamapplyingforindividual credit (First Middle Last Suffix) - Use a separator between names
copy |am applyingfor joint credit Total Numberof Borrowers_
Each Borrowerintendsto applyfor joint credit Yourinitials
Marital Status Dependents(notlisted by another Borrower) Contact Information
O Married Number __ Home Phone ( ) -
s SeparatedUnmarried
Ages CellPhone ( ) _7
(Single Divorced Widowed Civil Union Domestic Partnership Registered Work Phone (0) Ext
Reciprocal Beneficiary Relationship) Email
Current Address
Street Unit
City State ZIP Country
How Long at Current Address Years mdashMonths Housing O Noprimary housing expense copy) Own copy Rent($ month)
If at Current Addressfor LESS than 2 yearslist Former Address LC Does not apply
Street Unit
City State ZIP Country
How Long at Former Address Years mdashMonths Housing No primary housing expense Own Rent($ month)
Mailing Address- ifdifferent from CurrentAddress (| Does not apply
Street Unit
City State ZIP Country
easeaoemir ] Does not apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base $_mdashmdashmdashmdash__mdashmonth
City State ZIP Country Overtime =$_________monthBonus $ month
Position orTitle Checkif this statementapplies Commission $ month[] am employedby a family member
propertyseller real estate agent or otherparty to the transaction
TTStartDate0__mdashsmmddyy) MilitaryHow long in this line of work Years mdash_ Months Entitlements $_mdashsmontth
Other $ monthCheckif you are the Business () | have an ownershipshare of less than 25 Monthly Income(or Loss) mdashmdash_mdashOwnerorSelf-Employed O I have an ownership share of 25 or more sect TOTALS__000month
Uniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
1c IF APPLICABLE Complete Information for Additional EmploymentSelf-Employment and Income
Doesnot apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base $ month
City State ZIP Country Overtime mdash$ monthBonus $ month
Position orTitle Checkif this statementapplies Commission $ month| am employedby a family memberproperty seller real estate agent or otherparty to the transaction
Start Date mdash_mdashAA(mmddyyyy) Military
EntitlementsHow long in this line of work lsquoYears mdash_ Months $ month
7 7 Other $ monthCheckif you are the BusinessOwnerorSelf-Employed
| have an ownershipshare ofless than 25 Monthly Income(or Loss)| have an ownership share of 25 or more $ TOTAL $ 000month
PlMeNeeeMeeCee ti)LeeseteUeLimet Does not apply
Provideatleast 2 years of current and previous employment and income
Employeror Business Name Previous Gross Monthly
Street Unit Income $ month
City State ZIP Country
Position orTitleStart Date (mmddyyyy) Checkif you were the Business
Owneror Self-Employedmdash_ mdashEnd Date (mmddyyyy)
WCBeelcaTy Does not apply
Include incomefrom other sources below Under IncomeSource choosefrom the sourceslisted hereraquo Alimony+ Automobile Allowance Boarder Income
+ Capital Gains
Child Support+ Disabilitylaquo Foster Care
laquo Housing or Parsonage
+ Interest and Dividendslaquo Mortgage Credit Certificateraquo MortgageDifferential
Payments
raquo Notes Receivable+ Public Assistance- Retirement
(eg Pension IRA)
laquo Royalty Payments Separate Maintenance+ Social Security
+ Trust
laquo UnemploymentBenefits
laquo VA Compensation
cent Other
NOTEReveal alimony child support separate maintenance or other income ONLYIFyou wantit considered in determining yourqualification
for this loan
IncomeSource -mdash uselist above Monthly Income
$
$
$
Provide TOTAL AmountHere $ 000
Borrower Name
Uniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 2 Financial Information mdash Assets andLiabilities this section asks about things you ownthatare worth moneyand that you wantconsidered to qualify for this loan It then asks about your liabilities (or debts) that you pay
each month suchas credit cards alimony or other expenses
rNcee stLeVaalemities eitimeeecm dellaLC-
Include all accounts below Under Account Typechoosefrom the typeslisted here
laquo Checkinglaquo Savingsraquo Money Market
+ Certificate of Depositlaquo Mutual Fund+ Stocks
laquo Stock Optionslaquo Bonds+raquo Retirement(eg 407k IRA)
laquo Bridge Loan ProceedslaquoIndividual DevelopmentAccount
Trust Account- Cash Value ofLife Insurance(usedfor the transaction)
AccountType- use list above FinancialInstitution Account Number Cash or MarketValue
$
$
$
$
$
$ 000Provide TOTAL AmountHere|
Includeall other assets and credits below UnderAsset or Credit Type choose from the typeslisted here
Assets Credits- Proceeds from Real EstateProperty to be sold on orbefore closing
laquo Proceeds from Sale ofNon-Real Estate Asset
- Secured Borrowed Funds
cent Unsecured Borrowed Funds Other
raquo Earnest MoneylaquoEmployer Assistance- Lot Equity
Relocation Funds_raquo Rent Credit
laquo Sweat Equity+ Trade Equity
Assetor Credit Type mdash uselist above Cash or Market Value
$
$
$
$
$ 000Provide TOTAL AmountHere
2c Liabilities - Credit Cards Other Debts and Leases that You Owe C Does not apply
List all liabilities below (except real estate) and include deferred payments Under Account Type choose from thetypeslisted herelaquoRevolving (eg credit cards) +Installment (eg car student personal loans) Open 30-Day (balance paid monthly) + Lease (not realestate) +Other
Account Type mdashuse list above
To be paid offator before closingCompany Name Account Number Unpaid Balance Monthly Payment
$ $
$ $
$ $
$ $
$ $
2d OtherLiabilities and Expenses Does not apply
Includeall otherliabilities and expenses below Choose from the typeslisted here
+ Alimony Child Support -Separate Maintenance +JobRelatedExpenses +Other Monthly Payment
$
$
$
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 3 Financial Information mdash Real Estatethis section asks youtolist all properties you currently ownand what you owe onthem donot own anyreal estate
3a Property You Own If you are refinancinglist the property you are refinancing FIRST
Address Street Unit
City State ZIP Country
Sol Intended Occupancyinvestment PrimaryResidence SecondHome Other
Monthly InsuranceTaxesAssociation Duesetcifnot included in MonthlyMortgage Payment
For 2-4 Unit Primary or Investment PropertyStatus SoldPending Saleor Retained
=Monthly RentalIncomeProperty Value
$ $ $
Mortgage Loanson this Property Does not apply
MonthlyMortgagePayment
Type FHA VAConventionalUSDA-RD Other|
To be paid offator before closing
Credit Limit(ifapplicable)Creditor Name Account Number Unpaid Balance
$ $ $
$ $ $
3b IF APPLICABLE Complete Information for Additional Property Does not apply
Address Street Unit
City State ZIP Country
ldquoSold Intended Occupancyinvestment PrimaryResidence SecondHome Other
Monthly Insurance TaxesAssociation Duesetcifnot included in MonthlyMortgage Payment
For 2-4 Unit Primary or Investment PropertyStatus SoldPendingSaleor Retained
Monthly RentalIncomeProperty Value
$ $ $
Mortgage Loanson this Property Does not apply
Monthly
Mortgage
Payment
Type FHA VA
Conventional
USDA-RD Other|
To be paid offat
or before closing
Credit Limit
(ifapplicable)Creditor Name Account Number Unpaid Balance
$ $ $
$ $ $
$ $ $
$ $ $
$ $ $
3c IF APPLICABLE Complete Information for Additional Property Does not apply
Address Street Unit
City State ZIP Country
Intended Occupancyinvestment PrimaryResidence SecondHome Other
Monthly Insurance TaxesAssociation Duesetcifnot included in MonthlyMortgage Payment
For 2-4 Unit Primary or Investment PropertyStatus SoldPending Saleor Retained
Monthly RentalIncomeProperty Value
Mortgage Loanson this Property Does not apply
MonthlyMortgagePayment
Type FHA VAConventionalUSDA-RD Other|
To be paid offator before closing
Credit Limit(ifapplicable)Creditor Name Account Number Unpaid Balance
Borrower Name
Uniform Residential Loan Application
Freddie Mac Form 65 +raquo Fannie Mae Form 1003
Effective 12021
Section 4 Loan and Property Informationthis section asks about the loanrsquos purpose and the property youwantto purchase orrefinance
4a Loan and Property Information
LoanAmount $ Loan Purpose Purchase efinance Other(specify)
Property Address Street Unit
City State ZIP County
Numberof Units Property Value $
Occupancy Primary Residence Second Home InvestmentProperty FHA Secondary Residence
1 Mixed-Use PropertyIf you will occupy the propertywill you set aside space within the property to operate
your ownbusiness(eg daycare facility medicaloffice beautybarber shop)NO YES
2 Manufactured HomeIs the property a manufactured home(eg a factory built dwelling built on a permanentchassis) NO YES
4b Other New Mortgage Loansonthe Property Youare Buying or Refinancing Does not apply
LoanAmountAmountto be Drawn
Credit Limit(ifapplicable)Creditor Name Lien Type Monthly Payment
First Lien Subordinate Lien $ $ $
$ $ $First Lien SubordinateLien
4c Rental Income on the Property You Wantto Purchase For Purchase Only Does not apply
Completeif the property is a 2-4 Unit Primary Residence or an Investment Property Amount
Expected Monthly Rental Income $
Doesnot apply4d Gifts or Grants You Have Been GivenorWill Receive for this Loan
Includeall gifts and grants below Under Source choose from the sourceslisted here
Community Nonprofitlaquo Employer
raquo Federal Agencyraquo Local Agency
- Relative+ Religious Nonprofit
+ State Agency+ Unmarried Partner
raquo Lender Other
Asset TypeCash Gift Gift of Equity Grant DepositedNot Deposited Source - uselist above Cash or Market Value
Deposited Not Deposited $
$Deposited Not Deposited
Borrower Name
Uniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 5 DeclarationsThis section asks youspecific questions about the property your funding and yourpastfinancial history
5aAboutthis Property and Your Moneyfor this Loan
A Will you occupy the property as your primary residence
If YES have you had an ownershipinterest 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 investmentproperty(IP)
(2) How did you holdtitle to the property by yourself (S) jointly with your spouse(SP) or jointly with another person (O)
YESYES
B If this is a Purchase Transaction Do you have a family relationship or businessaffiliation with the seller of the property NO YES
C Are you borrowing any moneyforthis real estate transaction (eg money foryour closing costs or down payment) orobtaining any moneyfrom anotherparty such astheseller or realtor that you have notdisclosed on this loan application NO YES
If YES what is the amountof this money $
D 1 Have you orwill you be applying for a mortgage loan on anotherproperty (not the property securing this loan) on or
before closing this transaction that is not disclosed on this loan application
NO YES
2 Have you orwill you be applying for any newcredit (eg installment loan credit card etc) on or before closing this loan that
is not disclosed on this application
No YES
E Will this property be subject to a lien that could take priority over the first mortgagelien such as a clean energylien paid
through yourproperty taxes(eg the PropertyAssessed Clean Energy Program)NO YES
5b About YourFinances
F Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application NO YES
G Are there any outstanding judgments against you No YES
H Areyou currently delinquentor in default on a Federal debt No YES
I Areyou a party to a lawsuit in which you potentially have any personalfinancialliability NO YES
J Have you conveyedtitle to any property in lieu of foreclosure in the past 7 years NO YES
K Within the past 7 years have you completed a pre-foreclosure sale or short sale whereby the property wassold to a
third party and the Lenderagreed to acceptless than the outstanding mortgage balance due
NO YES
L Have you hadproperty foreclosed uponin thelast 7 years NO YES
M Have you declared bankruptcy within the past 7 years ONO YESIf YES identify the type(s) of bankruptcy Chapter7 Chapter11 Chapter12 Chapter 13
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 6 Acknowledgments and AgreementsThis section tells you about yourlegal obligations whenyousign this application
Acknowledgments and Agreements
Definitions- Lenderincludes the Lenderrsquos agents service providers and any oftheir successors andassigns
Other Loan Participantsrdquo includes(i) any actual or potential owners of
a loan resulting from this application (the ldquoLoanrsquo)(ii) acquirers ofany beneficial or other interest in the Loan(iii) any mortgageinsurer(iv) any guarantor (v) any servicer of the Loan and (vi) any of theseparties service providers successors or assigns
I agree to acknowledgeand representthe following
(1) The Complete Informationfor this Application- The information | have providedin this application is true accurate
and completeas of the date | signed this application
laquo If the information | submitted changesor | have new information
before closing of the Loan | must change and supplementthis
application including providing any updatedsupplementedrealestate sales contract
- For purchase transactions The terms and conditionsof anyrealestate sales contract signed by mein connection with this application
are true accurate and complete to the best of my knowledge andbelief | have not entered into any other agreement written ororal inconnection withthis real estate transaction
- The Lender and OtherLoan Participants mayrely on the informationcontainedin the application before and after closing of the Loan
- Any intentional or negligent misrepresentation of information may
result in the impositionof(a) civil liability on me including monetary damagesif a
person suffers any loss because the person relied on anymisrepresentation that | have made onthis application andor
(b) criminal penalties on me including but not limited to fine orimprisonment or both underthe provisions of Federal law(18 USC sectsect 1001 et seq)
(2) The Propertyrsquos SecurityThe Loan | have applied for in this application will be secured by
a mortgage or deedoftrust which provides the Lendera security
interest in the property described in this application
(3) The Propertys Appraisal Value and Condition- Any appraisal or value of the property obtained by the Lenderis
for use by the Lender and OtherLoanParticipantslaquoThe Lender and OtherLoan Participants have not made anyrepresentation or warranty express or implied to me about the
propertyits conditionorits value
(4) Electronic Records and Signatures- The Lender and OtherLoan Participants may keep any paper record
andorelectronic record of this application whether or not the Loan
is approved
BorrowerSignature
- If this application is created as (or converted into) an ldquoelectronicapplicationrdquo | consent to the use of ldquoelectronic recordsrdquo and
ldquoelectronic signaturesrdquo as the termsare defined in and governed byapplicable Federal andorstate electronic transactions laws
| intend to sign and have signedthis application either using my(a) electronic signature or(b) a written signature and agreethatif a paper version ofthis
application is converted into an electronic application theapplication will be an electronic record and the representationof my written signature on this application will be my binding
electronic signature- | agree that the applicationif delivered or transmitted to the Lenderor Other Loan Participants as an electronic record with myelectronicsignaturewill be as effective and enforceable as a paperapplicationsigned by mein writing
(5) Delinquencylaquo The Lender and OtherLoan Participants may report information about
my accountto credit bureaus Late payments missed paymentsorother defaults on my account maybereflected in my credit report andwill likely affect my credit score
- If | have trouble making my payments | understand that | may contacta HUD-approved housing counseling organization for advice about
actions I can take to meet my mortgageobligations
(6) Authorization for Use and Sharing of InformationBy signing belowin addition to the representations and agreementsmade above| expressly authorize the Lender and Other LoanParticipants to obtain use and share with each other(i) the loan
application and related loan information and documentation(ii) aconsumercredit report on me and(iii) my tax return information asnecessary to perform theactionslisted belowfor so long as they havean interest in my loanorits servicing
(a) process and underwrite myloan(b) verify any data contained in my consumercredit 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 analysisandreviews
(e) perform analysis and modeling for risk assessments(f) monitor the accountfor this loan for potential delinquencies and
determineanyassistance that may beavailable to me and
(g) other actions permissible under applicable law
Date (mmddyyyy)
Additional Borrower Signature Date (mmddyyyy)
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 7 Military ServiceThis section asks questions about your(or your deceased spouses) military service
Military Service of Borrower
Military Service mdash Did you (or your deceased spouse) everserve or are you currently serving in the United States Armed Forces NO YES
If YES check allthat apply Currently serving on active duty with projected expiration date of servicetour (mmddyyyy)
Currently retired discharged or separated from service
Only period of service was as a non-activated memberof the Reserve or National GuardSurviving spouse
Section 8 Demographic InformationThis section asks about your ethnicity sex and race
Demographic Information of Borrower
The purposeofcollecting this informationis to help ensure thatall applicants are treated fairly and that the housing needs of communities
and neighborhoodsare beingfulfilled 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 mayselect one or more designationsfor
Ethnicity and one or more designationsfor Race The law provides that we maynotdiscriminate on the basis of this information or onwhetheryou chooseto provideit However if you choose not to provide the information and you have madethis application in person Federal
regulations require us to note your ethnicity sex and race on thebasis of visual observation or surname Thelaw also provides that we may notdiscriminate on the basis of age or marital status information you providein this application If you do not wish to provide someorall of this
information please check below
Ethnicity Check one or more Race Check one or moreHispanic or Latino AmericanIndian or Alaska Native - Print nameofenrolled
or principaltribe Mexican PuertoRican CubanOther Hispanic or Latino - Print origin Asian
Asian Indian Chinese Filipino
Japanese Korean Vietnamese
OtherAsian mdash Print race
For example Hmong Laotian Thai Pakistani Cambodian and so on
Black or African American
Native Hawaiian or OtherPacific Islander
Native Hawaiian GuamanianorChamorro Samoan
For exampleArgentinean Colombian Dominican Nicaraguan
Salvadoran Spaniard andso on
Not Hispanic or Latino
| do not wish to providethis information
5Female OtherPacific Islander mdash Print race
Male For example Fijian Tongan and so on| do not wish to providethis information white
| do not wish to providethis information
Wasthe ethnicity of the Borrowercollected on the basis of visual observation or surname )NO YESWasthe sex of the Borrowercollected on the basis of visual observation or surname NO YESWastherace of the Borrowercollected on the basis of visual observation or surname NO YES
Face-to-Face Interview (includes Electronic Media w Video Component) TelephoneInterview Faxor Mail Email or Internet
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
ReelTemCrCL
Loan Originator Organization Name
Address
Loan Originator Organization NMLSR ID State License ID
Loan Originator Name
Loan Originator NMLSR ID State License ID
Date (mmddyyyy)
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Uniform Residential Loan Application mdash Additional BorrowerVerify and complete the information onthis application as directed by your Lender
Section 1 Borrower Informationthis section asks about yourpersonal information and your income fromemploymentandother sources such as retirement that you want considered to qualify for this loan
1a Personal Information
Name(First Middle Last Suffix)
Alternate Names - List any namesby which you are known or any namesunder which credit was previously received (First Middle Last Suffix)
Social Security Number - -(or Individual TaxpayerIdentification Number)
Dateof Birth Citizenship(mmddyyyy)
USCitizenPermanentResidentAlienNon-Permanent ResidentAlien
Type ofCredit| am applying for individualcredit
lam applying forjoint credit Total Number of Borrowers
Each Borrowerintendsto applyfor joint credit Your initials
List Name(s) of Other Borrower(s) Applying for this Loan
(First Middle Last Suffix) - Use a separator between names
Marital Status Dependents(notlisted by another Borrower)
Contact Information
Married Number _ Home Phone ( ) -
( ) _
( ) -mdash_ mdash_
Separated Ages CellPhone
Unmarried ens Work Phone Ext(Single Divorced WidowedCivil Union Domestic Partnership Registered
Reciprocal Beneficiary Relationship)lsquol
Emal
Current Address
Street Unit
City State ZIP Country
How Long at Current Address=Years mdashMonths Housing Noprimary housing expense Own Rent($ month)
If at Current Address for LESS than 2 yearslist Former Address Does not apply
Street Unit
City State ZIP Country
How Long at Former Address Years mdashMonths Housing Noprimary housing expense Own month)
Mailing Address- ifdifferent from CurrentAddress Does not apply
Street Unit
City State ZIP Country
eeeeCeeteiChuraleCme Doesnot apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base S$month
City State ZIP Country Overtime =$_____monthBonus $ month
Position orTitle Checkif this statementapplies Commission sect month| am employedby a family memberpropertyseller real estate agent or otherparty to the transaction
TTStart Date ____ (mmddyy) Military
Entitlements$_How longin this line of work Years =Months mdash monthSS
Other $ monthCheckif you are the BusinessOwnerorSelf-Employed
| have an ownershipshare ofless than 25 Monthly Income(or Loss) mdashmdash| have an ownership share of 25 or more $ TOTAL $ 000month
Uniform Residential Loan Application mdash Additional Borrower
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
CoeeeMCMCmeticlm tu)Comiteteilteeilelie mieit
Does not apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base
OvertimeBonus
Commission
MilitaryEntitlements
Other
$ month
$ month$ month
$ month
$ month
$ month
City State ZIP Country
Position orTitle ose if this statement applieslam employed by a family memberpropertyseller real estate agent or otherparty to the transaction
Start Date (mmddyy)How long in this line of work Years =Months
Checkif you are the Business
Owneror Self-Employed| have an ownershipshare of less than 25 Monthly Income(or Loss)
Ihave an ownership share of 25 or more $ TOTAL$ 000month
CPONMeeeMummaTestetiersdeere lire miret Does not apply
Provideat least 2 years of current and previous employment and income
Employeror Business Name Previous Gross MonthlyStreet Unit Income s month
City State ZIP Country
Position or Title
Start Date
End Date
Checkif you were the BusinessOwneror Self-Employed
(mmddyyyy)
(mmddyyyy) 1e Income from Other Sources Does not apply
Include incomefrom other sources below Under Income Source choose from the sourceslisted herelaquo Alimonylaquo Automobile Allowanceraquo Boarder Incomelaquo Capital Gains
Child Support+ Disability+ Foster Care Housing or Parsonage
+ Interest and DividendslaquoMortgage Credit Certificate Mortgage DifferentialPayments
laquo Notes Receivable+ Public Assistancelaquo Retirement(eg Pension IRA)
+raquo Royalty Payments Separate Maintenance
+ Social Security
raquo Trust
+ UnemploymentBenefits
laquo VA Compensation
laquo Other
NOTE Revealalimony child support separate maintenance or other income ONLYIFyou wantit considered in determining yourqualification
for this loan
Income Source - uselist above Monthly Income
$
$
$
$ 000Provide TOTAL AmountHere|
Section 2 Financial Information mdash Assets andLiabilities
Myinformation for Section 2 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 3 Financial Information mdash Real Estate
Myinformation for Section 3 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 4 Loan and Property Information
Myinformation for Section 4 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 5 DeclarationsThis section asks you specific questions about the property your funding and your past
financial history
5aAboutthis Property and Your Moneyforthis Loan
A Will you occupy the property as your primary residence NO YES
If YES have you had an ownershipinterest in another property in the last three years NO YES
If YES complete (1) and (2) below
(1)What type of property did you ownprimary residence (PR) FHA secondary residence (SR) second home(SH)
or investmentproperty (IP)
(2) How did you holdtitle to the property by yourself (S) jointly with your spouse(SP) or jointly with another person (O)
B If this is a Purchase Transaction Do you have a family relationship or businessaffiliation with the seller of the property NO YES Cc Are you borrowing any moneyforthis real estate transaction (eg money foryour closing costs or down payment) or
obtaining any moneyfrom anotherparty suchastheselleror realtor that you have not disclosed on this loan application NO YES
If YES whatis the amountof this money $
D 1 Have youorwill you be applying for a mortgage loan on anotherproperty (not the property securing this loan) on orbefore closing this transaction that is not disclosed on this loan application
NO YES
2 Have you orwill you be applying for any newcredit (eg installment loan credit card etc) on or before closing this loan that wsis not disclosed on this application
NO YES
E Will this property be subject to a lien that could take priority over thefirst mortgagelien such as a clean energylien paid
through yourproperty taxes(eg the PropertyAssessed Clean Energy Program)No YES
EK) Veli ellim ait
F Areyou a co-signer or guarantor on any debtor loan thatis not disclosed on this application NO ES
G Are there any outstanding judgments against you NO YES
H Are you currently delinquentor in default on a Federal debt NO YES
I Are you a party to a lawsuit in which you potentially have any personalfinancialliability NO YES
J Have you conveyedtitle to any property in lieu of foreclosure in the past 7 years NO YES
K Within the past 7 years have you completed a pre-foreclosure sale or short sale whereby the property wassold to a
third party and the Lender agreed to acceptless than the outstanding mortgage balance due
No YES
L Have you had property foreclosed uponin thelast 7 years NO YES
M Have you declared bankruptcy within the past 7 years no vESIf YES identify the type(s) of bankruptcy Chapter 7 Chapter11 Chapter12 Chapter 13
Section 6 Acknowledgements and AgreementsMy signature for Section 6 is on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 7 Military Service This section asks questions about your(or your deceased spouses) military service
Military Service of Borrower
Military Service mdash Did you (or your deceased spouse)everserve or are you currently serving in the United States Armed Forces NO YES
IfYES check allthat apply Currently serving on active duty with projected expiration date of servicetour (mmddyyyy)
Currently retired discharged or separated from service nnOnly period of service was as a non-activated memberofthe Reserve or National GuardSurviving spouse
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 8 Demographic InformationThis section asks about your ethnicity sex and race
Demographic Information of Borrower
The purposeofcollecting this information is to help ensure thatall applicants are treated fairly and that the housing needs of communities
and neighborhoodsare beingfulfilled 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 providethis information but are encouraged to do so You mayselect one or more designationsfor
Ethnicity and one or more designationsfor Race The law provides that we maynotdiscriminate onthe basis of this information or onwhetheryou chooseto provideit However if you choose notto provide the information and you have madethis application in person Federal
regulations require us to note yourethnicity sex and race on the basis of visual observation or surname The law also provides that we may notdiscriminate on the basis of age or marital status information you providein this application If you do not wish to provide someorall of this
information please check below
Ethnicity Check one or more Race Check one or moreHispanic or Latino AmericanIndian or Alaska Native - Print nameofenrolled
or principaltribeMexican PuertoRican Cuban
OtherHispanic or Latino - Printorigin siansian Indian Chinese Filipino
For exampleArgentinean Colombian Dominican NicaraguanSalvadoran Spaniard andso on
Japanese Korean VietnameseOtherAsian - Print race Forexample Hmong Laotian Thai Pakistani Cambodian andso on
Black or African American
Native Hawaiian or OtherPacific Islander
Native Hawaiian GuamanianorChamorro Samoan
OtherPacific Islander mdash Print race
Not Hispanic or Latino
| do not wish to providethis information
Sex
Female
Male
| do not wish to providethis informationFor example Fijian Tongan and so on
White
| do not wish to providethis information
Wasthe ethnicity of the Borrowercollected on thebasis of visual observation or surnameWasthesex of the Borrowercollected on the basis of visual observation or surnameWastherace of the Borrowercollected on the basis of visual observation or surname
)NO YESNO YESNO YES
Face-to-Face Interview (includes Electronic Media w Video Component) Telephone Interview Faxor Mail Email or Internet
Loan Originator Organization Name
Address
Loan Originator Organization NMLSR ID State License ID
Loan Originator Name
Loan Originator NMLSR ID State License ID
Email Phone (
Signature Date (mmddyyyy)
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Pe)aae-emeet)
Community Property State
At least one borrowerlives in a community propertystateThe property is in a community property state
Transaction DetailConversion of Contract for Deed or Land ContractRenovationConstruction-ConversionConstruction-to-Permanent
Single-Closing Two-ClosingConstructionImprovementCosts $
LotAcquired Date
Original Cost of Lot $(mmddyyyy)
Refinance Program
Full DocumentationInterest Rate ReductionStreamlined without Appraisal
Other
Refinance Type
NoCash OutLimited Cash OutCash Out
Energy Improvement
Mortgageloanwill finance energy-related improvements
Propertyis currently subject to a lien that could take priority ovethe first mortgagelien such as a clean energylien paid for througproperty taxes(eg the PropertyAssessed Clean Energyprogram)
Project Type Condominium Cooperative Planned Unit Development (PUD) Propertyis notlocatedin a project
Peiwlivcestetece)a)
Title to the Property Will be Held in What Name(s)
For RefinanceTitle to the Property is Currently Held in What Name(s
Trust Information
tle Will be Held byan Inter Vivos (Living) Trust
Title Will be Held by a Land TrustLeasehold Expiration Date
Mannerin WhichTitle Will be Held Indian Country Land Tenure
Sole OwnershipLife EstateTenancy in Common
Joint Tenancywith Right of Survivorship]Tenancybythe EntiretyOther
Fee Simple Ona ReservationIndividualTrust Land (AllottedRestricted)Tribal Trust Land On a ReservationTribal Trust Land Off ReservationAlaska Native Corporation Land
Estate Will be Held in
Fee Simple(mmddyyyy)
3 Mortgage LoanInformation
Termsof Loan
Note Rate
Loan Term (months)
MortgageLien Type
First LienSubordinate Lien
Mortgage Type Applied For
Conventional USDA-RDFHA VA Other
Amortization Type
Fixed RateAdjustable Rate
If Adjustable Rate
Initial Period Prior to First Adjustment
Subsequent AdjustmentPeriod
Proposed Monthly Paymentfor Property
First Mortgage (P amp I) $
Subordinate Lien(s) (P amp |) $
Other(explain)
Homeowners Insurance $(months)
(months)
Loan Features Property Taxes $
Balloon Balloon Term (months)
Interest Only Interest OnlyTermNegative AmortizationPrepaymentPenalty Prepayment Penalty Term (months) Other
Temporary Interest Rate BuydownInitial Buydown Rate TOTALOther(explain)
Mortgage Insurance $
AssociationProject Dues (Condo Co-Op PUD) $
Supplemental Property Insurance $
(months)
Borrower Name(s)Uniform Residential Loan Application mdash LenderLoan Information
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
L4 Qualifying the Borrower - Minimum Required Funds or Cash Back
DUEFROM BORROWER(S)
A Sales Contract Price
B Improvements Renovations and Repairs
C Land(ifacquired separately)
D For Refinance Balance of Mortgage Loanson the Propertyto be paid off in the Transaction
(See Table 3a Property You Own)
E Credit Cards and Other Debts Paid Off
(See Table 2c Liabilities mdash Credit Cards Other Debts and Leases that You Owe)
F BorrowerClosing Costs (including Prepaid andInitial Escrow Payments)
G Discount Points
HTOTAL DUE FROM BORROWER(s)(Total of A thru G)
TOTALMORTGAGE LOANS
Loan Amount
Loan AmountExcluding Financed Mortgage Insurance (or Mortgage Insurance Equivalent) $
Financed Mortgage Insurance (or Mortgage Insurance Equivalent) Amount $
Other New Mortgage Loanson the Property the Borrower(s) is Buying or Refinancing(See Table 4b Other New MortgageLoanson the Property You are Buying or Refinancing)
KTOTAL MORTGAGELOANS(Totalof| and J)
TOTALCREDITS
L Seller Credits (Enter the amountofBorrower(s) costs paid by the property seller)
MOtherCredits (Enter the sum ofall other credits mdash BorrowerPaid Fees Earnest Money EmployerAssistedHousing Lease Purchase Fund Lot Equity Relocation Funds Sweat Equity Trade Equity Other)
NTOTAL CREDITS(Total of L and M)
CALCULATION
TOTAL DUE FROM BORROWER(s)(Line H)
LESSTOTAL MORTGAGELOANS(Line K) AND TOTAL CREDITS(Line N)
Cash FromTothe Borrower(Line H minusLine K and Line N)NOTE This amountdoesnotinclude reservesor other funds that may be required by the Lenderto be verified
Borrower Name(s)Uniform Residential Loan Application mdash LenderLoan Information
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
Uniform Residential Loan Application mdash Unmarried Addendum
eeCeceetatimC elitleeComeLy
Lenders Instructions for Using the Unmarried Addendum
The Lender may use the Unmarried Addendum only when a Borrowerselected ldquoUnmarriedrdquoin Section 1 and the information collected is
necessary to determine howState property lawsdirectly or indirectly affecting creditworthiness apply including ensuring clear title
For example the Lender may use the Unmarried Addendum whentheBorrowerresides in a State that recognizescivil unions domestic
partnerships or registered reciprocal beneficiary relationships or when the property is located in such a State ldquoStaterdquo meansanystate the
District of Columbia the Commonwealth of Puerto Rico or anyterritory or possession of the United States
Ifyou selected ldquoUnmarriedrdquoin Section 1 is there a person whois not your legal spouse but whocurrently has real property rights similar to
those of a legal spouse +=) NOQ YES
If YES indicate the type of relationship and the State in which the relationship was formed For example indicate if you are in a
civil union domestic partnership registered reciprocal beneficiary relationship or other relationship recognized by the State in which you
currently reside or where the property is located
O Civil Union copy Domestic Partnership copy Registered Reciprocal Beneficiary Relationship copy) Other(explain)
Statea]
Borrower NameUniform Residential Loan Application mdash Unmarried Addendum
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Uniform Residential Loan Application mdash Continuation Sheet
Use this continuation sheet if you need more space to complete the Uniform Residential Loan Application
Borrower Name(First Middle Last Suffix )
Additional Information
Additional Borrower Name(First Middle Last Suffix )
Additional Information
IWefully understand thatit is a federal crime punishable by fine or imprisonment or both to knowingly make anyfalse statements concerningany of the abovefacts as applicable underthe provisions of federal law (18 USC sectsect 1001 et seq)
BorrowerSignature Date (mmddyyyy)
Additional Borrower Signature Date (mmddyyyy)
Uniform Residential Loan Application mdash Continuation SheetFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
INSTRUCTIONS FOR COMPLETING THE UNIFORM RESIDENTIAL LOAN APPLICATION
Use the instructions below to complete the enclosed Uniform Residential Loan Application (Freddie Mac Form 65Fannie Mae Form 1003) To avoid any delays in your application review please provide all of the requested information
If you need to make a correction on the application draw a line through the incorrect text and mark your initials beside the change Donrsquot use correction tape or fluid The application must be completed signed and dated in ink
The Uniform Residential Loan Application (URLA)
The URLA contains the following sections Section 1 Borrower Information Please provide your personal information income and employment
Section 2 Financial Information ndash Assets and Liabilities Please provide information about your financial assets personal financial obligations and debts you owe
Section 3 Financial Information ndash Real Estate Please provide information about property you own and the debts and expenses related to the property
Section 4 Loan and Property Information Please provide information about the loan purpose and the property you are buying or refinancing
Section 5 Declarations Please answer questions about the property how the property will be financed and your past financial history
Section 6 Acknowledgments and Agreements Informs you of your legal obligations related to the mortgage application and asks that you acknowledge certain information will be obtained used and shared
Section 7 Military Service Please provide information about your (or your deceased spousersquos) military service
Section 8 Demographic Information Requests information the Lender is required by law to ask you
Section 9 Loan Originator Information Will be completed by Chase
Uniform Residential Loan Application ndash Additional Borrower
The URLA ndash Additional Borrower contains the following sections Section 1 Borrower Information This is the same as the Borrower Information section of the URLA
Section 2 Financial Information ndash Assets and Liabilities Contains only the following statement for the additional Borrower to complete ldquoMy information for Section 2 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo The name of the other borrower is entered here
Complete a separate URLA for each BorrowermiddotThree or more Borrowers ndash Use any combination of URLA and URLA-Additional Borrower forms in accordance with the above examples
Section 3 Financial Information ndash Real Estate Contains only the following statement for the additional borrower to complete ldquoMy information for Section 3 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 4 Loan and Property Information Contains only the following statement for the additional borrower to complete ldquoMy information for Section 4 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 5 Declarations This is the same as the Declarations section of the URLA
Section 6 Acknowledgments and Agreements Contains only the following statement for the additional borrower to complete ldquoMy signature for Section 6 is on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 7 Military Service This is the same as the Military Service section of the URLA
Section 8 Demographic Information This is the same as the Demographic Information section on the URLA
Section 9 Loan Originator Information This is the same as the Loan Originator Information section of the URLA
Using the URLA and URLA ndash Additional Borrower Together The URLA and the URLA ndash Additional Borrower are used together to collect information for two Borrowers who have joint assets liabilities andor real estate information The URLA and URLA ndash Additional Borrower can also be used for Borrowers who do not have joint information but wish to combine their information on the URLA for ease of use Here are examples of how to use the URLA and URLA ndash Additional Borrower
For one borrower Complete the URLA
For two borrowers with joint financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you dont need to duplicate them on more than one URLA or o In cases where Borrowers are not collaborating when completing the loan application
joint assets liabilities and real estate may be duplicated on each URLA bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you do not need to duplicate them on more than one URLA or
o In cases where Borrowers are not collaborating when completing the loan application joint assets liabilities and real estate may be duplicated on each URLA
For two borrowers with separate financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower Report the assets liabilities and
real estate for the additional Borrower on the URLA or bull Complete a separate URLA for each Borrower
For three or more borrowers use any combination of URLA and URLA ndash Additional Borrower forms described for two borrowers
Uniform Residential Loan Application ndash Unmarried Addendum If any borrower listed on the URLA or URLA ndash Additional Borrower form selects Unmarried in Section 1 (Personal Information) the lender will complete this optional form
The information must be collected to determine how to apply state property laws that directly or indirectly affect creditworthiness including ensuring clear title
Uniform Residential Loan Application ndash Continuation Sheet Use the URLA ndash Continuation Sheet if you need more space to complete either the URLA or URLA ndash Additional Borrower forms
99177-URLAI-0215
HUD Addendum to Uniform Residential Loan Application OMB Approval No HUD 2502-0059 (exp )
Part I - Identifying Information HUDFHA Application for Insurance under the National Housing Act and Borrower Certification
FHA Case No (include any suffix) Mortgagee Case No
Mortgagee ID Sponsor ID Agent ID
Mortgagee Name Address (include ZIP Code) and Telephone Number
Type or print all entries clearly
Name and Address of Sponsor Name and Address of Agent
Borrowers Name amp Present Address (include ZIP Code) Property Address (include name of subdivision lot amp block no amp ZIP Code)
Sponsored Originations
Name of Third-Party Originator NMLS ID of Third-Party Originator
Part II - Borrower Consent for Social Security Administration to Verify Social Security Number I authorize the Social Security Administration (SSA) to verify my Social Security Number (SSN) to the Mortgagee and HUDFHA I authorize SSA to provide explanatory
information to HUDFHA in the event of a discrepancy This consent is valid for 180 days from the date signed unless indicated otherwise by the individual(s) named in this
loan application
Signature(s) of Borrower(s) - Read consent carefully Review accuracy of Social Security Number(s) provided on this application
Borrowerrsquos NameDate of BirthSocial Security Number
Co-Borrowerrsquos Name Date of BirthSocial Security Number
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
Part III - Borrower Notices Information and Acknowledgment Public Reporting Burden
Public reporting burden for this collection of information is estimated to average 10 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 conduct or sponsor and a person is not
required to respond to a collection of information unless that collection displays a valid OMB control number which can be located on the OMB Internet page at
httpwwwreginfogovpublicdoPRAMain
Privacy Act Information
The information requested on the Uniform Residential Loan Application and this Addendum is authorized by the National Housing Act of 1934 12 USC sect 1701 et seq The Debt
Collection Act of 1982 Pub L 97-365 and HUDrsquos Housing and Community Development Act of 1987 42 USC sect 3543 require persons applying for a federally insured loan to
furnish their SSN You must provide all the requested information including your SSN HUD may conduct a computer match to verify the information you provide HUD may
disclose certain information to Federal State and local agencies when relevant to civil criminal or regulatory investigations and prosecutions It will not otherwise be disclosed or
released outside of HUD except as required and permitted by law The information will be used to determine whether you qualify as a mortgagor Failure to provide any of the
requested information including SSN may result in disapproval of your loan application This is notice to you as required by the Right to Financial Privacy Act of 1978 that
HUDFHA has a right of access to financial records held by financial institutions in connection with the consideration or administration of assistance to you Financial records
involving your transaction will be available to HUDFHA without further notice or authorization but will not be disclosed or released by the institution to another Government Agency
or Department without your consent except as required or permitted by law
WARNING This warning applies to all certifications made in this document Anyone who knowingly submits a false claim or makes false statements is subject to criminal and civil penalties including confinement for up to 5 years fines and civil penalties 18 USC sectsect 287 1001 and 31 USC sect 3729
orm HUD-92900-A ( ) Page 1
Borrower Name ____________________________ FHA Case No __________________
Caution Delinquencies Defaults Foreclosures and Abuses Delinquencies defaults foreclosures and abuses of mortgage loans involving programs of the Federal Government can be costly and detrimental to your credit now and in the future The Mortgagee in this transaction its agents and assigns as well as the Federal Government its agencies agents and assigns are authorized to take any and all of the following actions in the event loan payments become delinquent on the mortgage loan described in the attached application (1) Report your name and account information to a credit bureau (2) Assess additional interest and penalty charges for the period of time that payment is not made (3) Assess charges to cover additional administrative costs incurred by the Federal Government to service your account (4) Offset amounts owed to you
under other Federal programs (5) Refer your account to a private attorney collection agency or mortgage servicing agency to collect the amount due foreclose
the mortgage sell the property and seek judgment against you for any deficiency (6) Refer your account to the Department of Justice (DOJ) for litigation in the
courts (7) If you are a current or retired Federal employee take action to offset your salary or civil service retirement benefits (8) Refer your debt to the Internal
Revenue Service for offset against any amount owed to you as an income tax refund and (9) Report any resulting written off debt of yours to the Internal Revenue Service as your taxable income All of these actions may be used to recover any debts owed when it is determined to be in the interest of the Mortgagee or Federal Government or both
As a mortgage loan borrower you will be legally obligated to make the mortgage payments called for by your mortgage loan contract The fact that you dispose of your property after the loan has been made will not relieve you of liability for making these payments Payment of the loan in full is ordinarily the way liability on a mortgage note is ended Some home buyers have the mistaken impression that if they sell their homes when they move to another locality or dispose of it for any other reasons they are no longer liable for the mortgage payments and that liability for these payments is solely that of the new owners Even though the new owners may agree in writing to assume liability for your mortgage payments this assumption agreement will not relieve you from liability to the holder of the note which you signed when you obtained the loan to buy the property Unless you are able to sell the property to a buyer who is acceptable to HUDFHA who will assume the payment of your obligation to the lender you will not be relieved from liability to repay any claim which HUDFHA may be required to pay your lender on account of default in your loan payments The amount of any such claim payment may be a debt owed by you to the Federal Government and subject to established collection procedures
Fair Housing Act I and anyone acting on my behalf are and will remain in compliance with the Fair Housing Act 42 USC sect 3604 et seq with respect to the dwelling or property covered by the loan and in the provision of services or facilities in connection therewith I recognize that any restrictive covenant on this property related to race color religion sex disability familial status or national origin is unlawful under the Fair Housing Act and unenforceable I further recognize that in addition to administrative action by HUD a civil action may be brought by the DOJ in any appropriate US court against any person responsible for a violation of the
applicable law
Certification and Acknowledgment All information in this application is given for the purpose of obtaining a loan to be insured under the National Housing Act and the information in the Uniform Residential Loan Application and this Addendum is true and complete to the best of my knowledge and belief Verification may be obtained from any source named herein I have read and understand the foregoing concerning my liability on the loan and Part III Borrower Notices Information and Acknowledgment
Signature(s) of Borrower(s) - Do not sign unless this application is fully completed Read the certification carefully and review accuracy of this application
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
orm HUD-92900-A ( Page 2
___________________________________
______________________________________________________
______________________________________________________________
- - - - - - - - - - - - - - - - - - - - - - -
Borrower Name ____________________________ FHA Case No __________________
Part IV - Direct Endorsement Approval for a HUD FHA-Insured Mortgage A Underwriting the Borrower
Date Mortgage Approved ______________________________ Date Approval Expires ______________________
For mortgages rated as an ldquoacceptrdquo or ldquoapproverdquo by FHAs TOTAL Mortgage Scorecard
The information submitted to TOTAL was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA4e Final Underwriting Decision (TOTAL) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee Representative Signature
Printed Name
Title
OR
For mortgages rated as a ldquoreferrdquo by FHAs TOTAL Mortgage Scorecard or manually underwritten by a Direct Endorsement underwriter I have personally reviewed and underwritten the borrowerrsquos credit application The information used to underwrite the borrower was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA5d Final Underwriting Decision (Manual) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
B Underwriting the Property
For all mortgages where FHA requires an appraisal I have personally reviewed and underwritten the appraisal according to FHA requirements I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
orm HUD-92900-A ( ) Page 3
Borrower Name ____________________________ FHA Case No __________________
Part V Mortgagees Certification
I have personally reviewed the mortgage documents and the application for insurance endorsement and This mortgage complies with SF Handbook 40001 Section IIA7 Post-Closing and Endorsement to the extent that no defect exists that would have changed the decision to endorse or submit the mortgage for insurance
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee
Name of Mortgageersquos Representative
Title of Mortgageersquos Representative
Signature of the Mortgageersquos Representative Date
orm HUD-92900-A ( ) Page 4
GENERAL AUTHORIZATION FOR A MORTGAGE LOAN ASSUMPTION
Applicant name(s)
Loan number
NOTICES AND DISCLOSURES
Non-discriminatory underwriting guidelines Anyone who inquires about the availability of credit from us has the right to receive a copy of our non-discriminatory underwriting guidelines To request a copy of these guidelines contact your Loan Processor
Attorney note Itrsquos the responsibility of our attorneys to protect our interest You may at your expense request an attorney to represent your interest
Notice to HUDFHA applicants As required by the Right to Financial Privacy Act of 1978 this notice is to inform you that the US Department of Housing and Urban Development (HUD)Federal Housing Administration (FHA) has a right of access to financial records held by financial institutions related to a request for assistance Financial records involving your assumption will be available to HUDFHA without further notice or authorization but wonrsquot be disclosed or released by us to another government agency or department without your consent except as required or permitted by law
Borrower consent to the use of tax return information I understand acknowledge and agree that the Lender and Other Loan Participants can obtain use and share tax return information for purposes of (i) providing an offer (ii) originating maintaining managing monitoring servicing selling insuring and securitizing a loan (iii) marketing or (iv) as otherwise permitted by applicable laws including state and federal privacy and data security laws The Lender includes the Lenderrsquos affiliates agents service providers and any of aforementioned partiesrsquo successors and assigns The Other Loan Participants includes any actual or potential owners of a loan resulting from your loan application or acquirers of any beneficial or other interest in the loan and mortgage insurer guarantor any servicers or service providers for these parties and any of aforementioned partiesrsquo successors and assigns
CERTIFICATION AND AUTHORIZATION
Environmental certification By signing below I represent and warrant that Irsquom not aware of any substances materials or products that may be an environmental hazard such as but not limited to asbestos formaldehyde radon gas lead-based paint fuel or chemical storage tanks (above or below ground) and contaminated soil or water on the property I acknowledge that Chase is relying on this representation and warranty as a material part of its loan application process I also am not aware of any landfill on any portion of the property
Exceptions to the above I further acknowledge (1) receipt of applicable disclosures from the seller in purchase transactions (2) that lead-based paint may exist in housing constructed prior to 1978 (3) that Chase performs no environmental investigation on my behalf and isnrsquot responsible for identifying lead-based paint or any other environmental conditions that might impact the property or its residents and (4) that it is my sole obligation to investigate for potential impact to the property from environmental conditions
Certifications I certify by signing below that (1) all of the loan application information provided is true and complete (2) I understand any intentional or negligent misrepresentation(s) of the information provided in conjunction with my application may result in civil liability andor 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 Chase its agents successors and assigns insurers and any other person who may suffer any loss due to reliance upon any misrepresentation that I have made on the application and (3) any significant change from the information provided at the time of application until the final loan application is signed may have a bearing on the approval of my application for a home loan
Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union
This question is asked because of state laws that extend the same or similar rights benefits and protections of spouses in a marriage to persons who are members of a partnership or union recognized under state law You should consult with your own legal advisor for advice regarding the rights protections benefits responsibilities obligations and duties of those who are registered domestic partners civil union partners or members of other unions recognized under applicable law
CREDIT AUTHORIZATION RELEASE
By signing below I authorize Chase andor my mortgage insurer (if any) to verify my past and present employment earnings records (including information contained in income tax returns that have been filed with the IRS) bank accounts stock holdings and any other information that it finds necessary to process my mortgage loan application or to review it for quality-control purposes I understand that a credit report will be ordered from a credit reporting agency for verification prior to loan closing as part of the application process and may be ordered after closing as part of the Lenderrsquos quality-control program A credit report may also be completed as part of the Lenderrsquos servicing or collection of the loan or in consideration of any other product or service that the Lender may consider offering me in the future and at any time throughout the life of the loan I understand that use of a photocopy of this form may be necessary to verify one or more of my credit references I understand that a photocopy or fax copy of this form will also serve as authorization
By signing below each applicant acknowledges (1) making the above certifications and authorizations and (2) that each applicant has received and understands the above notices and disclosures
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
You do not have to give us this information but if you donrsquot your application for approval as a borrower may be delayed or rejected The information requested in this form is authorized by Title 38 USC Chapter 37 (if VA) by 12 USC Section 1701 et seq (if HUDFHA) by 42 USC Section 1452b (if HUDCPD) and Title 42 USC 1471 et seq or 7 USC 1921 et seq (if USDA FHA)
Updated December 2021 99177-GA-0215
1b
2b
Form 4506-C (September 2020)
Department of the Treasury - Internal Revenue Service
IVES Request for Transcript of Tax Return OMB Number
1545-1872
Do not sign this form unless all applicable lines have been completed Request may be rejected if the form is incomplete or illegible
For more information about Form 4506-C visit wwwirsgov and search IVES
1a Name shown on tax return (if a joint return enter the name shown first)
First social security number on tax return individual taxpayer identification number or employer identification number (see instructions)
2a If a joint return enter spousersquos name shown on tax return Second social security number or individual taxpayer identification number if joint tax return
3 Current name address (including apt room or suite no) city state and ZIP code (see instructions)
4 Previous address shown on the last return filed if different from line 3 (see instructions)
5a IVES participant name address and SOR mailbox ID
DataVerify 875 Greentree Rd 8 Parkway Center Pittsburgh PA 15220
5b Customer file number (if applicable) (see instructions)
Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing (see instructions)
6 Transcript requested Enter the tax form number here (1040 1065 1120 etc) and check the appropriate box below Enter only one tax form number per request 1040
a Return Transcript which includes most of the line items of a tax return as filed with the IRS A tax return transcript does not reflect changes made to the account after the return is processed Transcripts are only available for the following returns Form 1040 series Form 1065 Form 1120 Form 1120-A Form 1120-H Form 1120-L and Form 1120S Return transcripts are available for the current year and returns processed during the prior 3 processing years
b Account Transcript which contains information on the financial status of the account such as payments made on the account penalty assessments and adjustments made by you or the IRS after the return was filed Return information is limited to items such as tax liability and estimated tax payments Account transcripts are available for most returns
c Record of Account which provides the most detailed information as it is a combination of the Return Transcript and the Account Transcript Available for current year and 3 prior tax years
7 Form W-2 Form 1099 series Form 1098 series or Form 5498 series transcript The IRS can provide a transcript that includes data from these information returns State or local information is not included with the Form W-2 information The IRS may be able to provide this transcript information for up to 10 years Information for the current year is generally not available until the year after it is filed with the IRS For example W-2 information for 2016 filed in 2017 will likely not be available from the IRS until 2018 If you need W-2 information for retirement purposes you should contact the Social Security Administration at 1-800-772-1213
Caution If you need a copy of Form W-2 or Form 1099 you should first contact the payer To get a copy of the Form W-2 or Form 1099 filed with your return you must use Form 4506 and request a copy of your return which includes all attachments
8 Year or period requested Enter the ending date of the tax year or period using the mmddyyyy format (see instructions)
12 31 2020 12 31 2019 12 31 2018 Caution Do not sign this form unless all applicable lines have been completed
Signature of taxpayer(s) I declare that I am either the taxpayer whose name is shown on line 1a or 2a or a person authorized to obtain the tax information requested If the request applies to a joint return at least one spouse must sign If signed by a corporate officer 1 percent or more shareholder partner managing member guardian tax matters partner executor receiver administrator trustee or party other than the taxpayer I certify that I have the authority to execute Form 4506-C on behalf of the taxpayer Note This form must be received by IRS within 120 days of the signature date
Signatory attests that heshe has read the attestation clause and upon so reading declares that heshe has the authority to sign the Form 4506-C See instructions
Sign Here
Signature (see instructions) Date Phone number of taxpayer on line 1a or 2a
PrintType name
Title (if line 1a above is a corporation partnership estate or trust)
Spousersquos signature Date
PrintType name
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020) For Privacy Act and Paperwork Reduction Act Notice see page 2
Instructions for Form 4506-C IVES Request for Transcript of Tax Return
Section references are to the Internal Revenue Code unless otherwise noted
Future Developments
For the latest information about Form 4506-C and its instructions go to wwwirsgov and search IVES Information about any recent developments affecting Form 4506-C (such as legislation enacted after we released it) will be posted on that page
Whats New Form 4506-C was created to be utilized by authorized IVES participants to order tax transcripts with the consent of the taxpayer
General Instructions
Caution Do not sign this form unless all applicable lines have been completed
Designated Recipient Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information received pursuant to the taxpayerrsquos consent and holds the recipient subject to penalties for any unauthorized access other use or redisclosure without the taxpayerrsquos express permission or request
Taxpayer Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information provided pursuant to your consent and holds the recipient subject to penalties brought by private right of action for any unauthorized access other use or redisclosure without your express permission or request
Purpose of form Use Form 4506-C to request tax return information through an authorized IVES participant You will designate an IVES participant to receive the information on line 5a
Note If you are unsure of which type of transcript you need check with the party requesting your tax information
Where to file The IVES participant will fax Form 4506-C with the approved IVES cover sheet to their assigned Service Center
Chart for ordering transcripts
If your assigned Service Center is
Fax the requests with the approved coversheet to
Austin Submission Processing Center
Austin IVES Team
844-249-6238
Fresno Submission Processing Center
Fresno IVES Team
844-249-6239
Kansas City Submission Processing Center
Kansas City IVES Team
844-249-8128
Ogden Submission Processing Center
Ogden IVES Team
844-249-8129
Specific Instructions
Line 1b Enter the social security number (SSN) or individual taxpayer identification number (ITIN) for the individual listed on line 1a or enter the employer identification number (EIN) for the business listed on line 1a
Line 3 Enter your current address If you use a PO box include it on this line
Line 4 Enter the address shown on the last return filed if different from the address entered on line 3
Note If the addresses on lines 3 and 4 are different and you have not changed your address with the IRS file Form 8822 Change of Address or Form 8822-BChange of Address or Responsible Party mdash Business with Form 4506-C
Line 5b Enter up to 10 numeric characters to create a unique customer file number that will appear on the transcript The customer file number cannot contain an SSN ITIN or EIN Completion of this line is not required
Note If you use an SSN name or combination of both we will not input the information and the customer file number will reflect a generic entry of 9999999999 on the transcript
Line 8 Enter the end date of the tax year or period requested in mmddyyyy format This may be a calendar year fiscal year or quarter Enter each quarter requested for quarterly returns Example Enter 12312018 for a calendar year 2018 Form 1040 transcript
Signature and date Form 4506-C must be signed and dated by the taxpayer listed on line 1a or 2a The IRS must receive Form 4506-C within 120 days of the date signed by the taxpayer or it will be rejected Ensure that all applicable lines including lines 5a through 8 are completed before signing
You must check the box in the signature area to acknowledge you have the authority to sign and request the information The form will not be processed if unchecked
Individuals Transcripts listed on on line 6 may be furnished to either spouse if jointly filed Only one signature is required Sign Form 4506-C exactly as your name appeared on the original return If you changed your name also sign your current name
Corporations Generally Form 4506-C can be signed by
(1) an officer having legal authority to bind the corporation (2) any person designated by the board of directors or other governing body or (3) any officer or employee on written request by any principal officer and attested to by the secretary or other officer A bona fide shareholder of record owning 1 percent or more of the outstanding stock of the corporation may submit a Form 4506-C but must provide documentation to support the requesters right to receive the information
Partnerships Generally Form 4506-C can be signed by any person who was a member of the partnership during any part of the tax period requested on line 8
All others See section 6103(e) if the taxpayer has died is insolvent is a dissolved corporation or if a trustee guardian executor receiver or administrator is acting for the taxpayer
Note If you are Heir at law Next of kin or Beneficiary you must be able to establish a material interest in the estate or trust
Documentation For entities other than individuals you must attach the authorization document For example this could be the letter from the principal officer authorizing an employee of the corporation or the letters testamentary authorizing an individual to act for an estate
Signature by a representative A representative can sign Form 4506-C for a taxpayer only if the taxpayer has specifically delegated this authority to the representative on Form 2848 line 5 The representative must attach Form 2848 showing the delegation to sign Form 4506-C
Privacy Act and Paperwork Reduction Act Notice We ask for the information on this form to establish your right to gain access to the requested tax information under the Internal Revenue Code We need this information to properly identify the tax information and respond to your request You are not required to request any transcript if you do request a transcript sections 6103 and 6109 and their regulations require you to provide this information including your SSN or EIN If you do not provide this information we may not be able to process your request Providing false or fraudulent information may subject you to penalties
Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and cities states the District of Columbia and US commonwealths and possessions for use in administering their tax laws We may also disclose this information to other countries under a tax treaty to federal and state agencies to enforce federal nontax criminal laws or to federal law enforcement and intelligence agencies to combat terrorism
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law Generally tax returns and return information are confidential as required by section 6103
The time needed to complete and file Form 4506-C will vary depending on individual circumstances The estimated average time is
Learning about the law or the form 10 min Preparing the form 12 min Copying assembling and sending the form to the IRS 20 min
If you have comments concerning the accuracy of these time estimates or suggestions for making Form 4506-C simpler we would be happy to hear from you You can write to
Internal Revenue Service Tax Forms and Publications Division 1111 Constitution Ave NW IR-6526 Washington DC 20224
Do not send the form to this address Instead see Where to file on this page
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020)
Rev April 2021 CHASEO Facts What does Chase do with your personal information
Why Financial companies choose how they share your personal information Federal law gives consumers the right to limit some but not all sharing Federal law also requires us to tell you how we collect share and protect your personal information Please read this notice carefully to understand what we do
What The types of personal information we collect and share depend on the product or service you have with us This information can include bull Social Security number and income bull account balances and transaction history bull credit history and payment history
How All financial companies need to share customers personal information to run their everyday business In the section below we list the reasons financial companies can share their customers personal information the reasons Chase chooses to share and whether you can limit this sharing
Reasons we can share your personal information Does Chase share
Can you limit this sharing
For our everyday business purposes - such as to process your transactions maintain your account(s) respond to court orders and legal investigations or report to credit bureaus
Yes No
For our marketing purposes - to offer our products and services to you
Yes No
For joint marketing with other financial companies Yes No
For our affiliates everyday business purposes - information about your transactions and experiences
Yes No
For our affiliates everyday business purposes - information about your creditworthiness
Yes Yes
For our affiliates to market to you Yes Yes
For nonaffiliates to market to you Yes Yes
a
0
To limit our sharing
bull Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
bull Visit us online chasecomprivacypreferences
Please note If you are a new customer we can begin sharing your information 30 days from the date we sent this notice When you are no longer our customer we continue to share your information as described in this notice However you can contact us at any time to limit our sharing
Questions
Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
PAGE 2
Who we are
Who is providing this notice The US consumer financial companies within the JPMorgan Chase amp Co family including JPMorgan Chase Bank NA Chase Insurance Agency Inc and JP Morgan Securities LLC
What we do
How does Chase protect my To protect your personal information from unauthorized access and use we personal information use security measures that comply with federal law These measures include
computer safeguards and secured files and buildings We authorize our employees to get your information only when they need it to do their work and we require companies that work for us to protect your information
How does Chase collect my We collect your personal information for example when you personal information bull open an account or make deposits or withdrawals from your account
bull pay your bills or apply for a loan bull use your credit or debit card We also collect your personal information from others such as credit bureaus affiliates or other companies
Why cant I limit all sharing Federal law gives you the right to limit only bull sharing for affiliates everyday business purposes - information about your
creditworthiness bull affiliates from using your information to market to you bull sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing See below for more on your rights under state law
What happens when I limit sharing for an account I hold jointly with someone else
Your choices will apply to everyone on your account
Definitions
Affiliates Companies related by common ownership or control They can be financial and non financial companies bull Our affiliates include companies with a Chase or JP Morgan name and financial companies such asjP Morgan Securities LLC
Nonaffiliates Companies not related by common ownership or control They can be financial and non financial companies bull Nonaffiliates we share with can include companies such as retailers auto dealers auto makers and membership clubs
Joint marketing A formal agreement between nonaffiliated financial companies that together market financial products or services to you bull Our joint marketing partners include categories of companies such as insurance companies
Other important information
VT Accounts with a Vermont mailing address are automatically treated as if they have limited the sharing as described on page 1 For joint marketing we will only disclose your name contact information and information about your transactions
NV We are providing you this notice pursuant to Nevada law If you prefer not to receive marketing calls from us you may be placed on our Internal Do Not Call List by calling 1-800-945-9470 or by writing to us at PO Box 734007 Dallas TX 75373-4007
For more information contact us at the address above or email PrivacylnfoJPMChasecom with Nevada Annual Notice in the subject line You may also contact the Nevada Attorney Generals office Bureau of Consumer Protection Office of the Nevada Attorney General 555 E Washington St Suite 3900 Las Vegas NV 89101 telephone number 1-702-486-3132 email BCPINFOagstatenvus
CA Accounts with a California mailing address are automatically treated as if they have limited the sharing with nonaffiliates as described on page 1 CA residents are provided a CA notice for additional choices
CHASE O
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
The following disclosure is required by the USA PATRIOT Act
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 opens an account
What this means to you When you 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 drivers
license or other identifying documents
99177-PAT-0215
VETERAN STATEMENT When this loan was opened the US Department of Veterans Affairs (VA) used the veteran borrowerrsquos entitlement which is a set amount the VA promises to repay a lender if the borrower defaults on the mortgage An assumption will modify who is obligated to pay the existing mortgage loan but all loan termsmdashincluding the entitlementmdashwill remain the same If the veteran borrower is being removed from the loan the entitlement would remain with whoever is assuming the loan because the loan will continue to be serviced by the VA If the applicant is also a veteran and can substitute his or her entitlement for the current entitlement then the current borrowerrsquos entitlement can be released
Please review the following questions and answer as appropriate This form requires completion by both the applicant(s) and current borrower(s)
1 Applicant to Complete
Are you (the applicant) currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the reverse side)
Yes (If yes please provide the information requested below answer the question in section 3 and sign and date this form at the bottom of the reverse side)
Name of applicant(s) who answered ldquoyesrdquo to the above question
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Are you receiving VA disability benefts
Applicant
Yes
No
Co-Applicant
Yes
No
Are you entitled to receive VA disability benefts Yes No Yes No
Have you received VA disability benefts in the past Yes No Yes No
Are you a surviving spouse of a veteran who died on active duty or as the result of a service-related disability
Yes No Yes No
Do you have any VA loans Yes No Yes No
2 Current Borrower to Complete
Is the current borrowerco-borrower currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the page)
Yes (If yes please answer the question in section 3 and sign and date this form at the bottom of the page)
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
________________________________________________________________________________________________
3 Applicant and Current Borrower to Complete
If the answer to the questions in section 1 and 2 are both yes please answer the following question After yoursquove reviewed and completed this entire form please sign and date at the bottom
Applicant Current Borrower
Do you want to apply for a substitution of entitlement Yes Yes No No
In order to complete a substitution of entitlement the veteran applicant must have suffcient entitlement to substitute for that of the current borrower Contact the VA Offce of Jurisdiction for your area for more information Also before the veteran applicant can substitute entitlement on a VA loan heshe must certify that the property securing the loan will be occupied as hisher primary residence Both the applicantrsquos and current borrowerrsquos original certifcate of eligibility will be required If your sales contract is contingent upon the restoration of entitlement please contact your VA Offce of Jurisdiction for complete procedures Otherwise the substitution will be completed after the loan has been approved and closed
Date Applicant printed name Applicant signature
Date Applicant printed name Applicant signature
Date Current Borrower printed name Current Borrower signature
Date Current Borrower printed name Current Borrower signature
Forms completed by Mail Phone
For Chase use only
Interviewer signature Date
99177-VS-0215
- Assumption Application Package_41521-noscannedpages-update-4pdf
-
- 1 FM203 Cover Pagepdf
- 2 FM202 Mortgage Assumption Application Package pagepdf
- 3 The Documents Youll need to Send Uspdf
- 4 FM201 FAQpdf
- 5 FM142 CIWpdf
- 6 FM126 URLApdf
- 7 FM130 URLA Instpdf
-
- Blank Page
-
- 8 92900a Addednum to Loan Applicationpdf
- 9 FM462 Gen Authpdf
- 10 FM220 4506-Cpdf
- 11 FM153 Chase Federal Privacy Noticepdf
- 12 FM144 Info on Opening a New Accountpdf
- 13 FM152 Veteran Statementpdf
-
- Date
- Loan number
- Applicant name
- Phone1
- Loan number 1
- Loan number 2
- Other
- Other_2
- 1
- 2
- undefined_7
- Available hours
- Available hours_2
- undefined_8
- Available hours_3
- undefined_9
- Current address 1
- Neither
- Available hours_4
- Available hours_5
- undefined_10
- Available hours_6
- 1_2
- 2_2
- undefined_11
- Available hours_7
- Available hours_8
- undefined_12
- Available hours_9
- FHA Case No include any suffix
- Mortgagee Case No
- Mortgagee ID
- Sponsor ID
- Agent ID
- Name and Address of Sponsor Name and Address of Agent
- Borrowers Name Present Address include ZIP Code Property Address
- include name of subdivision lot block no ZIP Code
- Name of ThirdParty Originator
- NMLS ID of ThirdParty Originator
- s application
- ty Number
- ty Number_2
- Date Signed_2
- Date Mortgage Approved
- Date Approval Expires
- Printed Name
- Title 1
- DEs ID Number
- DEs ID Number_2
- Mortgagee
- Name of Mortgagees Representative
- Title of Mortgagees Representative
- Signature of the Mortgagees Representative
- Date_2
- Applicant names 1
- Applicant names 2
- Applicant names 3
- Loan number_2
- Date_3
- Applicant printed name
- Social Security number
- Date_4
- Applicant printed name_2
- Social Security number_2
- Date_5
- Applicant printed name_3
- Social Security number_3
- Date_6
- Applicant printed name_4
- Social Security number_4
- 1a Name shown on tax return if a joint return enter the name shown first
- 1b First social security number on tax return individual taxpayer identification number or employer identification number see instructions
- 2a If a joint return enter spouses name shown on tax return
- 2b Second social security number or individual taxpayer identification number if joint tax return
- 4 Previous address shown on the last return filed if different from line 3 see instructions
- 5a IVES participant name address and SOR mailbox ID
- Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing see instructions
- Signature see instructions
- Date_7
- Phone number of taxpayer on line 1a or 2a
- PrintType name
- Here
- Spouses signature
- Date_8
- PrintType name_2
- Name
- Date of birth
- Service number
- Name_2
- Date of birth_2
- Service number_2
- Date_9
- Applicant printed name_5
- Date_10
- Applicant printed name_6
- Date_11
- Current Borrower printed name
- Date_12
- Current Borrower printed name_2
- Date_13
- Text3
- Text10
- undefined_13
- Text15
- undefined_14
- undefined_15
- undefined_16
- undefined_17
- undefined_18
- undefined_19
- undefined_20
- undefined_21
- undefined_23
- Reason for assumption Off
- Requestors relationship to owners Off
- Check one Off
- Check one1 Off
- Day1
- Evening
- Cell phone
- Check one2 Off
- Check one3 Off
- Check one4 Off
- Check one5 Off
- Text2-1
- Text2-2
- Text2-3
- Text2-4
- Text2-5
- Text2-6
- Text3-1
- Text3-2
- Text3-3
- Text3-4
- Text3-6
- Text3-7
- Text3-8
- Text3-9
- Text3-10
- Text3-11
- Text3-12
- Text3-13
- Text3-14
- Text3-15
- Text3-16
- Text3-17
- Text3-18
- Text3-19
- Text3-20
- Text3-21
- Text3-22
- Text3-23
- Text3-24
- Text3-25
- Text3-26
- Text3-27
- Text3-28
- Text3-29
- Text3-30
- Text3-31
- Text3-32
- Text3-33
- Text3-34
- Text3-35
- Text3-36
- Text3-37
- Text3-38
- Text3-39
- Text3-40
- Text3-41
- Text3-42
- Text3-43
- Text3-44
- Text3-45
- Text3-46
- Text3-47
- Text3-48
- Text3-49
- Text3-50
- Text3-51
- Text3-52
- Text3-53
- Text3-5
- Text3-54
- Text3-55
- Text3-56
- Citizenship Off
- Type of credit Off
- Marital Status Off
- Housing Off
- Housing1 Off
- ownership Off
- DNA1 Off
- DNA2 Off
- DNA3 Off
- family Off
- BO Off
- Total
- Text31
- Text32
- Text33
- Text34
- Text35
- Text36
- Text37
- Text38
- Text39
- Text310
- Text311
- Text312
- Text313
- Text314
- Text315
- Text316
- Text317
- Text318
- Text319
- ownership1 Off
- Total1
- Total1-2
- Check Box4-1 Off
- Text320
- Text321
- Text322
- Text323
- Text324
- Text325
- Text326
- Text327
- Text328
- Text329
- Check Box4-2 Off
- Check Box4-3 Off
- Check Box4-4 Off
- Check Box4-8 Off
- Check Box4-9 Off
- Text330
- Text331
- Text332
- Text333
- Text334
- Text335
- Text1-1
- Text1-2
- Text1-3
- Text1-4
- Text1-5
- Text1-6
- Text1-7
- Text1-8
- Text1-9
- Text1-10
- Text1-11
- Text1-12
- Text1-13
- Text1-14
- Text1-15
- Text1-16
- Text1-17
- Text1-18
- Text1-19
- Text1-20
- Text1-21
- Text1-22
- Text1-23
- Text1-24
- Text1-25
- Text1-26
- Text1-27
- Text1-28
- Text1-29
- Text1-30
- Text1-31
- Text1-32
- Text1-33
- Text1-34
- Text1-35
- Check Box3-2 Off
- Check Box2-1 Off
- Check Box2-2 Off
- Check Box2-3 Off
- Check Box2-4 Off
- Check Box2-5 Off
- Text1-36
- Text1-37
- Text1-38
- Text1-39
- Text1-40
- Text1-41
- Text1-42
- Text1-43
- Text1-44
- Text1-45
- Text1-46
- Text1-47
- Text1-48
- Text1-49
- Text1-50
- Text1-51
- Text1-52
- Text1-53
- Text1-54
- Text1-55
- Text1-56
- Text1-57
- Text1-58
- Text1-59
- Text1-60
- Text1-61
- Check Box3-11 Off
- A1
- A2
- A3
- A4
- A5
- A6
- A7
- A8
- A9
- A10
- A11
- A12
- Check Box3-1 Off
- Check Box30-1 Off
- Check Box30-2 Off
- Check Box30-4 Off
- Check Box30-5 Off
- Check Box30-7 Off
- Check Box30-8 Off
- Check Box30-9 Off
- Check Box30-10 Off
- Check Box30-11 Off
- Check Box30-12 Off
- A13
- A14
- A15
- A16
- A17 Off
- A18
- A19
- A20
- A21
- A22
- A23
- A24
- A25
- A26
- A27
- A28
- A29
- A30
- A31
- A32
- A33
- A34
- A35
- A36
- A37
- A38 Off
- A39
- A40
- A41
- A42
- A43
- A44
- A45
- A46
- A47
- A48
- A49
- A50
- A51
- A52
- A53
- A54
- A55
- A56
- A57
- A58
- A59
- A60
- A61
- A62
- A63
- A64
- A65
- A66
- A67
- A68
- A69
- A70
- A71
- A72
- A73
- A74
- Loan Purpose Off
- occupancy1 Off
- lien type Off
- lientype Off
- mixed use Off
- manufactured home Off
- deposit1 Off
- deposit2 Off
- B1
- B2
- B3
- B4
- B5
- B6
- B7
- B8
- B9
- B10
- fha Off
- Check Box51 Off
- B11
- B12
- B13
- B14
- B15
- B16
- B17
- B18
- B19 Off
- B20
- B21
- B22 Off
- B23
- B24
- B25
- B26
- B27
- B28
- A
-
- Will you occupy the property as your primary residence Off
- Will you occupy the property as your primary residence1 Off
-
- If yes have you had an ownership interest in another property in the last three years Off
- Text9-2
- B
-
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property Off
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property1 Off
-
- 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 Off
- 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 application1 Off
-
- 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 Off
- 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 application1 Off
-
- new credit Off
- 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) Off
- the Property Assessed Clean Energy Program)1 Off
-
- F
-
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application Off
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application1 Off
-
- G
-
- Are there any outstanding judgments against you Off
- Are there any outstanding judgments against you1 Off
-
- H
-
- Are you currently delinquent or in default on a Federal debt Off
- Are you currently delinquent or in default on a Federal debt1 Off
-
- I
-
- Are you a party to a lawsuit in which you potentially have any personal financial liability Off
- Are you a party to a lawsuit in which you potentially have any personal financial liability1 Off
-
- J
-
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years Off
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years1 Off
-
- 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 Off
- 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 due1 Off
-
- L
-
- Have you had property foreclosed upon in the last 7 years Off
- Have you had property foreclosed upon in the last 7 years1 Off
-
- M
-
- Have you declared bankruptcy within the past 7 years Off
- Have you declared bankruptcy within the past 7 years1 Off
-
- Check Box8-2 Off
- Check Box8-3 Off
- Check Box8-4 Off
- Text9-3
- Text9-5
- Text9-6
- Text97
- military Off
- ethnicity Off
- sex Off
- race Off
- demo Off
- Text12-1
- Check Box11-1 Off
- Check Box11-2 Off
- Check Box11-3 Off
- Check Box11-4 Off
- Check Box11-5 Off
- Check Box11-6 Off
- Check Box11-7 Off
- Check Box11-8 Off
- Check Box11-9 Off
- Text12-2
- Check Box11-10 Off
- Check Box11-11 Off
- Check Box11-12 Off
- Check Box11-13 Off
- Check Box11-14 Off
- Check Box11-15 Off
- Text12-3
- Check Box11-16 Off
- Check Box11-17 Off
- Check Box11-18 Off
- Check Box11-19 Off
- Check Box11-20 Off
- Check Box11-21 Off
- Check Box11-22 Off
- Check Box11-23 Off
- Text12-4
- Check Box11-24 Off
- Check Box11-25 Off
- Check Box11-26 Off
- Check Box11-27 Off
- Check Box11-28 Off
- Check Box11-29 Off
- Text12-5
- Check Box11-30 Off
- Check Box11-31 Off
- citizen Off
- credit Off
- marital status1 Off
- housing-1 Off
- housing-2 Off
- own Off
- C1
- C2
- C3
- C6
- C7
- C8
- C9
- C10
- C11
- C12
- C13
- C14
- C15
- C16
- C17
- C18
- C19
- C20
- C21
- C22
- C23
- C24
- C25
- C26
- C27
- C28
- C29
- C30
- C31
- C32
- C33
- C34
- C35
- Check Box-2 Off
- C36
- C37
- C38
- C39
- C4
- C40
- C41
- C42
- C43
- C44
- C45
- C46
- C47
- Check Box-3 Off
- Check Box-4 Off
- C48
- C49
- C5
- C50
- C51
- C52
- C53
- C54
- C55
- Check Box-1-1 Off
- own1 Off
- Check Box-1 Off
- D1 Off
- D2
- D3
- D4
- D5
- D6
- D7
- D8
- D9
- D10
- D11
- D12
- D13
- D14 Off
- D15 Off
- D16
- D17
- D18
- D19
- D20
- D21
- D22
- D23
- D24 Off
- D25
- D26
- D27
- D28
- D29
- D30
- D31
- D32
- D33
- D34
- D35 Off
- D36
- D37 Off
- D38
- D39
- D40
- D41
- D42
- D43
- D44
- D45
- D46
- D47
- If yes have you had an ownership interest in another property in the last three years1 Off
- new credit1 Off
- Check Box8-1 Off
- Check Box8-1-2 Off
- Check Box8-1-1 Off
- Check Box8-1-3 Off
- Check Box8-1-4 Off
- Military Service mdash Did you (or your deceased spouse) ever serve or are you currently serving in the United States Armed Forces 1 Off
- Check1 Off
- Text9-1-1
- Check2 Off
- Check3 Off
- Check4 Off
- Text9-1
- E1
- E2
- E3
- Was the ethnicity of the Borrower collected on the basis of visual observation or surname1 Off
- Was the sex of the Borrower collected on the basis of visual observation or surname1 Off
- Was the race of the Borrower collected on the basis of visual observation or surname1 Off
- The Demographic Information was provided through1 Off
- F1 Off
- F2 Off
- F3 Off
- F4 Off
- F5 Off
- F6
- F7 Off
- F8 Off
- F9 Off
- F10 Off
- F11 Off
- F12 Off
- F13
- F14 Off
- F15 Off
- F16 Off
- F17 Off
- F18 Off
- F19 Off
- F20 Off
- F21 Off
- F22
- F23 Off
- F24 Off
- F25 Off
- F26 Off
- F27 Off
- F28 Off
- F29
- F30 Off
- F31 Off
- undefined_13-1
- undefined_13-2
- undefined_14-1
- undefined_15-1
- undefined_16-1
- undefined_17-1
- undefined_18-1
- undefined_19-1
- undefined_21-1
- undefined_20-1
- undefined_23-1
- undefined_13_1
- Single-Two Off
- Refi type Off
- refi program Off
- Estate Off
- Title held Off
- Trust Information Off
- Indian Country Land Tenure Off
- Mortgage Type Applied For Off
- Mortgage Lien Type Off
- Amortization Type Off
- G1 Off
- G2 Off
- G3 Off
- G4 Off
- G5 Off
- G6
- G7
- G8
- G9
- G10 Off
- G11 Off
- G12 Off
- G13 Off
- G14 Off
- G15 Off
- G16
- G17
- G18
- G19
- G20
- G21
- G22
- G23 Off
- G24
- G25 Off
- G26
- G27 Off
- G28 Off
- G29
- G30 Off
- G31
- G32 Off
- G33
- G34
- G35
- G36
- G37
- G38
- G39
- G40
- G41
- G42
- Property Held
- refi
- Text18-1
- Text18-2
- Text18-3
- Text18-4
- Text18-5
- Text18-6
- Text18-7
- Text18-8
- Text18-9
- Text18-10
- Text18-11
- Text18-12
- Text18-13
- Text18-14
- Text18-15
- Text18-16
- Text18-17
- Text18-18
- Text18-19
- Lender
- case no
- If you selected ldquoUnmarriedrdquo in Section 1 is there a person who is not your legal spouse but who currently has real property rights similar to those of a legal spouse Off
- Relationship and State Off
- Other-5
- Text19-1
- BName
- Additional Information
- ABN
- Additional Information1
- BSign
- BSDate
- ABSign
- ABDate
- MortageeNameAddress
- NAmeAddress
- Bname1
- DOB1
- DOB2
- SignOfBorr1
- SignOfBorr
- Date Signed
- SignOfBorr2
- SignOfBorr3
- Date Signed3
- Date Signed4
- MortgageeRepSign
- DirectSign
- DirectSign1
- Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union Off
- AppSign
- AppSign1
- AppSign2
- AppSign3
- Nopage38 Off
- Yespage38 Off
- Yes1 Off
- No1 Off
- Yes2 Off
- Yes3 Off
- Yes4 Off
- Yes5 Off
- Yes6 Off
- Yes7 Off
- Yes8 Off
- Yes9 Off
- Yes10 Off
- No2 Off
- No3 Off
- No4 Off
- No5 Off
- No6 Off
- No7 Off
- No8 Off
- No9 Off
- No10 Off
- BorrowerNo Off
- BorrowerYes Off
- AppSignature
- AppSignature1
- CurrentSign
- CurrentSign1
- InterviewSign
- Yes_1 Off
- No_1 Off
- Yes_2 Off
- No_2 Off
- Mail Off
- Phone Off
[ ][ ][ ]
[ ]
[ ]
[ ]
[ ]
[ ][ ][ ]
( )
( )
( )
[ ] [ ] [ ]
[ ] [ ] [ ] [ ]
[ ]
[ ]
[ ]
( )
( )
( )
( )
( )
( )
[ ] [ ] [ ]
[ ] [ ] [ ]
[ ]
[ ]
[ ]
[ ]
ytra
P ytra
PCustomer Information Worksheet
Loan number
Address of property to be assumed
Reason for assumption ( heck one) [ ]
Divorce Death of original owner Existing owners are selling the home Other
[ ][ ][ ] ___________________________
[ [ [ [
] Spouse Child Parent Other
] ] ] ____________________________
relationship to owners (check one)
Parties to the assumption In the sections below please identify the parties associated with the assumption of the loan This includes
Individuals who will be added to the loan Individuals who are already on the loan and who will remain on the loan Individuals who are already on the loan and who will be removed from the loan
If more than three parties are associated with the assumption please provide the requested information on a separate page and attach it to this worksheet
Name
Par
ty
Current address
Check one Check one New to the loan (being added) Already on the loan and will remain Already on the loan and will be removed
Day phone
Evening phone
Cell phone
Active-duty military Military veteran Neither
Available hours
Available hours
Available hours
Name Current address
Check one Check one New to the loan (being added) Already on the loan and will remain Already on the loan and will be removed Day phone
Evening phone
Cell phone
Active-duty military Military veteran Neither
Available hours
Available hours
Available hours
Name Current address
Check one Check one New to the loan (being added)
Already on the loan and will be removed
Evening phone
Cell phone
Active-duty military Military veteran Neither
Already on the loan and will remain
Day phone Available hours
Available hours
Available hours
Esta comunicacioacuten contiene informacioacuten importante acerca de la cuenta Si tiene alguna pregunta o necesita ayuda para traducirla comuniacutequese con nosotros llamando al 1-855-280-4198
FM142
Uniform Residential Loan ApplicationVerify and complete the information onthis applicationIf you are applying for this loan with others each additional Borrower must provide
information as directed by your Lender
Section 1 Borrower Informationthis section asks about yourpersonal information and your income fromemploymentandother sources such as retirement that you want considered to qualify for this loan
1a Personal Information
Name(First Middle Last Suffix) Social Security Number - -
(orIndividual TaxpayerIdentification Number)
Alternate Names- List any namesby which you are known or any namesunderwhich credit was previously received (First Middle Last Suffix)
Date ofBirth Citizenship(mmddyyyy) USCitizen
copy PermanentResidentAliencopy Non-PermanentResidentAlien
Type of Credit List Name(s) of Other Borrower(s) Applying for this Loan
copy lamapplyingforindividual credit (First Middle Last Suffix) - Use a separator between names
copy |am applyingfor joint credit Total Numberof Borrowers_
Each Borrowerintendsto applyfor joint credit Yourinitials
Marital Status Dependents(notlisted by another Borrower) Contact Information
O Married Number __ Home Phone ( ) -
s SeparatedUnmarried
Ages CellPhone ( ) _7
(Single Divorced Widowed Civil Union Domestic Partnership Registered Work Phone (0) Ext
Reciprocal Beneficiary Relationship) Email
Current Address
Street Unit
City State ZIP Country
How Long at Current Address Years mdashMonths Housing O Noprimary housing expense copy) Own copy Rent($ month)
If at Current Addressfor LESS than 2 yearslist Former Address LC Does not apply
Street Unit
City State ZIP Country
How Long at Former Address Years mdashMonths Housing No primary housing expense Own Rent($ month)
Mailing Address- ifdifferent from CurrentAddress (| Does not apply
Street Unit
City State ZIP Country
easeaoemir ] Does not apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base $_mdashmdashmdashmdash__mdashmonth
City State ZIP Country Overtime =$_________monthBonus $ month
Position orTitle Checkif this statementapplies Commission $ month[] am employedby a family member
propertyseller real estate agent or otherparty to the transaction
TTStartDate0__mdashsmmddyy) MilitaryHow long in this line of work Years mdash_ Months Entitlements $_mdashsmontth
Other $ monthCheckif you are the Business () | have an ownershipshare of less than 25 Monthly Income(or Loss) mdashmdash_mdashOwnerorSelf-Employed O I have an ownership share of 25 or more sect TOTALS__000month
Uniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
1c IF APPLICABLE Complete Information for Additional EmploymentSelf-Employment and Income
Doesnot apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base $ month
City State ZIP Country Overtime mdash$ monthBonus $ month
Position orTitle Checkif this statementapplies Commission $ month| am employedby a family memberproperty seller real estate agent or otherparty to the transaction
Start Date mdash_mdashAA(mmddyyyy) Military
EntitlementsHow long in this line of work lsquoYears mdash_ Months $ month
7 7 Other $ monthCheckif you are the BusinessOwnerorSelf-Employed
| have an ownershipshare ofless than 25 Monthly Income(or Loss)| have an ownership share of 25 or more $ TOTAL $ 000month
PlMeNeeeMeeCee ti)LeeseteUeLimet Does not apply
Provideatleast 2 years of current and previous employment and income
Employeror Business Name Previous Gross Monthly
Street Unit Income $ month
City State ZIP Country
Position orTitleStart Date (mmddyyyy) Checkif you were the Business
Owneror Self-Employedmdash_ mdashEnd Date (mmddyyyy)
WCBeelcaTy Does not apply
Include incomefrom other sources below Under IncomeSource choosefrom the sourceslisted hereraquo Alimony+ Automobile Allowance Boarder Income
+ Capital Gains
Child Support+ Disabilitylaquo Foster Care
laquo Housing or Parsonage
+ Interest and Dividendslaquo Mortgage Credit Certificateraquo MortgageDifferential
Payments
raquo Notes Receivable+ Public Assistance- Retirement
(eg Pension IRA)
laquo Royalty Payments Separate Maintenance+ Social Security
+ Trust
laquo UnemploymentBenefits
laquo VA Compensation
cent Other
NOTEReveal alimony child support separate maintenance or other income ONLYIFyou wantit considered in determining yourqualification
for this loan
IncomeSource -mdash uselist above Monthly Income
$
$
$
Provide TOTAL AmountHere $ 000
Borrower Name
Uniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 2 Financial Information mdash Assets andLiabilities this section asks about things you ownthatare worth moneyand that you wantconsidered to qualify for this loan It then asks about your liabilities (or debts) that you pay
each month suchas credit cards alimony or other expenses
rNcee stLeVaalemities eitimeeecm dellaLC-
Include all accounts below Under Account Typechoosefrom the typeslisted here
laquo Checkinglaquo Savingsraquo Money Market
+ Certificate of Depositlaquo Mutual Fund+ Stocks
laquo Stock Optionslaquo Bonds+raquo Retirement(eg 407k IRA)
laquo Bridge Loan ProceedslaquoIndividual DevelopmentAccount
Trust Account- Cash Value ofLife Insurance(usedfor the transaction)
AccountType- use list above FinancialInstitution Account Number Cash or MarketValue
$
$
$
$
$
$ 000Provide TOTAL AmountHere|
Includeall other assets and credits below UnderAsset or Credit Type choose from the typeslisted here
Assets Credits- Proceeds from Real EstateProperty to be sold on orbefore closing
laquo Proceeds from Sale ofNon-Real Estate Asset
- Secured Borrowed Funds
cent Unsecured Borrowed Funds Other
raquo Earnest MoneylaquoEmployer Assistance- Lot Equity
Relocation Funds_raquo Rent Credit
laquo Sweat Equity+ Trade Equity
Assetor Credit Type mdash uselist above Cash or Market Value
$
$
$
$
$ 000Provide TOTAL AmountHere
2c Liabilities - Credit Cards Other Debts and Leases that You Owe C Does not apply
List all liabilities below (except real estate) and include deferred payments Under Account Type choose from thetypeslisted herelaquoRevolving (eg credit cards) +Installment (eg car student personal loans) Open 30-Day (balance paid monthly) + Lease (not realestate) +Other
Account Type mdashuse list above
To be paid offator before closingCompany Name Account Number Unpaid Balance Monthly Payment
$ $
$ $
$ $
$ $
$ $
2d OtherLiabilities and Expenses Does not apply
Includeall otherliabilities and expenses below Choose from the typeslisted here
+ Alimony Child Support -Separate Maintenance +JobRelatedExpenses +Other Monthly Payment
$
$
$
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 3 Financial Information mdash Real Estatethis section asks youtolist all properties you currently ownand what you owe onthem donot own anyreal estate
3a Property You Own If you are refinancinglist the property you are refinancing FIRST
Address Street Unit
City State ZIP Country
Sol Intended Occupancyinvestment PrimaryResidence SecondHome Other
Monthly InsuranceTaxesAssociation Duesetcifnot included in MonthlyMortgage Payment
For 2-4 Unit Primary or Investment PropertyStatus SoldPending Saleor Retained
=Monthly RentalIncomeProperty Value
$ $ $
Mortgage Loanson this Property Does not apply
MonthlyMortgagePayment
Type FHA VAConventionalUSDA-RD Other|
To be paid offator before closing
Credit Limit(ifapplicable)Creditor Name Account Number Unpaid Balance
$ $ $
$ $ $
3b IF APPLICABLE Complete Information for Additional Property Does not apply
Address Street Unit
City State ZIP Country
ldquoSold Intended Occupancyinvestment PrimaryResidence SecondHome Other
Monthly Insurance TaxesAssociation Duesetcifnot included in MonthlyMortgage Payment
For 2-4 Unit Primary or Investment PropertyStatus SoldPendingSaleor Retained
Monthly RentalIncomeProperty Value
$ $ $
Mortgage Loanson this Property Does not apply
Monthly
Mortgage
Payment
Type FHA VA
Conventional
USDA-RD Other|
To be paid offat
or before closing
Credit Limit
(ifapplicable)Creditor Name Account Number Unpaid Balance
$ $ $
$ $ $
$ $ $
$ $ $
$ $ $
3c IF APPLICABLE Complete Information for Additional Property Does not apply
Address Street Unit
City State ZIP Country
Intended Occupancyinvestment PrimaryResidence SecondHome Other
Monthly Insurance TaxesAssociation Duesetcifnot included in MonthlyMortgage Payment
For 2-4 Unit Primary or Investment PropertyStatus SoldPending Saleor Retained
Monthly RentalIncomeProperty Value
Mortgage Loanson this Property Does not apply
MonthlyMortgagePayment
Type FHA VAConventionalUSDA-RD Other|
To be paid offator before closing
Credit Limit(ifapplicable)Creditor Name Account Number Unpaid Balance
Borrower Name
Uniform Residential Loan Application
Freddie Mac Form 65 +raquo Fannie Mae Form 1003
Effective 12021
Section 4 Loan and Property Informationthis section asks about the loanrsquos purpose and the property youwantto purchase orrefinance
4a Loan and Property Information
LoanAmount $ Loan Purpose Purchase efinance Other(specify)
Property Address Street Unit
City State ZIP County
Numberof Units Property Value $
Occupancy Primary Residence Second Home InvestmentProperty FHA Secondary Residence
1 Mixed-Use PropertyIf you will occupy the propertywill you set aside space within the property to operate
your ownbusiness(eg daycare facility medicaloffice beautybarber shop)NO YES
2 Manufactured HomeIs the property a manufactured home(eg a factory built dwelling built on a permanentchassis) NO YES
4b Other New Mortgage Loansonthe Property Youare Buying or Refinancing Does not apply
LoanAmountAmountto be Drawn
Credit Limit(ifapplicable)Creditor Name Lien Type Monthly Payment
First Lien Subordinate Lien $ $ $
$ $ $First Lien SubordinateLien
4c Rental Income on the Property You Wantto Purchase For Purchase Only Does not apply
Completeif the property is a 2-4 Unit Primary Residence or an Investment Property Amount
Expected Monthly Rental Income $
Doesnot apply4d Gifts or Grants You Have Been GivenorWill Receive for this Loan
Includeall gifts and grants below Under Source choose from the sourceslisted here
Community Nonprofitlaquo Employer
raquo Federal Agencyraquo Local Agency
- Relative+ Religious Nonprofit
+ State Agency+ Unmarried Partner
raquo Lender Other
Asset TypeCash Gift Gift of Equity Grant DepositedNot Deposited Source - uselist above Cash or Market Value
Deposited Not Deposited $
$Deposited Not Deposited
Borrower Name
Uniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 5 DeclarationsThis section asks youspecific questions about the property your funding and yourpastfinancial history
5aAboutthis Property and Your Moneyfor this Loan
A Will you occupy the property as your primary residence
If YES have you had an ownershipinterest 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 investmentproperty(IP)
(2) How did you holdtitle to the property by yourself (S) jointly with your spouse(SP) or jointly with another person (O)
YESYES
B If this is a Purchase Transaction Do you have a family relationship or businessaffiliation with the seller of the property NO YES
C Are you borrowing any moneyforthis real estate transaction (eg money foryour closing costs or down payment) orobtaining any moneyfrom anotherparty such astheseller or realtor that you have notdisclosed on this loan application NO YES
If YES what is the amountof this money $
D 1 Have you orwill you be applying for a mortgage loan on anotherproperty (not the property securing this loan) on or
before closing this transaction that is not disclosed on this loan application
NO YES
2 Have you orwill you be applying for any newcredit (eg installment loan credit card etc) on or before closing this loan that
is not disclosed on this application
No YES
E Will this property be subject to a lien that could take priority over the first mortgagelien such as a clean energylien paid
through yourproperty taxes(eg the PropertyAssessed Clean Energy Program)NO YES
5b About YourFinances
F Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application NO YES
G Are there any outstanding judgments against you No YES
H Areyou currently delinquentor in default on a Federal debt No YES
I Areyou a party to a lawsuit in which you potentially have any personalfinancialliability NO YES
J Have you conveyedtitle to any property in lieu of foreclosure in the past 7 years NO YES
K Within the past 7 years have you completed a pre-foreclosure sale or short sale whereby the property wassold to a
third party and the Lenderagreed to acceptless than the outstanding mortgage balance due
NO YES
L Have you hadproperty foreclosed uponin thelast 7 years NO YES
M Have you declared bankruptcy within the past 7 years ONO YESIf YES identify the type(s) of bankruptcy Chapter7 Chapter11 Chapter12 Chapter 13
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 6 Acknowledgments and AgreementsThis section tells you about yourlegal obligations whenyousign this application
Acknowledgments and Agreements
Definitions- Lenderincludes the Lenderrsquos agents service providers and any oftheir successors andassigns
Other Loan Participantsrdquo includes(i) any actual or potential owners of
a loan resulting from this application (the ldquoLoanrsquo)(ii) acquirers ofany beneficial or other interest in the Loan(iii) any mortgageinsurer(iv) any guarantor (v) any servicer of the Loan and (vi) any of theseparties service providers successors or assigns
I agree to acknowledgeand representthe following
(1) The Complete Informationfor this Application- The information | have providedin this application is true accurate
and completeas of the date | signed this application
laquo If the information | submitted changesor | have new information
before closing of the Loan | must change and supplementthis
application including providing any updatedsupplementedrealestate sales contract
- For purchase transactions The terms and conditionsof anyrealestate sales contract signed by mein connection with this application
are true accurate and complete to the best of my knowledge andbelief | have not entered into any other agreement written ororal inconnection withthis real estate transaction
- The Lender and OtherLoan Participants mayrely on the informationcontainedin the application before and after closing of the Loan
- Any intentional or negligent misrepresentation of information may
result in the impositionof(a) civil liability on me including monetary damagesif a
person suffers any loss because the person relied on anymisrepresentation that | have made onthis application andor
(b) criminal penalties on me including but not limited to fine orimprisonment or both underthe provisions of Federal law(18 USC sectsect 1001 et seq)
(2) The Propertyrsquos SecurityThe Loan | have applied for in this application will be secured by
a mortgage or deedoftrust which provides the Lendera security
interest in the property described in this application
(3) The Propertys Appraisal Value and Condition- Any appraisal or value of the property obtained by the Lenderis
for use by the Lender and OtherLoanParticipantslaquoThe Lender and OtherLoan Participants have not made anyrepresentation or warranty express or implied to me about the
propertyits conditionorits value
(4) Electronic Records and Signatures- The Lender and OtherLoan Participants may keep any paper record
andorelectronic record of this application whether or not the Loan
is approved
BorrowerSignature
- If this application is created as (or converted into) an ldquoelectronicapplicationrdquo | consent to the use of ldquoelectronic recordsrdquo and
ldquoelectronic signaturesrdquo as the termsare defined in and governed byapplicable Federal andorstate electronic transactions laws
| intend to sign and have signedthis application either using my(a) electronic signature or(b) a written signature and agreethatif a paper version ofthis
application is converted into an electronic application theapplication will be an electronic record and the representationof my written signature on this application will be my binding
electronic signature- | agree that the applicationif delivered or transmitted to the Lenderor Other Loan Participants as an electronic record with myelectronicsignaturewill be as effective and enforceable as a paperapplicationsigned by mein writing
(5) Delinquencylaquo The Lender and OtherLoan Participants may report information about
my accountto credit bureaus Late payments missed paymentsorother defaults on my account maybereflected in my credit report andwill likely affect my credit score
- If | have trouble making my payments | understand that | may contacta HUD-approved housing counseling organization for advice about
actions I can take to meet my mortgageobligations
(6) Authorization for Use and Sharing of InformationBy signing belowin addition to the representations and agreementsmade above| expressly authorize the Lender and Other LoanParticipants to obtain use and share with each other(i) the loan
application and related loan information and documentation(ii) aconsumercredit report on me and(iii) my tax return information asnecessary to perform theactionslisted belowfor so long as they havean interest in my loanorits servicing
(a) process and underwrite myloan(b) verify any data contained in my consumercredit 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 analysisandreviews
(e) perform analysis and modeling for risk assessments(f) monitor the accountfor this loan for potential delinquencies and
determineanyassistance that may beavailable to me and
(g) other actions permissible under applicable law
Date (mmddyyyy)
Additional Borrower Signature Date (mmddyyyy)
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 7 Military ServiceThis section asks questions about your(or your deceased spouses) military service
Military Service of Borrower
Military Service mdash Did you (or your deceased spouse) everserve or are you currently serving in the United States Armed Forces NO YES
If YES check allthat apply Currently serving on active duty with projected expiration date of servicetour (mmddyyyy)
Currently retired discharged or separated from service
Only period of service was as a non-activated memberof the Reserve or National GuardSurviving spouse
Section 8 Demographic InformationThis section asks about your ethnicity sex and race
Demographic Information of Borrower
The purposeofcollecting this informationis to help ensure thatall applicants are treated fairly and that the housing needs of communities
and neighborhoodsare beingfulfilled 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 mayselect one or more designationsfor
Ethnicity and one or more designationsfor Race The law provides that we maynotdiscriminate on the basis of this information or onwhetheryou chooseto provideit However if you choose not to provide the information and you have madethis application in person Federal
regulations require us to note your ethnicity sex and race on thebasis of visual observation or surname Thelaw also provides that we may notdiscriminate on the basis of age or marital status information you providein this application If you do not wish to provide someorall of this
information please check below
Ethnicity Check one or more Race Check one or moreHispanic or Latino AmericanIndian or Alaska Native - Print nameofenrolled
or principaltribe Mexican PuertoRican CubanOther Hispanic or Latino - Print origin Asian
Asian Indian Chinese Filipino
Japanese Korean Vietnamese
OtherAsian mdash Print race
For example Hmong Laotian Thai Pakistani Cambodian and so on
Black or African American
Native Hawaiian or OtherPacific Islander
Native Hawaiian GuamanianorChamorro Samoan
For exampleArgentinean Colombian Dominican Nicaraguan
Salvadoran Spaniard andso on
Not Hispanic or Latino
| do not wish to providethis information
5Female OtherPacific Islander mdash Print race
Male For example Fijian Tongan and so on| do not wish to providethis information white
| do not wish to providethis information
Wasthe ethnicity of the Borrowercollected on the basis of visual observation or surname )NO YESWasthe sex of the Borrowercollected on the basis of visual observation or surname NO YESWastherace of the Borrowercollected on the basis of visual observation or surname NO YES
Face-to-Face Interview (includes Electronic Media w Video Component) TelephoneInterview Faxor Mail Email or Internet
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
ReelTemCrCL
Loan Originator Organization Name
Address
Loan Originator Organization NMLSR ID State License ID
Loan Originator Name
Loan Originator NMLSR ID State License ID
Date (mmddyyyy)
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Uniform Residential Loan Application mdash Additional BorrowerVerify and complete the information onthis application as directed by your Lender
Section 1 Borrower Informationthis section asks about yourpersonal information and your income fromemploymentandother sources such as retirement that you want considered to qualify for this loan
1a Personal Information
Name(First Middle Last Suffix)
Alternate Names - List any namesby which you are known or any namesunder which credit was previously received (First Middle Last Suffix)
Social Security Number - -(or Individual TaxpayerIdentification Number)
Dateof Birth Citizenship(mmddyyyy)
USCitizenPermanentResidentAlienNon-Permanent ResidentAlien
Type ofCredit| am applying for individualcredit
lam applying forjoint credit Total Number of Borrowers
Each Borrowerintendsto applyfor joint credit Your initials
List Name(s) of Other Borrower(s) Applying for this Loan
(First Middle Last Suffix) - Use a separator between names
Marital Status Dependents(notlisted by another Borrower)
Contact Information
Married Number _ Home Phone ( ) -
( ) _
( ) -mdash_ mdash_
Separated Ages CellPhone
Unmarried ens Work Phone Ext(Single Divorced WidowedCivil Union Domestic Partnership Registered
Reciprocal Beneficiary Relationship)lsquol
Emal
Current Address
Street Unit
City State ZIP Country
How Long at Current Address=Years mdashMonths Housing Noprimary housing expense Own Rent($ month)
If at Current Address for LESS than 2 yearslist Former Address Does not apply
Street Unit
City State ZIP Country
How Long at Former Address Years mdashMonths Housing Noprimary housing expense Own month)
Mailing Address- ifdifferent from CurrentAddress Does not apply
Street Unit
City State ZIP Country
eeeeCeeteiChuraleCme Doesnot apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base S$month
City State ZIP Country Overtime =$_____monthBonus $ month
Position orTitle Checkif this statementapplies Commission sect month| am employedby a family memberpropertyseller real estate agent or otherparty to the transaction
TTStart Date ____ (mmddyy) Military
Entitlements$_How longin this line of work Years =Months mdash monthSS
Other $ monthCheckif you are the BusinessOwnerorSelf-Employed
| have an ownershipshare ofless than 25 Monthly Income(or Loss) mdashmdash| have an ownership share of 25 or more $ TOTAL $ 000month
Uniform Residential Loan Application mdash Additional Borrower
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
CoeeeMCMCmeticlm tu)Comiteteilteeilelie mieit
Does not apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base
OvertimeBonus
Commission
MilitaryEntitlements
Other
$ month
$ month$ month
$ month
$ month
$ month
City State ZIP Country
Position orTitle ose if this statement applieslam employed by a family memberpropertyseller real estate agent or otherparty to the transaction
Start Date (mmddyy)How long in this line of work Years =Months
Checkif you are the Business
Owneror Self-Employed| have an ownershipshare of less than 25 Monthly Income(or Loss)
Ihave an ownership share of 25 or more $ TOTAL$ 000month
CPONMeeeMummaTestetiersdeere lire miret Does not apply
Provideat least 2 years of current and previous employment and income
Employeror Business Name Previous Gross MonthlyStreet Unit Income s month
City State ZIP Country
Position or Title
Start Date
End Date
Checkif you were the BusinessOwneror Self-Employed
(mmddyyyy)
(mmddyyyy) 1e Income from Other Sources Does not apply
Include incomefrom other sources below Under Income Source choose from the sourceslisted herelaquo Alimonylaquo Automobile Allowanceraquo Boarder Incomelaquo Capital Gains
Child Support+ Disability+ Foster Care Housing or Parsonage
+ Interest and DividendslaquoMortgage Credit Certificate Mortgage DifferentialPayments
laquo Notes Receivable+ Public Assistancelaquo Retirement(eg Pension IRA)
+raquo Royalty Payments Separate Maintenance
+ Social Security
raquo Trust
+ UnemploymentBenefits
laquo VA Compensation
laquo Other
NOTE Revealalimony child support separate maintenance or other income ONLYIFyou wantit considered in determining yourqualification
for this loan
Income Source - uselist above Monthly Income
$
$
$
$ 000Provide TOTAL AmountHere|
Section 2 Financial Information mdash Assets andLiabilities
Myinformation for Section 2 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 3 Financial Information mdash Real Estate
Myinformation for Section 3 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 4 Loan and Property Information
Myinformation for Section 4 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 5 DeclarationsThis section asks you specific questions about the property your funding and your past
financial history
5aAboutthis Property and Your Moneyforthis Loan
A Will you occupy the property as your primary residence NO YES
If YES have you had an ownershipinterest in another property in the last three years NO YES
If YES complete (1) and (2) below
(1)What type of property did you ownprimary residence (PR) FHA secondary residence (SR) second home(SH)
or investmentproperty (IP)
(2) How did you holdtitle to the property by yourself (S) jointly with your spouse(SP) or jointly with another person (O)
B If this is a Purchase Transaction Do you have a family relationship or businessaffiliation with the seller of the property NO YES Cc Are you borrowing any moneyforthis real estate transaction (eg money foryour closing costs or down payment) or
obtaining any moneyfrom anotherparty suchastheselleror realtor that you have not disclosed on this loan application NO YES
If YES whatis the amountof this money $
D 1 Have youorwill you be applying for a mortgage loan on anotherproperty (not the property securing this loan) on orbefore closing this transaction that is not disclosed on this loan application
NO YES
2 Have you orwill you be applying for any newcredit (eg installment loan credit card etc) on or before closing this loan that wsis not disclosed on this application
NO YES
E Will this property be subject to a lien that could take priority over thefirst mortgagelien such as a clean energylien paid
through yourproperty taxes(eg the PropertyAssessed Clean Energy Program)No YES
EK) Veli ellim ait
F Areyou a co-signer or guarantor on any debtor loan thatis not disclosed on this application NO ES
G Are there any outstanding judgments against you NO YES
H Are you currently delinquentor in default on a Federal debt NO YES
I Are you a party to a lawsuit in which you potentially have any personalfinancialliability NO YES
J Have you conveyedtitle to any property in lieu of foreclosure in the past 7 years NO YES
K Within the past 7 years have you completed a pre-foreclosure sale or short sale whereby the property wassold to a
third party and the Lender agreed to acceptless than the outstanding mortgage balance due
No YES
L Have you had property foreclosed uponin thelast 7 years NO YES
M Have you declared bankruptcy within the past 7 years no vESIf YES identify the type(s) of bankruptcy Chapter 7 Chapter11 Chapter12 Chapter 13
Section 6 Acknowledgements and AgreementsMy signature for Section 6 is on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 7 Military Service This section asks questions about your(or your deceased spouses) military service
Military Service of Borrower
Military Service mdash Did you (or your deceased spouse)everserve or are you currently serving in the United States Armed Forces NO YES
IfYES check allthat apply Currently serving on active duty with projected expiration date of servicetour (mmddyyyy)
Currently retired discharged or separated from service nnOnly period of service was as a non-activated memberofthe Reserve or National GuardSurviving spouse
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 8 Demographic InformationThis section asks about your ethnicity sex and race
Demographic Information of Borrower
The purposeofcollecting this information is to help ensure thatall applicants are treated fairly and that the housing needs of communities
and neighborhoodsare beingfulfilled 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 providethis information but are encouraged to do so You mayselect one or more designationsfor
Ethnicity and one or more designationsfor Race The law provides that we maynotdiscriminate onthe basis of this information or onwhetheryou chooseto provideit However if you choose notto provide the information and you have madethis application in person Federal
regulations require us to note yourethnicity sex and race on the basis of visual observation or surname The law also provides that we may notdiscriminate on the basis of age or marital status information you providein this application If you do not wish to provide someorall of this
information please check below
Ethnicity Check one or more Race Check one or moreHispanic or Latino AmericanIndian or Alaska Native - Print nameofenrolled
or principaltribeMexican PuertoRican Cuban
OtherHispanic or Latino - Printorigin siansian Indian Chinese Filipino
For exampleArgentinean Colombian Dominican NicaraguanSalvadoran Spaniard andso on
Japanese Korean VietnameseOtherAsian - Print race Forexample Hmong Laotian Thai Pakistani Cambodian andso on
Black or African American
Native Hawaiian or OtherPacific Islander
Native Hawaiian GuamanianorChamorro Samoan
OtherPacific Islander mdash Print race
Not Hispanic or Latino
| do not wish to providethis information
Sex
Female
Male
| do not wish to providethis informationFor example Fijian Tongan and so on
White
| do not wish to providethis information
Wasthe ethnicity of the Borrowercollected on thebasis of visual observation or surnameWasthesex of the Borrowercollected on the basis of visual observation or surnameWastherace of the Borrowercollected on the basis of visual observation or surname
)NO YESNO YESNO YES
Face-to-Face Interview (includes Electronic Media w Video Component) Telephone Interview Faxor Mail Email or Internet
Loan Originator Organization Name
Address
Loan Originator Organization NMLSR ID State License ID
Loan Originator Name
Loan Originator NMLSR ID State License ID
Email Phone (
Signature Date (mmddyyyy)
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Pe)aae-emeet)
Community Property State
At least one borrowerlives in a community propertystateThe property is in a community property state
Transaction DetailConversion of Contract for Deed or Land ContractRenovationConstruction-ConversionConstruction-to-Permanent
Single-Closing Two-ClosingConstructionImprovementCosts $
LotAcquired Date
Original Cost of Lot $(mmddyyyy)
Refinance Program
Full DocumentationInterest Rate ReductionStreamlined without Appraisal
Other
Refinance Type
NoCash OutLimited Cash OutCash Out
Energy Improvement
Mortgageloanwill finance energy-related improvements
Propertyis currently subject to a lien that could take priority ovethe first mortgagelien such as a clean energylien paid for througproperty taxes(eg the PropertyAssessed Clean Energyprogram)
Project Type Condominium Cooperative Planned Unit Development (PUD) Propertyis notlocatedin a project
Peiwlivcestetece)a)
Title to the Property Will be Held in What Name(s)
For RefinanceTitle to the Property is Currently Held in What Name(s
Trust Information
tle Will be Held byan Inter Vivos (Living) Trust
Title Will be Held by a Land TrustLeasehold Expiration Date
Mannerin WhichTitle Will be Held Indian Country Land Tenure
Sole OwnershipLife EstateTenancy in Common
Joint Tenancywith Right of Survivorship]Tenancybythe EntiretyOther
Fee Simple Ona ReservationIndividualTrust Land (AllottedRestricted)Tribal Trust Land On a ReservationTribal Trust Land Off ReservationAlaska Native Corporation Land
Estate Will be Held in
Fee Simple(mmddyyyy)
3 Mortgage LoanInformation
Termsof Loan
Note Rate
Loan Term (months)
MortgageLien Type
First LienSubordinate Lien
Mortgage Type Applied For
Conventional USDA-RDFHA VA Other
Amortization Type
Fixed RateAdjustable Rate
If Adjustable Rate
Initial Period Prior to First Adjustment
Subsequent AdjustmentPeriod
Proposed Monthly Paymentfor Property
First Mortgage (P amp I) $
Subordinate Lien(s) (P amp |) $
Other(explain)
Homeowners Insurance $(months)
(months)
Loan Features Property Taxes $
Balloon Balloon Term (months)
Interest Only Interest OnlyTermNegative AmortizationPrepaymentPenalty Prepayment Penalty Term (months) Other
Temporary Interest Rate BuydownInitial Buydown Rate TOTALOther(explain)
Mortgage Insurance $
AssociationProject Dues (Condo Co-Op PUD) $
Supplemental Property Insurance $
(months)
Borrower Name(s)Uniform Residential Loan Application mdash LenderLoan Information
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
L4 Qualifying the Borrower - Minimum Required Funds or Cash Back
DUEFROM BORROWER(S)
A Sales Contract Price
B Improvements Renovations and Repairs
C Land(ifacquired separately)
D For Refinance Balance of Mortgage Loanson the Propertyto be paid off in the Transaction
(See Table 3a Property You Own)
E Credit Cards and Other Debts Paid Off
(See Table 2c Liabilities mdash Credit Cards Other Debts and Leases that You Owe)
F BorrowerClosing Costs (including Prepaid andInitial Escrow Payments)
G Discount Points
HTOTAL DUE FROM BORROWER(s)(Total of A thru G)
TOTALMORTGAGE LOANS
Loan Amount
Loan AmountExcluding Financed Mortgage Insurance (or Mortgage Insurance Equivalent) $
Financed Mortgage Insurance (or Mortgage Insurance Equivalent) Amount $
Other New Mortgage Loanson the Property the Borrower(s) is Buying or Refinancing(See Table 4b Other New MortgageLoanson the Property You are Buying or Refinancing)
KTOTAL MORTGAGELOANS(Totalof| and J)
TOTALCREDITS
L Seller Credits (Enter the amountofBorrower(s) costs paid by the property seller)
MOtherCredits (Enter the sum ofall other credits mdash BorrowerPaid Fees Earnest Money EmployerAssistedHousing Lease Purchase Fund Lot Equity Relocation Funds Sweat Equity Trade Equity Other)
NTOTAL CREDITS(Total of L and M)
CALCULATION
TOTAL DUE FROM BORROWER(s)(Line H)
LESSTOTAL MORTGAGELOANS(Line K) AND TOTAL CREDITS(Line N)
Cash FromTothe Borrower(Line H minusLine K and Line N)NOTE This amountdoesnotinclude reservesor other funds that may be required by the Lenderto be verified
Borrower Name(s)Uniform Residential Loan Application mdash LenderLoan Information
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
Uniform Residential Loan Application mdash Unmarried Addendum
eeCeceetatimC elitleeComeLy
Lenders Instructions for Using the Unmarried Addendum
The Lender may use the Unmarried Addendum only when a Borrowerselected ldquoUnmarriedrdquoin Section 1 and the information collected is
necessary to determine howState property lawsdirectly or indirectly affecting creditworthiness apply including ensuring clear title
For example the Lender may use the Unmarried Addendum whentheBorrowerresides in a State that recognizescivil unions domestic
partnerships or registered reciprocal beneficiary relationships or when the property is located in such a State ldquoStaterdquo meansanystate the
District of Columbia the Commonwealth of Puerto Rico or anyterritory or possession of the United States
Ifyou selected ldquoUnmarriedrdquoin Section 1 is there a person whois not your legal spouse but whocurrently has real property rights similar to
those of a legal spouse +=) NOQ YES
If YES indicate the type of relationship and the State in which the relationship was formed For example indicate if you are in a
civil union domestic partnership registered reciprocal beneficiary relationship or other relationship recognized by the State in which you
currently reside or where the property is located
O Civil Union copy Domestic Partnership copy Registered Reciprocal Beneficiary Relationship copy) Other(explain)
Statea]
Borrower NameUniform Residential Loan Application mdash Unmarried Addendum
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Uniform Residential Loan Application mdash Continuation Sheet
Use this continuation sheet if you need more space to complete the Uniform Residential Loan Application
Borrower Name(First Middle Last Suffix )
Additional Information
Additional Borrower Name(First Middle Last Suffix )
Additional Information
IWefully understand thatit is a federal crime punishable by fine or imprisonment or both to knowingly make anyfalse statements concerningany of the abovefacts as applicable underthe provisions of federal law (18 USC sectsect 1001 et seq)
BorrowerSignature Date (mmddyyyy)
Additional Borrower Signature Date (mmddyyyy)
Uniform Residential Loan Application mdash Continuation SheetFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
INSTRUCTIONS FOR COMPLETING THE UNIFORM RESIDENTIAL LOAN APPLICATION
Use the instructions below to complete the enclosed Uniform Residential Loan Application (Freddie Mac Form 65Fannie Mae Form 1003) To avoid any delays in your application review please provide all of the requested information
If you need to make a correction on the application draw a line through the incorrect text and mark your initials beside the change Donrsquot use correction tape or fluid The application must be completed signed and dated in ink
The Uniform Residential Loan Application (URLA)
The URLA contains the following sections Section 1 Borrower Information Please provide your personal information income and employment
Section 2 Financial Information ndash Assets and Liabilities Please provide information about your financial assets personal financial obligations and debts you owe
Section 3 Financial Information ndash Real Estate Please provide information about property you own and the debts and expenses related to the property
Section 4 Loan and Property Information Please provide information about the loan purpose and the property you are buying or refinancing
Section 5 Declarations Please answer questions about the property how the property will be financed and your past financial history
Section 6 Acknowledgments and Agreements Informs you of your legal obligations related to the mortgage application and asks that you acknowledge certain information will be obtained used and shared
Section 7 Military Service Please provide information about your (or your deceased spousersquos) military service
Section 8 Demographic Information Requests information the Lender is required by law to ask you
Section 9 Loan Originator Information Will be completed by Chase
Uniform Residential Loan Application ndash Additional Borrower
The URLA ndash Additional Borrower contains the following sections Section 1 Borrower Information This is the same as the Borrower Information section of the URLA
Section 2 Financial Information ndash Assets and Liabilities Contains only the following statement for the additional Borrower to complete ldquoMy information for Section 2 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo The name of the other borrower is entered here
Complete a separate URLA for each BorrowermiddotThree or more Borrowers ndash Use any combination of URLA and URLA-Additional Borrower forms in accordance with the above examples
Section 3 Financial Information ndash Real Estate Contains only the following statement for the additional borrower to complete ldquoMy information for Section 3 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 4 Loan and Property Information Contains only the following statement for the additional borrower to complete ldquoMy information for Section 4 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 5 Declarations This is the same as the Declarations section of the URLA
Section 6 Acknowledgments and Agreements Contains only the following statement for the additional borrower to complete ldquoMy signature for Section 6 is on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 7 Military Service This is the same as the Military Service section of the URLA
Section 8 Demographic Information This is the same as the Demographic Information section on the URLA
Section 9 Loan Originator Information This is the same as the Loan Originator Information section of the URLA
Using the URLA and URLA ndash Additional Borrower Together The URLA and the URLA ndash Additional Borrower are used together to collect information for two Borrowers who have joint assets liabilities andor real estate information The URLA and URLA ndash Additional Borrower can also be used for Borrowers who do not have joint information but wish to combine their information on the URLA for ease of use Here are examples of how to use the URLA and URLA ndash Additional Borrower
For one borrower Complete the URLA
For two borrowers with joint financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you dont need to duplicate them on more than one URLA or o In cases where Borrowers are not collaborating when completing the loan application
joint assets liabilities and real estate may be duplicated on each URLA bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you do not need to duplicate them on more than one URLA or
o In cases where Borrowers are not collaborating when completing the loan application joint assets liabilities and real estate may be duplicated on each URLA
For two borrowers with separate financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower Report the assets liabilities and
real estate for the additional Borrower on the URLA or bull Complete a separate URLA for each Borrower
For three or more borrowers use any combination of URLA and URLA ndash Additional Borrower forms described for two borrowers
Uniform Residential Loan Application ndash Unmarried Addendum If any borrower listed on the URLA or URLA ndash Additional Borrower form selects Unmarried in Section 1 (Personal Information) the lender will complete this optional form
The information must be collected to determine how to apply state property laws that directly or indirectly affect creditworthiness including ensuring clear title
Uniform Residential Loan Application ndash Continuation Sheet Use the URLA ndash Continuation Sheet if you need more space to complete either the URLA or URLA ndash Additional Borrower forms
99177-URLAI-0215
HUD Addendum to Uniform Residential Loan Application OMB Approval No HUD 2502-0059 (exp )
Part I - Identifying Information HUDFHA Application for Insurance under the National Housing Act and Borrower Certification
FHA Case No (include any suffix) Mortgagee Case No
Mortgagee ID Sponsor ID Agent ID
Mortgagee Name Address (include ZIP Code) and Telephone Number
Type or print all entries clearly
Name and Address of Sponsor Name and Address of Agent
Borrowers Name amp Present Address (include ZIP Code) Property Address (include name of subdivision lot amp block no amp ZIP Code)
Sponsored Originations
Name of Third-Party Originator NMLS ID of Third-Party Originator
Part II - Borrower Consent for Social Security Administration to Verify Social Security Number I authorize the Social Security Administration (SSA) to verify my Social Security Number (SSN) to the Mortgagee and HUDFHA I authorize SSA to provide explanatory
information to HUDFHA in the event of a discrepancy This consent is valid for 180 days from the date signed unless indicated otherwise by the individual(s) named in this
loan application
Signature(s) of Borrower(s) - Read consent carefully Review accuracy of Social Security Number(s) provided on this application
Borrowerrsquos NameDate of BirthSocial Security Number
Co-Borrowerrsquos Name Date of BirthSocial Security Number
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
Part III - Borrower Notices Information and Acknowledgment Public Reporting Burden
Public reporting burden for this collection of information is estimated to average 10 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 conduct or sponsor and a person is not
required to respond to a collection of information unless that collection displays a valid OMB control number which can be located on the OMB Internet page at
httpwwwreginfogovpublicdoPRAMain
Privacy Act Information
The information requested on the Uniform Residential Loan Application and this Addendum is authorized by the National Housing Act of 1934 12 USC sect 1701 et seq The Debt
Collection Act of 1982 Pub L 97-365 and HUDrsquos Housing and Community Development Act of 1987 42 USC sect 3543 require persons applying for a federally insured loan to
furnish their SSN You must provide all the requested information including your SSN HUD may conduct a computer match to verify the information you provide HUD may
disclose certain information to Federal State and local agencies when relevant to civil criminal or regulatory investigations and prosecutions It will not otherwise be disclosed or
released outside of HUD except as required and permitted by law The information will be used to determine whether you qualify as a mortgagor Failure to provide any of the
requested information including SSN may result in disapproval of your loan application This is notice to you as required by the Right to Financial Privacy Act of 1978 that
HUDFHA has a right of access to financial records held by financial institutions in connection with the consideration or administration of assistance to you Financial records
involving your transaction will be available to HUDFHA without further notice or authorization but will not be disclosed or released by the institution to another Government Agency
or Department without your consent except as required or permitted by law
WARNING This warning applies to all certifications made in this document Anyone who knowingly submits a false claim or makes false statements is subject to criminal and civil penalties including confinement for up to 5 years fines and civil penalties 18 USC sectsect 287 1001 and 31 USC sect 3729
orm HUD-92900-A ( ) Page 1
Borrower Name ____________________________ FHA Case No __________________
Caution Delinquencies Defaults Foreclosures and Abuses Delinquencies defaults foreclosures and abuses of mortgage loans involving programs of the Federal Government can be costly and detrimental to your credit now and in the future The Mortgagee in this transaction its agents and assigns as well as the Federal Government its agencies agents and assigns are authorized to take any and all of the following actions in the event loan payments become delinquent on the mortgage loan described in the attached application (1) Report your name and account information to a credit bureau (2) Assess additional interest and penalty charges for the period of time that payment is not made (3) Assess charges to cover additional administrative costs incurred by the Federal Government to service your account (4) Offset amounts owed to you
under other Federal programs (5) Refer your account to a private attorney collection agency or mortgage servicing agency to collect the amount due foreclose
the mortgage sell the property and seek judgment against you for any deficiency (6) Refer your account to the Department of Justice (DOJ) for litigation in the
courts (7) If you are a current or retired Federal employee take action to offset your salary or civil service retirement benefits (8) Refer your debt to the Internal
Revenue Service for offset against any amount owed to you as an income tax refund and (9) Report any resulting written off debt of yours to the Internal Revenue Service as your taxable income All of these actions may be used to recover any debts owed when it is determined to be in the interest of the Mortgagee or Federal Government or both
As a mortgage loan borrower you will be legally obligated to make the mortgage payments called for by your mortgage loan contract The fact that you dispose of your property after the loan has been made will not relieve you of liability for making these payments Payment of the loan in full is ordinarily the way liability on a mortgage note is ended Some home buyers have the mistaken impression that if they sell their homes when they move to another locality or dispose of it for any other reasons they are no longer liable for the mortgage payments and that liability for these payments is solely that of the new owners Even though the new owners may agree in writing to assume liability for your mortgage payments this assumption agreement will not relieve you from liability to the holder of the note which you signed when you obtained the loan to buy the property Unless you are able to sell the property to a buyer who is acceptable to HUDFHA who will assume the payment of your obligation to the lender you will not be relieved from liability to repay any claim which HUDFHA may be required to pay your lender on account of default in your loan payments The amount of any such claim payment may be a debt owed by you to the Federal Government and subject to established collection procedures
Fair Housing Act I and anyone acting on my behalf are and will remain in compliance with the Fair Housing Act 42 USC sect 3604 et seq with respect to the dwelling or property covered by the loan and in the provision of services or facilities in connection therewith I recognize that any restrictive covenant on this property related to race color religion sex disability familial status or national origin is unlawful under the Fair Housing Act and unenforceable I further recognize that in addition to administrative action by HUD a civil action may be brought by the DOJ in any appropriate US court against any person responsible for a violation of the
applicable law
Certification and Acknowledgment All information in this application is given for the purpose of obtaining a loan to be insured under the National Housing Act and the information in the Uniform Residential Loan Application and this Addendum is true and complete to the best of my knowledge and belief Verification may be obtained from any source named herein I have read and understand the foregoing concerning my liability on the loan and Part III Borrower Notices Information and Acknowledgment
Signature(s) of Borrower(s) - Do not sign unless this application is fully completed Read the certification carefully and review accuracy of this application
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
orm HUD-92900-A ( Page 2
___________________________________
______________________________________________________
______________________________________________________________
- - - - - - - - - - - - - - - - - - - - - - -
Borrower Name ____________________________ FHA Case No __________________
Part IV - Direct Endorsement Approval for a HUD FHA-Insured Mortgage A Underwriting the Borrower
Date Mortgage Approved ______________________________ Date Approval Expires ______________________
For mortgages rated as an ldquoacceptrdquo or ldquoapproverdquo by FHAs TOTAL Mortgage Scorecard
The information submitted to TOTAL was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA4e Final Underwriting Decision (TOTAL) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee Representative Signature
Printed Name
Title
OR
For mortgages rated as a ldquoreferrdquo by FHAs TOTAL Mortgage Scorecard or manually underwritten by a Direct Endorsement underwriter I have personally reviewed and underwritten the borrowerrsquos credit application The information used to underwrite the borrower was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA5d Final Underwriting Decision (Manual) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
B Underwriting the Property
For all mortgages where FHA requires an appraisal I have personally reviewed and underwritten the appraisal according to FHA requirements I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
orm HUD-92900-A ( ) Page 3
Borrower Name ____________________________ FHA Case No __________________
Part V Mortgagees Certification
I have personally reviewed the mortgage documents and the application for insurance endorsement and This mortgage complies with SF Handbook 40001 Section IIA7 Post-Closing and Endorsement to the extent that no defect exists that would have changed the decision to endorse or submit the mortgage for insurance
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee
Name of Mortgageersquos Representative
Title of Mortgageersquos Representative
Signature of the Mortgageersquos Representative Date
orm HUD-92900-A ( ) Page 4
GENERAL AUTHORIZATION FOR A MORTGAGE LOAN ASSUMPTION
Applicant name(s)
Loan number
NOTICES AND DISCLOSURES
Non-discriminatory underwriting guidelines Anyone who inquires about the availability of credit from us has the right to receive a copy of our non-discriminatory underwriting guidelines To request a copy of these guidelines contact your Loan Processor
Attorney note Itrsquos the responsibility of our attorneys to protect our interest You may at your expense request an attorney to represent your interest
Notice to HUDFHA applicants As required by the Right to Financial Privacy Act of 1978 this notice is to inform you that the US Department of Housing and Urban Development (HUD)Federal Housing Administration (FHA) has a right of access to financial records held by financial institutions related to a request for assistance Financial records involving your assumption will be available to HUDFHA without further notice or authorization but wonrsquot be disclosed or released by us to another government agency or department without your consent except as required or permitted by law
Borrower consent to the use of tax return information I understand acknowledge and agree that the Lender and Other Loan Participants can obtain use and share tax return information for purposes of (i) providing an offer (ii) originating maintaining managing monitoring servicing selling insuring and securitizing a loan (iii) marketing or (iv) as otherwise permitted by applicable laws including state and federal privacy and data security laws The Lender includes the Lenderrsquos affiliates agents service providers and any of aforementioned partiesrsquo successors and assigns The Other Loan Participants includes any actual or potential owners of a loan resulting from your loan application or acquirers of any beneficial or other interest in the loan and mortgage insurer guarantor any servicers or service providers for these parties and any of aforementioned partiesrsquo successors and assigns
CERTIFICATION AND AUTHORIZATION
Environmental certification By signing below I represent and warrant that Irsquom not aware of any substances materials or products that may be an environmental hazard such as but not limited to asbestos formaldehyde radon gas lead-based paint fuel or chemical storage tanks (above or below ground) and contaminated soil or water on the property I acknowledge that Chase is relying on this representation and warranty as a material part of its loan application process I also am not aware of any landfill on any portion of the property
Exceptions to the above I further acknowledge (1) receipt of applicable disclosures from the seller in purchase transactions (2) that lead-based paint may exist in housing constructed prior to 1978 (3) that Chase performs no environmental investigation on my behalf and isnrsquot responsible for identifying lead-based paint or any other environmental conditions that might impact the property or its residents and (4) that it is my sole obligation to investigate for potential impact to the property from environmental conditions
Certifications I certify by signing below that (1) all of the loan application information provided is true and complete (2) I understand any intentional or negligent misrepresentation(s) of the information provided in conjunction with my application may result in civil liability andor 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 Chase its agents successors and assigns insurers and any other person who may suffer any loss due to reliance upon any misrepresentation that I have made on the application and (3) any significant change from the information provided at the time of application until the final loan application is signed may have a bearing on the approval of my application for a home loan
Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union
This question is asked because of state laws that extend the same or similar rights benefits and protections of spouses in a marriage to persons who are members of a partnership or union recognized under state law You should consult with your own legal advisor for advice regarding the rights protections benefits responsibilities obligations and duties of those who are registered domestic partners civil union partners or members of other unions recognized under applicable law
CREDIT AUTHORIZATION RELEASE
By signing below I authorize Chase andor my mortgage insurer (if any) to verify my past and present employment earnings records (including information contained in income tax returns that have been filed with the IRS) bank accounts stock holdings and any other information that it finds necessary to process my mortgage loan application or to review it for quality-control purposes I understand that a credit report will be ordered from a credit reporting agency for verification prior to loan closing as part of the application process and may be ordered after closing as part of the Lenderrsquos quality-control program A credit report may also be completed as part of the Lenderrsquos servicing or collection of the loan or in consideration of any other product or service that the Lender may consider offering me in the future and at any time throughout the life of the loan I understand that use of a photocopy of this form may be necessary to verify one or more of my credit references I understand that a photocopy or fax copy of this form will also serve as authorization
By signing below each applicant acknowledges (1) making the above certifications and authorizations and (2) that each applicant has received and understands the above notices and disclosures
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
You do not have to give us this information but if you donrsquot your application for approval as a borrower may be delayed or rejected The information requested in this form is authorized by Title 38 USC Chapter 37 (if VA) by 12 USC Section 1701 et seq (if HUDFHA) by 42 USC Section 1452b (if HUDCPD) and Title 42 USC 1471 et seq or 7 USC 1921 et seq (if USDA FHA)
Updated December 2021 99177-GA-0215
1b
2b
Form 4506-C (September 2020)
Department of the Treasury - Internal Revenue Service
IVES Request for Transcript of Tax Return OMB Number
1545-1872
Do not sign this form unless all applicable lines have been completed Request may be rejected if the form is incomplete or illegible
For more information about Form 4506-C visit wwwirsgov and search IVES
1a Name shown on tax return (if a joint return enter the name shown first)
First social security number on tax return individual taxpayer identification number or employer identification number (see instructions)
2a If a joint return enter spousersquos name shown on tax return Second social security number or individual taxpayer identification number if joint tax return
3 Current name address (including apt room or suite no) city state and ZIP code (see instructions)
4 Previous address shown on the last return filed if different from line 3 (see instructions)
5a IVES participant name address and SOR mailbox ID
DataVerify 875 Greentree Rd 8 Parkway Center Pittsburgh PA 15220
5b Customer file number (if applicable) (see instructions)
Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing (see instructions)
6 Transcript requested Enter the tax form number here (1040 1065 1120 etc) and check the appropriate box below Enter only one tax form number per request 1040
a Return Transcript which includes most of the line items of a tax return as filed with the IRS A tax return transcript does not reflect changes made to the account after the return is processed Transcripts are only available for the following returns Form 1040 series Form 1065 Form 1120 Form 1120-A Form 1120-H Form 1120-L and Form 1120S Return transcripts are available for the current year and returns processed during the prior 3 processing years
b Account Transcript which contains information on the financial status of the account such as payments made on the account penalty assessments and adjustments made by you or the IRS after the return was filed Return information is limited to items such as tax liability and estimated tax payments Account transcripts are available for most returns
c Record of Account which provides the most detailed information as it is a combination of the Return Transcript and the Account Transcript Available for current year and 3 prior tax years
7 Form W-2 Form 1099 series Form 1098 series or Form 5498 series transcript The IRS can provide a transcript that includes data from these information returns State or local information is not included with the Form W-2 information The IRS may be able to provide this transcript information for up to 10 years Information for the current year is generally not available until the year after it is filed with the IRS For example W-2 information for 2016 filed in 2017 will likely not be available from the IRS until 2018 If you need W-2 information for retirement purposes you should contact the Social Security Administration at 1-800-772-1213
Caution If you need a copy of Form W-2 or Form 1099 you should first contact the payer To get a copy of the Form W-2 or Form 1099 filed with your return you must use Form 4506 and request a copy of your return which includes all attachments
8 Year or period requested Enter the ending date of the tax year or period using the mmddyyyy format (see instructions)
12 31 2020 12 31 2019 12 31 2018 Caution Do not sign this form unless all applicable lines have been completed
Signature of taxpayer(s) I declare that I am either the taxpayer whose name is shown on line 1a or 2a or a person authorized to obtain the tax information requested If the request applies to a joint return at least one spouse must sign If signed by a corporate officer 1 percent or more shareholder partner managing member guardian tax matters partner executor receiver administrator trustee or party other than the taxpayer I certify that I have the authority to execute Form 4506-C on behalf of the taxpayer Note This form must be received by IRS within 120 days of the signature date
Signatory attests that heshe has read the attestation clause and upon so reading declares that heshe has the authority to sign the Form 4506-C See instructions
Sign Here
Signature (see instructions) Date Phone number of taxpayer on line 1a or 2a
PrintType name
Title (if line 1a above is a corporation partnership estate or trust)
Spousersquos signature Date
PrintType name
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020) For Privacy Act and Paperwork Reduction Act Notice see page 2
Instructions for Form 4506-C IVES Request for Transcript of Tax Return
Section references are to the Internal Revenue Code unless otherwise noted
Future Developments
For the latest information about Form 4506-C and its instructions go to wwwirsgov and search IVES Information about any recent developments affecting Form 4506-C (such as legislation enacted after we released it) will be posted on that page
Whats New Form 4506-C was created to be utilized by authorized IVES participants to order tax transcripts with the consent of the taxpayer
General Instructions
Caution Do not sign this form unless all applicable lines have been completed
Designated Recipient Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information received pursuant to the taxpayerrsquos consent and holds the recipient subject to penalties for any unauthorized access other use or redisclosure without the taxpayerrsquos express permission or request
Taxpayer Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information provided pursuant to your consent and holds the recipient subject to penalties brought by private right of action for any unauthorized access other use or redisclosure without your express permission or request
Purpose of form Use Form 4506-C to request tax return information through an authorized IVES participant You will designate an IVES participant to receive the information on line 5a
Note If you are unsure of which type of transcript you need check with the party requesting your tax information
Where to file The IVES participant will fax Form 4506-C with the approved IVES cover sheet to their assigned Service Center
Chart for ordering transcripts
If your assigned Service Center is
Fax the requests with the approved coversheet to
Austin Submission Processing Center
Austin IVES Team
844-249-6238
Fresno Submission Processing Center
Fresno IVES Team
844-249-6239
Kansas City Submission Processing Center
Kansas City IVES Team
844-249-8128
Ogden Submission Processing Center
Ogden IVES Team
844-249-8129
Specific Instructions
Line 1b Enter the social security number (SSN) or individual taxpayer identification number (ITIN) for the individual listed on line 1a or enter the employer identification number (EIN) for the business listed on line 1a
Line 3 Enter your current address If you use a PO box include it on this line
Line 4 Enter the address shown on the last return filed if different from the address entered on line 3
Note If the addresses on lines 3 and 4 are different and you have not changed your address with the IRS file Form 8822 Change of Address or Form 8822-BChange of Address or Responsible Party mdash Business with Form 4506-C
Line 5b Enter up to 10 numeric characters to create a unique customer file number that will appear on the transcript The customer file number cannot contain an SSN ITIN or EIN Completion of this line is not required
Note If you use an SSN name or combination of both we will not input the information and the customer file number will reflect a generic entry of 9999999999 on the transcript
Line 8 Enter the end date of the tax year or period requested in mmddyyyy format This may be a calendar year fiscal year or quarter Enter each quarter requested for quarterly returns Example Enter 12312018 for a calendar year 2018 Form 1040 transcript
Signature and date Form 4506-C must be signed and dated by the taxpayer listed on line 1a or 2a The IRS must receive Form 4506-C within 120 days of the date signed by the taxpayer or it will be rejected Ensure that all applicable lines including lines 5a through 8 are completed before signing
You must check the box in the signature area to acknowledge you have the authority to sign and request the information The form will not be processed if unchecked
Individuals Transcripts listed on on line 6 may be furnished to either spouse if jointly filed Only one signature is required Sign Form 4506-C exactly as your name appeared on the original return If you changed your name also sign your current name
Corporations Generally Form 4506-C can be signed by
(1) an officer having legal authority to bind the corporation (2) any person designated by the board of directors or other governing body or (3) any officer or employee on written request by any principal officer and attested to by the secretary or other officer A bona fide shareholder of record owning 1 percent or more of the outstanding stock of the corporation may submit a Form 4506-C but must provide documentation to support the requesters right to receive the information
Partnerships Generally Form 4506-C can be signed by any person who was a member of the partnership during any part of the tax period requested on line 8
All others See section 6103(e) if the taxpayer has died is insolvent is a dissolved corporation or if a trustee guardian executor receiver or administrator is acting for the taxpayer
Note If you are Heir at law Next of kin or Beneficiary you must be able to establish a material interest in the estate or trust
Documentation For entities other than individuals you must attach the authorization document For example this could be the letter from the principal officer authorizing an employee of the corporation or the letters testamentary authorizing an individual to act for an estate
Signature by a representative A representative can sign Form 4506-C for a taxpayer only if the taxpayer has specifically delegated this authority to the representative on Form 2848 line 5 The representative must attach Form 2848 showing the delegation to sign Form 4506-C
Privacy Act and Paperwork Reduction Act Notice We ask for the information on this form to establish your right to gain access to the requested tax information under the Internal Revenue Code We need this information to properly identify the tax information and respond to your request You are not required to request any transcript if you do request a transcript sections 6103 and 6109 and their regulations require you to provide this information including your SSN or EIN If you do not provide this information we may not be able to process your request Providing false or fraudulent information may subject you to penalties
Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and cities states the District of Columbia and US commonwealths and possessions for use in administering their tax laws We may also disclose this information to other countries under a tax treaty to federal and state agencies to enforce federal nontax criminal laws or to federal law enforcement and intelligence agencies to combat terrorism
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law Generally tax returns and return information are confidential as required by section 6103
The time needed to complete and file Form 4506-C will vary depending on individual circumstances The estimated average time is
Learning about the law or the form 10 min Preparing the form 12 min Copying assembling and sending the form to the IRS 20 min
If you have comments concerning the accuracy of these time estimates or suggestions for making Form 4506-C simpler we would be happy to hear from you You can write to
Internal Revenue Service Tax Forms and Publications Division 1111 Constitution Ave NW IR-6526 Washington DC 20224
Do not send the form to this address Instead see Where to file on this page
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020)
Rev April 2021 CHASEO Facts What does Chase do with your personal information
Why Financial companies choose how they share your personal information Federal law gives consumers the right to limit some but not all sharing Federal law also requires us to tell you how we collect share and protect your personal information Please read this notice carefully to understand what we do
What The types of personal information we collect and share depend on the product or service you have with us This information can include bull Social Security number and income bull account balances and transaction history bull credit history and payment history
How All financial companies need to share customers personal information to run their everyday business In the section below we list the reasons financial companies can share their customers personal information the reasons Chase chooses to share and whether you can limit this sharing
Reasons we can share your personal information Does Chase share
Can you limit this sharing
For our everyday business purposes - such as to process your transactions maintain your account(s) respond to court orders and legal investigations or report to credit bureaus
Yes No
For our marketing purposes - to offer our products and services to you
Yes No
For joint marketing with other financial companies Yes No
For our affiliates everyday business purposes - information about your transactions and experiences
Yes No
For our affiliates everyday business purposes - information about your creditworthiness
Yes Yes
For our affiliates to market to you Yes Yes
For nonaffiliates to market to you Yes Yes
a
0
To limit our sharing
bull Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
bull Visit us online chasecomprivacypreferences
Please note If you are a new customer we can begin sharing your information 30 days from the date we sent this notice When you are no longer our customer we continue to share your information as described in this notice However you can contact us at any time to limit our sharing
Questions
Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
PAGE 2
Who we are
Who is providing this notice The US consumer financial companies within the JPMorgan Chase amp Co family including JPMorgan Chase Bank NA Chase Insurance Agency Inc and JP Morgan Securities LLC
What we do
How does Chase protect my To protect your personal information from unauthorized access and use we personal information use security measures that comply with federal law These measures include
computer safeguards and secured files and buildings We authorize our employees to get your information only when they need it to do their work and we require companies that work for us to protect your information
How does Chase collect my We collect your personal information for example when you personal information bull open an account or make deposits or withdrawals from your account
bull pay your bills or apply for a loan bull use your credit or debit card We also collect your personal information from others such as credit bureaus affiliates or other companies
Why cant I limit all sharing Federal law gives you the right to limit only bull sharing for affiliates everyday business purposes - information about your
creditworthiness bull affiliates from using your information to market to you bull sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing See below for more on your rights under state law
What happens when I limit sharing for an account I hold jointly with someone else
Your choices will apply to everyone on your account
Definitions
Affiliates Companies related by common ownership or control They can be financial and non financial companies bull Our affiliates include companies with a Chase or JP Morgan name and financial companies such asjP Morgan Securities LLC
Nonaffiliates Companies not related by common ownership or control They can be financial and non financial companies bull Nonaffiliates we share with can include companies such as retailers auto dealers auto makers and membership clubs
Joint marketing A formal agreement between nonaffiliated financial companies that together market financial products or services to you bull Our joint marketing partners include categories of companies such as insurance companies
Other important information
VT Accounts with a Vermont mailing address are automatically treated as if they have limited the sharing as described on page 1 For joint marketing we will only disclose your name contact information and information about your transactions
NV We are providing you this notice pursuant to Nevada law If you prefer not to receive marketing calls from us you may be placed on our Internal Do Not Call List by calling 1-800-945-9470 or by writing to us at PO Box 734007 Dallas TX 75373-4007
For more information contact us at the address above or email PrivacylnfoJPMChasecom with Nevada Annual Notice in the subject line You may also contact the Nevada Attorney Generals office Bureau of Consumer Protection Office of the Nevada Attorney General 555 E Washington St Suite 3900 Las Vegas NV 89101 telephone number 1-702-486-3132 email BCPINFOagstatenvus
CA Accounts with a California mailing address are automatically treated as if they have limited the sharing with nonaffiliates as described on page 1 CA residents are provided a CA notice for additional choices
CHASE O
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
The following disclosure is required by the USA PATRIOT Act
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 opens an account
What this means to you When you 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 drivers
license or other identifying documents
99177-PAT-0215
VETERAN STATEMENT When this loan was opened the US Department of Veterans Affairs (VA) used the veteran borrowerrsquos entitlement which is a set amount the VA promises to repay a lender if the borrower defaults on the mortgage An assumption will modify who is obligated to pay the existing mortgage loan but all loan termsmdashincluding the entitlementmdashwill remain the same If the veteran borrower is being removed from the loan the entitlement would remain with whoever is assuming the loan because the loan will continue to be serviced by the VA If the applicant is also a veteran and can substitute his or her entitlement for the current entitlement then the current borrowerrsquos entitlement can be released
Please review the following questions and answer as appropriate This form requires completion by both the applicant(s) and current borrower(s)
1 Applicant to Complete
Are you (the applicant) currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the reverse side)
Yes (If yes please provide the information requested below answer the question in section 3 and sign and date this form at the bottom of the reverse side)
Name of applicant(s) who answered ldquoyesrdquo to the above question
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Are you receiving VA disability benefts
Applicant
Yes
No
Co-Applicant
Yes
No
Are you entitled to receive VA disability benefts Yes No Yes No
Have you received VA disability benefts in the past Yes No Yes No
Are you a surviving spouse of a veteran who died on active duty or as the result of a service-related disability
Yes No Yes No
Do you have any VA loans Yes No Yes No
2 Current Borrower to Complete
Is the current borrowerco-borrower currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the page)
Yes (If yes please answer the question in section 3 and sign and date this form at the bottom of the page)
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
________________________________________________________________________________________________
3 Applicant and Current Borrower to Complete
If the answer to the questions in section 1 and 2 are both yes please answer the following question After yoursquove reviewed and completed this entire form please sign and date at the bottom
Applicant Current Borrower
Do you want to apply for a substitution of entitlement Yes Yes No No
In order to complete a substitution of entitlement the veteran applicant must have suffcient entitlement to substitute for that of the current borrower Contact the VA Offce of Jurisdiction for your area for more information Also before the veteran applicant can substitute entitlement on a VA loan heshe must certify that the property securing the loan will be occupied as hisher primary residence Both the applicantrsquos and current borrowerrsquos original certifcate of eligibility will be required If your sales contract is contingent upon the restoration of entitlement please contact your VA Offce of Jurisdiction for complete procedures Otherwise the substitution will be completed after the loan has been approved and closed
Date Applicant printed name Applicant signature
Date Applicant printed name Applicant signature
Date Current Borrower printed name Current Borrower signature
Date Current Borrower printed name Current Borrower signature
Forms completed by Mail Phone
For Chase use only
Interviewer signature Date
99177-VS-0215
- Assumption Application Package_41521-noscannedpages-update-4pdf
-
- 1 FM203 Cover Pagepdf
- 2 FM202 Mortgage Assumption Application Package pagepdf
- 3 The Documents Youll need to Send Uspdf
- 4 FM201 FAQpdf
- 5 FM142 CIWpdf
- 6 FM126 URLApdf
- 7 FM130 URLA Instpdf
-
- Blank Page
-
- 8 92900a Addednum to Loan Applicationpdf
- 9 FM462 Gen Authpdf
- 10 FM220 4506-Cpdf
- 11 FM153 Chase Federal Privacy Noticepdf
- 12 FM144 Info on Opening a New Accountpdf
- 13 FM152 Veteran Statementpdf
-
- Date
- Loan number
- Applicant name
- Phone1
- Loan number 1
- Loan number 2
- Other
- Other_2
- 1
- 2
- undefined_7
- Available hours
- Available hours_2
- undefined_8
- Available hours_3
- undefined_9
- Current address 1
- Neither
- Available hours_4
- Available hours_5
- undefined_10
- Available hours_6
- 1_2
- 2_2
- undefined_11
- Available hours_7
- Available hours_8
- undefined_12
- Available hours_9
- FHA Case No include any suffix
- Mortgagee Case No
- Mortgagee ID
- Sponsor ID
- Agent ID
- Name and Address of Sponsor Name and Address of Agent
- Borrowers Name Present Address include ZIP Code Property Address
- include name of subdivision lot block no ZIP Code
- Name of ThirdParty Originator
- NMLS ID of ThirdParty Originator
- s application
- ty Number
- ty Number_2
- Date Signed_2
- Date Mortgage Approved
- Date Approval Expires
- Printed Name
- Title 1
- DEs ID Number
- DEs ID Number_2
- Mortgagee
- Name of Mortgagees Representative
- Title of Mortgagees Representative
- Signature of the Mortgagees Representative
- Date_2
- Applicant names 1
- Applicant names 2
- Applicant names 3
- Loan number_2
- Date_3
- Applicant printed name
- Social Security number
- Date_4
- Applicant printed name_2
- Social Security number_2
- Date_5
- Applicant printed name_3
- Social Security number_3
- Date_6
- Applicant printed name_4
- Social Security number_4
- 1a Name shown on tax return if a joint return enter the name shown first
- 1b First social security number on tax return individual taxpayer identification number or employer identification number see instructions
- 2a If a joint return enter spouses name shown on tax return
- 2b Second social security number or individual taxpayer identification number if joint tax return
- 4 Previous address shown on the last return filed if different from line 3 see instructions
- 5a IVES participant name address and SOR mailbox ID
- Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing see instructions
- Signature see instructions
- Date_7
- Phone number of taxpayer on line 1a or 2a
- PrintType name
- Here
- Spouses signature
- Date_8
- PrintType name_2
- Name
- Date of birth
- Service number
- Name_2
- Date of birth_2
- Service number_2
- Date_9
- Applicant printed name_5
- Date_10
- Applicant printed name_6
- Date_11
- Current Borrower printed name
- Date_12
- Current Borrower printed name_2
- Date_13
- Text3
- Text10
- undefined_13
- Text15
- undefined_14
- undefined_15
- undefined_16
- undefined_17
- undefined_18
- undefined_19
- undefined_20
- undefined_21
- undefined_23
- Reason for assumption Off
- Requestors relationship to owners Off
- Check one Off
- Check one1 Off
- Day1
- Evening
- Cell phone
- Check one2 Off
- Check one3 Off
- Check one4 Off
- Check one5 Off
- Text2-1
- Text2-2
- Text2-3
- Text2-4
- Text2-5
- Text2-6
- Text3-1
- Text3-2
- Text3-3
- Text3-4
- Text3-6
- Text3-7
- Text3-8
- Text3-9
- Text3-10
- Text3-11
- Text3-12
- Text3-13
- Text3-14
- Text3-15
- Text3-16
- Text3-17
- Text3-18
- Text3-19
- Text3-20
- Text3-21
- Text3-22
- Text3-23
- Text3-24
- Text3-25
- Text3-26
- Text3-27
- Text3-28
- Text3-29
- Text3-30
- Text3-31
- Text3-32
- Text3-33
- Text3-34
- Text3-35
- Text3-36
- Text3-37
- Text3-38
- Text3-39
- Text3-40
- Text3-41
- Text3-42
- Text3-43
- Text3-44
- Text3-45
- Text3-46
- Text3-47
- Text3-48
- Text3-49
- Text3-50
- Text3-51
- Text3-52
- Text3-53
- Text3-5
- Text3-54
- Text3-55
- Text3-56
- Citizenship Off
- Type of credit Off
- Marital Status Off
- Housing Off
- Housing1 Off
- ownership Off
- DNA1 Off
- DNA2 Off
- DNA3 Off
- family Off
- BO Off
- Total
- Text31
- Text32
- Text33
- Text34
- Text35
- Text36
- Text37
- Text38
- Text39
- Text310
- Text311
- Text312
- Text313
- Text314
- Text315
- Text316
- Text317
- Text318
- Text319
- ownership1 Off
- Total1
- Total1-2
- Check Box4-1 Off
- Text320
- Text321
- Text322
- Text323
- Text324
- Text325
- Text326
- Text327
- Text328
- Text329
- Check Box4-2 Off
- Check Box4-3 Off
- Check Box4-4 Off
- Check Box4-8 Off
- Check Box4-9 Off
- Text330
- Text331
- Text332
- Text333
- Text334
- Text335
- Text1-1
- Text1-2
- Text1-3
- Text1-4
- Text1-5
- Text1-6
- Text1-7
- Text1-8
- Text1-9
- Text1-10
- Text1-11
- Text1-12
- Text1-13
- Text1-14
- Text1-15
- Text1-16
- Text1-17
- Text1-18
- Text1-19
- Text1-20
- Text1-21
- Text1-22
- Text1-23
- Text1-24
- Text1-25
- Text1-26
- Text1-27
- Text1-28
- Text1-29
- Text1-30
- Text1-31
- Text1-32
- Text1-33
- Text1-34
- Text1-35
- Check Box3-2 Off
- Check Box2-1 Off
- Check Box2-2 Off
- Check Box2-3 Off
- Check Box2-4 Off
- Check Box2-5 Off
- Text1-36
- Text1-37
- Text1-38
- Text1-39
- Text1-40
- Text1-41
- Text1-42
- Text1-43
- Text1-44
- Text1-45
- Text1-46
- Text1-47
- Text1-48
- Text1-49
- Text1-50
- Text1-51
- Text1-52
- Text1-53
- Text1-54
- Text1-55
- Text1-56
- Text1-57
- Text1-58
- Text1-59
- Text1-60
- Text1-61
- Check Box3-11 Off
- A1
- A2
- A3
- A4
- A5
- A6
- A7
- A8
- A9
- A10
- A11
- A12
- Check Box3-1 Off
- Check Box30-1 Off
- Check Box30-2 Off
- Check Box30-4 Off
- Check Box30-5 Off
- Check Box30-7 Off
- Check Box30-8 Off
- Check Box30-9 Off
- Check Box30-10 Off
- Check Box30-11 Off
- Check Box30-12 Off
- A13
- A14
- A15
- A16
- A17 Off
- A18
- A19
- A20
- A21
- A22
- A23
- A24
- A25
- A26
- A27
- A28
- A29
- A30
- A31
- A32
- A33
- A34
- A35
- A36
- A37
- A38 Off
- A39
- A40
- A41
- A42
- A43
- A44
- A45
- A46
- A47
- A48
- A49
- A50
- A51
- A52
- A53
- A54
- A55
- A56
- A57
- A58
- A59
- A60
- A61
- A62
- A63
- A64
- A65
- A66
- A67
- A68
- A69
- A70
- A71
- A72
- A73
- A74
- Loan Purpose Off
- occupancy1 Off
- lien type Off
- lientype Off
- mixed use Off
- manufactured home Off
- deposit1 Off
- deposit2 Off
- B1
- B2
- B3
- B4
- B5
- B6
- B7
- B8
- B9
- B10
- fha Off
- Check Box51 Off
- B11
- B12
- B13
- B14
- B15
- B16
- B17
- B18
- B19 Off
- B20
- B21
- B22 Off
- B23
- B24
- B25
- B26
- B27
- B28
- A
-
- Will you occupy the property as your primary residence Off
- Will you occupy the property as your primary residence1 Off
-
- If yes have you had an ownership interest in another property in the last three years Off
- Text9-2
- B
-
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property Off
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property1 Off
-
- 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 Off
- 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 application1 Off
-
- 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 Off
- 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 application1 Off
-
- new credit Off
- 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) Off
- the Property Assessed Clean Energy Program)1 Off
-
- F
-
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application Off
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application1 Off
-
- G
-
- Are there any outstanding judgments against you Off
- Are there any outstanding judgments against you1 Off
-
- H
-
- Are you currently delinquent or in default on a Federal debt Off
- Are you currently delinquent or in default on a Federal debt1 Off
-
- I
-
- Are you a party to a lawsuit in which you potentially have any personal financial liability Off
- Are you a party to a lawsuit in which you potentially have any personal financial liability1 Off
-
- J
-
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years Off
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years1 Off
-
- 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 Off
- 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 due1 Off
-
- L
-
- Have you had property foreclosed upon in the last 7 years Off
- Have you had property foreclosed upon in the last 7 years1 Off
-
- M
-
- Have you declared bankruptcy within the past 7 years Off
- Have you declared bankruptcy within the past 7 years1 Off
-
- Check Box8-2 Off
- Check Box8-3 Off
- Check Box8-4 Off
- Text9-3
- Text9-5
- Text9-6
- Text97
- military Off
- ethnicity Off
- sex Off
- race Off
- demo Off
- Text12-1
- Check Box11-1 Off
- Check Box11-2 Off
- Check Box11-3 Off
- Check Box11-4 Off
- Check Box11-5 Off
- Check Box11-6 Off
- Check Box11-7 Off
- Check Box11-8 Off
- Check Box11-9 Off
- Text12-2
- Check Box11-10 Off
- Check Box11-11 Off
- Check Box11-12 Off
- Check Box11-13 Off
- Check Box11-14 Off
- Check Box11-15 Off
- Text12-3
- Check Box11-16 Off
- Check Box11-17 Off
- Check Box11-18 Off
- Check Box11-19 Off
- Check Box11-20 Off
- Check Box11-21 Off
- Check Box11-22 Off
- Check Box11-23 Off
- Text12-4
- Check Box11-24 Off
- Check Box11-25 Off
- Check Box11-26 Off
- Check Box11-27 Off
- Check Box11-28 Off
- Check Box11-29 Off
- Text12-5
- Check Box11-30 Off
- Check Box11-31 Off
- citizen Off
- credit Off
- marital status1 Off
- housing-1 Off
- housing-2 Off
- own Off
- C1
- C2
- C3
- C6
- C7
- C8
- C9
- C10
- C11
- C12
- C13
- C14
- C15
- C16
- C17
- C18
- C19
- C20
- C21
- C22
- C23
- C24
- C25
- C26
- C27
- C28
- C29
- C30
- C31
- C32
- C33
- C34
- C35
- Check Box-2 Off
- C36
- C37
- C38
- C39
- C4
- C40
- C41
- C42
- C43
- C44
- C45
- C46
- C47
- Check Box-3 Off
- Check Box-4 Off
- C48
- C49
- C5
- C50
- C51
- C52
- C53
- C54
- C55
- Check Box-1-1 Off
- own1 Off
- Check Box-1 Off
- D1 Off
- D2
- D3
- D4
- D5
- D6
- D7
- D8
- D9
- D10
- D11
- D12
- D13
- D14 Off
- D15 Off
- D16
- D17
- D18
- D19
- D20
- D21
- D22
- D23
- D24 Off
- D25
- D26
- D27
- D28
- D29
- D30
- D31
- D32
- D33
- D34
- D35 Off
- D36
- D37 Off
- D38
- D39
- D40
- D41
- D42
- D43
- D44
- D45
- D46
- D47
- If yes have you had an ownership interest in another property in the last three years1 Off
- new credit1 Off
- Check Box8-1 Off
- Check Box8-1-2 Off
- Check Box8-1-1 Off
- Check Box8-1-3 Off
- Check Box8-1-4 Off
- Military Service mdash Did you (or your deceased spouse) ever serve or are you currently serving in the United States Armed Forces 1 Off
- Check1 Off
- Text9-1-1
- Check2 Off
- Check3 Off
- Check4 Off
- Text9-1
- E1
- E2
- E3
- Was the ethnicity of the Borrower collected on the basis of visual observation or surname1 Off
- Was the sex of the Borrower collected on the basis of visual observation or surname1 Off
- Was the race of the Borrower collected on the basis of visual observation or surname1 Off
- The Demographic Information was provided through1 Off
- F1 Off
- F2 Off
- F3 Off
- F4 Off
- F5 Off
- F6
- F7 Off
- F8 Off
- F9 Off
- F10 Off
- F11 Off
- F12 Off
- F13
- F14 Off
- F15 Off
- F16 Off
- F17 Off
- F18 Off
- F19 Off
- F20 Off
- F21 Off
- F22
- F23 Off
- F24 Off
- F25 Off
- F26 Off
- F27 Off
- F28 Off
- F29
- F30 Off
- F31 Off
- undefined_13-1
- undefined_13-2
- undefined_14-1
- undefined_15-1
- undefined_16-1
- undefined_17-1
- undefined_18-1
- undefined_19-1
- undefined_21-1
- undefined_20-1
- undefined_23-1
- undefined_13_1
- Single-Two Off
- Refi type Off
- refi program Off
- Estate Off
- Title held Off
- Trust Information Off
- Indian Country Land Tenure Off
- Mortgage Type Applied For Off
- Mortgage Lien Type Off
- Amortization Type Off
- G1 Off
- G2 Off
- G3 Off
- G4 Off
- G5 Off
- G6
- G7
- G8
- G9
- G10 Off
- G11 Off
- G12 Off
- G13 Off
- G14 Off
- G15 Off
- G16
- G17
- G18
- G19
- G20
- G21
- G22
- G23 Off
- G24
- G25 Off
- G26
- G27 Off
- G28 Off
- G29
- G30 Off
- G31
- G32 Off
- G33
- G34
- G35
- G36
- G37
- G38
- G39
- G40
- G41
- G42
- Property Held
- refi
- Text18-1
- Text18-2
- Text18-3
- Text18-4
- Text18-5
- Text18-6
- Text18-7
- Text18-8
- Text18-9
- Text18-10
- Text18-11
- Text18-12
- Text18-13
- Text18-14
- Text18-15
- Text18-16
- Text18-17
- Text18-18
- Text18-19
- Lender
- case no
- If you selected ldquoUnmarriedrdquo in Section 1 is there a person who is not your legal spouse but who currently has real property rights similar to those of a legal spouse Off
- Relationship and State Off
- Other-5
- Text19-1
- BName
- Additional Information
- ABN
- Additional Information1
- BSign
- BSDate
- ABSign
- ABDate
- MortageeNameAddress
- NAmeAddress
- Bname1
- DOB1
- DOB2
- SignOfBorr1
- SignOfBorr
- Date Signed
- SignOfBorr2
- SignOfBorr3
- Date Signed3
- Date Signed4
- MortgageeRepSign
- DirectSign
- DirectSign1
- Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union Off
- AppSign
- AppSign1
- AppSign2
- AppSign3
- Nopage38 Off
- Yespage38 Off
- Yes1 Off
- No1 Off
- Yes2 Off
- Yes3 Off
- Yes4 Off
- Yes5 Off
- Yes6 Off
- Yes7 Off
- Yes8 Off
- Yes9 Off
- Yes10 Off
- No2 Off
- No3 Off
- No4 Off
- No5 Off
- No6 Off
- No7 Off
- No8 Off
- No9 Off
- No10 Off
- BorrowerNo Off
- BorrowerYes Off
- AppSignature
- AppSignature1
- CurrentSign
- CurrentSign1
- InterviewSign
- Yes_1 Off
- No_1 Off
- Yes_2 Off
- No_2 Off
- Mail Off
- Phone Off
Uniform Residential Loan ApplicationVerify and complete the information onthis applicationIf you are applying for this loan with others each additional Borrower must provide
information as directed by your Lender
Section 1 Borrower Informationthis section asks about yourpersonal information and your income fromemploymentandother sources such as retirement that you want considered to qualify for this loan
1a Personal Information
Name(First Middle Last Suffix) Social Security Number - -
(orIndividual TaxpayerIdentification Number)
Alternate Names- List any namesby which you are known or any namesunderwhich credit was previously received (First Middle Last Suffix)
Date ofBirth Citizenship(mmddyyyy) USCitizen
copy PermanentResidentAliencopy Non-PermanentResidentAlien
Type of Credit List Name(s) of Other Borrower(s) Applying for this Loan
copy lamapplyingforindividual credit (First Middle Last Suffix) - Use a separator between names
copy |am applyingfor joint credit Total Numberof Borrowers_
Each Borrowerintendsto applyfor joint credit Yourinitials
Marital Status Dependents(notlisted by another Borrower) Contact Information
O Married Number __ Home Phone ( ) -
s SeparatedUnmarried
Ages CellPhone ( ) _7
(Single Divorced Widowed Civil Union Domestic Partnership Registered Work Phone (0) Ext
Reciprocal Beneficiary Relationship) Email
Current Address
Street Unit
City State ZIP Country
How Long at Current Address Years mdashMonths Housing O Noprimary housing expense copy) Own copy Rent($ month)
If at Current Addressfor LESS than 2 yearslist Former Address LC Does not apply
Street Unit
City State ZIP Country
How Long at Former Address Years mdashMonths Housing No primary housing expense Own Rent($ month)
Mailing Address- ifdifferent from CurrentAddress (| Does not apply
Street Unit
City State ZIP Country
easeaoemir ] Does not apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base $_mdashmdashmdashmdash__mdashmonth
City State ZIP Country Overtime =$_________monthBonus $ month
Position orTitle Checkif this statementapplies Commission $ month[] am employedby a family member
propertyseller real estate agent or otherparty to the transaction
TTStartDate0__mdashsmmddyy) MilitaryHow long in this line of work Years mdash_ Months Entitlements $_mdashsmontth
Other $ monthCheckif you are the Business () | have an ownershipshare of less than 25 Monthly Income(or Loss) mdashmdash_mdashOwnerorSelf-Employed O I have an ownership share of 25 or more sect TOTALS__000month
Uniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
1c IF APPLICABLE Complete Information for Additional EmploymentSelf-Employment and Income
Doesnot apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base $ month
City State ZIP Country Overtime mdash$ monthBonus $ month
Position orTitle Checkif this statementapplies Commission $ month| am employedby a family memberproperty seller real estate agent or otherparty to the transaction
Start Date mdash_mdashAA(mmddyyyy) Military
EntitlementsHow long in this line of work lsquoYears mdash_ Months $ month
7 7 Other $ monthCheckif you are the BusinessOwnerorSelf-Employed
| have an ownershipshare ofless than 25 Monthly Income(or Loss)| have an ownership share of 25 or more $ TOTAL $ 000month
PlMeNeeeMeeCee ti)LeeseteUeLimet Does not apply
Provideatleast 2 years of current and previous employment and income
Employeror Business Name Previous Gross Monthly
Street Unit Income $ month
City State ZIP Country
Position orTitleStart Date (mmddyyyy) Checkif you were the Business
Owneror Self-Employedmdash_ mdashEnd Date (mmddyyyy)
WCBeelcaTy Does not apply
Include incomefrom other sources below Under IncomeSource choosefrom the sourceslisted hereraquo Alimony+ Automobile Allowance Boarder Income
+ Capital Gains
Child Support+ Disabilitylaquo Foster Care
laquo Housing or Parsonage
+ Interest and Dividendslaquo Mortgage Credit Certificateraquo MortgageDifferential
Payments
raquo Notes Receivable+ Public Assistance- Retirement
(eg Pension IRA)
laquo Royalty Payments Separate Maintenance+ Social Security
+ Trust
laquo UnemploymentBenefits
laquo VA Compensation
cent Other
NOTEReveal alimony child support separate maintenance or other income ONLYIFyou wantit considered in determining yourqualification
for this loan
IncomeSource -mdash uselist above Monthly Income
$
$
$
Provide TOTAL AmountHere $ 000
Borrower Name
Uniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 2 Financial Information mdash Assets andLiabilities this section asks about things you ownthatare worth moneyand that you wantconsidered to qualify for this loan It then asks about your liabilities (or debts) that you pay
each month suchas credit cards alimony or other expenses
rNcee stLeVaalemities eitimeeecm dellaLC-
Include all accounts below Under Account Typechoosefrom the typeslisted here
laquo Checkinglaquo Savingsraquo Money Market
+ Certificate of Depositlaquo Mutual Fund+ Stocks
laquo Stock Optionslaquo Bonds+raquo Retirement(eg 407k IRA)
laquo Bridge Loan ProceedslaquoIndividual DevelopmentAccount
Trust Account- Cash Value ofLife Insurance(usedfor the transaction)
AccountType- use list above FinancialInstitution Account Number Cash or MarketValue
$
$
$
$
$
$ 000Provide TOTAL AmountHere|
Includeall other assets and credits below UnderAsset or Credit Type choose from the typeslisted here
Assets Credits- Proceeds from Real EstateProperty to be sold on orbefore closing
laquo Proceeds from Sale ofNon-Real Estate Asset
- Secured Borrowed Funds
cent Unsecured Borrowed Funds Other
raquo Earnest MoneylaquoEmployer Assistance- Lot Equity
Relocation Funds_raquo Rent Credit
laquo Sweat Equity+ Trade Equity
Assetor Credit Type mdash uselist above Cash or Market Value
$
$
$
$
$ 000Provide TOTAL AmountHere
2c Liabilities - Credit Cards Other Debts and Leases that You Owe C Does not apply
List all liabilities below (except real estate) and include deferred payments Under Account Type choose from thetypeslisted herelaquoRevolving (eg credit cards) +Installment (eg car student personal loans) Open 30-Day (balance paid monthly) + Lease (not realestate) +Other
Account Type mdashuse list above
To be paid offator before closingCompany Name Account Number Unpaid Balance Monthly Payment
$ $
$ $
$ $
$ $
$ $
2d OtherLiabilities and Expenses Does not apply
Includeall otherliabilities and expenses below Choose from the typeslisted here
+ Alimony Child Support -Separate Maintenance +JobRelatedExpenses +Other Monthly Payment
$
$
$
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 3 Financial Information mdash Real Estatethis section asks youtolist all properties you currently ownand what you owe onthem donot own anyreal estate
3a Property You Own If you are refinancinglist the property you are refinancing FIRST
Address Street Unit
City State ZIP Country
Sol Intended Occupancyinvestment PrimaryResidence SecondHome Other
Monthly InsuranceTaxesAssociation Duesetcifnot included in MonthlyMortgage Payment
For 2-4 Unit Primary or Investment PropertyStatus SoldPending Saleor Retained
=Monthly RentalIncomeProperty Value
$ $ $
Mortgage Loanson this Property Does not apply
MonthlyMortgagePayment
Type FHA VAConventionalUSDA-RD Other|
To be paid offator before closing
Credit Limit(ifapplicable)Creditor Name Account Number Unpaid Balance
$ $ $
$ $ $
3b IF APPLICABLE Complete Information for Additional Property Does not apply
Address Street Unit
City State ZIP Country
ldquoSold Intended Occupancyinvestment PrimaryResidence SecondHome Other
Monthly Insurance TaxesAssociation Duesetcifnot included in MonthlyMortgage Payment
For 2-4 Unit Primary or Investment PropertyStatus SoldPendingSaleor Retained
Monthly RentalIncomeProperty Value
$ $ $
Mortgage Loanson this Property Does not apply
Monthly
Mortgage
Payment
Type FHA VA
Conventional
USDA-RD Other|
To be paid offat
or before closing
Credit Limit
(ifapplicable)Creditor Name Account Number Unpaid Balance
$ $ $
$ $ $
$ $ $
$ $ $
$ $ $
3c IF APPLICABLE Complete Information for Additional Property Does not apply
Address Street Unit
City State ZIP Country
Intended Occupancyinvestment PrimaryResidence SecondHome Other
Monthly Insurance TaxesAssociation Duesetcifnot included in MonthlyMortgage Payment
For 2-4 Unit Primary or Investment PropertyStatus SoldPending Saleor Retained
Monthly RentalIncomeProperty Value
Mortgage Loanson this Property Does not apply
MonthlyMortgagePayment
Type FHA VAConventionalUSDA-RD Other|
To be paid offator before closing
Credit Limit(ifapplicable)Creditor Name Account Number Unpaid Balance
Borrower Name
Uniform Residential Loan Application
Freddie Mac Form 65 +raquo Fannie Mae Form 1003
Effective 12021
Section 4 Loan and Property Informationthis section asks about the loanrsquos purpose and the property youwantto purchase orrefinance
4a Loan and Property Information
LoanAmount $ Loan Purpose Purchase efinance Other(specify)
Property Address Street Unit
City State ZIP County
Numberof Units Property Value $
Occupancy Primary Residence Second Home InvestmentProperty FHA Secondary Residence
1 Mixed-Use PropertyIf you will occupy the propertywill you set aside space within the property to operate
your ownbusiness(eg daycare facility medicaloffice beautybarber shop)NO YES
2 Manufactured HomeIs the property a manufactured home(eg a factory built dwelling built on a permanentchassis) NO YES
4b Other New Mortgage Loansonthe Property Youare Buying or Refinancing Does not apply
LoanAmountAmountto be Drawn
Credit Limit(ifapplicable)Creditor Name Lien Type Monthly Payment
First Lien Subordinate Lien $ $ $
$ $ $First Lien SubordinateLien
4c Rental Income on the Property You Wantto Purchase For Purchase Only Does not apply
Completeif the property is a 2-4 Unit Primary Residence or an Investment Property Amount
Expected Monthly Rental Income $
Doesnot apply4d Gifts or Grants You Have Been GivenorWill Receive for this Loan
Includeall gifts and grants below Under Source choose from the sourceslisted here
Community Nonprofitlaquo Employer
raquo Federal Agencyraquo Local Agency
- Relative+ Religious Nonprofit
+ State Agency+ Unmarried Partner
raquo Lender Other
Asset TypeCash Gift Gift of Equity Grant DepositedNot Deposited Source - uselist above Cash or Market Value
Deposited Not Deposited $
$Deposited Not Deposited
Borrower Name
Uniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 5 DeclarationsThis section asks youspecific questions about the property your funding and yourpastfinancial history
5aAboutthis Property and Your Moneyfor this Loan
A Will you occupy the property as your primary residence
If YES have you had an ownershipinterest 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 investmentproperty(IP)
(2) How did you holdtitle to the property by yourself (S) jointly with your spouse(SP) or jointly with another person (O)
YESYES
B If this is a Purchase Transaction Do you have a family relationship or businessaffiliation with the seller of the property NO YES
C Are you borrowing any moneyforthis real estate transaction (eg money foryour closing costs or down payment) orobtaining any moneyfrom anotherparty such astheseller or realtor that you have notdisclosed on this loan application NO YES
If YES what is the amountof this money $
D 1 Have you orwill you be applying for a mortgage loan on anotherproperty (not the property securing this loan) on or
before closing this transaction that is not disclosed on this loan application
NO YES
2 Have you orwill you be applying for any newcredit (eg installment loan credit card etc) on or before closing this loan that
is not disclosed on this application
No YES
E Will this property be subject to a lien that could take priority over the first mortgagelien such as a clean energylien paid
through yourproperty taxes(eg the PropertyAssessed Clean Energy Program)NO YES
5b About YourFinances
F Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application NO YES
G Are there any outstanding judgments against you No YES
H Areyou currently delinquentor in default on a Federal debt No YES
I Areyou a party to a lawsuit in which you potentially have any personalfinancialliability NO YES
J Have you conveyedtitle to any property in lieu of foreclosure in the past 7 years NO YES
K Within the past 7 years have you completed a pre-foreclosure sale or short sale whereby the property wassold to a
third party and the Lenderagreed to acceptless than the outstanding mortgage balance due
NO YES
L Have you hadproperty foreclosed uponin thelast 7 years NO YES
M Have you declared bankruptcy within the past 7 years ONO YESIf YES identify the type(s) of bankruptcy Chapter7 Chapter11 Chapter12 Chapter 13
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 6 Acknowledgments and AgreementsThis section tells you about yourlegal obligations whenyousign this application
Acknowledgments and Agreements
Definitions- Lenderincludes the Lenderrsquos agents service providers and any oftheir successors andassigns
Other Loan Participantsrdquo includes(i) any actual or potential owners of
a loan resulting from this application (the ldquoLoanrsquo)(ii) acquirers ofany beneficial or other interest in the Loan(iii) any mortgageinsurer(iv) any guarantor (v) any servicer of the Loan and (vi) any of theseparties service providers successors or assigns
I agree to acknowledgeand representthe following
(1) The Complete Informationfor this Application- The information | have providedin this application is true accurate
and completeas of the date | signed this application
laquo If the information | submitted changesor | have new information
before closing of the Loan | must change and supplementthis
application including providing any updatedsupplementedrealestate sales contract
- For purchase transactions The terms and conditionsof anyrealestate sales contract signed by mein connection with this application
are true accurate and complete to the best of my knowledge andbelief | have not entered into any other agreement written ororal inconnection withthis real estate transaction
- The Lender and OtherLoan Participants mayrely on the informationcontainedin the application before and after closing of the Loan
- Any intentional or negligent misrepresentation of information may
result in the impositionof(a) civil liability on me including monetary damagesif a
person suffers any loss because the person relied on anymisrepresentation that | have made onthis application andor
(b) criminal penalties on me including but not limited to fine orimprisonment or both underthe provisions of Federal law(18 USC sectsect 1001 et seq)
(2) The Propertyrsquos SecurityThe Loan | have applied for in this application will be secured by
a mortgage or deedoftrust which provides the Lendera security
interest in the property described in this application
(3) The Propertys Appraisal Value and Condition- Any appraisal or value of the property obtained by the Lenderis
for use by the Lender and OtherLoanParticipantslaquoThe Lender and OtherLoan Participants have not made anyrepresentation or warranty express or implied to me about the
propertyits conditionorits value
(4) Electronic Records and Signatures- The Lender and OtherLoan Participants may keep any paper record
andorelectronic record of this application whether or not the Loan
is approved
BorrowerSignature
- If this application is created as (or converted into) an ldquoelectronicapplicationrdquo | consent to the use of ldquoelectronic recordsrdquo and
ldquoelectronic signaturesrdquo as the termsare defined in and governed byapplicable Federal andorstate electronic transactions laws
| intend to sign and have signedthis application either using my(a) electronic signature or(b) a written signature and agreethatif a paper version ofthis
application is converted into an electronic application theapplication will be an electronic record and the representationof my written signature on this application will be my binding
electronic signature- | agree that the applicationif delivered or transmitted to the Lenderor Other Loan Participants as an electronic record with myelectronicsignaturewill be as effective and enforceable as a paperapplicationsigned by mein writing
(5) Delinquencylaquo The Lender and OtherLoan Participants may report information about
my accountto credit bureaus Late payments missed paymentsorother defaults on my account maybereflected in my credit report andwill likely affect my credit score
- If | have trouble making my payments | understand that | may contacta HUD-approved housing counseling organization for advice about
actions I can take to meet my mortgageobligations
(6) Authorization for Use and Sharing of InformationBy signing belowin addition to the representations and agreementsmade above| expressly authorize the Lender and Other LoanParticipants to obtain use and share with each other(i) the loan
application and related loan information and documentation(ii) aconsumercredit report on me and(iii) my tax return information asnecessary to perform theactionslisted belowfor so long as they havean interest in my loanorits servicing
(a) process and underwrite myloan(b) verify any data contained in my consumercredit 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 analysisandreviews
(e) perform analysis and modeling for risk assessments(f) monitor the accountfor this loan for potential delinquencies and
determineanyassistance that may beavailable to me and
(g) other actions permissible under applicable law
Date (mmddyyyy)
Additional Borrower Signature Date (mmddyyyy)
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 7 Military ServiceThis section asks questions about your(or your deceased spouses) military service
Military Service of Borrower
Military Service mdash Did you (or your deceased spouse) everserve or are you currently serving in the United States Armed Forces NO YES
If YES check allthat apply Currently serving on active duty with projected expiration date of servicetour (mmddyyyy)
Currently retired discharged or separated from service
Only period of service was as a non-activated memberof the Reserve or National GuardSurviving spouse
Section 8 Demographic InformationThis section asks about your ethnicity sex and race
Demographic Information of Borrower
The purposeofcollecting this informationis to help ensure thatall applicants are treated fairly and that the housing needs of communities
and neighborhoodsare beingfulfilled 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 mayselect one or more designationsfor
Ethnicity and one or more designationsfor Race The law provides that we maynotdiscriminate on the basis of this information or onwhetheryou chooseto provideit However if you choose not to provide the information and you have madethis application in person Federal
regulations require us to note your ethnicity sex and race on thebasis of visual observation or surname Thelaw also provides that we may notdiscriminate on the basis of age or marital status information you providein this application If you do not wish to provide someorall of this
information please check below
Ethnicity Check one or more Race Check one or moreHispanic or Latino AmericanIndian or Alaska Native - Print nameofenrolled
or principaltribe Mexican PuertoRican CubanOther Hispanic or Latino - Print origin Asian
Asian Indian Chinese Filipino
Japanese Korean Vietnamese
OtherAsian mdash Print race
For example Hmong Laotian Thai Pakistani Cambodian and so on
Black or African American
Native Hawaiian or OtherPacific Islander
Native Hawaiian GuamanianorChamorro Samoan
For exampleArgentinean Colombian Dominican Nicaraguan
Salvadoran Spaniard andso on
Not Hispanic or Latino
| do not wish to providethis information
5Female OtherPacific Islander mdash Print race
Male For example Fijian Tongan and so on| do not wish to providethis information white
| do not wish to providethis information
Wasthe ethnicity of the Borrowercollected on the basis of visual observation or surname )NO YESWasthe sex of the Borrowercollected on the basis of visual observation or surname NO YESWastherace of the Borrowercollected on the basis of visual observation or surname NO YES
Face-to-Face Interview (includes Electronic Media w Video Component) TelephoneInterview Faxor Mail Email or Internet
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
ReelTemCrCL
Loan Originator Organization Name
Address
Loan Originator Organization NMLSR ID State License ID
Loan Originator Name
Loan Originator NMLSR ID State License ID
Date (mmddyyyy)
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Uniform Residential Loan Application mdash Additional BorrowerVerify and complete the information onthis application as directed by your Lender
Section 1 Borrower Informationthis section asks about yourpersonal information and your income fromemploymentandother sources such as retirement that you want considered to qualify for this loan
1a Personal Information
Name(First Middle Last Suffix)
Alternate Names - List any namesby which you are known or any namesunder which credit was previously received (First Middle Last Suffix)
Social Security Number - -(or Individual TaxpayerIdentification Number)
Dateof Birth Citizenship(mmddyyyy)
USCitizenPermanentResidentAlienNon-Permanent ResidentAlien
Type ofCredit| am applying for individualcredit
lam applying forjoint credit Total Number of Borrowers
Each Borrowerintendsto applyfor joint credit Your initials
List Name(s) of Other Borrower(s) Applying for this Loan
(First Middle Last Suffix) - Use a separator between names
Marital Status Dependents(notlisted by another Borrower)
Contact Information
Married Number _ Home Phone ( ) -
( ) _
( ) -mdash_ mdash_
Separated Ages CellPhone
Unmarried ens Work Phone Ext(Single Divorced WidowedCivil Union Domestic Partnership Registered
Reciprocal Beneficiary Relationship)lsquol
Emal
Current Address
Street Unit
City State ZIP Country
How Long at Current Address=Years mdashMonths Housing Noprimary housing expense Own Rent($ month)
If at Current Address for LESS than 2 yearslist Former Address Does not apply
Street Unit
City State ZIP Country
How Long at Former Address Years mdashMonths Housing Noprimary housing expense Own month)
Mailing Address- ifdifferent from CurrentAddress Does not apply
Street Unit
City State ZIP Country
eeeeCeeteiChuraleCme Doesnot apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base S$month
City State ZIP Country Overtime =$_____monthBonus $ month
Position orTitle Checkif this statementapplies Commission sect month| am employedby a family memberpropertyseller real estate agent or otherparty to the transaction
TTStart Date ____ (mmddyy) Military
Entitlements$_How longin this line of work Years =Months mdash monthSS
Other $ monthCheckif you are the BusinessOwnerorSelf-Employed
| have an ownershipshare ofless than 25 Monthly Income(or Loss) mdashmdash| have an ownership share of 25 or more $ TOTAL $ 000month
Uniform Residential Loan Application mdash Additional Borrower
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
CoeeeMCMCmeticlm tu)Comiteteilteeilelie mieit
Does not apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base
OvertimeBonus
Commission
MilitaryEntitlements
Other
$ month
$ month$ month
$ month
$ month
$ month
City State ZIP Country
Position orTitle ose if this statement applieslam employed by a family memberpropertyseller real estate agent or otherparty to the transaction
Start Date (mmddyy)How long in this line of work Years =Months
Checkif you are the Business
Owneror Self-Employed| have an ownershipshare of less than 25 Monthly Income(or Loss)
Ihave an ownership share of 25 or more $ TOTAL$ 000month
CPONMeeeMummaTestetiersdeere lire miret Does not apply
Provideat least 2 years of current and previous employment and income
Employeror Business Name Previous Gross MonthlyStreet Unit Income s month
City State ZIP Country
Position or Title
Start Date
End Date
Checkif you were the BusinessOwneror Self-Employed
(mmddyyyy)
(mmddyyyy) 1e Income from Other Sources Does not apply
Include incomefrom other sources below Under Income Source choose from the sourceslisted herelaquo Alimonylaquo Automobile Allowanceraquo Boarder Incomelaquo Capital Gains
Child Support+ Disability+ Foster Care Housing or Parsonage
+ Interest and DividendslaquoMortgage Credit Certificate Mortgage DifferentialPayments
laquo Notes Receivable+ Public Assistancelaquo Retirement(eg Pension IRA)
+raquo Royalty Payments Separate Maintenance
+ Social Security
raquo Trust
+ UnemploymentBenefits
laquo VA Compensation
laquo Other
NOTE Revealalimony child support separate maintenance or other income ONLYIFyou wantit considered in determining yourqualification
for this loan
Income Source - uselist above Monthly Income
$
$
$
$ 000Provide TOTAL AmountHere|
Section 2 Financial Information mdash Assets andLiabilities
Myinformation for Section 2 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 3 Financial Information mdash Real Estate
Myinformation for Section 3 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 4 Loan and Property Information
Myinformation for Section 4 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 5 DeclarationsThis section asks you specific questions about the property your funding and your past
financial history
5aAboutthis Property and Your Moneyforthis Loan
A Will you occupy the property as your primary residence NO YES
If YES have you had an ownershipinterest in another property in the last three years NO YES
If YES complete (1) and (2) below
(1)What type of property did you ownprimary residence (PR) FHA secondary residence (SR) second home(SH)
or investmentproperty (IP)
(2) How did you holdtitle to the property by yourself (S) jointly with your spouse(SP) or jointly with another person (O)
B If this is a Purchase Transaction Do you have a family relationship or businessaffiliation with the seller of the property NO YES Cc Are you borrowing any moneyforthis real estate transaction (eg money foryour closing costs or down payment) or
obtaining any moneyfrom anotherparty suchastheselleror realtor that you have not disclosed on this loan application NO YES
If YES whatis the amountof this money $
D 1 Have youorwill you be applying for a mortgage loan on anotherproperty (not the property securing this loan) on orbefore closing this transaction that is not disclosed on this loan application
NO YES
2 Have you orwill you be applying for any newcredit (eg installment loan credit card etc) on or before closing this loan that wsis not disclosed on this application
NO YES
E Will this property be subject to a lien that could take priority over thefirst mortgagelien such as a clean energylien paid
through yourproperty taxes(eg the PropertyAssessed Clean Energy Program)No YES
EK) Veli ellim ait
F Areyou a co-signer or guarantor on any debtor loan thatis not disclosed on this application NO ES
G Are there any outstanding judgments against you NO YES
H Are you currently delinquentor in default on a Federal debt NO YES
I Are you a party to a lawsuit in which you potentially have any personalfinancialliability NO YES
J Have you conveyedtitle to any property in lieu of foreclosure in the past 7 years NO YES
K Within the past 7 years have you completed a pre-foreclosure sale or short sale whereby the property wassold to a
third party and the Lender agreed to acceptless than the outstanding mortgage balance due
No YES
L Have you had property foreclosed uponin thelast 7 years NO YES
M Have you declared bankruptcy within the past 7 years no vESIf YES identify the type(s) of bankruptcy Chapter 7 Chapter11 Chapter12 Chapter 13
Section 6 Acknowledgements and AgreementsMy signature for Section 6 is on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 7 Military Service This section asks questions about your(or your deceased spouses) military service
Military Service of Borrower
Military Service mdash Did you (or your deceased spouse)everserve or are you currently serving in the United States Armed Forces NO YES
IfYES check allthat apply Currently serving on active duty with projected expiration date of servicetour (mmddyyyy)
Currently retired discharged or separated from service nnOnly period of service was as a non-activated memberofthe Reserve or National GuardSurviving spouse
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 8 Demographic InformationThis section asks about your ethnicity sex and race
Demographic Information of Borrower
The purposeofcollecting this information is to help ensure thatall applicants are treated fairly and that the housing needs of communities
and neighborhoodsare beingfulfilled 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 providethis information but are encouraged to do so You mayselect one or more designationsfor
Ethnicity and one or more designationsfor Race The law provides that we maynotdiscriminate onthe basis of this information or onwhetheryou chooseto provideit However if you choose notto provide the information and you have madethis application in person Federal
regulations require us to note yourethnicity sex and race on the basis of visual observation or surname The law also provides that we may notdiscriminate on the basis of age or marital status information you providein this application If you do not wish to provide someorall of this
information please check below
Ethnicity Check one or more Race Check one or moreHispanic or Latino AmericanIndian or Alaska Native - Print nameofenrolled
or principaltribeMexican PuertoRican Cuban
OtherHispanic or Latino - Printorigin siansian Indian Chinese Filipino
For exampleArgentinean Colombian Dominican NicaraguanSalvadoran Spaniard andso on
Japanese Korean VietnameseOtherAsian - Print race Forexample Hmong Laotian Thai Pakistani Cambodian andso on
Black or African American
Native Hawaiian or OtherPacific Islander
Native Hawaiian GuamanianorChamorro Samoan
OtherPacific Islander mdash Print race
Not Hispanic or Latino
| do not wish to providethis information
Sex
Female
Male
| do not wish to providethis informationFor example Fijian Tongan and so on
White
| do not wish to providethis information
Wasthe ethnicity of the Borrowercollected on thebasis of visual observation or surnameWasthesex of the Borrowercollected on the basis of visual observation or surnameWastherace of the Borrowercollected on the basis of visual observation or surname
)NO YESNO YESNO YES
Face-to-Face Interview (includes Electronic Media w Video Component) Telephone Interview Faxor Mail Email or Internet
Loan Originator Organization Name
Address
Loan Originator Organization NMLSR ID State License ID
Loan Originator Name
Loan Originator NMLSR ID State License ID
Email Phone (
Signature Date (mmddyyyy)
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Pe)aae-emeet)
Community Property State
At least one borrowerlives in a community propertystateThe property is in a community property state
Transaction DetailConversion of Contract for Deed or Land ContractRenovationConstruction-ConversionConstruction-to-Permanent
Single-Closing Two-ClosingConstructionImprovementCosts $
LotAcquired Date
Original Cost of Lot $(mmddyyyy)
Refinance Program
Full DocumentationInterest Rate ReductionStreamlined without Appraisal
Other
Refinance Type
NoCash OutLimited Cash OutCash Out
Energy Improvement
Mortgageloanwill finance energy-related improvements
Propertyis currently subject to a lien that could take priority ovethe first mortgagelien such as a clean energylien paid for througproperty taxes(eg the PropertyAssessed Clean Energyprogram)
Project Type Condominium Cooperative Planned Unit Development (PUD) Propertyis notlocatedin a project
Peiwlivcestetece)a)
Title to the Property Will be Held in What Name(s)
For RefinanceTitle to the Property is Currently Held in What Name(s
Trust Information
tle Will be Held byan Inter Vivos (Living) Trust
Title Will be Held by a Land TrustLeasehold Expiration Date
Mannerin WhichTitle Will be Held Indian Country Land Tenure
Sole OwnershipLife EstateTenancy in Common
Joint Tenancywith Right of Survivorship]Tenancybythe EntiretyOther
Fee Simple Ona ReservationIndividualTrust Land (AllottedRestricted)Tribal Trust Land On a ReservationTribal Trust Land Off ReservationAlaska Native Corporation Land
Estate Will be Held in
Fee Simple(mmddyyyy)
3 Mortgage LoanInformation
Termsof Loan
Note Rate
Loan Term (months)
MortgageLien Type
First LienSubordinate Lien
Mortgage Type Applied For
Conventional USDA-RDFHA VA Other
Amortization Type
Fixed RateAdjustable Rate
If Adjustable Rate
Initial Period Prior to First Adjustment
Subsequent AdjustmentPeriod
Proposed Monthly Paymentfor Property
First Mortgage (P amp I) $
Subordinate Lien(s) (P amp |) $
Other(explain)
Homeowners Insurance $(months)
(months)
Loan Features Property Taxes $
Balloon Balloon Term (months)
Interest Only Interest OnlyTermNegative AmortizationPrepaymentPenalty Prepayment Penalty Term (months) Other
Temporary Interest Rate BuydownInitial Buydown Rate TOTALOther(explain)
Mortgage Insurance $
AssociationProject Dues (Condo Co-Op PUD) $
Supplemental Property Insurance $
(months)
Borrower Name(s)Uniform Residential Loan Application mdash LenderLoan Information
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
L4 Qualifying the Borrower - Minimum Required Funds or Cash Back
DUEFROM BORROWER(S)
A Sales Contract Price
B Improvements Renovations and Repairs
C Land(ifacquired separately)
D For Refinance Balance of Mortgage Loanson the Propertyto be paid off in the Transaction
(See Table 3a Property You Own)
E Credit Cards and Other Debts Paid Off
(See Table 2c Liabilities mdash Credit Cards Other Debts and Leases that You Owe)
F BorrowerClosing Costs (including Prepaid andInitial Escrow Payments)
G Discount Points
HTOTAL DUE FROM BORROWER(s)(Total of A thru G)
TOTALMORTGAGE LOANS
Loan Amount
Loan AmountExcluding Financed Mortgage Insurance (or Mortgage Insurance Equivalent) $
Financed Mortgage Insurance (or Mortgage Insurance Equivalent) Amount $
Other New Mortgage Loanson the Property the Borrower(s) is Buying or Refinancing(See Table 4b Other New MortgageLoanson the Property You are Buying or Refinancing)
KTOTAL MORTGAGELOANS(Totalof| and J)
TOTALCREDITS
L Seller Credits (Enter the amountofBorrower(s) costs paid by the property seller)
MOtherCredits (Enter the sum ofall other credits mdash BorrowerPaid Fees Earnest Money EmployerAssistedHousing Lease Purchase Fund Lot Equity Relocation Funds Sweat Equity Trade Equity Other)
NTOTAL CREDITS(Total of L and M)
CALCULATION
TOTAL DUE FROM BORROWER(s)(Line H)
LESSTOTAL MORTGAGELOANS(Line K) AND TOTAL CREDITS(Line N)
Cash FromTothe Borrower(Line H minusLine K and Line N)NOTE This amountdoesnotinclude reservesor other funds that may be required by the Lenderto be verified
Borrower Name(s)Uniform Residential Loan Application mdash LenderLoan Information
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
Uniform Residential Loan Application mdash Unmarried Addendum
eeCeceetatimC elitleeComeLy
Lenders Instructions for Using the Unmarried Addendum
The Lender may use the Unmarried Addendum only when a Borrowerselected ldquoUnmarriedrdquoin Section 1 and the information collected is
necessary to determine howState property lawsdirectly or indirectly affecting creditworthiness apply including ensuring clear title
For example the Lender may use the Unmarried Addendum whentheBorrowerresides in a State that recognizescivil unions domestic
partnerships or registered reciprocal beneficiary relationships or when the property is located in such a State ldquoStaterdquo meansanystate the
District of Columbia the Commonwealth of Puerto Rico or anyterritory or possession of the United States
Ifyou selected ldquoUnmarriedrdquoin Section 1 is there a person whois not your legal spouse but whocurrently has real property rights similar to
those of a legal spouse +=) NOQ YES
If YES indicate the type of relationship and the State in which the relationship was formed For example indicate if you are in a
civil union domestic partnership registered reciprocal beneficiary relationship or other relationship recognized by the State in which you
currently reside or where the property is located
O Civil Union copy Domestic Partnership copy Registered Reciprocal Beneficiary Relationship copy) Other(explain)
Statea]
Borrower NameUniform Residential Loan Application mdash Unmarried Addendum
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Uniform Residential Loan Application mdash Continuation Sheet
Use this continuation sheet if you need more space to complete the Uniform Residential Loan Application
Borrower Name(First Middle Last Suffix )
Additional Information
Additional Borrower Name(First Middle Last Suffix )
Additional Information
IWefully understand thatit is a federal crime punishable by fine or imprisonment or both to knowingly make anyfalse statements concerningany of the abovefacts as applicable underthe provisions of federal law (18 USC sectsect 1001 et seq)
BorrowerSignature Date (mmddyyyy)
Additional Borrower Signature Date (mmddyyyy)
Uniform Residential Loan Application mdash Continuation SheetFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
INSTRUCTIONS FOR COMPLETING THE UNIFORM RESIDENTIAL LOAN APPLICATION
Use the instructions below to complete the enclosed Uniform Residential Loan Application (Freddie Mac Form 65Fannie Mae Form 1003) To avoid any delays in your application review please provide all of the requested information
If you need to make a correction on the application draw a line through the incorrect text and mark your initials beside the change Donrsquot use correction tape or fluid The application must be completed signed and dated in ink
The Uniform Residential Loan Application (URLA)
The URLA contains the following sections Section 1 Borrower Information Please provide your personal information income and employment
Section 2 Financial Information ndash Assets and Liabilities Please provide information about your financial assets personal financial obligations and debts you owe
Section 3 Financial Information ndash Real Estate Please provide information about property you own and the debts and expenses related to the property
Section 4 Loan and Property Information Please provide information about the loan purpose and the property you are buying or refinancing
Section 5 Declarations Please answer questions about the property how the property will be financed and your past financial history
Section 6 Acknowledgments and Agreements Informs you of your legal obligations related to the mortgage application and asks that you acknowledge certain information will be obtained used and shared
Section 7 Military Service Please provide information about your (or your deceased spousersquos) military service
Section 8 Demographic Information Requests information the Lender is required by law to ask you
Section 9 Loan Originator Information Will be completed by Chase
Uniform Residential Loan Application ndash Additional Borrower
The URLA ndash Additional Borrower contains the following sections Section 1 Borrower Information This is the same as the Borrower Information section of the URLA
Section 2 Financial Information ndash Assets and Liabilities Contains only the following statement for the additional Borrower to complete ldquoMy information for Section 2 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo The name of the other borrower is entered here
Complete a separate URLA for each BorrowermiddotThree or more Borrowers ndash Use any combination of URLA and URLA-Additional Borrower forms in accordance with the above examples
Section 3 Financial Information ndash Real Estate Contains only the following statement for the additional borrower to complete ldquoMy information for Section 3 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 4 Loan and Property Information Contains only the following statement for the additional borrower to complete ldquoMy information for Section 4 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 5 Declarations This is the same as the Declarations section of the URLA
Section 6 Acknowledgments and Agreements Contains only the following statement for the additional borrower to complete ldquoMy signature for Section 6 is on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 7 Military Service This is the same as the Military Service section of the URLA
Section 8 Demographic Information This is the same as the Demographic Information section on the URLA
Section 9 Loan Originator Information This is the same as the Loan Originator Information section of the URLA
Using the URLA and URLA ndash Additional Borrower Together The URLA and the URLA ndash Additional Borrower are used together to collect information for two Borrowers who have joint assets liabilities andor real estate information The URLA and URLA ndash Additional Borrower can also be used for Borrowers who do not have joint information but wish to combine their information on the URLA for ease of use Here are examples of how to use the URLA and URLA ndash Additional Borrower
For one borrower Complete the URLA
For two borrowers with joint financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you dont need to duplicate them on more than one URLA or o In cases where Borrowers are not collaborating when completing the loan application
joint assets liabilities and real estate may be duplicated on each URLA bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you do not need to duplicate them on more than one URLA or
o In cases where Borrowers are not collaborating when completing the loan application joint assets liabilities and real estate may be duplicated on each URLA
For two borrowers with separate financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower Report the assets liabilities and
real estate for the additional Borrower on the URLA or bull Complete a separate URLA for each Borrower
For three or more borrowers use any combination of URLA and URLA ndash Additional Borrower forms described for two borrowers
Uniform Residential Loan Application ndash Unmarried Addendum If any borrower listed on the URLA or URLA ndash Additional Borrower form selects Unmarried in Section 1 (Personal Information) the lender will complete this optional form
The information must be collected to determine how to apply state property laws that directly or indirectly affect creditworthiness including ensuring clear title
Uniform Residential Loan Application ndash Continuation Sheet Use the URLA ndash Continuation Sheet if you need more space to complete either the URLA or URLA ndash Additional Borrower forms
99177-URLAI-0215
HUD Addendum to Uniform Residential Loan Application OMB Approval No HUD 2502-0059 (exp )
Part I - Identifying Information HUDFHA Application for Insurance under the National Housing Act and Borrower Certification
FHA Case No (include any suffix) Mortgagee Case No
Mortgagee ID Sponsor ID Agent ID
Mortgagee Name Address (include ZIP Code) and Telephone Number
Type or print all entries clearly
Name and Address of Sponsor Name and Address of Agent
Borrowers Name amp Present Address (include ZIP Code) Property Address (include name of subdivision lot amp block no amp ZIP Code)
Sponsored Originations
Name of Third-Party Originator NMLS ID of Third-Party Originator
Part II - Borrower Consent for Social Security Administration to Verify Social Security Number I authorize the Social Security Administration (SSA) to verify my Social Security Number (SSN) to the Mortgagee and HUDFHA I authorize SSA to provide explanatory
information to HUDFHA in the event of a discrepancy This consent is valid for 180 days from the date signed unless indicated otherwise by the individual(s) named in this
loan application
Signature(s) of Borrower(s) - Read consent carefully Review accuracy of Social Security Number(s) provided on this application
Borrowerrsquos NameDate of BirthSocial Security Number
Co-Borrowerrsquos Name Date of BirthSocial Security Number
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
Part III - Borrower Notices Information and Acknowledgment Public Reporting Burden
Public reporting burden for this collection of information is estimated to average 10 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 conduct or sponsor and a person is not
required to respond to a collection of information unless that collection displays a valid OMB control number which can be located on the OMB Internet page at
httpwwwreginfogovpublicdoPRAMain
Privacy Act Information
The information requested on the Uniform Residential Loan Application and this Addendum is authorized by the National Housing Act of 1934 12 USC sect 1701 et seq The Debt
Collection Act of 1982 Pub L 97-365 and HUDrsquos Housing and Community Development Act of 1987 42 USC sect 3543 require persons applying for a federally insured loan to
furnish their SSN You must provide all the requested information including your SSN HUD may conduct a computer match to verify the information you provide HUD may
disclose certain information to Federal State and local agencies when relevant to civil criminal or regulatory investigations and prosecutions It will not otherwise be disclosed or
released outside of HUD except as required and permitted by law The information will be used to determine whether you qualify as a mortgagor Failure to provide any of the
requested information including SSN may result in disapproval of your loan application This is notice to you as required by the Right to Financial Privacy Act of 1978 that
HUDFHA has a right of access to financial records held by financial institutions in connection with the consideration or administration of assistance to you Financial records
involving your transaction will be available to HUDFHA without further notice or authorization but will not be disclosed or released by the institution to another Government Agency
or Department without your consent except as required or permitted by law
WARNING This warning applies to all certifications made in this document Anyone who knowingly submits a false claim or makes false statements is subject to criminal and civil penalties including confinement for up to 5 years fines and civil penalties 18 USC sectsect 287 1001 and 31 USC sect 3729
orm HUD-92900-A ( ) Page 1
Borrower Name ____________________________ FHA Case No __________________
Caution Delinquencies Defaults Foreclosures and Abuses Delinquencies defaults foreclosures and abuses of mortgage loans involving programs of the Federal Government can be costly and detrimental to your credit now and in the future The Mortgagee in this transaction its agents and assigns as well as the Federal Government its agencies agents and assigns are authorized to take any and all of the following actions in the event loan payments become delinquent on the mortgage loan described in the attached application (1) Report your name and account information to a credit bureau (2) Assess additional interest and penalty charges for the period of time that payment is not made (3) Assess charges to cover additional administrative costs incurred by the Federal Government to service your account (4) Offset amounts owed to you
under other Federal programs (5) Refer your account to a private attorney collection agency or mortgage servicing agency to collect the amount due foreclose
the mortgage sell the property and seek judgment against you for any deficiency (6) Refer your account to the Department of Justice (DOJ) for litigation in the
courts (7) If you are a current or retired Federal employee take action to offset your salary or civil service retirement benefits (8) Refer your debt to the Internal
Revenue Service for offset against any amount owed to you as an income tax refund and (9) Report any resulting written off debt of yours to the Internal Revenue Service as your taxable income All of these actions may be used to recover any debts owed when it is determined to be in the interest of the Mortgagee or Federal Government or both
As a mortgage loan borrower you will be legally obligated to make the mortgage payments called for by your mortgage loan contract The fact that you dispose of your property after the loan has been made will not relieve you of liability for making these payments Payment of the loan in full is ordinarily the way liability on a mortgage note is ended Some home buyers have the mistaken impression that if they sell their homes when they move to another locality or dispose of it for any other reasons they are no longer liable for the mortgage payments and that liability for these payments is solely that of the new owners Even though the new owners may agree in writing to assume liability for your mortgage payments this assumption agreement will not relieve you from liability to the holder of the note which you signed when you obtained the loan to buy the property Unless you are able to sell the property to a buyer who is acceptable to HUDFHA who will assume the payment of your obligation to the lender you will not be relieved from liability to repay any claim which HUDFHA may be required to pay your lender on account of default in your loan payments The amount of any such claim payment may be a debt owed by you to the Federal Government and subject to established collection procedures
Fair Housing Act I and anyone acting on my behalf are and will remain in compliance with the Fair Housing Act 42 USC sect 3604 et seq with respect to the dwelling or property covered by the loan and in the provision of services or facilities in connection therewith I recognize that any restrictive covenant on this property related to race color religion sex disability familial status or national origin is unlawful under the Fair Housing Act and unenforceable I further recognize that in addition to administrative action by HUD a civil action may be brought by the DOJ in any appropriate US court against any person responsible for a violation of the
applicable law
Certification and Acknowledgment All information in this application is given for the purpose of obtaining a loan to be insured under the National Housing Act and the information in the Uniform Residential Loan Application and this Addendum is true and complete to the best of my knowledge and belief Verification may be obtained from any source named herein I have read and understand the foregoing concerning my liability on the loan and Part III Borrower Notices Information and Acknowledgment
Signature(s) of Borrower(s) - Do not sign unless this application is fully completed Read the certification carefully and review accuracy of this application
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
orm HUD-92900-A ( Page 2
___________________________________
______________________________________________________
______________________________________________________________
- - - - - - - - - - - - - - - - - - - - - - -
Borrower Name ____________________________ FHA Case No __________________
Part IV - Direct Endorsement Approval for a HUD FHA-Insured Mortgage A Underwriting the Borrower
Date Mortgage Approved ______________________________ Date Approval Expires ______________________
For mortgages rated as an ldquoacceptrdquo or ldquoapproverdquo by FHAs TOTAL Mortgage Scorecard
The information submitted to TOTAL was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA4e Final Underwriting Decision (TOTAL) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee Representative Signature
Printed Name
Title
OR
For mortgages rated as a ldquoreferrdquo by FHAs TOTAL Mortgage Scorecard or manually underwritten by a Direct Endorsement underwriter I have personally reviewed and underwritten the borrowerrsquos credit application The information used to underwrite the borrower was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA5d Final Underwriting Decision (Manual) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
B Underwriting the Property
For all mortgages where FHA requires an appraisal I have personally reviewed and underwritten the appraisal according to FHA requirements I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
orm HUD-92900-A ( ) Page 3
Borrower Name ____________________________ FHA Case No __________________
Part V Mortgagees Certification
I have personally reviewed the mortgage documents and the application for insurance endorsement and This mortgage complies with SF Handbook 40001 Section IIA7 Post-Closing and Endorsement to the extent that no defect exists that would have changed the decision to endorse or submit the mortgage for insurance
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee
Name of Mortgageersquos Representative
Title of Mortgageersquos Representative
Signature of the Mortgageersquos Representative Date
orm HUD-92900-A ( ) Page 4
GENERAL AUTHORIZATION FOR A MORTGAGE LOAN ASSUMPTION
Applicant name(s)
Loan number
NOTICES AND DISCLOSURES
Non-discriminatory underwriting guidelines Anyone who inquires about the availability of credit from us has the right to receive a copy of our non-discriminatory underwriting guidelines To request a copy of these guidelines contact your Loan Processor
Attorney note Itrsquos the responsibility of our attorneys to protect our interest You may at your expense request an attorney to represent your interest
Notice to HUDFHA applicants As required by the Right to Financial Privacy Act of 1978 this notice is to inform you that the US Department of Housing and Urban Development (HUD)Federal Housing Administration (FHA) has a right of access to financial records held by financial institutions related to a request for assistance Financial records involving your assumption will be available to HUDFHA without further notice or authorization but wonrsquot be disclosed or released by us to another government agency or department without your consent except as required or permitted by law
Borrower consent to the use of tax return information I understand acknowledge and agree that the Lender and Other Loan Participants can obtain use and share tax return information for purposes of (i) providing an offer (ii) originating maintaining managing monitoring servicing selling insuring and securitizing a loan (iii) marketing or (iv) as otherwise permitted by applicable laws including state and federal privacy and data security laws The Lender includes the Lenderrsquos affiliates agents service providers and any of aforementioned partiesrsquo successors and assigns The Other Loan Participants includes any actual or potential owners of a loan resulting from your loan application or acquirers of any beneficial or other interest in the loan and mortgage insurer guarantor any servicers or service providers for these parties and any of aforementioned partiesrsquo successors and assigns
CERTIFICATION AND AUTHORIZATION
Environmental certification By signing below I represent and warrant that Irsquom not aware of any substances materials or products that may be an environmental hazard such as but not limited to asbestos formaldehyde radon gas lead-based paint fuel or chemical storage tanks (above or below ground) and contaminated soil or water on the property I acknowledge that Chase is relying on this representation and warranty as a material part of its loan application process I also am not aware of any landfill on any portion of the property
Exceptions to the above I further acknowledge (1) receipt of applicable disclosures from the seller in purchase transactions (2) that lead-based paint may exist in housing constructed prior to 1978 (3) that Chase performs no environmental investigation on my behalf and isnrsquot responsible for identifying lead-based paint or any other environmental conditions that might impact the property or its residents and (4) that it is my sole obligation to investigate for potential impact to the property from environmental conditions
Certifications I certify by signing below that (1) all of the loan application information provided is true and complete (2) I understand any intentional or negligent misrepresentation(s) of the information provided in conjunction with my application may result in civil liability andor 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 Chase its agents successors and assigns insurers and any other person who may suffer any loss due to reliance upon any misrepresentation that I have made on the application and (3) any significant change from the information provided at the time of application until the final loan application is signed may have a bearing on the approval of my application for a home loan
Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union
This question is asked because of state laws that extend the same or similar rights benefits and protections of spouses in a marriage to persons who are members of a partnership or union recognized under state law You should consult with your own legal advisor for advice regarding the rights protections benefits responsibilities obligations and duties of those who are registered domestic partners civil union partners or members of other unions recognized under applicable law
CREDIT AUTHORIZATION RELEASE
By signing below I authorize Chase andor my mortgage insurer (if any) to verify my past and present employment earnings records (including information contained in income tax returns that have been filed with the IRS) bank accounts stock holdings and any other information that it finds necessary to process my mortgage loan application or to review it for quality-control purposes I understand that a credit report will be ordered from a credit reporting agency for verification prior to loan closing as part of the application process and may be ordered after closing as part of the Lenderrsquos quality-control program A credit report may also be completed as part of the Lenderrsquos servicing or collection of the loan or in consideration of any other product or service that the Lender may consider offering me in the future and at any time throughout the life of the loan I understand that use of a photocopy of this form may be necessary to verify one or more of my credit references I understand that a photocopy or fax copy of this form will also serve as authorization
By signing below each applicant acknowledges (1) making the above certifications and authorizations and (2) that each applicant has received and understands the above notices and disclosures
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
You do not have to give us this information but if you donrsquot your application for approval as a borrower may be delayed or rejected The information requested in this form is authorized by Title 38 USC Chapter 37 (if VA) by 12 USC Section 1701 et seq (if HUDFHA) by 42 USC Section 1452b (if HUDCPD) and Title 42 USC 1471 et seq or 7 USC 1921 et seq (if USDA FHA)
Updated December 2021 99177-GA-0215
1b
2b
Form 4506-C (September 2020)
Department of the Treasury - Internal Revenue Service
IVES Request for Transcript of Tax Return OMB Number
1545-1872
Do not sign this form unless all applicable lines have been completed Request may be rejected if the form is incomplete or illegible
For more information about Form 4506-C visit wwwirsgov and search IVES
1a Name shown on tax return (if a joint return enter the name shown first)
First social security number on tax return individual taxpayer identification number or employer identification number (see instructions)
2a If a joint return enter spousersquos name shown on tax return Second social security number or individual taxpayer identification number if joint tax return
3 Current name address (including apt room or suite no) city state and ZIP code (see instructions)
4 Previous address shown on the last return filed if different from line 3 (see instructions)
5a IVES participant name address and SOR mailbox ID
DataVerify 875 Greentree Rd 8 Parkway Center Pittsburgh PA 15220
5b Customer file number (if applicable) (see instructions)
Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing (see instructions)
6 Transcript requested Enter the tax form number here (1040 1065 1120 etc) and check the appropriate box below Enter only one tax form number per request 1040
a Return Transcript which includes most of the line items of a tax return as filed with the IRS A tax return transcript does not reflect changes made to the account after the return is processed Transcripts are only available for the following returns Form 1040 series Form 1065 Form 1120 Form 1120-A Form 1120-H Form 1120-L and Form 1120S Return transcripts are available for the current year and returns processed during the prior 3 processing years
b Account Transcript which contains information on the financial status of the account such as payments made on the account penalty assessments and adjustments made by you or the IRS after the return was filed Return information is limited to items such as tax liability and estimated tax payments Account transcripts are available for most returns
c Record of Account which provides the most detailed information as it is a combination of the Return Transcript and the Account Transcript Available for current year and 3 prior tax years
7 Form W-2 Form 1099 series Form 1098 series or Form 5498 series transcript The IRS can provide a transcript that includes data from these information returns State or local information is not included with the Form W-2 information The IRS may be able to provide this transcript information for up to 10 years Information for the current year is generally not available until the year after it is filed with the IRS For example W-2 information for 2016 filed in 2017 will likely not be available from the IRS until 2018 If you need W-2 information for retirement purposes you should contact the Social Security Administration at 1-800-772-1213
Caution If you need a copy of Form W-2 or Form 1099 you should first contact the payer To get a copy of the Form W-2 or Form 1099 filed with your return you must use Form 4506 and request a copy of your return which includes all attachments
8 Year or period requested Enter the ending date of the tax year or period using the mmddyyyy format (see instructions)
12 31 2020 12 31 2019 12 31 2018 Caution Do not sign this form unless all applicable lines have been completed
Signature of taxpayer(s) I declare that I am either the taxpayer whose name is shown on line 1a or 2a or a person authorized to obtain the tax information requested If the request applies to a joint return at least one spouse must sign If signed by a corporate officer 1 percent or more shareholder partner managing member guardian tax matters partner executor receiver administrator trustee or party other than the taxpayer I certify that I have the authority to execute Form 4506-C on behalf of the taxpayer Note This form must be received by IRS within 120 days of the signature date
Signatory attests that heshe has read the attestation clause and upon so reading declares that heshe has the authority to sign the Form 4506-C See instructions
Sign Here
Signature (see instructions) Date Phone number of taxpayer on line 1a or 2a
PrintType name
Title (if line 1a above is a corporation partnership estate or trust)
Spousersquos signature Date
PrintType name
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020) For Privacy Act and Paperwork Reduction Act Notice see page 2
Instructions for Form 4506-C IVES Request for Transcript of Tax Return
Section references are to the Internal Revenue Code unless otherwise noted
Future Developments
For the latest information about Form 4506-C and its instructions go to wwwirsgov and search IVES Information about any recent developments affecting Form 4506-C (such as legislation enacted after we released it) will be posted on that page
Whats New Form 4506-C was created to be utilized by authorized IVES participants to order tax transcripts with the consent of the taxpayer
General Instructions
Caution Do not sign this form unless all applicable lines have been completed
Designated Recipient Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information received pursuant to the taxpayerrsquos consent and holds the recipient subject to penalties for any unauthorized access other use or redisclosure without the taxpayerrsquos express permission or request
Taxpayer Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information provided pursuant to your consent and holds the recipient subject to penalties brought by private right of action for any unauthorized access other use or redisclosure without your express permission or request
Purpose of form Use Form 4506-C to request tax return information through an authorized IVES participant You will designate an IVES participant to receive the information on line 5a
Note If you are unsure of which type of transcript you need check with the party requesting your tax information
Where to file The IVES participant will fax Form 4506-C with the approved IVES cover sheet to their assigned Service Center
Chart for ordering transcripts
If your assigned Service Center is
Fax the requests with the approved coversheet to
Austin Submission Processing Center
Austin IVES Team
844-249-6238
Fresno Submission Processing Center
Fresno IVES Team
844-249-6239
Kansas City Submission Processing Center
Kansas City IVES Team
844-249-8128
Ogden Submission Processing Center
Ogden IVES Team
844-249-8129
Specific Instructions
Line 1b Enter the social security number (SSN) or individual taxpayer identification number (ITIN) for the individual listed on line 1a or enter the employer identification number (EIN) for the business listed on line 1a
Line 3 Enter your current address If you use a PO box include it on this line
Line 4 Enter the address shown on the last return filed if different from the address entered on line 3
Note If the addresses on lines 3 and 4 are different and you have not changed your address with the IRS file Form 8822 Change of Address or Form 8822-BChange of Address or Responsible Party mdash Business with Form 4506-C
Line 5b Enter up to 10 numeric characters to create a unique customer file number that will appear on the transcript The customer file number cannot contain an SSN ITIN or EIN Completion of this line is not required
Note If you use an SSN name or combination of both we will not input the information and the customer file number will reflect a generic entry of 9999999999 on the transcript
Line 8 Enter the end date of the tax year or period requested in mmddyyyy format This may be a calendar year fiscal year or quarter Enter each quarter requested for quarterly returns Example Enter 12312018 for a calendar year 2018 Form 1040 transcript
Signature and date Form 4506-C must be signed and dated by the taxpayer listed on line 1a or 2a The IRS must receive Form 4506-C within 120 days of the date signed by the taxpayer or it will be rejected Ensure that all applicable lines including lines 5a through 8 are completed before signing
You must check the box in the signature area to acknowledge you have the authority to sign and request the information The form will not be processed if unchecked
Individuals Transcripts listed on on line 6 may be furnished to either spouse if jointly filed Only one signature is required Sign Form 4506-C exactly as your name appeared on the original return If you changed your name also sign your current name
Corporations Generally Form 4506-C can be signed by
(1) an officer having legal authority to bind the corporation (2) any person designated by the board of directors or other governing body or (3) any officer or employee on written request by any principal officer and attested to by the secretary or other officer A bona fide shareholder of record owning 1 percent or more of the outstanding stock of the corporation may submit a Form 4506-C but must provide documentation to support the requesters right to receive the information
Partnerships Generally Form 4506-C can be signed by any person who was a member of the partnership during any part of the tax period requested on line 8
All others See section 6103(e) if the taxpayer has died is insolvent is a dissolved corporation or if a trustee guardian executor receiver or administrator is acting for the taxpayer
Note If you are Heir at law Next of kin or Beneficiary you must be able to establish a material interest in the estate or trust
Documentation For entities other than individuals you must attach the authorization document For example this could be the letter from the principal officer authorizing an employee of the corporation or the letters testamentary authorizing an individual to act for an estate
Signature by a representative A representative can sign Form 4506-C for a taxpayer only if the taxpayer has specifically delegated this authority to the representative on Form 2848 line 5 The representative must attach Form 2848 showing the delegation to sign Form 4506-C
Privacy Act and Paperwork Reduction Act Notice We ask for the information on this form to establish your right to gain access to the requested tax information under the Internal Revenue Code We need this information to properly identify the tax information and respond to your request You are not required to request any transcript if you do request a transcript sections 6103 and 6109 and their regulations require you to provide this information including your SSN or EIN If you do not provide this information we may not be able to process your request Providing false or fraudulent information may subject you to penalties
Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and cities states the District of Columbia and US commonwealths and possessions for use in administering their tax laws We may also disclose this information to other countries under a tax treaty to federal and state agencies to enforce federal nontax criminal laws or to federal law enforcement and intelligence agencies to combat terrorism
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law Generally tax returns and return information are confidential as required by section 6103
The time needed to complete and file Form 4506-C will vary depending on individual circumstances The estimated average time is
Learning about the law or the form 10 min Preparing the form 12 min Copying assembling and sending the form to the IRS 20 min
If you have comments concerning the accuracy of these time estimates or suggestions for making Form 4506-C simpler we would be happy to hear from you You can write to
Internal Revenue Service Tax Forms and Publications Division 1111 Constitution Ave NW IR-6526 Washington DC 20224
Do not send the form to this address Instead see Where to file on this page
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020)
Rev April 2021 CHASEO Facts What does Chase do with your personal information
Why Financial companies choose how they share your personal information Federal law gives consumers the right to limit some but not all sharing Federal law also requires us to tell you how we collect share and protect your personal information Please read this notice carefully to understand what we do
What The types of personal information we collect and share depend on the product or service you have with us This information can include bull Social Security number and income bull account balances and transaction history bull credit history and payment history
How All financial companies need to share customers personal information to run their everyday business In the section below we list the reasons financial companies can share their customers personal information the reasons Chase chooses to share and whether you can limit this sharing
Reasons we can share your personal information Does Chase share
Can you limit this sharing
For our everyday business purposes - such as to process your transactions maintain your account(s) respond to court orders and legal investigations or report to credit bureaus
Yes No
For our marketing purposes - to offer our products and services to you
Yes No
For joint marketing with other financial companies Yes No
For our affiliates everyday business purposes - information about your transactions and experiences
Yes No
For our affiliates everyday business purposes - information about your creditworthiness
Yes Yes
For our affiliates to market to you Yes Yes
For nonaffiliates to market to you Yes Yes
a
0
To limit our sharing
bull Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
bull Visit us online chasecomprivacypreferences
Please note If you are a new customer we can begin sharing your information 30 days from the date we sent this notice When you are no longer our customer we continue to share your information as described in this notice However you can contact us at any time to limit our sharing
Questions
Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
PAGE 2
Who we are
Who is providing this notice The US consumer financial companies within the JPMorgan Chase amp Co family including JPMorgan Chase Bank NA Chase Insurance Agency Inc and JP Morgan Securities LLC
What we do
How does Chase protect my To protect your personal information from unauthorized access and use we personal information use security measures that comply with federal law These measures include
computer safeguards and secured files and buildings We authorize our employees to get your information only when they need it to do their work and we require companies that work for us to protect your information
How does Chase collect my We collect your personal information for example when you personal information bull open an account or make deposits or withdrawals from your account
bull pay your bills or apply for a loan bull use your credit or debit card We also collect your personal information from others such as credit bureaus affiliates or other companies
Why cant I limit all sharing Federal law gives you the right to limit only bull sharing for affiliates everyday business purposes - information about your
creditworthiness bull affiliates from using your information to market to you bull sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing See below for more on your rights under state law
What happens when I limit sharing for an account I hold jointly with someone else
Your choices will apply to everyone on your account
Definitions
Affiliates Companies related by common ownership or control They can be financial and non financial companies bull Our affiliates include companies with a Chase or JP Morgan name and financial companies such asjP Morgan Securities LLC
Nonaffiliates Companies not related by common ownership or control They can be financial and non financial companies bull Nonaffiliates we share with can include companies such as retailers auto dealers auto makers and membership clubs
Joint marketing A formal agreement between nonaffiliated financial companies that together market financial products or services to you bull Our joint marketing partners include categories of companies such as insurance companies
Other important information
VT Accounts with a Vermont mailing address are automatically treated as if they have limited the sharing as described on page 1 For joint marketing we will only disclose your name contact information and information about your transactions
NV We are providing you this notice pursuant to Nevada law If you prefer not to receive marketing calls from us you may be placed on our Internal Do Not Call List by calling 1-800-945-9470 or by writing to us at PO Box 734007 Dallas TX 75373-4007
For more information contact us at the address above or email PrivacylnfoJPMChasecom with Nevada Annual Notice in the subject line You may also contact the Nevada Attorney Generals office Bureau of Consumer Protection Office of the Nevada Attorney General 555 E Washington St Suite 3900 Las Vegas NV 89101 telephone number 1-702-486-3132 email BCPINFOagstatenvus
CA Accounts with a California mailing address are automatically treated as if they have limited the sharing with nonaffiliates as described on page 1 CA residents are provided a CA notice for additional choices
CHASE O
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
The following disclosure is required by the USA PATRIOT Act
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 opens an account
What this means to you When you 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 drivers
license or other identifying documents
99177-PAT-0215
VETERAN STATEMENT When this loan was opened the US Department of Veterans Affairs (VA) used the veteran borrowerrsquos entitlement which is a set amount the VA promises to repay a lender if the borrower defaults on the mortgage An assumption will modify who is obligated to pay the existing mortgage loan but all loan termsmdashincluding the entitlementmdashwill remain the same If the veteran borrower is being removed from the loan the entitlement would remain with whoever is assuming the loan because the loan will continue to be serviced by the VA If the applicant is also a veteran and can substitute his or her entitlement for the current entitlement then the current borrowerrsquos entitlement can be released
Please review the following questions and answer as appropriate This form requires completion by both the applicant(s) and current borrower(s)
1 Applicant to Complete
Are you (the applicant) currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the reverse side)
Yes (If yes please provide the information requested below answer the question in section 3 and sign and date this form at the bottom of the reverse side)
Name of applicant(s) who answered ldquoyesrdquo to the above question
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Are you receiving VA disability benefts
Applicant
Yes
No
Co-Applicant
Yes
No
Are you entitled to receive VA disability benefts Yes No Yes No
Have you received VA disability benefts in the past Yes No Yes No
Are you a surviving spouse of a veteran who died on active duty or as the result of a service-related disability
Yes No Yes No
Do you have any VA loans Yes No Yes No
2 Current Borrower to Complete
Is the current borrowerco-borrower currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the page)
Yes (If yes please answer the question in section 3 and sign and date this form at the bottom of the page)
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
________________________________________________________________________________________________
3 Applicant and Current Borrower to Complete
If the answer to the questions in section 1 and 2 are both yes please answer the following question After yoursquove reviewed and completed this entire form please sign and date at the bottom
Applicant Current Borrower
Do you want to apply for a substitution of entitlement Yes Yes No No
In order to complete a substitution of entitlement the veteran applicant must have suffcient entitlement to substitute for that of the current borrower Contact the VA Offce of Jurisdiction for your area for more information Also before the veteran applicant can substitute entitlement on a VA loan heshe must certify that the property securing the loan will be occupied as hisher primary residence Both the applicantrsquos and current borrowerrsquos original certifcate of eligibility will be required If your sales contract is contingent upon the restoration of entitlement please contact your VA Offce of Jurisdiction for complete procedures Otherwise the substitution will be completed after the loan has been approved and closed
Date Applicant printed name Applicant signature
Date Applicant printed name Applicant signature
Date Current Borrower printed name Current Borrower signature
Date Current Borrower printed name Current Borrower signature
Forms completed by Mail Phone
For Chase use only
Interviewer signature Date
99177-VS-0215
- Assumption Application Package_41521-noscannedpages-update-4pdf
-
- 1 FM203 Cover Pagepdf
- 2 FM202 Mortgage Assumption Application Package pagepdf
- 3 The Documents Youll need to Send Uspdf
- 4 FM201 FAQpdf
- 5 FM142 CIWpdf
- 6 FM126 URLApdf
- 7 FM130 URLA Instpdf
-
- Blank Page
-
- 8 92900a Addednum to Loan Applicationpdf
- 9 FM462 Gen Authpdf
- 10 FM220 4506-Cpdf
- 11 FM153 Chase Federal Privacy Noticepdf
- 12 FM144 Info on Opening a New Accountpdf
- 13 FM152 Veteran Statementpdf
-
- Date
- Loan number
- Applicant name
- Phone1
- Loan number 1
- Loan number 2
- Other
- Other_2
- 1
- 2
- undefined_7
- Available hours
- Available hours_2
- undefined_8
- Available hours_3
- undefined_9
- Current address 1
- Neither
- Available hours_4
- Available hours_5
- undefined_10
- Available hours_6
- 1_2
- 2_2
- undefined_11
- Available hours_7
- Available hours_8
- undefined_12
- Available hours_9
- FHA Case No include any suffix
- Mortgagee Case No
- Mortgagee ID
- Sponsor ID
- Agent ID
- Name and Address of Sponsor Name and Address of Agent
- Borrowers Name Present Address include ZIP Code Property Address
- include name of subdivision lot block no ZIP Code
- Name of ThirdParty Originator
- NMLS ID of ThirdParty Originator
- s application
- ty Number
- ty Number_2
- Date Signed_2
- Date Mortgage Approved
- Date Approval Expires
- Printed Name
- Title 1
- DEs ID Number
- DEs ID Number_2
- Mortgagee
- Name of Mortgagees Representative
- Title of Mortgagees Representative
- Signature of the Mortgagees Representative
- Date_2
- Applicant names 1
- Applicant names 2
- Applicant names 3
- Loan number_2
- Date_3
- Applicant printed name
- Social Security number
- Date_4
- Applicant printed name_2
- Social Security number_2
- Date_5
- Applicant printed name_3
- Social Security number_3
- Date_6
- Applicant printed name_4
- Social Security number_4
- 1a Name shown on tax return if a joint return enter the name shown first
- 1b First social security number on tax return individual taxpayer identification number or employer identification number see instructions
- 2a If a joint return enter spouses name shown on tax return
- 2b Second social security number or individual taxpayer identification number if joint tax return
- 4 Previous address shown on the last return filed if different from line 3 see instructions
- 5a IVES participant name address and SOR mailbox ID
- Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing see instructions
- Signature see instructions
- Date_7
- Phone number of taxpayer on line 1a or 2a
- PrintType name
- Here
- Spouses signature
- Date_8
- PrintType name_2
- Name
- Date of birth
- Service number
- Name_2
- Date of birth_2
- Service number_2
- Date_9
- Applicant printed name_5
- Date_10
- Applicant printed name_6
- Date_11
- Current Borrower printed name
- Date_12
- Current Borrower printed name_2
- Date_13
- Text3
- Text10
- undefined_13
- Text15
- undefined_14
- undefined_15
- undefined_16
- undefined_17
- undefined_18
- undefined_19
- undefined_20
- undefined_21
- undefined_23
- Reason for assumption Off
- Requestors relationship to owners Off
- Check one Off
- Check one1 Off
- Day1
- Evening
- Cell phone
- Check one2 Off
- Check one3 Off
- Check one4 Off
- Check one5 Off
- Text2-1
- Text2-2
- Text2-3
- Text2-4
- Text2-5
- Text2-6
- Text3-1
- Text3-2
- Text3-3
- Text3-4
- Text3-6
- Text3-7
- Text3-8
- Text3-9
- Text3-10
- Text3-11
- Text3-12
- Text3-13
- Text3-14
- Text3-15
- Text3-16
- Text3-17
- Text3-18
- Text3-19
- Text3-20
- Text3-21
- Text3-22
- Text3-23
- Text3-24
- Text3-25
- Text3-26
- Text3-27
- Text3-28
- Text3-29
- Text3-30
- Text3-31
- Text3-32
- Text3-33
- Text3-34
- Text3-35
- Text3-36
- Text3-37
- Text3-38
- Text3-39
- Text3-40
- Text3-41
- Text3-42
- Text3-43
- Text3-44
- Text3-45
- Text3-46
- Text3-47
- Text3-48
- Text3-49
- Text3-50
- Text3-51
- Text3-52
- Text3-53
- Text3-5
- Text3-54
- Text3-55
- Text3-56
- Citizenship Off
- Type of credit Off
- Marital Status Off
- Housing Off
- Housing1 Off
- ownership Off
- DNA1 Off
- DNA2 Off
- DNA3 Off
- family Off
- BO Off
- Total
- Text31
- Text32
- Text33
- Text34
- Text35
- Text36
- Text37
- Text38
- Text39
- Text310
- Text311
- Text312
- Text313
- Text314
- Text315
- Text316
- Text317
- Text318
- Text319
- ownership1 Off
- Total1
- Total1-2
- Check Box4-1 Off
- Text320
- Text321
- Text322
- Text323
- Text324
- Text325
- Text326
- Text327
- Text328
- Text329
- Check Box4-2 Off
- Check Box4-3 Off
- Check Box4-4 Off
- Check Box4-8 Off
- Check Box4-9 Off
- Text330
- Text331
- Text332
- Text333
- Text334
- Text335
- Text1-1
- Text1-2
- Text1-3
- Text1-4
- Text1-5
- Text1-6
- Text1-7
- Text1-8
- Text1-9
- Text1-10
- Text1-11
- Text1-12
- Text1-13
- Text1-14
- Text1-15
- Text1-16
- Text1-17
- Text1-18
- Text1-19
- Text1-20
- Text1-21
- Text1-22
- Text1-23
- Text1-24
- Text1-25
- Text1-26
- Text1-27
- Text1-28
- Text1-29
- Text1-30
- Text1-31
- Text1-32
- Text1-33
- Text1-34
- Text1-35
- Check Box3-2 Off
- Check Box2-1 Off
- Check Box2-2 Off
- Check Box2-3 Off
- Check Box2-4 Off
- Check Box2-5 Off
- Text1-36
- Text1-37
- Text1-38
- Text1-39
- Text1-40
- Text1-41
- Text1-42
- Text1-43
- Text1-44
- Text1-45
- Text1-46
- Text1-47
- Text1-48
- Text1-49
- Text1-50
- Text1-51
- Text1-52
- Text1-53
- Text1-54
- Text1-55
- Text1-56
- Text1-57
- Text1-58
- Text1-59
- Text1-60
- Text1-61
- Check Box3-11 Off
- A1
- A2
- A3
- A4
- A5
- A6
- A7
- A8
- A9
- A10
- A11
- A12
- Check Box3-1 Off
- Check Box30-1 Off
- Check Box30-2 Off
- Check Box30-4 Off
- Check Box30-5 Off
- Check Box30-7 Off
- Check Box30-8 Off
- Check Box30-9 Off
- Check Box30-10 Off
- Check Box30-11 Off
- Check Box30-12 Off
- A13
- A14
- A15
- A16
- A17 Off
- A18
- A19
- A20
- A21
- A22
- A23
- A24
- A25
- A26
- A27
- A28
- A29
- A30
- A31
- A32
- A33
- A34
- A35
- A36
- A37
- A38 Off
- A39
- A40
- A41
- A42
- A43
- A44
- A45
- A46
- A47
- A48
- A49
- A50
- A51
- A52
- A53
- A54
- A55
- A56
- A57
- A58
- A59
- A60
- A61
- A62
- A63
- A64
- A65
- A66
- A67
- A68
- A69
- A70
- A71
- A72
- A73
- A74
- Loan Purpose Off
- occupancy1 Off
- lien type Off
- lientype Off
- mixed use Off
- manufactured home Off
- deposit1 Off
- deposit2 Off
- B1
- B2
- B3
- B4
- B5
- B6
- B7
- B8
- B9
- B10
- fha Off
- Check Box51 Off
- B11
- B12
- B13
- B14
- B15
- B16
- B17
- B18
- B19 Off
- B20
- B21
- B22 Off
- B23
- B24
- B25
- B26
- B27
- B28
- A
-
- Will you occupy the property as your primary residence Off
- Will you occupy the property as your primary residence1 Off
-
- If yes have you had an ownership interest in another property in the last three years Off
- Text9-2
- B
-
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property Off
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property1 Off
-
- 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 Off
- 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 application1 Off
-
- 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 Off
- 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 application1 Off
-
- new credit Off
- 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) Off
- the Property Assessed Clean Energy Program)1 Off
-
- F
-
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application Off
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application1 Off
-
- G
-
- Are there any outstanding judgments against you Off
- Are there any outstanding judgments against you1 Off
-
- H
-
- Are you currently delinquent or in default on a Federal debt Off
- Are you currently delinquent or in default on a Federal debt1 Off
-
- I
-
- Are you a party to a lawsuit in which you potentially have any personal financial liability Off
- Are you a party to a lawsuit in which you potentially have any personal financial liability1 Off
-
- J
-
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years Off
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years1 Off
-
- 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 Off
- 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 due1 Off
-
- L
-
- Have you had property foreclosed upon in the last 7 years Off
- Have you had property foreclosed upon in the last 7 years1 Off
-
- M
-
- Have you declared bankruptcy within the past 7 years Off
- Have you declared bankruptcy within the past 7 years1 Off
-
- Check Box8-2 Off
- Check Box8-3 Off
- Check Box8-4 Off
- Text9-3
- Text9-5
- Text9-6
- Text97
- military Off
- ethnicity Off
- sex Off
- race Off
- demo Off
- Text12-1
- Check Box11-1 Off
- Check Box11-2 Off
- Check Box11-3 Off
- Check Box11-4 Off
- Check Box11-5 Off
- Check Box11-6 Off
- Check Box11-7 Off
- Check Box11-8 Off
- Check Box11-9 Off
- Text12-2
- Check Box11-10 Off
- Check Box11-11 Off
- Check Box11-12 Off
- Check Box11-13 Off
- Check Box11-14 Off
- Check Box11-15 Off
- Text12-3
- Check Box11-16 Off
- Check Box11-17 Off
- Check Box11-18 Off
- Check Box11-19 Off
- Check Box11-20 Off
- Check Box11-21 Off
- Check Box11-22 Off
- Check Box11-23 Off
- Text12-4
- Check Box11-24 Off
- Check Box11-25 Off
- Check Box11-26 Off
- Check Box11-27 Off
- Check Box11-28 Off
- Check Box11-29 Off
- Text12-5
- Check Box11-30 Off
- Check Box11-31 Off
- citizen Off
- credit Off
- marital status1 Off
- housing-1 Off
- housing-2 Off
- own Off
- C1
- C2
- C3
- C6
- C7
- C8
- C9
- C10
- C11
- C12
- C13
- C14
- C15
- C16
- C17
- C18
- C19
- C20
- C21
- C22
- C23
- C24
- C25
- C26
- C27
- C28
- C29
- C30
- C31
- C32
- C33
- C34
- C35
- Check Box-2 Off
- C36
- C37
- C38
- C39
- C4
- C40
- C41
- C42
- C43
- C44
- C45
- C46
- C47
- Check Box-3 Off
- Check Box-4 Off
- C48
- C49
- C5
- C50
- C51
- C52
- C53
- C54
- C55
- Check Box-1-1 Off
- own1 Off
- Check Box-1 Off
- D1 Off
- D2
- D3
- D4
- D5
- D6
- D7
- D8
- D9
- D10
- D11
- D12
- D13
- D14 Off
- D15 Off
- D16
- D17
- D18
- D19
- D20
- D21
- D22
- D23
- D24 Off
- D25
- D26
- D27
- D28
- D29
- D30
- D31
- D32
- D33
- D34
- D35 Off
- D36
- D37 Off
- D38
- D39
- D40
- D41
- D42
- D43
- D44
- D45
- D46
- D47
- If yes have you had an ownership interest in another property in the last three years1 Off
- new credit1 Off
- Check Box8-1 Off
- Check Box8-1-2 Off
- Check Box8-1-1 Off
- Check Box8-1-3 Off
- Check Box8-1-4 Off
- Military Service mdash Did you (or your deceased spouse) ever serve or are you currently serving in the United States Armed Forces 1 Off
- Check1 Off
- Text9-1-1
- Check2 Off
- Check3 Off
- Check4 Off
- Text9-1
- E1
- E2
- E3
- Was the ethnicity of the Borrower collected on the basis of visual observation or surname1 Off
- Was the sex of the Borrower collected on the basis of visual observation or surname1 Off
- Was the race of the Borrower collected on the basis of visual observation or surname1 Off
- The Demographic Information was provided through1 Off
- F1 Off
- F2 Off
- F3 Off
- F4 Off
- F5 Off
- F6
- F7 Off
- F8 Off
- F9 Off
- F10 Off
- F11 Off
- F12 Off
- F13
- F14 Off
- F15 Off
- F16 Off
- F17 Off
- F18 Off
- F19 Off
- F20 Off
- F21 Off
- F22
- F23 Off
- F24 Off
- F25 Off
- F26 Off
- F27 Off
- F28 Off
- F29
- F30 Off
- F31 Off
- undefined_13-1
- undefined_13-2
- undefined_14-1
- undefined_15-1
- undefined_16-1
- undefined_17-1
- undefined_18-1
- undefined_19-1
- undefined_21-1
- undefined_20-1
- undefined_23-1
- undefined_13_1
- Single-Two Off
- Refi type Off
- refi program Off
- Estate Off
- Title held Off
- Trust Information Off
- Indian Country Land Tenure Off
- Mortgage Type Applied For Off
- Mortgage Lien Type Off
- Amortization Type Off
- G1 Off
- G2 Off
- G3 Off
- G4 Off
- G5 Off
- G6
- G7
- G8
- G9
- G10 Off
- G11 Off
- G12 Off
- G13 Off
- G14 Off
- G15 Off
- G16
- G17
- G18
- G19
- G20
- G21
- G22
- G23 Off
- G24
- G25 Off
- G26
- G27 Off
- G28 Off
- G29
- G30 Off
- G31
- G32 Off
- G33
- G34
- G35
- G36
- G37
- G38
- G39
- G40
- G41
- G42
- Property Held
- refi
- Text18-1
- Text18-2
- Text18-3
- Text18-4
- Text18-5
- Text18-6
- Text18-7
- Text18-8
- Text18-9
- Text18-10
- Text18-11
- Text18-12
- Text18-13
- Text18-14
- Text18-15
- Text18-16
- Text18-17
- Text18-18
- Text18-19
- Lender
- case no
- If you selected ldquoUnmarriedrdquo in Section 1 is there a person who is not your legal spouse but who currently has real property rights similar to those of a legal spouse Off
- Relationship and State Off
- Other-5
- Text19-1
- BName
- Additional Information
- ABN
- Additional Information1
- BSign
- BSDate
- ABSign
- ABDate
- MortageeNameAddress
- NAmeAddress
- Bname1
- DOB1
- DOB2
- SignOfBorr1
- SignOfBorr
- Date Signed
- SignOfBorr2
- SignOfBorr3
- Date Signed3
- Date Signed4
- MortgageeRepSign
- DirectSign
- DirectSign1
- Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union Off
- AppSign
- AppSign1
- AppSign2
- AppSign3
- Nopage38 Off
- Yespage38 Off
- Yes1 Off
- No1 Off
- Yes2 Off
- Yes3 Off
- Yes4 Off
- Yes5 Off
- Yes6 Off
- Yes7 Off
- Yes8 Off
- Yes9 Off
- Yes10 Off
- No2 Off
- No3 Off
- No4 Off
- No5 Off
- No6 Off
- No7 Off
- No8 Off
- No9 Off
- No10 Off
- BorrowerNo Off
- BorrowerYes Off
- AppSignature
- AppSignature1
- CurrentSign
- CurrentSign1
- InterviewSign
- Yes_1 Off
- No_1 Off
- Yes_2 Off
- No_2 Off
- Mail Off
- Phone Off
1c IF APPLICABLE Complete Information for Additional EmploymentSelf-Employment and Income
Doesnot apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base $ month
City State ZIP Country Overtime mdash$ monthBonus $ month
Position orTitle Checkif this statementapplies Commission $ month| am employedby a family memberproperty seller real estate agent or otherparty to the transaction
Start Date mdash_mdashAA(mmddyyyy) Military
EntitlementsHow long in this line of work lsquoYears mdash_ Months $ month
7 7 Other $ monthCheckif you are the BusinessOwnerorSelf-Employed
| have an ownershipshare ofless than 25 Monthly Income(or Loss)| have an ownership share of 25 or more $ TOTAL $ 000month
PlMeNeeeMeeCee ti)LeeseteUeLimet Does not apply
Provideatleast 2 years of current and previous employment and income
Employeror Business Name Previous Gross Monthly
Street Unit Income $ month
City State ZIP Country
Position orTitleStart Date (mmddyyyy) Checkif you were the Business
Owneror Self-Employedmdash_ mdashEnd Date (mmddyyyy)
WCBeelcaTy Does not apply
Include incomefrom other sources below Under IncomeSource choosefrom the sourceslisted hereraquo Alimony+ Automobile Allowance Boarder Income
+ Capital Gains
Child Support+ Disabilitylaquo Foster Care
laquo Housing or Parsonage
+ Interest and Dividendslaquo Mortgage Credit Certificateraquo MortgageDifferential
Payments
raquo Notes Receivable+ Public Assistance- Retirement
(eg Pension IRA)
laquo Royalty Payments Separate Maintenance+ Social Security
+ Trust
laquo UnemploymentBenefits
laquo VA Compensation
cent Other
NOTEReveal alimony child support separate maintenance or other income ONLYIFyou wantit considered in determining yourqualification
for this loan
IncomeSource -mdash uselist above Monthly Income
$
$
$
Provide TOTAL AmountHere $ 000
Borrower Name
Uniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 2 Financial Information mdash Assets andLiabilities this section asks about things you ownthatare worth moneyand that you wantconsidered to qualify for this loan It then asks about your liabilities (or debts) that you pay
each month suchas credit cards alimony or other expenses
rNcee stLeVaalemities eitimeeecm dellaLC-
Include all accounts below Under Account Typechoosefrom the typeslisted here
laquo Checkinglaquo Savingsraquo Money Market
+ Certificate of Depositlaquo Mutual Fund+ Stocks
laquo Stock Optionslaquo Bonds+raquo Retirement(eg 407k IRA)
laquo Bridge Loan ProceedslaquoIndividual DevelopmentAccount
Trust Account- Cash Value ofLife Insurance(usedfor the transaction)
AccountType- use list above FinancialInstitution Account Number Cash or MarketValue
$
$
$
$
$
$ 000Provide TOTAL AmountHere|
Includeall other assets and credits below UnderAsset or Credit Type choose from the typeslisted here
Assets Credits- Proceeds from Real EstateProperty to be sold on orbefore closing
laquo Proceeds from Sale ofNon-Real Estate Asset
- Secured Borrowed Funds
cent Unsecured Borrowed Funds Other
raquo Earnest MoneylaquoEmployer Assistance- Lot Equity
Relocation Funds_raquo Rent Credit
laquo Sweat Equity+ Trade Equity
Assetor Credit Type mdash uselist above Cash or Market Value
$
$
$
$
$ 000Provide TOTAL AmountHere
2c Liabilities - Credit Cards Other Debts and Leases that You Owe C Does not apply
List all liabilities below (except real estate) and include deferred payments Under Account Type choose from thetypeslisted herelaquoRevolving (eg credit cards) +Installment (eg car student personal loans) Open 30-Day (balance paid monthly) + Lease (not realestate) +Other
Account Type mdashuse list above
To be paid offator before closingCompany Name Account Number Unpaid Balance Monthly Payment
$ $
$ $
$ $
$ $
$ $
2d OtherLiabilities and Expenses Does not apply
Includeall otherliabilities and expenses below Choose from the typeslisted here
+ Alimony Child Support -Separate Maintenance +JobRelatedExpenses +Other Monthly Payment
$
$
$
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 3 Financial Information mdash Real Estatethis section asks youtolist all properties you currently ownand what you owe onthem donot own anyreal estate
3a Property You Own If you are refinancinglist the property you are refinancing FIRST
Address Street Unit
City State ZIP Country
Sol Intended Occupancyinvestment PrimaryResidence SecondHome Other
Monthly InsuranceTaxesAssociation Duesetcifnot included in MonthlyMortgage Payment
For 2-4 Unit Primary or Investment PropertyStatus SoldPending Saleor Retained
=Monthly RentalIncomeProperty Value
$ $ $
Mortgage Loanson this Property Does not apply
MonthlyMortgagePayment
Type FHA VAConventionalUSDA-RD Other|
To be paid offator before closing
Credit Limit(ifapplicable)Creditor Name Account Number Unpaid Balance
$ $ $
$ $ $
3b IF APPLICABLE Complete Information for Additional Property Does not apply
Address Street Unit
City State ZIP Country
ldquoSold Intended Occupancyinvestment PrimaryResidence SecondHome Other
Monthly Insurance TaxesAssociation Duesetcifnot included in MonthlyMortgage Payment
For 2-4 Unit Primary or Investment PropertyStatus SoldPendingSaleor Retained
Monthly RentalIncomeProperty Value
$ $ $
Mortgage Loanson this Property Does not apply
Monthly
Mortgage
Payment
Type FHA VA
Conventional
USDA-RD Other|
To be paid offat
or before closing
Credit Limit
(ifapplicable)Creditor Name Account Number Unpaid Balance
$ $ $
$ $ $
$ $ $
$ $ $
$ $ $
3c IF APPLICABLE Complete Information for Additional Property Does not apply
Address Street Unit
City State ZIP Country
Intended Occupancyinvestment PrimaryResidence SecondHome Other
Monthly Insurance TaxesAssociation Duesetcifnot included in MonthlyMortgage Payment
For 2-4 Unit Primary or Investment PropertyStatus SoldPending Saleor Retained
Monthly RentalIncomeProperty Value
Mortgage Loanson this Property Does not apply
MonthlyMortgagePayment
Type FHA VAConventionalUSDA-RD Other|
To be paid offator before closing
Credit Limit(ifapplicable)Creditor Name Account Number Unpaid Balance
Borrower Name
Uniform Residential Loan Application
Freddie Mac Form 65 +raquo Fannie Mae Form 1003
Effective 12021
Section 4 Loan and Property Informationthis section asks about the loanrsquos purpose and the property youwantto purchase orrefinance
4a Loan and Property Information
LoanAmount $ Loan Purpose Purchase efinance Other(specify)
Property Address Street Unit
City State ZIP County
Numberof Units Property Value $
Occupancy Primary Residence Second Home InvestmentProperty FHA Secondary Residence
1 Mixed-Use PropertyIf you will occupy the propertywill you set aside space within the property to operate
your ownbusiness(eg daycare facility medicaloffice beautybarber shop)NO YES
2 Manufactured HomeIs the property a manufactured home(eg a factory built dwelling built on a permanentchassis) NO YES
4b Other New Mortgage Loansonthe Property Youare Buying or Refinancing Does not apply
LoanAmountAmountto be Drawn
Credit Limit(ifapplicable)Creditor Name Lien Type Monthly Payment
First Lien Subordinate Lien $ $ $
$ $ $First Lien SubordinateLien
4c Rental Income on the Property You Wantto Purchase For Purchase Only Does not apply
Completeif the property is a 2-4 Unit Primary Residence or an Investment Property Amount
Expected Monthly Rental Income $
Doesnot apply4d Gifts or Grants You Have Been GivenorWill Receive for this Loan
Includeall gifts and grants below Under Source choose from the sourceslisted here
Community Nonprofitlaquo Employer
raquo Federal Agencyraquo Local Agency
- Relative+ Religious Nonprofit
+ State Agency+ Unmarried Partner
raquo Lender Other
Asset TypeCash Gift Gift of Equity Grant DepositedNot Deposited Source - uselist above Cash or Market Value
Deposited Not Deposited $
$Deposited Not Deposited
Borrower Name
Uniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 5 DeclarationsThis section asks youspecific questions about the property your funding and yourpastfinancial history
5aAboutthis Property and Your Moneyfor this Loan
A Will you occupy the property as your primary residence
If YES have you had an ownershipinterest 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 investmentproperty(IP)
(2) How did you holdtitle to the property by yourself (S) jointly with your spouse(SP) or jointly with another person (O)
YESYES
B If this is a Purchase Transaction Do you have a family relationship or businessaffiliation with the seller of the property NO YES
C Are you borrowing any moneyforthis real estate transaction (eg money foryour closing costs or down payment) orobtaining any moneyfrom anotherparty such astheseller or realtor that you have notdisclosed on this loan application NO YES
If YES what is the amountof this money $
D 1 Have you orwill you be applying for a mortgage loan on anotherproperty (not the property securing this loan) on or
before closing this transaction that is not disclosed on this loan application
NO YES
2 Have you orwill you be applying for any newcredit (eg installment loan credit card etc) on or before closing this loan that
is not disclosed on this application
No YES
E Will this property be subject to a lien that could take priority over the first mortgagelien such as a clean energylien paid
through yourproperty taxes(eg the PropertyAssessed Clean Energy Program)NO YES
5b About YourFinances
F Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application NO YES
G Are there any outstanding judgments against you No YES
H Areyou currently delinquentor in default on a Federal debt No YES
I Areyou a party to a lawsuit in which you potentially have any personalfinancialliability NO YES
J Have you conveyedtitle to any property in lieu of foreclosure in the past 7 years NO YES
K Within the past 7 years have you completed a pre-foreclosure sale or short sale whereby the property wassold to a
third party and the Lenderagreed to acceptless than the outstanding mortgage balance due
NO YES
L Have you hadproperty foreclosed uponin thelast 7 years NO YES
M Have you declared bankruptcy within the past 7 years ONO YESIf YES identify the type(s) of bankruptcy Chapter7 Chapter11 Chapter12 Chapter 13
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 6 Acknowledgments and AgreementsThis section tells you about yourlegal obligations whenyousign this application
Acknowledgments and Agreements
Definitions- Lenderincludes the Lenderrsquos agents service providers and any oftheir successors andassigns
Other Loan Participantsrdquo includes(i) any actual or potential owners of
a loan resulting from this application (the ldquoLoanrsquo)(ii) acquirers ofany beneficial or other interest in the Loan(iii) any mortgageinsurer(iv) any guarantor (v) any servicer of the Loan and (vi) any of theseparties service providers successors or assigns
I agree to acknowledgeand representthe following
(1) The Complete Informationfor this Application- The information | have providedin this application is true accurate
and completeas of the date | signed this application
laquo If the information | submitted changesor | have new information
before closing of the Loan | must change and supplementthis
application including providing any updatedsupplementedrealestate sales contract
- For purchase transactions The terms and conditionsof anyrealestate sales contract signed by mein connection with this application
are true accurate and complete to the best of my knowledge andbelief | have not entered into any other agreement written ororal inconnection withthis real estate transaction
- The Lender and OtherLoan Participants mayrely on the informationcontainedin the application before and after closing of the Loan
- Any intentional or negligent misrepresentation of information may
result in the impositionof(a) civil liability on me including monetary damagesif a
person suffers any loss because the person relied on anymisrepresentation that | have made onthis application andor
(b) criminal penalties on me including but not limited to fine orimprisonment or both underthe provisions of Federal law(18 USC sectsect 1001 et seq)
(2) The Propertyrsquos SecurityThe Loan | have applied for in this application will be secured by
a mortgage or deedoftrust which provides the Lendera security
interest in the property described in this application
(3) The Propertys Appraisal Value and Condition- Any appraisal or value of the property obtained by the Lenderis
for use by the Lender and OtherLoanParticipantslaquoThe Lender and OtherLoan Participants have not made anyrepresentation or warranty express or implied to me about the
propertyits conditionorits value
(4) Electronic Records and Signatures- The Lender and OtherLoan Participants may keep any paper record
andorelectronic record of this application whether or not the Loan
is approved
BorrowerSignature
- If this application is created as (or converted into) an ldquoelectronicapplicationrdquo | consent to the use of ldquoelectronic recordsrdquo and
ldquoelectronic signaturesrdquo as the termsare defined in and governed byapplicable Federal andorstate electronic transactions laws
| intend to sign and have signedthis application either using my(a) electronic signature or(b) a written signature and agreethatif a paper version ofthis
application is converted into an electronic application theapplication will be an electronic record and the representationof my written signature on this application will be my binding
electronic signature- | agree that the applicationif delivered or transmitted to the Lenderor Other Loan Participants as an electronic record with myelectronicsignaturewill be as effective and enforceable as a paperapplicationsigned by mein writing
(5) Delinquencylaquo The Lender and OtherLoan Participants may report information about
my accountto credit bureaus Late payments missed paymentsorother defaults on my account maybereflected in my credit report andwill likely affect my credit score
- If | have trouble making my payments | understand that | may contacta HUD-approved housing counseling organization for advice about
actions I can take to meet my mortgageobligations
(6) Authorization for Use and Sharing of InformationBy signing belowin addition to the representations and agreementsmade above| expressly authorize the Lender and Other LoanParticipants to obtain use and share with each other(i) the loan
application and related loan information and documentation(ii) aconsumercredit report on me and(iii) my tax return information asnecessary to perform theactionslisted belowfor so long as they havean interest in my loanorits servicing
(a) process and underwrite myloan(b) verify any data contained in my consumercredit 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 analysisandreviews
(e) perform analysis and modeling for risk assessments(f) monitor the accountfor this loan for potential delinquencies and
determineanyassistance that may beavailable to me and
(g) other actions permissible under applicable law
Date (mmddyyyy)
Additional Borrower Signature Date (mmddyyyy)
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 7 Military ServiceThis section asks questions about your(or your deceased spouses) military service
Military Service of Borrower
Military Service mdash Did you (or your deceased spouse) everserve or are you currently serving in the United States Armed Forces NO YES
If YES check allthat apply Currently serving on active duty with projected expiration date of servicetour (mmddyyyy)
Currently retired discharged or separated from service
Only period of service was as a non-activated memberof the Reserve or National GuardSurviving spouse
Section 8 Demographic InformationThis section asks about your ethnicity sex and race
Demographic Information of Borrower
The purposeofcollecting this informationis to help ensure thatall applicants are treated fairly and that the housing needs of communities
and neighborhoodsare beingfulfilled 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 mayselect one or more designationsfor
Ethnicity and one or more designationsfor Race The law provides that we maynotdiscriminate on the basis of this information or onwhetheryou chooseto provideit However if you choose not to provide the information and you have madethis application in person Federal
regulations require us to note your ethnicity sex and race on thebasis of visual observation or surname Thelaw also provides that we may notdiscriminate on the basis of age or marital status information you providein this application If you do not wish to provide someorall of this
information please check below
Ethnicity Check one or more Race Check one or moreHispanic or Latino AmericanIndian or Alaska Native - Print nameofenrolled
or principaltribe Mexican PuertoRican CubanOther Hispanic or Latino - Print origin Asian
Asian Indian Chinese Filipino
Japanese Korean Vietnamese
OtherAsian mdash Print race
For example Hmong Laotian Thai Pakistani Cambodian and so on
Black or African American
Native Hawaiian or OtherPacific Islander
Native Hawaiian GuamanianorChamorro Samoan
For exampleArgentinean Colombian Dominican Nicaraguan
Salvadoran Spaniard andso on
Not Hispanic or Latino
| do not wish to providethis information
5Female OtherPacific Islander mdash Print race
Male For example Fijian Tongan and so on| do not wish to providethis information white
| do not wish to providethis information
Wasthe ethnicity of the Borrowercollected on the basis of visual observation or surname )NO YESWasthe sex of the Borrowercollected on the basis of visual observation or surname NO YESWastherace of the Borrowercollected on the basis of visual observation or surname NO YES
Face-to-Face Interview (includes Electronic Media w Video Component) TelephoneInterview Faxor Mail Email or Internet
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
ReelTemCrCL
Loan Originator Organization Name
Address
Loan Originator Organization NMLSR ID State License ID
Loan Originator Name
Loan Originator NMLSR ID State License ID
Date (mmddyyyy)
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Uniform Residential Loan Application mdash Additional BorrowerVerify and complete the information onthis application as directed by your Lender
Section 1 Borrower Informationthis section asks about yourpersonal information and your income fromemploymentandother sources such as retirement that you want considered to qualify for this loan
1a Personal Information
Name(First Middle Last Suffix)
Alternate Names - List any namesby which you are known or any namesunder which credit was previously received (First Middle Last Suffix)
Social Security Number - -(or Individual TaxpayerIdentification Number)
Dateof Birth Citizenship(mmddyyyy)
USCitizenPermanentResidentAlienNon-Permanent ResidentAlien
Type ofCredit| am applying for individualcredit
lam applying forjoint credit Total Number of Borrowers
Each Borrowerintendsto applyfor joint credit Your initials
List Name(s) of Other Borrower(s) Applying for this Loan
(First Middle Last Suffix) - Use a separator between names
Marital Status Dependents(notlisted by another Borrower)
Contact Information
Married Number _ Home Phone ( ) -
( ) _
( ) -mdash_ mdash_
Separated Ages CellPhone
Unmarried ens Work Phone Ext(Single Divorced WidowedCivil Union Domestic Partnership Registered
Reciprocal Beneficiary Relationship)lsquol
Emal
Current Address
Street Unit
City State ZIP Country
How Long at Current Address=Years mdashMonths Housing Noprimary housing expense Own Rent($ month)
If at Current Address for LESS than 2 yearslist Former Address Does not apply
Street Unit
City State ZIP Country
How Long at Former Address Years mdashMonths Housing Noprimary housing expense Own month)
Mailing Address- ifdifferent from CurrentAddress Does not apply
Street Unit
City State ZIP Country
eeeeCeeteiChuraleCme Doesnot apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base S$month
City State ZIP Country Overtime =$_____monthBonus $ month
Position orTitle Checkif this statementapplies Commission sect month| am employedby a family memberpropertyseller real estate agent or otherparty to the transaction
TTStart Date ____ (mmddyy) Military
Entitlements$_How longin this line of work Years =Months mdash monthSS
Other $ monthCheckif you are the BusinessOwnerorSelf-Employed
| have an ownershipshare ofless than 25 Monthly Income(or Loss) mdashmdash| have an ownership share of 25 or more $ TOTAL $ 000month
Uniform Residential Loan Application mdash Additional Borrower
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
CoeeeMCMCmeticlm tu)Comiteteilteeilelie mieit
Does not apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base
OvertimeBonus
Commission
MilitaryEntitlements
Other
$ month
$ month$ month
$ month
$ month
$ month
City State ZIP Country
Position orTitle ose if this statement applieslam employed by a family memberpropertyseller real estate agent or otherparty to the transaction
Start Date (mmddyy)How long in this line of work Years =Months
Checkif you are the Business
Owneror Self-Employed| have an ownershipshare of less than 25 Monthly Income(or Loss)
Ihave an ownership share of 25 or more $ TOTAL$ 000month
CPONMeeeMummaTestetiersdeere lire miret Does not apply
Provideat least 2 years of current and previous employment and income
Employeror Business Name Previous Gross MonthlyStreet Unit Income s month
City State ZIP Country
Position or Title
Start Date
End Date
Checkif you were the BusinessOwneror Self-Employed
(mmddyyyy)
(mmddyyyy) 1e Income from Other Sources Does not apply
Include incomefrom other sources below Under Income Source choose from the sourceslisted herelaquo Alimonylaquo Automobile Allowanceraquo Boarder Incomelaquo Capital Gains
Child Support+ Disability+ Foster Care Housing or Parsonage
+ Interest and DividendslaquoMortgage Credit Certificate Mortgage DifferentialPayments
laquo Notes Receivable+ Public Assistancelaquo Retirement(eg Pension IRA)
+raquo Royalty Payments Separate Maintenance
+ Social Security
raquo Trust
+ UnemploymentBenefits
laquo VA Compensation
laquo Other
NOTE Revealalimony child support separate maintenance or other income ONLYIFyou wantit considered in determining yourqualification
for this loan
Income Source - uselist above Monthly Income
$
$
$
$ 000Provide TOTAL AmountHere|
Section 2 Financial Information mdash Assets andLiabilities
Myinformation for Section 2 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 3 Financial Information mdash Real Estate
Myinformation for Section 3 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 4 Loan and Property Information
Myinformation for Section 4 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 5 DeclarationsThis section asks you specific questions about the property your funding and your past
financial history
5aAboutthis Property and Your Moneyforthis Loan
A Will you occupy the property as your primary residence NO YES
If YES have you had an ownershipinterest in another property in the last three years NO YES
If YES complete (1) and (2) below
(1)What type of property did you ownprimary residence (PR) FHA secondary residence (SR) second home(SH)
or investmentproperty (IP)
(2) How did you holdtitle to the property by yourself (S) jointly with your spouse(SP) or jointly with another person (O)
B If this is a Purchase Transaction Do you have a family relationship or businessaffiliation with the seller of the property NO YES Cc Are you borrowing any moneyforthis real estate transaction (eg money foryour closing costs or down payment) or
obtaining any moneyfrom anotherparty suchastheselleror realtor that you have not disclosed on this loan application NO YES
If YES whatis the amountof this money $
D 1 Have youorwill you be applying for a mortgage loan on anotherproperty (not the property securing this loan) on orbefore closing this transaction that is not disclosed on this loan application
NO YES
2 Have you orwill you be applying for any newcredit (eg installment loan credit card etc) on or before closing this loan that wsis not disclosed on this application
NO YES
E Will this property be subject to a lien that could take priority over thefirst mortgagelien such as a clean energylien paid
through yourproperty taxes(eg the PropertyAssessed Clean Energy Program)No YES
EK) Veli ellim ait
F Areyou a co-signer or guarantor on any debtor loan thatis not disclosed on this application NO ES
G Are there any outstanding judgments against you NO YES
H Are you currently delinquentor in default on a Federal debt NO YES
I Are you a party to a lawsuit in which you potentially have any personalfinancialliability NO YES
J Have you conveyedtitle to any property in lieu of foreclosure in the past 7 years NO YES
K Within the past 7 years have you completed a pre-foreclosure sale or short sale whereby the property wassold to a
third party and the Lender agreed to acceptless than the outstanding mortgage balance due
No YES
L Have you had property foreclosed uponin thelast 7 years NO YES
M Have you declared bankruptcy within the past 7 years no vESIf YES identify the type(s) of bankruptcy Chapter 7 Chapter11 Chapter12 Chapter 13
Section 6 Acknowledgements and AgreementsMy signature for Section 6 is on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 7 Military Service This section asks questions about your(or your deceased spouses) military service
Military Service of Borrower
Military Service mdash Did you (or your deceased spouse)everserve or are you currently serving in the United States Armed Forces NO YES
IfYES check allthat apply Currently serving on active duty with projected expiration date of servicetour (mmddyyyy)
Currently retired discharged or separated from service nnOnly period of service was as a non-activated memberofthe Reserve or National GuardSurviving spouse
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 8 Demographic InformationThis section asks about your ethnicity sex and race
Demographic Information of Borrower
The purposeofcollecting this information is to help ensure thatall applicants are treated fairly and that the housing needs of communities
and neighborhoodsare beingfulfilled 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 providethis information but are encouraged to do so You mayselect one or more designationsfor
Ethnicity and one or more designationsfor Race The law provides that we maynotdiscriminate onthe basis of this information or onwhetheryou chooseto provideit However if you choose notto provide the information and you have madethis application in person Federal
regulations require us to note yourethnicity sex and race on the basis of visual observation or surname The law also provides that we may notdiscriminate on the basis of age or marital status information you providein this application If you do not wish to provide someorall of this
information please check below
Ethnicity Check one or more Race Check one or moreHispanic or Latino AmericanIndian or Alaska Native - Print nameofenrolled
or principaltribeMexican PuertoRican Cuban
OtherHispanic or Latino - Printorigin siansian Indian Chinese Filipino
For exampleArgentinean Colombian Dominican NicaraguanSalvadoran Spaniard andso on
Japanese Korean VietnameseOtherAsian - Print race Forexample Hmong Laotian Thai Pakistani Cambodian andso on
Black or African American
Native Hawaiian or OtherPacific Islander
Native Hawaiian GuamanianorChamorro Samoan
OtherPacific Islander mdash Print race
Not Hispanic or Latino
| do not wish to providethis information
Sex
Female
Male
| do not wish to providethis informationFor example Fijian Tongan and so on
White
| do not wish to providethis information
Wasthe ethnicity of the Borrowercollected on thebasis of visual observation or surnameWasthesex of the Borrowercollected on the basis of visual observation or surnameWastherace of the Borrowercollected on the basis of visual observation or surname
)NO YESNO YESNO YES
Face-to-Face Interview (includes Electronic Media w Video Component) Telephone Interview Faxor Mail Email or Internet
Loan Originator Organization Name
Address
Loan Originator Organization NMLSR ID State License ID
Loan Originator Name
Loan Originator NMLSR ID State License ID
Email Phone (
Signature Date (mmddyyyy)
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Pe)aae-emeet)
Community Property State
At least one borrowerlives in a community propertystateThe property is in a community property state
Transaction DetailConversion of Contract for Deed or Land ContractRenovationConstruction-ConversionConstruction-to-Permanent
Single-Closing Two-ClosingConstructionImprovementCosts $
LotAcquired Date
Original Cost of Lot $(mmddyyyy)
Refinance Program
Full DocumentationInterest Rate ReductionStreamlined without Appraisal
Other
Refinance Type
NoCash OutLimited Cash OutCash Out
Energy Improvement
Mortgageloanwill finance energy-related improvements
Propertyis currently subject to a lien that could take priority ovethe first mortgagelien such as a clean energylien paid for througproperty taxes(eg the PropertyAssessed Clean Energyprogram)
Project Type Condominium Cooperative Planned Unit Development (PUD) Propertyis notlocatedin a project
Peiwlivcestetece)a)
Title to the Property Will be Held in What Name(s)
For RefinanceTitle to the Property is Currently Held in What Name(s
Trust Information
tle Will be Held byan Inter Vivos (Living) Trust
Title Will be Held by a Land TrustLeasehold Expiration Date
Mannerin WhichTitle Will be Held Indian Country Land Tenure
Sole OwnershipLife EstateTenancy in Common
Joint Tenancywith Right of Survivorship]Tenancybythe EntiretyOther
Fee Simple Ona ReservationIndividualTrust Land (AllottedRestricted)Tribal Trust Land On a ReservationTribal Trust Land Off ReservationAlaska Native Corporation Land
Estate Will be Held in
Fee Simple(mmddyyyy)
3 Mortgage LoanInformation
Termsof Loan
Note Rate
Loan Term (months)
MortgageLien Type
First LienSubordinate Lien
Mortgage Type Applied For
Conventional USDA-RDFHA VA Other
Amortization Type
Fixed RateAdjustable Rate
If Adjustable Rate
Initial Period Prior to First Adjustment
Subsequent AdjustmentPeriod
Proposed Monthly Paymentfor Property
First Mortgage (P amp I) $
Subordinate Lien(s) (P amp |) $
Other(explain)
Homeowners Insurance $(months)
(months)
Loan Features Property Taxes $
Balloon Balloon Term (months)
Interest Only Interest OnlyTermNegative AmortizationPrepaymentPenalty Prepayment Penalty Term (months) Other
Temporary Interest Rate BuydownInitial Buydown Rate TOTALOther(explain)
Mortgage Insurance $
AssociationProject Dues (Condo Co-Op PUD) $
Supplemental Property Insurance $
(months)
Borrower Name(s)Uniform Residential Loan Application mdash LenderLoan Information
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
L4 Qualifying the Borrower - Minimum Required Funds or Cash Back
DUEFROM BORROWER(S)
A Sales Contract Price
B Improvements Renovations and Repairs
C Land(ifacquired separately)
D For Refinance Balance of Mortgage Loanson the Propertyto be paid off in the Transaction
(See Table 3a Property You Own)
E Credit Cards and Other Debts Paid Off
(See Table 2c Liabilities mdash Credit Cards Other Debts and Leases that You Owe)
F BorrowerClosing Costs (including Prepaid andInitial Escrow Payments)
G Discount Points
HTOTAL DUE FROM BORROWER(s)(Total of A thru G)
TOTALMORTGAGE LOANS
Loan Amount
Loan AmountExcluding Financed Mortgage Insurance (or Mortgage Insurance Equivalent) $
Financed Mortgage Insurance (or Mortgage Insurance Equivalent) Amount $
Other New Mortgage Loanson the Property the Borrower(s) is Buying or Refinancing(See Table 4b Other New MortgageLoanson the Property You are Buying or Refinancing)
KTOTAL MORTGAGELOANS(Totalof| and J)
TOTALCREDITS
L Seller Credits (Enter the amountofBorrower(s) costs paid by the property seller)
MOtherCredits (Enter the sum ofall other credits mdash BorrowerPaid Fees Earnest Money EmployerAssistedHousing Lease Purchase Fund Lot Equity Relocation Funds Sweat Equity Trade Equity Other)
NTOTAL CREDITS(Total of L and M)
CALCULATION
TOTAL DUE FROM BORROWER(s)(Line H)
LESSTOTAL MORTGAGELOANS(Line K) AND TOTAL CREDITS(Line N)
Cash FromTothe Borrower(Line H minusLine K and Line N)NOTE This amountdoesnotinclude reservesor other funds that may be required by the Lenderto be verified
Borrower Name(s)Uniform Residential Loan Application mdash LenderLoan Information
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
Uniform Residential Loan Application mdash Unmarried Addendum
eeCeceetatimC elitleeComeLy
Lenders Instructions for Using the Unmarried Addendum
The Lender may use the Unmarried Addendum only when a Borrowerselected ldquoUnmarriedrdquoin Section 1 and the information collected is
necessary to determine howState property lawsdirectly or indirectly affecting creditworthiness apply including ensuring clear title
For example the Lender may use the Unmarried Addendum whentheBorrowerresides in a State that recognizescivil unions domestic
partnerships or registered reciprocal beneficiary relationships or when the property is located in such a State ldquoStaterdquo meansanystate the
District of Columbia the Commonwealth of Puerto Rico or anyterritory or possession of the United States
Ifyou selected ldquoUnmarriedrdquoin Section 1 is there a person whois not your legal spouse but whocurrently has real property rights similar to
those of a legal spouse +=) NOQ YES
If YES indicate the type of relationship and the State in which the relationship was formed For example indicate if you are in a
civil union domestic partnership registered reciprocal beneficiary relationship or other relationship recognized by the State in which you
currently reside or where the property is located
O Civil Union copy Domestic Partnership copy Registered Reciprocal Beneficiary Relationship copy) Other(explain)
Statea]
Borrower NameUniform Residential Loan Application mdash Unmarried Addendum
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Uniform Residential Loan Application mdash Continuation Sheet
Use this continuation sheet if you need more space to complete the Uniform Residential Loan Application
Borrower Name(First Middle Last Suffix )
Additional Information
Additional Borrower Name(First Middle Last Suffix )
Additional Information
IWefully understand thatit is a federal crime punishable by fine or imprisonment or both to knowingly make anyfalse statements concerningany of the abovefacts as applicable underthe provisions of federal law (18 USC sectsect 1001 et seq)
BorrowerSignature Date (mmddyyyy)
Additional Borrower Signature Date (mmddyyyy)
Uniform Residential Loan Application mdash Continuation SheetFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
INSTRUCTIONS FOR COMPLETING THE UNIFORM RESIDENTIAL LOAN APPLICATION
Use the instructions below to complete the enclosed Uniform Residential Loan Application (Freddie Mac Form 65Fannie Mae Form 1003) To avoid any delays in your application review please provide all of the requested information
If you need to make a correction on the application draw a line through the incorrect text and mark your initials beside the change Donrsquot use correction tape or fluid The application must be completed signed and dated in ink
The Uniform Residential Loan Application (URLA)
The URLA contains the following sections Section 1 Borrower Information Please provide your personal information income and employment
Section 2 Financial Information ndash Assets and Liabilities Please provide information about your financial assets personal financial obligations and debts you owe
Section 3 Financial Information ndash Real Estate Please provide information about property you own and the debts and expenses related to the property
Section 4 Loan and Property Information Please provide information about the loan purpose and the property you are buying or refinancing
Section 5 Declarations Please answer questions about the property how the property will be financed and your past financial history
Section 6 Acknowledgments and Agreements Informs you of your legal obligations related to the mortgage application and asks that you acknowledge certain information will be obtained used and shared
Section 7 Military Service Please provide information about your (or your deceased spousersquos) military service
Section 8 Demographic Information Requests information the Lender is required by law to ask you
Section 9 Loan Originator Information Will be completed by Chase
Uniform Residential Loan Application ndash Additional Borrower
The URLA ndash Additional Borrower contains the following sections Section 1 Borrower Information This is the same as the Borrower Information section of the URLA
Section 2 Financial Information ndash Assets and Liabilities Contains only the following statement for the additional Borrower to complete ldquoMy information for Section 2 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo The name of the other borrower is entered here
Complete a separate URLA for each BorrowermiddotThree or more Borrowers ndash Use any combination of URLA and URLA-Additional Borrower forms in accordance with the above examples
Section 3 Financial Information ndash Real Estate Contains only the following statement for the additional borrower to complete ldquoMy information for Section 3 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 4 Loan and Property Information Contains only the following statement for the additional borrower to complete ldquoMy information for Section 4 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 5 Declarations This is the same as the Declarations section of the URLA
Section 6 Acknowledgments and Agreements Contains only the following statement for the additional borrower to complete ldquoMy signature for Section 6 is on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 7 Military Service This is the same as the Military Service section of the URLA
Section 8 Demographic Information This is the same as the Demographic Information section on the URLA
Section 9 Loan Originator Information This is the same as the Loan Originator Information section of the URLA
Using the URLA and URLA ndash Additional Borrower Together The URLA and the URLA ndash Additional Borrower are used together to collect information for two Borrowers who have joint assets liabilities andor real estate information The URLA and URLA ndash Additional Borrower can also be used for Borrowers who do not have joint information but wish to combine their information on the URLA for ease of use Here are examples of how to use the URLA and URLA ndash Additional Borrower
For one borrower Complete the URLA
For two borrowers with joint financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you dont need to duplicate them on more than one URLA or o In cases where Borrowers are not collaborating when completing the loan application
joint assets liabilities and real estate may be duplicated on each URLA bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you do not need to duplicate them on more than one URLA or
o In cases where Borrowers are not collaborating when completing the loan application joint assets liabilities and real estate may be duplicated on each URLA
For two borrowers with separate financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower Report the assets liabilities and
real estate for the additional Borrower on the URLA or bull Complete a separate URLA for each Borrower
For three or more borrowers use any combination of URLA and URLA ndash Additional Borrower forms described for two borrowers
Uniform Residential Loan Application ndash Unmarried Addendum If any borrower listed on the URLA or URLA ndash Additional Borrower form selects Unmarried in Section 1 (Personal Information) the lender will complete this optional form
The information must be collected to determine how to apply state property laws that directly or indirectly affect creditworthiness including ensuring clear title
Uniform Residential Loan Application ndash Continuation Sheet Use the URLA ndash Continuation Sheet if you need more space to complete either the URLA or URLA ndash Additional Borrower forms
99177-URLAI-0215
HUD Addendum to Uniform Residential Loan Application OMB Approval No HUD 2502-0059 (exp )
Part I - Identifying Information HUDFHA Application for Insurance under the National Housing Act and Borrower Certification
FHA Case No (include any suffix) Mortgagee Case No
Mortgagee ID Sponsor ID Agent ID
Mortgagee Name Address (include ZIP Code) and Telephone Number
Type or print all entries clearly
Name and Address of Sponsor Name and Address of Agent
Borrowers Name amp Present Address (include ZIP Code) Property Address (include name of subdivision lot amp block no amp ZIP Code)
Sponsored Originations
Name of Third-Party Originator NMLS ID of Third-Party Originator
Part II - Borrower Consent for Social Security Administration to Verify Social Security Number I authorize the Social Security Administration (SSA) to verify my Social Security Number (SSN) to the Mortgagee and HUDFHA I authorize SSA to provide explanatory
information to HUDFHA in the event of a discrepancy This consent is valid for 180 days from the date signed unless indicated otherwise by the individual(s) named in this
loan application
Signature(s) of Borrower(s) - Read consent carefully Review accuracy of Social Security Number(s) provided on this application
Borrowerrsquos NameDate of BirthSocial Security Number
Co-Borrowerrsquos Name Date of BirthSocial Security Number
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
Part III - Borrower Notices Information and Acknowledgment Public Reporting Burden
Public reporting burden for this collection of information is estimated to average 10 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 conduct or sponsor and a person is not
required to respond to a collection of information unless that collection displays a valid OMB control number which can be located on the OMB Internet page at
httpwwwreginfogovpublicdoPRAMain
Privacy Act Information
The information requested on the Uniform Residential Loan Application and this Addendum is authorized by the National Housing Act of 1934 12 USC sect 1701 et seq The Debt
Collection Act of 1982 Pub L 97-365 and HUDrsquos Housing and Community Development Act of 1987 42 USC sect 3543 require persons applying for a federally insured loan to
furnish their SSN You must provide all the requested information including your SSN HUD may conduct a computer match to verify the information you provide HUD may
disclose certain information to Federal State and local agencies when relevant to civil criminal or regulatory investigations and prosecutions It will not otherwise be disclosed or
released outside of HUD except as required and permitted by law The information will be used to determine whether you qualify as a mortgagor Failure to provide any of the
requested information including SSN may result in disapproval of your loan application This is notice to you as required by the Right to Financial Privacy Act of 1978 that
HUDFHA has a right of access to financial records held by financial institutions in connection with the consideration or administration of assistance to you Financial records
involving your transaction will be available to HUDFHA without further notice or authorization but will not be disclosed or released by the institution to another Government Agency
or Department without your consent except as required or permitted by law
WARNING This warning applies to all certifications made in this document Anyone who knowingly submits a false claim or makes false statements is subject to criminal and civil penalties including confinement for up to 5 years fines and civil penalties 18 USC sectsect 287 1001 and 31 USC sect 3729
orm HUD-92900-A ( ) Page 1
Borrower Name ____________________________ FHA Case No __________________
Caution Delinquencies Defaults Foreclosures and Abuses Delinquencies defaults foreclosures and abuses of mortgage loans involving programs of the Federal Government can be costly and detrimental to your credit now and in the future The Mortgagee in this transaction its agents and assigns as well as the Federal Government its agencies agents and assigns are authorized to take any and all of the following actions in the event loan payments become delinquent on the mortgage loan described in the attached application (1) Report your name and account information to a credit bureau (2) Assess additional interest and penalty charges for the period of time that payment is not made (3) Assess charges to cover additional administrative costs incurred by the Federal Government to service your account (4) Offset amounts owed to you
under other Federal programs (5) Refer your account to a private attorney collection agency or mortgage servicing agency to collect the amount due foreclose
the mortgage sell the property and seek judgment against you for any deficiency (6) Refer your account to the Department of Justice (DOJ) for litigation in the
courts (7) If you are a current or retired Federal employee take action to offset your salary or civil service retirement benefits (8) Refer your debt to the Internal
Revenue Service for offset against any amount owed to you as an income tax refund and (9) Report any resulting written off debt of yours to the Internal Revenue Service as your taxable income All of these actions may be used to recover any debts owed when it is determined to be in the interest of the Mortgagee or Federal Government or both
As a mortgage loan borrower you will be legally obligated to make the mortgage payments called for by your mortgage loan contract The fact that you dispose of your property after the loan has been made will not relieve you of liability for making these payments Payment of the loan in full is ordinarily the way liability on a mortgage note is ended Some home buyers have the mistaken impression that if they sell their homes when they move to another locality or dispose of it for any other reasons they are no longer liable for the mortgage payments and that liability for these payments is solely that of the new owners Even though the new owners may agree in writing to assume liability for your mortgage payments this assumption agreement will not relieve you from liability to the holder of the note which you signed when you obtained the loan to buy the property Unless you are able to sell the property to a buyer who is acceptable to HUDFHA who will assume the payment of your obligation to the lender you will not be relieved from liability to repay any claim which HUDFHA may be required to pay your lender on account of default in your loan payments The amount of any such claim payment may be a debt owed by you to the Federal Government and subject to established collection procedures
Fair Housing Act I and anyone acting on my behalf are and will remain in compliance with the Fair Housing Act 42 USC sect 3604 et seq with respect to the dwelling or property covered by the loan and in the provision of services or facilities in connection therewith I recognize that any restrictive covenant on this property related to race color religion sex disability familial status or national origin is unlawful under the Fair Housing Act and unenforceable I further recognize that in addition to administrative action by HUD a civil action may be brought by the DOJ in any appropriate US court against any person responsible for a violation of the
applicable law
Certification and Acknowledgment All information in this application is given for the purpose of obtaining a loan to be insured under the National Housing Act and the information in the Uniform Residential Loan Application and this Addendum is true and complete to the best of my knowledge and belief Verification may be obtained from any source named herein I have read and understand the foregoing concerning my liability on the loan and Part III Borrower Notices Information and Acknowledgment
Signature(s) of Borrower(s) - Do not sign unless this application is fully completed Read the certification carefully and review accuracy of this application
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
orm HUD-92900-A ( Page 2
___________________________________
______________________________________________________
______________________________________________________________
- - - - - - - - - - - - - - - - - - - - - - -
Borrower Name ____________________________ FHA Case No __________________
Part IV - Direct Endorsement Approval for a HUD FHA-Insured Mortgage A Underwriting the Borrower
Date Mortgage Approved ______________________________ Date Approval Expires ______________________
For mortgages rated as an ldquoacceptrdquo or ldquoapproverdquo by FHAs TOTAL Mortgage Scorecard
The information submitted to TOTAL was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA4e Final Underwriting Decision (TOTAL) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee Representative Signature
Printed Name
Title
OR
For mortgages rated as a ldquoreferrdquo by FHAs TOTAL Mortgage Scorecard or manually underwritten by a Direct Endorsement underwriter I have personally reviewed and underwritten the borrowerrsquos credit application The information used to underwrite the borrower was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA5d Final Underwriting Decision (Manual) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
B Underwriting the Property
For all mortgages where FHA requires an appraisal I have personally reviewed and underwritten the appraisal according to FHA requirements I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
orm HUD-92900-A ( ) Page 3
Borrower Name ____________________________ FHA Case No __________________
Part V Mortgagees Certification
I have personally reviewed the mortgage documents and the application for insurance endorsement and This mortgage complies with SF Handbook 40001 Section IIA7 Post-Closing and Endorsement to the extent that no defect exists that would have changed the decision to endorse or submit the mortgage for insurance
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee
Name of Mortgageersquos Representative
Title of Mortgageersquos Representative
Signature of the Mortgageersquos Representative Date
orm HUD-92900-A ( ) Page 4
GENERAL AUTHORIZATION FOR A MORTGAGE LOAN ASSUMPTION
Applicant name(s)
Loan number
NOTICES AND DISCLOSURES
Non-discriminatory underwriting guidelines Anyone who inquires about the availability of credit from us has the right to receive a copy of our non-discriminatory underwriting guidelines To request a copy of these guidelines contact your Loan Processor
Attorney note Itrsquos the responsibility of our attorneys to protect our interest You may at your expense request an attorney to represent your interest
Notice to HUDFHA applicants As required by the Right to Financial Privacy Act of 1978 this notice is to inform you that the US Department of Housing and Urban Development (HUD)Federal Housing Administration (FHA) has a right of access to financial records held by financial institutions related to a request for assistance Financial records involving your assumption will be available to HUDFHA without further notice or authorization but wonrsquot be disclosed or released by us to another government agency or department without your consent except as required or permitted by law
Borrower consent to the use of tax return information I understand acknowledge and agree that the Lender and Other Loan Participants can obtain use and share tax return information for purposes of (i) providing an offer (ii) originating maintaining managing monitoring servicing selling insuring and securitizing a loan (iii) marketing or (iv) as otherwise permitted by applicable laws including state and federal privacy and data security laws The Lender includes the Lenderrsquos affiliates agents service providers and any of aforementioned partiesrsquo successors and assigns The Other Loan Participants includes any actual or potential owners of a loan resulting from your loan application or acquirers of any beneficial or other interest in the loan and mortgage insurer guarantor any servicers or service providers for these parties and any of aforementioned partiesrsquo successors and assigns
CERTIFICATION AND AUTHORIZATION
Environmental certification By signing below I represent and warrant that Irsquom not aware of any substances materials or products that may be an environmental hazard such as but not limited to asbestos formaldehyde radon gas lead-based paint fuel or chemical storage tanks (above or below ground) and contaminated soil or water on the property I acknowledge that Chase is relying on this representation and warranty as a material part of its loan application process I also am not aware of any landfill on any portion of the property
Exceptions to the above I further acknowledge (1) receipt of applicable disclosures from the seller in purchase transactions (2) that lead-based paint may exist in housing constructed prior to 1978 (3) that Chase performs no environmental investigation on my behalf and isnrsquot responsible for identifying lead-based paint or any other environmental conditions that might impact the property or its residents and (4) that it is my sole obligation to investigate for potential impact to the property from environmental conditions
Certifications I certify by signing below that (1) all of the loan application information provided is true and complete (2) I understand any intentional or negligent misrepresentation(s) of the information provided in conjunction with my application may result in civil liability andor 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 Chase its agents successors and assigns insurers and any other person who may suffer any loss due to reliance upon any misrepresentation that I have made on the application and (3) any significant change from the information provided at the time of application until the final loan application is signed may have a bearing on the approval of my application for a home loan
Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union
This question is asked because of state laws that extend the same or similar rights benefits and protections of spouses in a marriage to persons who are members of a partnership or union recognized under state law You should consult with your own legal advisor for advice regarding the rights protections benefits responsibilities obligations and duties of those who are registered domestic partners civil union partners or members of other unions recognized under applicable law
CREDIT AUTHORIZATION RELEASE
By signing below I authorize Chase andor my mortgage insurer (if any) to verify my past and present employment earnings records (including information contained in income tax returns that have been filed with the IRS) bank accounts stock holdings and any other information that it finds necessary to process my mortgage loan application or to review it for quality-control purposes I understand that a credit report will be ordered from a credit reporting agency for verification prior to loan closing as part of the application process and may be ordered after closing as part of the Lenderrsquos quality-control program A credit report may also be completed as part of the Lenderrsquos servicing or collection of the loan or in consideration of any other product or service that the Lender may consider offering me in the future and at any time throughout the life of the loan I understand that use of a photocopy of this form may be necessary to verify one or more of my credit references I understand that a photocopy or fax copy of this form will also serve as authorization
By signing below each applicant acknowledges (1) making the above certifications and authorizations and (2) that each applicant has received and understands the above notices and disclosures
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
You do not have to give us this information but if you donrsquot your application for approval as a borrower may be delayed or rejected The information requested in this form is authorized by Title 38 USC Chapter 37 (if VA) by 12 USC Section 1701 et seq (if HUDFHA) by 42 USC Section 1452b (if HUDCPD) and Title 42 USC 1471 et seq or 7 USC 1921 et seq (if USDA FHA)
Updated December 2021 99177-GA-0215
1b
2b
Form 4506-C (September 2020)
Department of the Treasury - Internal Revenue Service
IVES Request for Transcript of Tax Return OMB Number
1545-1872
Do not sign this form unless all applicable lines have been completed Request may be rejected if the form is incomplete or illegible
For more information about Form 4506-C visit wwwirsgov and search IVES
1a Name shown on tax return (if a joint return enter the name shown first)
First social security number on tax return individual taxpayer identification number or employer identification number (see instructions)
2a If a joint return enter spousersquos name shown on tax return Second social security number or individual taxpayer identification number if joint tax return
3 Current name address (including apt room or suite no) city state and ZIP code (see instructions)
4 Previous address shown on the last return filed if different from line 3 (see instructions)
5a IVES participant name address and SOR mailbox ID
DataVerify 875 Greentree Rd 8 Parkway Center Pittsburgh PA 15220
5b Customer file number (if applicable) (see instructions)
Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing (see instructions)
6 Transcript requested Enter the tax form number here (1040 1065 1120 etc) and check the appropriate box below Enter only one tax form number per request 1040
a Return Transcript which includes most of the line items of a tax return as filed with the IRS A tax return transcript does not reflect changes made to the account after the return is processed Transcripts are only available for the following returns Form 1040 series Form 1065 Form 1120 Form 1120-A Form 1120-H Form 1120-L and Form 1120S Return transcripts are available for the current year and returns processed during the prior 3 processing years
b Account Transcript which contains information on the financial status of the account such as payments made on the account penalty assessments and adjustments made by you or the IRS after the return was filed Return information is limited to items such as tax liability and estimated tax payments Account transcripts are available for most returns
c Record of Account which provides the most detailed information as it is a combination of the Return Transcript and the Account Transcript Available for current year and 3 prior tax years
7 Form W-2 Form 1099 series Form 1098 series or Form 5498 series transcript The IRS can provide a transcript that includes data from these information returns State or local information is not included with the Form W-2 information The IRS may be able to provide this transcript information for up to 10 years Information for the current year is generally not available until the year after it is filed with the IRS For example W-2 information for 2016 filed in 2017 will likely not be available from the IRS until 2018 If you need W-2 information for retirement purposes you should contact the Social Security Administration at 1-800-772-1213
Caution If you need a copy of Form W-2 or Form 1099 you should first contact the payer To get a copy of the Form W-2 or Form 1099 filed with your return you must use Form 4506 and request a copy of your return which includes all attachments
8 Year or period requested Enter the ending date of the tax year or period using the mmddyyyy format (see instructions)
12 31 2020 12 31 2019 12 31 2018 Caution Do not sign this form unless all applicable lines have been completed
Signature of taxpayer(s) I declare that I am either the taxpayer whose name is shown on line 1a or 2a or a person authorized to obtain the tax information requested If the request applies to a joint return at least one spouse must sign If signed by a corporate officer 1 percent or more shareholder partner managing member guardian tax matters partner executor receiver administrator trustee or party other than the taxpayer I certify that I have the authority to execute Form 4506-C on behalf of the taxpayer Note This form must be received by IRS within 120 days of the signature date
Signatory attests that heshe has read the attestation clause and upon so reading declares that heshe has the authority to sign the Form 4506-C See instructions
Sign Here
Signature (see instructions) Date Phone number of taxpayer on line 1a or 2a
PrintType name
Title (if line 1a above is a corporation partnership estate or trust)
Spousersquos signature Date
PrintType name
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020) For Privacy Act and Paperwork Reduction Act Notice see page 2
Instructions for Form 4506-C IVES Request for Transcript of Tax Return
Section references are to the Internal Revenue Code unless otherwise noted
Future Developments
For the latest information about Form 4506-C and its instructions go to wwwirsgov and search IVES Information about any recent developments affecting Form 4506-C (such as legislation enacted after we released it) will be posted on that page
Whats New Form 4506-C was created to be utilized by authorized IVES participants to order tax transcripts with the consent of the taxpayer
General Instructions
Caution Do not sign this form unless all applicable lines have been completed
Designated Recipient Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information received pursuant to the taxpayerrsquos consent and holds the recipient subject to penalties for any unauthorized access other use or redisclosure without the taxpayerrsquos express permission or request
Taxpayer Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information provided pursuant to your consent and holds the recipient subject to penalties brought by private right of action for any unauthorized access other use or redisclosure without your express permission or request
Purpose of form Use Form 4506-C to request tax return information through an authorized IVES participant You will designate an IVES participant to receive the information on line 5a
Note If you are unsure of which type of transcript you need check with the party requesting your tax information
Where to file The IVES participant will fax Form 4506-C with the approved IVES cover sheet to their assigned Service Center
Chart for ordering transcripts
If your assigned Service Center is
Fax the requests with the approved coversheet to
Austin Submission Processing Center
Austin IVES Team
844-249-6238
Fresno Submission Processing Center
Fresno IVES Team
844-249-6239
Kansas City Submission Processing Center
Kansas City IVES Team
844-249-8128
Ogden Submission Processing Center
Ogden IVES Team
844-249-8129
Specific Instructions
Line 1b Enter the social security number (SSN) or individual taxpayer identification number (ITIN) for the individual listed on line 1a or enter the employer identification number (EIN) for the business listed on line 1a
Line 3 Enter your current address If you use a PO box include it on this line
Line 4 Enter the address shown on the last return filed if different from the address entered on line 3
Note If the addresses on lines 3 and 4 are different and you have not changed your address with the IRS file Form 8822 Change of Address or Form 8822-BChange of Address or Responsible Party mdash Business with Form 4506-C
Line 5b Enter up to 10 numeric characters to create a unique customer file number that will appear on the transcript The customer file number cannot contain an SSN ITIN or EIN Completion of this line is not required
Note If you use an SSN name or combination of both we will not input the information and the customer file number will reflect a generic entry of 9999999999 on the transcript
Line 8 Enter the end date of the tax year or period requested in mmddyyyy format This may be a calendar year fiscal year or quarter Enter each quarter requested for quarterly returns Example Enter 12312018 for a calendar year 2018 Form 1040 transcript
Signature and date Form 4506-C must be signed and dated by the taxpayer listed on line 1a or 2a The IRS must receive Form 4506-C within 120 days of the date signed by the taxpayer or it will be rejected Ensure that all applicable lines including lines 5a through 8 are completed before signing
You must check the box in the signature area to acknowledge you have the authority to sign and request the information The form will not be processed if unchecked
Individuals Transcripts listed on on line 6 may be furnished to either spouse if jointly filed Only one signature is required Sign Form 4506-C exactly as your name appeared on the original return If you changed your name also sign your current name
Corporations Generally Form 4506-C can be signed by
(1) an officer having legal authority to bind the corporation (2) any person designated by the board of directors or other governing body or (3) any officer or employee on written request by any principal officer and attested to by the secretary or other officer A bona fide shareholder of record owning 1 percent or more of the outstanding stock of the corporation may submit a Form 4506-C but must provide documentation to support the requesters right to receive the information
Partnerships Generally Form 4506-C can be signed by any person who was a member of the partnership during any part of the tax period requested on line 8
All others See section 6103(e) if the taxpayer has died is insolvent is a dissolved corporation or if a trustee guardian executor receiver or administrator is acting for the taxpayer
Note If you are Heir at law Next of kin or Beneficiary you must be able to establish a material interest in the estate or trust
Documentation For entities other than individuals you must attach the authorization document For example this could be the letter from the principal officer authorizing an employee of the corporation or the letters testamentary authorizing an individual to act for an estate
Signature by a representative A representative can sign Form 4506-C for a taxpayer only if the taxpayer has specifically delegated this authority to the representative on Form 2848 line 5 The representative must attach Form 2848 showing the delegation to sign Form 4506-C
Privacy Act and Paperwork Reduction Act Notice We ask for the information on this form to establish your right to gain access to the requested tax information under the Internal Revenue Code We need this information to properly identify the tax information and respond to your request You are not required to request any transcript if you do request a transcript sections 6103 and 6109 and their regulations require you to provide this information including your SSN or EIN If you do not provide this information we may not be able to process your request Providing false or fraudulent information may subject you to penalties
Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and cities states the District of Columbia and US commonwealths and possessions for use in administering their tax laws We may also disclose this information to other countries under a tax treaty to federal and state agencies to enforce federal nontax criminal laws or to federal law enforcement and intelligence agencies to combat terrorism
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law Generally tax returns and return information are confidential as required by section 6103
The time needed to complete and file Form 4506-C will vary depending on individual circumstances The estimated average time is
Learning about the law or the form 10 min Preparing the form 12 min Copying assembling and sending the form to the IRS 20 min
If you have comments concerning the accuracy of these time estimates or suggestions for making Form 4506-C simpler we would be happy to hear from you You can write to
Internal Revenue Service Tax Forms and Publications Division 1111 Constitution Ave NW IR-6526 Washington DC 20224
Do not send the form to this address Instead see Where to file on this page
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020)
Rev April 2021 CHASEO Facts What does Chase do with your personal information
Why Financial companies choose how they share your personal information Federal law gives consumers the right to limit some but not all sharing Federal law also requires us to tell you how we collect share and protect your personal information Please read this notice carefully to understand what we do
What The types of personal information we collect and share depend on the product or service you have with us This information can include bull Social Security number and income bull account balances and transaction history bull credit history and payment history
How All financial companies need to share customers personal information to run their everyday business In the section below we list the reasons financial companies can share their customers personal information the reasons Chase chooses to share and whether you can limit this sharing
Reasons we can share your personal information Does Chase share
Can you limit this sharing
For our everyday business purposes - such as to process your transactions maintain your account(s) respond to court orders and legal investigations or report to credit bureaus
Yes No
For our marketing purposes - to offer our products and services to you
Yes No
For joint marketing with other financial companies Yes No
For our affiliates everyday business purposes - information about your transactions and experiences
Yes No
For our affiliates everyday business purposes - information about your creditworthiness
Yes Yes
For our affiliates to market to you Yes Yes
For nonaffiliates to market to you Yes Yes
a
0
To limit our sharing
bull Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
bull Visit us online chasecomprivacypreferences
Please note If you are a new customer we can begin sharing your information 30 days from the date we sent this notice When you are no longer our customer we continue to share your information as described in this notice However you can contact us at any time to limit our sharing
Questions
Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
PAGE 2
Who we are
Who is providing this notice The US consumer financial companies within the JPMorgan Chase amp Co family including JPMorgan Chase Bank NA Chase Insurance Agency Inc and JP Morgan Securities LLC
What we do
How does Chase protect my To protect your personal information from unauthorized access and use we personal information use security measures that comply with federal law These measures include
computer safeguards and secured files and buildings We authorize our employees to get your information only when they need it to do their work and we require companies that work for us to protect your information
How does Chase collect my We collect your personal information for example when you personal information bull open an account or make deposits or withdrawals from your account
bull pay your bills or apply for a loan bull use your credit or debit card We also collect your personal information from others such as credit bureaus affiliates or other companies
Why cant I limit all sharing Federal law gives you the right to limit only bull sharing for affiliates everyday business purposes - information about your
creditworthiness bull affiliates from using your information to market to you bull sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing See below for more on your rights under state law
What happens when I limit sharing for an account I hold jointly with someone else
Your choices will apply to everyone on your account
Definitions
Affiliates Companies related by common ownership or control They can be financial and non financial companies bull Our affiliates include companies with a Chase or JP Morgan name and financial companies such asjP Morgan Securities LLC
Nonaffiliates Companies not related by common ownership or control They can be financial and non financial companies bull Nonaffiliates we share with can include companies such as retailers auto dealers auto makers and membership clubs
Joint marketing A formal agreement between nonaffiliated financial companies that together market financial products or services to you bull Our joint marketing partners include categories of companies such as insurance companies
Other important information
VT Accounts with a Vermont mailing address are automatically treated as if they have limited the sharing as described on page 1 For joint marketing we will only disclose your name contact information and information about your transactions
NV We are providing you this notice pursuant to Nevada law If you prefer not to receive marketing calls from us you may be placed on our Internal Do Not Call List by calling 1-800-945-9470 or by writing to us at PO Box 734007 Dallas TX 75373-4007
For more information contact us at the address above or email PrivacylnfoJPMChasecom with Nevada Annual Notice in the subject line You may also contact the Nevada Attorney Generals office Bureau of Consumer Protection Office of the Nevada Attorney General 555 E Washington St Suite 3900 Las Vegas NV 89101 telephone number 1-702-486-3132 email BCPINFOagstatenvus
CA Accounts with a California mailing address are automatically treated as if they have limited the sharing with nonaffiliates as described on page 1 CA residents are provided a CA notice for additional choices
CHASE O
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
The following disclosure is required by the USA PATRIOT Act
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 opens an account
What this means to you When you 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 drivers
license or other identifying documents
99177-PAT-0215
VETERAN STATEMENT When this loan was opened the US Department of Veterans Affairs (VA) used the veteran borrowerrsquos entitlement which is a set amount the VA promises to repay a lender if the borrower defaults on the mortgage An assumption will modify who is obligated to pay the existing mortgage loan but all loan termsmdashincluding the entitlementmdashwill remain the same If the veteran borrower is being removed from the loan the entitlement would remain with whoever is assuming the loan because the loan will continue to be serviced by the VA If the applicant is also a veteran and can substitute his or her entitlement for the current entitlement then the current borrowerrsquos entitlement can be released
Please review the following questions and answer as appropriate This form requires completion by both the applicant(s) and current borrower(s)
1 Applicant to Complete
Are you (the applicant) currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the reverse side)
Yes (If yes please provide the information requested below answer the question in section 3 and sign and date this form at the bottom of the reverse side)
Name of applicant(s) who answered ldquoyesrdquo to the above question
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Are you receiving VA disability benefts
Applicant
Yes
No
Co-Applicant
Yes
No
Are you entitled to receive VA disability benefts Yes No Yes No
Have you received VA disability benefts in the past Yes No Yes No
Are you a surviving spouse of a veteran who died on active duty or as the result of a service-related disability
Yes No Yes No
Do you have any VA loans Yes No Yes No
2 Current Borrower to Complete
Is the current borrowerco-borrower currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the page)
Yes (If yes please answer the question in section 3 and sign and date this form at the bottom of the page)
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
________________________________________________________________________________________________
3 Applicant and Current Borrower to Complete
If the answer to the questions in section 1 and 2 are both yes please answer the following question After yoursquove reviewed and completed this entire form please sign and date at the bottom
Applicant Current Borrower
Do you want to apply for a substitution of entitlement Yes Yes No No
In order to complete a substitution of entitlement the veteran applicant must have suffcient entitlement to substitute for that of the current borrower Contact the VA Offce of Jurisdiction for your area for more information Also before the veteran applicant can substitute entitlement on a VA loan heshe must certify that the property securing the loan will be occupied as hisher primary residence Both the applicantrsquos and current borrowerrsquos original certifcate of eligibility will be required If your sales contract is contingent upon the restoration of entitlement please contact your VA Offce of Jurisdiction for complete procedures Otherwise the substitution will be completed after the loan has been approved and closed
Date Applicant printed name Applicant signature
Date Applicant printed name Applicant signature
Date Current Borrower printed name Current Borrower signature
Date Current Borrower printed name Current Borrower signature
Forms completed by Mail Phone
For Chase use only
Interviewer signature Date
99177-VS-0215
- Assumption Application Package_41521-noscannedpages-update-4pdf
-
- 1 FM203 Cover Pagepdf
- 2 FM202 Mortgage Assumption Application Package pagepdf
- 3 The Documents Youll need to Send Uspdf
- 4 FM201 FAQpdf
- 5 FM142 CIWpdf
- 6 FM126 URLApdf
- 7 FM130 URLA Instpdf
-
- Blank Page
-
- 8 92900a Addednum to Loan Applicationpdf
- 9 FM462 Gen Authpdf
- 10 FM220 4506-Cpdf
- 11 FM153 Chase Federal Privacy Noticepdf
- 12 FM144 Info on Opening a New Accountpdf
- 13 FM152 Veteran Statementpdf
-
- Date
- Loan number
- Applicant name
- Phone1
- Loan number 1
- Loan number 2
- Other
- Other_2
- 1
- 2
- undefined_7
- Available hours
- Available hours_2
- undefined_8
- Available hours_3
- undefined_9
- Current address 1
- Neither
- Available hours_4
- Available hours_5
- undefined_10
- Available hours_6
- 1_2
- 2_2
- undefined_11
- Available hours_7
- Available hours_8
- undefined_12
- Available hours_9
- FHA Case No include any suffix
- Mortgagee Case No
- Mortgagee ID
- Sponsor ID
- Agent ID
- Name and Address of Sponsor Name and Address of Agent
- Borrowers Name Present Address include ZIP Code Property Address
- include name of subdivision lot block no ZIP Code
- Name of ThirdParty Originator
- NMLS ID of ThirdParty Originator
- s application
- ty Number
- ty Number_2
- Date Signed_2
- Date Mortgage Approved
- Date Approval Expires
- Printed Name
- Title 1
- DEs ID Number
- DEs ID Number_2
- Mortgagee
- Name of Mortgagees Representative
- Title of Mortgagees Representative
- Signature of the Mortgagees Representative
- Date_2
- Applicant names 1
- Applicant names 2
- Applicant names 3
- Loan number_2
- Date_3
- Applicant printed name
- Social Security number
- Date_4
- Applicant printed name_2
- Social Security number_2
- Date_5
- Applicant printed name_3
- Social Security number_3
- Date_6
- Applicant printed name_4
- Social Security number_4
- 1a Name shown on tax return if a joint return enter the name shown first
- 1b First social security number on tax return individual taxpayer identification number or employer identification number see instructions
- 2a If a joint return enter spouses name shown on tax return
- 2b Second social security number or individual taxpayer identification number if joint tax return
- 4 Previous address shown on the last return filed if different from line 3 see instructions
- 5a IVES participant name address and SOR mailbox ID
- Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing see instructions
- Signature see instructions
- Date_7
- Phone number of taxpayer on line 1a or 2a
- PrintType name
- Here
- Spouses signature
- Date_8
- PrintType name_2
- Name
- Date of birth
- Service number
- Name_2
- Date of birth_2
- Service number_2
- Date_9
- Applicant printed name_5
- Date_10
- Applicant printed name_6
- Date_11
- Current Borrower printed name
- Date_12
- Current Borrower printed name_2
- Date_13
- Text3
- Text10
- undefined_13
- Text15
- undefined_14
- undefined_15
- undefined_16
- undefined_17
- undefined_18
- undefined_19
- undefined_20
- undefined_21
- undefined_23
- Reason for assumption Off
- Requestors relationship to owners Off
- Check one Off
- Check one1 Off
- Day1
- Evening
- Cell phone
- Check one2 Off
- Check one3 Off
- Check one4 Off
- Check one5 Off
- Text2-1
- Text2-2
- Text2-3
- Text2-4
- Text2-5
- Text2-6
- Text3-1
- Text3-2
- Text3-3
- Text3-4
- Text3-6
- Text3-7
- Text3-8
- Text3-9
- Text3-10
- Text3-11
- Text3-12
- Text3-13
- Text3-14
- Text3-15
- Text3-16
- Text3-17
- Text3-18
- Text3-19
- Text3-20
- Text3-21
- Text3-22
- Text3-23
- Text3-24
- Text3-25
- Text3-26
- Text3-27
- Text3-28
- Text3-29
- Text3-30
- Text3-31
- Text3-32
- Text3-33
- Text3-34
- Text3-35
- Text3-36
- Text3-37
- Text3-38
- Text3-39
- Text3-40
- Text3-41
- Text3-42
- Text3-43
- Text3-44
- Text3-45
- Text3-46
- Text3-47
- Text3-48
- Text3-49
- Text3-50
- Text3-51
- Text3-52
- Text3-53
- Text3-5
- Text3-54
- Text3-55
- Text3-56
- Citizenship Off
- Type of credit Off
- Marital Status Off
- Housing Off
- Housing1 Off
- ownership Off
- DNA1 Off
- DNA2 Off
- DNA3 Off
- family Off
- BO Off
- Total
- Text31
- Text32
- Text33
- Text34
- Text35
- Text36
- Text37
- Text38
- Text39
- Text310
- Text311
- Text312
- Text313
- Text314
- Text315
- Text316
- Text317
- Text318
- Text319
- ownership1 Off
- Total1
- Total1-2
- Check Box4-1 Off
- Text320
- Text321
- Text322
- Text323
- Text324
- Text325
- Text326
- Text327
- Text328
- Text329
- Check Box4-2 Off
- Check Box4-3 Off
- Check Box4-4 Off
- Check Box4-8 Off
- Check Box4-9 Off
- Text330
- Text331
- Text332
- Text333
- Text334
- Text335
- Text1-1
- Text1-2
- Text1-3
- Text1-4
- Text1-5
- Text1-6
- Text1-7
- Text1-8
- Text1-9
- Text1-10
- Text1-11
- Text1-12
- Text1-13
- Text1-14
- Text1-15
- Text1-16
- Text1-17
- Text1-18
- Text1-19
- Text1-20
- Text1-21
- Text1-22
- Text1-23
- Text1-24
- Text1-25
- Text1-26
- Text1-27
- Text1-28
- Text1-29
- Text1-30
- Text1-31
- Text1-32
- Text1-33
- Text1-34
- Text1-35
- Check Box3-2 Off
- Check Box2-1 Off
- Check Box2-2 Off
- Check Box2-3 Off
- Check Box2-4 Off
- Check Box2-5 Off
- Text1-36
- Text1-37
- Text1-38
- Text1-39
- Text1-40
- Text1-41
- Text1-42
- Text1-43
- Text1-44
- Text1-45
- Text1-46
- Text1-47
- Text1-48
- Text1-49
- Text1-50
- Text1-51
- Text1-52
- Text1-53
- Text1-54
- Text1-55
- Text1-56
- Text1-57
- Text1-58
- Text1-59
- Text1-60
- Text1-61
- Check Box3-11 Off
- A1
- A2
- A3
- A4
- A5
- A6
- A7
- A8
- A9
- A10
- A11
- A12
- Check Box3-1 Off
- Check Box30-1 Off
- Check Box30-2 Off
- Check Box30-4 Off
- Check Box30-5 Off
- Check Box30-7 Off
- Check Box30-8 Off
- Check Box30-9 Off
- Check Box30-10 Off
- Check Box30-11 Off
- Check Box30-12 Off
- A13
- A14
- A15
- A16
- A17 Off
- A18
- A19
- A20
- A21
- A22
- A23
- A24
- A25
- A26
- A27
- A28
- A29
- A30
- A31
- A32
- A33
- A34
- A35
- A36
- A37
- A38 Off
- A39
- A40
- A41
- A42
- A43
- A44
- A45
- A46
- A47
- A48
- A49
- A50
- A51
- A52
- A53
- A54
- A55
- A56
- A57
- A58
- A59
- A60
- A61
- A62
- A63
- A64
- A65
- A66
- A67
- A68
- A69
- A70
- A71
- A72
- A73
- A74
- Loan Purpose Off
- occupancy1 Off
- lien type Off
- lientype Off
- mixed use Off
- manufactured home Off
- deposit1 Off
- deposit2 Off
- B1
- B2
- B3
- B4
- B5
- B6
- B7
- B8
- B9
- B10
- fha Off
- Check Box51 Off
- B11
- B12
- B13
- B14
- B15
- B16
- B17
- B18
- B19 Off
- B20
- B21
- B22 Off
- B23
- B24
- B25
- B26
- B27
- B28
- A
-
- Will you occupy the property as your primary residence Off
- Will you occupy the property as your primary residence1 Off
-
- If yes have you had an ownership interest in another property in the last three years Off
- Text9-2
- B
-
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property Off
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property1 Off
-
- 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 Off
- 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 application1 Off
-
- 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 Off
- 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 application1 Off
-
- new credit Off
- 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) Off
- the Property Assessed Clean Energy Program)1 Off
-
- F
-
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application Off
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application1 Off
-
- G
-
- Are there any outstanding judgments against you Off
- Are there any outstanding judgments against you1 Off
-
- H
-
- Are you currently delinquent or in default on a Federal debt Off
- Are you currently delinquent or in default on a Federal debt1 Off
-
- I
-
- Are you a party to a lawsuit in which you potentially have any personal financial liability Off
- Are you a party to a lawsuit in which you potentially have any personal financial liability1 Off
-
- J
-
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years Off
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years1 Off
-
- 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 Off
- 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 due1 Off
-
- L
-
- Have you had property foreclosed upon in the last 7 years Off
- Have you had property foreclosed upon in the last 7 years1 Off
-
- M
-
- Have you declared bankruptcy within the past 7 years Off
- Have you declared bankruptcy within the past 7 years1 Off
-
- Check Box8-2 Off
- Check Box8-3 Off
- Check Box8-4 Off
- Text9-3
- Text9-5
- Text9-6
- Text97
- military Off
- ethnicity Off
- sex Off
- race Off
- demo Off
- Text12-1
- Check Box11-1 Off
- Check Box11-2 Off
- Check Box11-3 Off
- Check Box11-4 Off
- Check Box11-5 Off
- Check Box11-6 Off
- Check Box11-7 Off
- Check Box11-8 Off
- Check Box11-9 Off
- Text12-2
- Check Box11-10 Off
- Check Box11-11 Off
- Check Box11-12 Off
- Check Box11-13 Off
- Check Box11-14 Off
- Check Box11-15 Off
- Text12-3
- Check Box11-16 Off
- Check Box11-17 Off
- Check Box11-18 Off
- Check Box11-19 Off
- Check Box11-20 Off
- Check Box11-21 Off
- Check Box11-22 Off
- Check Box11-23 Off
- Text12-4
- Check Box11-24 Off
- Check Box11-25 Off
- Check Box11-26 Off
- Check Box11-27 Off
- Check Box11-28 Off
- Check Box11-29 Off
- Text12-5
- Check Box11-30 Off
- Check Box11-31 Off
- citizen Off
- credit Off
- marital status1 Off
- housing-1 Off
- housing-2 Off
- own Off
- C1
- C2
- C3
- C6
- C7
- C8
- C9
- C10
- C11
- C12
- C13
- C14
- C15
- C16
- C17
- C18
- C19
- C20
- C21
- C22
- C23
- C24
- C25
- C26
- C27
- C28
- C29
- C30
- C31
- C32
- C33
- C34
- C35
- Check Box-2 Off
- C36
- C37
- C38
- C39
- C4
- C40
- C41
- C42
- C43
- C44
- C45
- C46
- C47
- Check Box-3 Off
- Check Box-4 Off
- C48
- C49
- C5
- C50
- C51
- C52
- C53
- C54
- C55
- Check Box-1-1 Off
- own1 Off
- Check Box-1 Off
- D1 Off
- D2
- D3
- D4
- D5
- D6
- D7
- D8
- D9
- D10
- D11
- D12
- D13
- D14 Off
- D15 Off
- D16
- D17
- D18
- D19
- D20
- D21
- D22
- D23
- D24 Off
- D25
- D26
- D27
- D28
- D29
- D30
- D31
- D32
- D33
- D34
- D35 Off
- D36
- D37 Off
- D38
- D39
- D40
- D41
- D42
- D43
- D44
- D45
- D46
- D47
- If yes have you had an ownership interest in another property in the last three years1 Off
- new credit1 Off
- Check Box8-1 Off
- Check Box8-1-2 Off
- Check Box8-1-1 Off
- Check Box8-1-3 Off
- Check Box8-1-4 Off
- Military Service mdash Did you (or your deceased spouse) ever serve or are you currently serving in the United States Armed Forces 1 Off
- Check1 Off
- Text9-1-1
- Check2 Off
- Check3 Off
- Check4 Off
- Text9-1
- E1
- E2
- E3
- Was the ethnicity of the Borrower collected on the basis of visual observation or surname1 Off
- Was the sex of the Borrower collected on the basis of visual observation or surname1 Off
- Was the race of the Borrower collected on the basis of visual observation or surname1 Off
- The Demographic Information was provided through1 Off
- F1 Off
- F2 Off
- F3 Off
- F4 Off
- F5 Off
- F6
- F7 Off
- F8 Off
- F9 Off
- F10 Off
- F11 Off
- F12 Off
- F13
- F14 Off
- F15 Off
- F16 Off
- F17 Off
- F18 Off
- F19 Off
- F20 Off
- F21 Off
- F22
- F23 Off
- F24 Off
- F25 Off
- F26 Off
- F27 Off
- F28 Off
- F29
- F30 Off
- F31 Off
- undefined_13-1
- undefined_13-2
- undefined_14-1
- undefined_15-1
- undefined_16-1
- undefined_17-1
- undefined_18-1
- undefined_19-1
- undefined_21-1
- undefined_20-1
- undefined_23-1
- undefined_13_1
- Single-Two Off
- Refi type Off
- refi program Off
- Estate Off
- Title held Off
- Trust Information Off
- Indian Country Land Tenure Off
- Mortgage Type Applied For Off
- Mortgage Lien Type Off
- Amortization Type Off
- G1 Off
- G2 Off
- G3 Off
- G4 Off
- G5 Off
- G6
- G7
- G8
- G9
- G10 Off
- G11 Off
- G12 Off
- G13 Off
- G14 Off
- G15 Off
- G16
- G17
- G18
- G19
- G20
- G21
- G22
- G23 Off
- G24
- G25 Off
- G26
- G27 Off
- G28 Off
- G29
- G30 Off
- G31
- G32 Off
- G33
- G34
- G35
- G36
- G37
- G38
- G39
- G40
- G41
- G42
- Property Held
- refi
- Text18-1
- Text18-2
- Text18-3
- Text18-4
- Text18-5
- Text18-6
- Text18-7
- Text18-8
- Text18-9
- Text18-10
- Text18-11
- Text18-12
- Text18-13
- Text18-14
- Text18-15
- Text18-16
- Text18-17
- Text18-18
- Text18-19
- Lender
- case no
- If you selected ldquoUnmarriedrdquo in Section 1 is there a person who is not your legal spouse but who currently has real property rights similar to those of a legal spouse Off
- Relationship and State Off
- Other-5
- Text19-1
- BName
- Additional Information
- ABN
- Additional Information1
- BSign
- BSDate
- ABSign
- ABDate
- MortageeNameAddress
- NAmeAddress
- Bname1
- DOB1
- DOB2
- SignOfBorr1
- SignOfBorr
- Date Signed
- SignOfBorr2
- SignOfBorr3
- Date Signed3
- Date Signed4
- MortgageeRepSign
- DirectSign
- DirectSign1
- Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union Off
- AppSign
- AppSign1
- AppSign2
- AppSign3
- Nopage38 Off
- Yespage38 Off
- Yes1 Off
- No1 Off
- Yes2 Off
- Yes3 Off
- Yes4 Off
- Yes5 Off
- Yes6 Off
- Yes7 Off
- Yes8 Off
- Yes9 Off
- Yes10 Off
- No2 Off
- No3 Off
- No4 Off
- No5 Off
- No6 Off
- No7 Off
- No8 Off
- No9 Off
- No10 Off
- BorrowerNo Off
- BorrowerYes Off
- AppSignature
- AppSignature1
- CurrentSign
- CurrentSign1
- InterviewSign
- Yes_1 Off
- No_1 Off
- Yes_2 Off
- No_2 Off
- Mail Off
- Phone Off
Section 2 Financial Information mdash Assets andLiabilities this section asks about things you ownthatare worth moneyand that you wantconsidered to qualify for this loan It then asks about your liabilities (or debts) that you pay
each month suchas credit cards alimony or other expenses
rNcee stLeVaalemities eitimeeecm dellaLC-
Include all accounts below Under Account Typechoosefrom the typeslisted here
laquo Checkinglaquo Savingsraquo Money Market
+ Certificate of Depositlaquo Mutual Fund+ Stocks
laquo Stock Optionslaquo Bonds+raquo Retirement(eg 407k IRA)
laquo Bridge Loan ProceedslaquoIndividual DevelopmentAccount
Trust Account- Cash Value ofLife Insurance(usedfor the transaction)
AccountType- use list above FinancialInstitution Account Number Cash or MarketValue
$
$
$
$
$
$ 000Provide TOTAL AmountHere|
Includeall other assets and credits below UnderAsset or Credit Type choose from the typeslisted here
Assets Credits- Proceeds from Real EstateProperty to be sold on orbefore closing
laquo Proceeds from Sale ofNon-Real Estate Asset
- Secured Borrowed Funds
cent Unsecured Borrowed Funds Other
raquo Earnest MoneylaquoEmployer Assistance- Lot Equity
Relocation Funds_raquo Rent Credit
laquo Sweat Equity+ Trade Equity
Assetor Credit Type mdash uselist above Cash or Market Value
$
$
$
$
$ 000Provide TOTAL AmountHere
2c Liabilities - Credit Cards Other Debts and Leases that You Owe C Does not apply
List all liabilities below (except real estate) and include deferred payments Under Account Type choose from thetypeslisted herelaquoRevolving (eg credit cards) +Installment (eg car student personal loans) Open 30-Day (balance paid monthly) + Lease (not realestate) +Other
Account Type mdashuse list above
To be paid offator before closingCompany Name Account Number Unpaid Balance Monthly Payment
$ $
$ $
$ $
$ $
$ $
2d OtherLiabilities and Expenses Does not apply
Includeall otherliabilities and expenses below Choose from the typeslisted here
+ Alimony Child Support -Separate Maintenance +JobRelatedExpenses +Other Monthly Payment
$
$
$
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 3 Financial Information mdash Real Estatethis section asks youtolist all properties you currently ownand what you owe onthem donot own anyreal estate
3a Property You Own If you are refinancinglist the property you are refinancing FIRST
Address Street Unit
City State ZIP Country
Sol Intended Occupancyinvestment PrimaryResidence SecondHome Other
Monthly InsuranceTaxesAssociation Duesetcifnot included in MonthlyMortgage Payment
For 2-4 Unit Primary or Investment PropertyStatus SoldPending Saleor Retained
=Monthly RentalIncomeProperty Value
$ $ $
Mortgage Loanson this Property Does not apply
MonthlyMortgagePayment
Type FHA VAConventionalUSDA-RD Other|
To be paid offator before closing
Credit Limit(ifapplicable)Creditor Name Account Number Unpaid Balance
$ $ $
$ $ $
3b IF APPLICABLE Complete Information for Additional Property Does not apply
Address Street Unit
City State ZIP Country
ldquoSold Intended Occupancyinvestment PrimaryResidence SecondHome Other
Monthly Insurance TaxesAssociation Duesetcifnot included in MonthlyMortgage Payment
For 2-4 Unit Primary or Investment PropertyStatus SoldPendingSaleor Retained
Monthly RentalIncomeProperty Value
$ $ $
Mortgage Loanson this Property Does not apply
Monthly
Mortgage
Payment
Type FHA VA
Conventional
USDA-RD Other|
To be paid offat
or before closing
Credit Limit
(ifapplicable)Creditor Name Account Number Unpaid Balance
$ $ $
$ $ $
$ $ $
$ $ $
$ $ $
3c IF APPLICABLE Complete Information for Additional Property Does not apply
Address Street Unit
City State ZIP Country
Intended Occupancyinvestment PrimaryResidence SecondHome Other
Monthly Insurance TaxesAssociation Duesetcifnot included in MonthlyMortgage Payment
For 2-4 Unit Primary or Investment PropertyStatus SoldPending Saleor Retained
Monthly RentalIncomeProperty Value
Mortgage Loanson this Property Does not apply
MonthlyMortgagePayment
Type FHA VAConventionalUSDA-RD Other|
To be paid offator before closing
Credit Limit(ifapplicable)Creditor Name Account Number Unpaid Balance
Borrower Name
Uniform Residential Loan Application
Freddie Mac Form 65 +raquo Fannie Mae Form 1003
Effective 12021
Section 4 Loan and Property Informationthis section asks about the loanrsquos purpose and the property youwantto purchase orrefinance
4a Loan and Property Information
LoanAmount $ Loan Purpose Purchase efinance Other(specify)
Property Address Street Unit
City State ZIP County
Numberof Units Property Value $
Occupancy Primary Residence Second Home InvestmentProperty FHA Secondary Residence
1 Mixed-Use PropertyIf you will occupy the propertywill you set aside space within the property to operate
your ownbusiness(eg daycare facility medicaloffice beautybarber shop)NO YES
2 Manufactured HomeIs the property a manufactured home(eg a factory built dwelling built on a permanentchassis) NO YES
4b Other New Mortgage Loansonthe Property Youare Buying or Refinancing Does not apply
LoanAmountAmountto be Drawn
Credit Limit(ifapplicable)Creditor Name Lien Type Monthly Payment
First Lien Subordinate Lien $ $ $
$ $ $First Lien SubordinateLien
4c Rental Income on the Property You Wantto Purchase For Purchase Only Does not apply
Completeif the property is a 2-4 Unit Primary Residence or an Investment Property Amount
Expected Monthly Rental Income $
Doesnot apply4d Gifts or Grants You Have Been GivenorWill Receive for this Loan
Includeall gifts and grants below Under Source choose from the sourceslisted here
Community Nonprofitlaquo Employer
raquo Federal Agencyraquo Local Agency
- Relative+ Religious Nonprofit
+ State Agency+ Unmarried Partner
raquo Lender Other
Asset TypeCash Gift Gift of Equity Grant DepositedNot Deposited Source - uselist above Cash or Market Value
Deposited Not Deposited $
$Deposited Not Deposited
Borrower Name
Uniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 5 DeclarationsThis section asks youspecific questions about the property your funding and yourpastfinancial history
5aAboutthis Property and Your Moneyfor this Loan
A Will you occupy the property as your primary residence
If YES have you had an ownershipinterest 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 investmentproperty(IP)
(2) How did you holdtitle to the property by yourself (S) jointly with your spouse(SP) or jointly with another person (O)
YESYES
B If this is a Purchase Transaction Do you have a family relationship or businessaffiliation with the seller of the property NO YES
C Are you borrowing any moneyforthis real estate transaction (eg money foryour closing costs or down payment) orobtaining any moneyfrom anotherparty such astheseller or realtor that you have notdisclosed on this loan application NO YES
If YES what is the amountof this money $
D 1 Have you orwill you be applying for a mortgage loan on anotherproperty (not the property securing this loan) on or
before closing this transaction that is not disclosed on this loan application
NO YES
2 Have you orwill you be applying for any newcredit (eg installment loan credit card etc) on or before closing this loan that
is not disclosed on this application
No YES
E Will this property be subject to a lien that could take priority over the first mortgagelien such as a clean energylien paid
through yourproperty taxes(eg the PropertyAssessed Clean Energy Program)NO YES
5b About YourFinances
F Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application NO YES
G Are there any outstanding judgments against you No YES
H Areyou currently delinquentor in default on a Federal debt No YES
I Areyou a party to a lawsuit in which you potentially have any personalfinancialliability NO YES
J Have you conveyedtitle to any property in lieu of foreclosure in the past 7 years NO YES
K Within the past 7 years have you completed a pre-foreclosure sale or short sale whereby the property wassold to a
third party and the Lenderagreed to acceptless than the outstanding mortgage balance due
NO YES
L Have you hadproperty foreclosed uponin thelast 7 years NO YES
M Have you declared bankruptcy within the past 7 years ONO YESIf YES identify the type(s) of bankruptcy Chapter7 Chapter11 Chapter12 Chapter 13
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 6 Acknowledgments and AgreementsThis section tells you about yourlegal obligations whenyousign this application
Acknowledgments and Agreements
Definitions- Lenderincludes the Lenderrsquos agents service providers and any oftheir successors andassigns
Other Loan Participantsrdquo includes(i) any actual or potential owners of
a loan resulting from this application (the ldquoLoanrsquo)(ii) acquirers ofany beneficial or other interest in the Loan(iii) any mortgageinsurer(iv) any guarantor (v) any servicer of the Loan and (vi) any of theseparties service providers successors or assigns
I agree to acknowledgeand representthe following
(1) The Complete Informationfor this Application- The information | have providedin this application is true accurate
and completeas of the date | signed this application
laquo If the information | submitted changesor | have new information
before closing of the Loan | must change and supplementthis
application including providing any updatedsupplementedrealestate sales contract
- For purchase transactions The terms and conditionsof anyrealestate sales contract signed by mein connection with this application
are true accurate and complete to the best of my knowledge andbelief | have not entered into any other agreement written ororal inconnection withthis real estate transaction
- The Lender and OtherLoan Participants mayrely on the informationcontainedin the application before and after closing of the Loan
- Any intentional or negligent misrepresentation of information may
result in the impositionof(a) civil liability on me including monetary damagesif a
person suffers any loss because the person relied on anymisrepresentation that | have made onthis application andor
(b) criminal penalties on me including but not limited to fine orimprisonment or both underthe provisions of Federal law(18 USC sectsect 1001 et seq)
(2) The Propertyrsquos SecurityThe Loan | have applied for in this application will be secured by
a mortgage or deedoftrust which provides the Lendera security
interest in the property described in this application
(3) The Propertys Appraisal Value and Condition- Any appraisal or value of the property obtained by the Lenderis
for use by the Lender and OtherLoanParticipantslaquoThe Lender and OtherLoan Participants have not made anyrepresentation or warranty express or implied to me about the
propertyits conditionorits value
(4) Electronic Records and Signatures- The Lender and OtherLoan Participants may keep any paper record
andorelectronic record of this application whether or not the Loan
is approved
BorrowerSignature
- If this application is created as (or converted into) an ldquoelectronicapplicationrdquo | consent to the use of ldquoelectronic recordsrdquo and
ldquoelectronic signaturesrdquo as the termsare defined in and governed byapplicable Federal andorstate electronic transactions laws
| intend to sign and have signedthis application either using my(a) electronic signature or(b) a written signature and agreethatif a paper version ofthis
application is converted into an electronic application theapplication will be an electronic record and the representationof my written signature on this application will be my binding
electronic signature- | agree that the applicationif delivered or transmitted to the Lenderor Other Loan Participants as an electronic record with myelectronicsignaturewill be as effective and enforceable as a paperapplicationsigned by mein writing
(5) Delinquencylaquo The Lender and OtherLoan Participants may report information about
my accountto credit bureaus Late payments missed paymentsorother defaults on my account maybereflected in my credit report andwill likely affect my credit score
- If | have trouble making my payments | understand that | may contacta HUD-approved housing counseling organization for advice about
actions I can take to meet my mortgageobligations
(6) Authorization for Use and Sharing of InformationBy signing belowin addition to the representations and agreementsmade above| expressly authorize the Lender and Other LoanParticipants to obtain use and share with each other(i) the loan
application and related loan information and documentation(ii) aconsumercredit report on me and(iii) my tax return information asnecessary to perform theactionslisted belowfor so long as they havean interest in my loanorits servicing
(a) process and underwrite myloan(b) verify any data contained in my consumercredit 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 analysisandreviews
(e) perform analysis and modeling for risk assessments(f) monitor the accountfor this loan for potential delinquencies and
determineanyassistance that may beavailable to me and
(g) other actions permissible under applicable law
Date (mmddyyyy)
Additional Borrower Signature Date (mmddyyyy)
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 7 Military ServiceThis section asks questions about your(or your deceased spouses) military service
Military Service of Borrower
Military Service mdash Did you (or your deceased spouse) everserve or are you currently serving in the United States Armed Forces NO YES
If YES check allthat apply Currently serving on active duty with projected expiration date of servicetour (mmddyyyy)
Currently retired discharged or separated from service
Only period of service was as a non-activated memberof the Reserve or National GuardSurviving spouse
Section 8 Demographic InformationThis section asks about your ethnicity sex and race
Demographic Information of Borrower
The purposeofcollecting this informationis to help ensure thatall applicants are treated fairly and that the housing needs of communities
and neighborhoodsare beingfulfilled 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 mayselect one or more designationsfor
Ethnicity and one or more designationsfor Race The law provides that we maynotdiscriminate on the basis of this information or onwhetheryou chooseto provideit However if you choose not to provide the information and you have madethis application in person Federal
regulations require us to note your ethnicity sex and race on thebasis of visual observation or surname Thelaw also provides that we may notdiscriminate on the basis of age or marital status information you providein this application If you do not wish to provide someorall of this
information please check below
Ethnicity Check one or more Race Check one or moreHispanic or Latino AmericanIndian or Alaska Native - Print nameofenrolled
or principaltribe Mexican PuertoRican CubanOther Hispanic or Latino - Print origin Asian
Asian Indian Chinese Filipino
Japanese Korean Vietnamese
OtherAsian mdash Print race
For example Hmong Laotian Thai Pakistani Cambodian and so on
Black or African American
Native Hawaiian or OtherPacific Islander
Native Hawaiian GuamanianorChamorro Samoan
For exampleArgentinean Colombian Dominican Nicaraguan
Salvadoran Spaniard andso on
Not Hispanic or Latino
| do not wish to providethis information
5Female OtherPacific Islander mdash Print race
Male For example Fijian Tongan and so on| do not wish to providethis information white
| do not wish to providethis information
Wasthe ethnicity of the Borrowercollected on the basis of visual observation or surname )NO YESWasthe sex of the Borrowercollected on the basis of visual observation or surname NO YESWastherace of the Borrowercollected on the basis of visual observation or surname NO YES
Face-to-Face Interview (includes Electronic Media w Video Component) TelephoneInterview Faxor Mail Email or Internet
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
ReelTemCrCL
Loan Originator Organization Name
Address
Loan Originator Organization NMLSR ID State License ID
Loan Originator Name
Loan Originator NMLSR ID State License ID
Date (mmddyyyy)
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Uniform Residential Loan Application mdash Additional BorrowerVerify and complete the information onthis application as directed by your Lender
Section 1 Borrower Informationthis section asks about yourpersonal information and your income fromemploymentandother sources such as retirement that you want considered to qualify for this loan
1a Personal Information
Name(First Middle Last Suffix)
Alternate Names - List any namesby which you are known or any namesunder which credit was previously received (First Middle Last Suffix)
Social Security Number - -(or Individual TaxpayerIdentification Number)
Dateof Birth Citizenship(mmddyyyy)
USCitizenPermanentResidentAlienNon-Permanent ResidentAlien
Type ofCredit| am applying for individualcredit
lam applying forjoint credit Total Number of Borrowers
Each Borrowerintendsto applyfor joint credit Your initials
List Name(s) of Other Borrower(s) Applying for this Loan
(First Middle Last Suffix) - Use a separator between names
Marital Status Dependents(notlisted by another Borrower)
Contact Information
Married Number _ Home Phone ( ) -
( ) _
( ) -mdash_ mdash_
Separated Ages CellPhone
Unmarried ens Work Phone Ext(Single Divorced WidowedCivil Union Domestic Partnership Registered
Reciprocal Beneficiary Relationship)lsquol
Emal
Current Address
Street Unit
City State ZIP Country
How Long at Current Address=Years mdashMonths Housing Noprimary housing expense Own Rent($ month)
If at Current Address for LESS than 2 yearslist Former Address Does not apply
Street Unit
City State ZIP Country
How Long at Former Address Years mdashMonths Housing Noprimary housing expense Own month)
Mailing Address- ifdifferent from CurrentAddress Does not apply
Street Unit
City State ZIP Country
eeeeCeeteiChuraleCme Doesnot apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base S$month
City State ZIP Country Overtime =$_____monthBonus $ month
Position orTitle Checkif this statementapplies Commission sect month| am employedby a family memberpropertyseller real estate agent or otherparty to the transaction
TTStart Date ____ (mmddyy) Military
Entitlements$_How longin this line of work Years =Months mdash monthSS
Other $ monthCheckif you are the BusinessOwnerorSelf-Employed
| have an ownershipshare ofless than 25 Monthly Income(or Loss) mdashmdash| have an ownership share of 25 or more $ TOTAL $ 000month
Uniform Residential Loan Application mdash Additional Borrower
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
CoeeeMCMCmeticlm tu)Comiteteilteeilelie mieit
Does not apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base
OvertimeBonus
Commission
MilitaryEntitlements
Other
$ month
$ month$ month
$ month
$ month
$ month
City State ZIP Country
Position orTitle ose if this statement applieslam employed by a family memberpropertyseller real estate agent or otherparty to the transaction
Start Date (mmddyy)How long in this line of work Years =Months
Checkif you are the Business
Owneror Self-Employed| have an ownershipshare of less than 25 Monthly Income(or Loss)
Ihave an ownership share of 25 or more $ TOTAL$ 000month
CPONMeeeMummaTestetiersdeere lire miret Does not apply
Provideat least 2 years of current and previous employment and income
Employeror Business Name Previous Gross MonthlyStreet Unit Income s month
City State ZIP Country
Position or Title
Start Date
End Date
Checkif you were the BusinessOwneror Self-Employed
(mmddyyyy)
(mmddyyyy) 1e Income from Other Sources Does not apply
Include incomefrom other sources below Under Income Source choose from the sourceslisted herelaquo Alimonylaquo Automobile Allowanceraquo Boarder Incomelaquo Capital Gains
Child Support+ Disability+ Foster Care Housing or Parsonage
+ Interest and DividendslaquoMortgage Credit Certificate Mortgage DifferentialPayments
laquo Notes Receivable+ Public Assistancelaquo Retirement(eg Pension IRA)
+raquo Royalty Payments Separate Maintenance
+ Social Security
raquo Trust
+ UnemploymentBenefits
laquo VA Compensation
laquo Other
NOTE Revealalimony child support separate maintenance or other income ONLYIFyou wantit considered in determining yourqualification
for this loan
Income Source - uselist above Monthly Income
$
$
$
$ 000Provide TOTAL AmountHere|
Section 2 Financial Information mdash Assets andLiabilities
Myinformation for Section 2 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 3 Financial Information mdash Real Estate
Myinformation for Section 3 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 4 Loan and Property Information
Myinformation for Section 4 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 5 DeclarationsThis section asks you specific questions about the property your funding and your past
financial history
5aAboutthis Property and Your Moneyforthis Loan
A Will you occupy the property as your primary residence NO YES
If YES have you had an ownershipinterest in another property in the last three years NO YES
If YES complete (1) and (2) below
(1)What type of property did you ownprimary residence (PR) FHA secondary residence (SR) second home(SH)
or investmentproperty (IP)
(2) How did you holdtitle to the property by yourself (S) jointly with your spouse(SP) or jointly with another person (O)
B If this is a Purchase Transaction Do you have a family relationship or businessaffiliation with the seller of the property NO YES Cc Are you borrowing any moneyforthis real estate transaction (eg money foryour closing costs or down payment) or
obtaining any moneyfrom anotherparty suchastheselleror realtor that you have not disclosed on this loan application NO YES
If YES whatis the amountof this money $
D 1 Have youorwill you be applying for a mortgage loan on anotherproperty (not the property securing this loan) on orbefore closing this transaction that is not disclosed on this loan application
NO YES
2 Have you orwill you be applying for any newcredit (eg installment loan credit card etc) on or before closing this loan that wsis not disclosed on this application
NO YES
E Will this property be subject to a lien that could take priority over thefirst mortgagelien such as a clean energylien paid
through yourproperty taxes(eg the PropertyAssessed Clean Energy Program)No YES
EK) Veli ellim ait
F Areyou a co-signer or guarantor on any debtor loan thatis not disclosed on this application NO ES
G Are there any outstanding judgments against you NO YES
H Are you currently delinquentor in default on a Federal debt NO YES
I Are you a party to a lawsuit in which you potentially have any personalfinancialliability NO YES
J Have you conveyedtitle to any property in lieu of foreclosure in the past 7 years NO YES
K Within the past 7 years have you completed a pre-foreclosure sale or short sale whereby the property wassold to a
third party and the Lender agreed to acceptless than the outstanding mortgage balance due
No YES
L Have you had property foreclosed uponin thelast 7 years NO YES
M Have you declared bankruptcy within the past 7 years no vESIf YES identify the type(s) of bankruptcy Chapter 7 Chapter11 Chapter12 Chapter 13
Section 6 Acknowledgements and AgreementsMy signature for Section 6 is on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 7 Military Service This section asks questions about your(or your deceased spouses) military service
Military Service of Borrower
Military Service mdash Did you (or your deceased spouse)everserve or are you currently serving in the United States Armed Forces NO YES
IfYES check allthat apply Currently serving on active duty with projected expiration date of servicetour (mmddyyyy)
Currently retired discharged or separated from service nnOnly period of service was as a non-activated memberofthe Reserve or National GuardSurviving spouse
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 8 Demographic InformationThis section asks about your ethnicity sex and race
Demographic Information of Borrower
The purposeofcollecting this information is to help ensure thatall applicants are treated fairly and that the housing needs of communities
and neighborhoodsare beingfulfilled 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 providethis information but are encouraged to do so You mayselect one or more designationsfor
Ethnicity and one or more designationsfor Race The law provides that we maynotdiscriminate onthe basis of this information or onwhetheryou chooseto provideit However if you choose notto provide the information and you have madethis application in person Federal
regulations require us to note yourethnicity sex and race on the basis of visual observation or surname The law also provides that we may notdiscriminate on the basis of age or marital status information you providein this application If you do not wish to provide someorall of this
information please check below
Ethnicity Check one or more Race Check one or moreHispanic or Latino AmericanIndian or Alaska Native - Print nameofenrolled
or principaltribeMexican PuertoRican Cuban
OtherHispanic or Latino - Printorigin siansian Indian Chinese Filipino
For exampleArgentinean Colombian Dominican NicaraguanSalvadoran Spaniard andso on
Japanese Korean VietnameseOtherAsian - Print race Forexample Hmong Laotian Thai Pakistani Cambodian andso on
Black or African American
Native Hawaiian or OtherPacific Islander
Native Hawaiian GuamanianorChamorro Samoan
OtherPacific Islander mdash Print race
Not Hispanic or Latino
| do not wish to providethis information
Sex
Female
Male
| do not wish to providethis informationFor example Fijian Tongan and so on
White
| do not wish to providethis information
Wasthe ethnicity of the Borrowercollected on thebasis of visual observation or surnameWasthesex of the Borrowercollected on the basis of visual observation or surnameWastherace of the Borrowercollected on the basis of visual observation or surname
)NO YESNO YESNO YES
Face-to-Face Interview (includes Electronic Media w Video Component) Telephone Interview Faxor Mail Email or Internet
Loan Originator Organization Name
Address
Loan Originator Organization NMLSR ID State License ID
Loan Originator Name
Loan Originator NMLSR ID State License ID
Email Phone (
Signature Date (mmddyyyy)
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Pe)aae-emeet)
Community Property State
At least one borrowerlives in a community propertystateThe property is in a community property state
Transaction DetailConversion of Contract for Deed or Land ContractRenovationConstruction-ConversionConstruction-to-Permanent
Single-Closing Two-ClosingConstructionImprovementCosts $
LotAcquired Date
Original Cost of Lot $(mmddyyyy)
Refinance Program
Full DocumentationInterest Rate ReductionStreamlined without Appraisal
Other
Refinance Type
NoCash OutLimited Cash OutCash Out
Energy Improvement
Mortgageloanwill finance energy-related improvements
Propertyis currently subject to a lien that could take priority ovethe first mortgagelien such as a clean energylien paid for througproperty taxes(eg the PropertyAssessed Clean Energyprogram)
Project Type Condominium Cooperative Planned Unit Development (PUD) Propertyis notlocatedin a project
Peiwlivcestetece)a)
Title to the Property Will be Held in What Name(s)
For RefinanceTitle to the Property is Currently Held in What Name(s
Trust Information
tle Will be Held byan Inter Vivos (Living) Trust
Title Will be Held by a Land TrustLeasehold Expiration Date
Mannerin WhichTitle Will be Held Indian Country Land Tenure
Sole OwnershipLife EstateTenancy in Common
Joint Tenancywith Right of Survivorship]Tenancybythe EntiretyOther
Fee Simple Ona ReservationIndividualTrust Land (AllottedRestricted)Tribal Trust Land On a ReservationTribal Trust Land Off ReservationAlaska Native Corporation Land
Estate Will be Held in
Fee Simple(mmddyyyy)
3 Mortgage LoanInformation
Termsof Loan
Note Rate
Loan Term (months)
MortgageLien Type
First LienSubordinate Lien
Mortgage Type Applied For
Conventional USDA-RDFHA VA Other
Amortization Type
Fixed RateAdjustable Rate
If Adjustable Rate
Initial Period Prior to First Adjustment
Subsequent AdjustmentPeriod
Proposed Monthly Paymentfor Property
First Mortgage (P amp I) $
Subordinate Lien(s) (P amp |) $
Other(explain)
Homeowners Insurance $(months)
(months)
Loan Features Property Taxes $
Balloon Balloon Term (months)
Interest Only Interest OnlyTermNegative AmortizationPrepaymentPenalty Prepayment Penalty Term (months) Other
Temporary Interest Rate BuydownInitial Buydown Rate TOTALOther(explain)
Mortgage Insurance $
AssociationProject Dues (Condo Co-Op PUD) $
Supplemental Property Insurance $
(months)
Borrower Name(s)Uniform Residential Loan Application mdash LenderLoan Information
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
L4 Qualifying the Borrower - Minimum Required Funds or Cash Back
DUEFROM BORROWER(S)
A Sales Contract Price
B Improvements Renovations and Repairs
C Land(ifacquired separately)
D For Refinance Balance of Mortgage Loanson the Propertyto be paid off in the Transaction
(See Table 3a Property You Own)
E Credit Cards and Other Debts Paid Off
(See Table 2c Liabilities mdash Credit Cards Other Debts and Leases that You Owe)
F BorrowerClosing Costs (including Prepaid andInitial Escrow Payments)
G Discount Points
HTOTAL DUE FROM BORROWER(s)(Total of A thru G)
TOTALMORTGAGE LOANS
Loan Amount
Loan AmountExcluding Financed Mortgage Insurance (or Mortgage Insurance Equivalent) $
Financed Mortgage Insurance (or Mortgage Insurance Equivalent) Amount $
Other New Mortgage Loanson the Property the Borrower(s) is Buying or Refinancing(See Table 4b Other New MortgageLoanson the Property You are Buying or Refinancing)
KTOTAL MORTGAGELOANS(Totalof| and J)
TOTALCREDITS
L Seller Credits (Enter the amountofBorrower(s) costs paid by the property seller)
MOtherCredits (Enter the sum ofall other credits mdash BorrowerPaid Fees Earnest Money EmployerAssistedHousing Lease Purchase Fund Lot Equity Relocation Funds Sweat Equity Trade Equity Other)
NTOTAL CREDITS(Total of L and M)
CALCULATION
TOTAL DUE FROM BORROWER(s)(Line H)
LESSTOTAL MORTGAGELOANS(Line K) AND TOTAL CREDITS(Line N)
Cash FromTothe Borrower(Line H minusLine K and Line N)NOTE This amountdoesnotinclude reservesor other funds that may be required by the Lenderto be verified
Borrower Name(s)Uniform Residential Loan Application mdash LenderLoan Information
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
Uniform Residential Loan Application mdash Unmarried Addendum
eeCeceetatimC elitleeComeLy
Lenders Instructions for Using the Unmarried Addendum
The Lender may use the Unmarried Addendum only when a Borrowerselected ldquoUnmarriedrdquoin Section 1 and the information collected is
necessary to determine howState property lawsdirectly or indirectly affecting creditworthiness apply including ensuring clear title
For example the Lender may use the Unmarried Addendum whentheBorrowerresides in a State that recognizescivil unions domestic
partnerships or registered reciprocal beneficiary relationships or when the property is located in such a State ldquoStaterdquo meansanystate the
District of Columbia the Commonwealth of Puerto Rico or anyterritory or possession of the United States
Ifyou selected ldquoUnmarriedrdquoin Section 1 is there a person whois not your legal spouse but whocurrently has real property rights similar to
those of a legal spouse +=) NOQ YES
If YES indicate the type of relationship and the State in which the relationship was formed For example indicate if you are in a
civil union domestic partnership registered reciprocal beneficiary relationship or other relationship recognized by the State in which you
currently reside or where the property is located
O Civil Union copy Domestic Partnership copy Registered Reciprocal Beneficiary Relationship copy) Other(explain)
Statea]
Borrower NameUniform Residential Loan Application mdash Unmarried Addendum
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Uniform Residential Loan Application mdash Continuation Sheet
Use this continuation sheet if you need more space to complete the Uniform Residential Loan Application
Borrower Name(First Middle Last Suffix )
Additional Information
Additional Borrower Name(First Middle Last Suffix )
Additional Information
IWefully understand thatit is a federal crime punishable by fine or imprisonment or both to knowingly make anyfalse statements concerningany of the abovefacts as applicable underthe provisions of federal law (18 USC sectsect 1001 et seq)
BorrowerSignature Date (mmddyyyy)
Additional Borrower Signature Date (mmddyyyy)
Uniform Residential Loan Application mdash Continuation SheetFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
INSTRUCTIONS FOR COMPLETING THE UNIFORM RESIDENTIAL LOAN APPLICATION
Use the instructions below to complete the enclosed Uniform Residential Loan Application (Freddie Mac Form 65Fannie Mae Form 1003) To avoid any delays in your application review please provide all of the requested information
If you need to make a correction on the application draw a line through the incorrect text and mark your initials beside the change Donrsquot use correction tape or fluid The application must be completed signed and dated in ink
The Uniform Residential Loan Application (URLA)
The URLA contains the following sections Section 1 Borrower Information Please provide your personal information income and employment
Section 2 Financial Information ndash Assets and Liabilities Please provide information about your financial assets personal financial obligations and debts you owe
Section 3 Financial Information ndash Real Estate Please provide information about property you own and the debts and expenses related to the property
Section 4 Loan and Property Information Please provide information about the loan purpose and the property you are buying or refinancing
Section 5 Declarations Please answer questions about the property how the property will be financed and your past financial history
Section 6 Acknowledgments and Agreements Informs you of your legal obligations related to the mortgage application and asks that you acknowledge certain information will be obtained used and shared
Section 7 Military Service Please provide information about your (or your deceased spousersquos) military service
Section 8 Demographic Information Requests information the Lender is required by law to ask you
Section 9 Loan Originator Information Will be completed by Chase
Uniform Residential Loan Application ndash Additional Borrower
The URLA ndash Additional Borrower contains the following sections Section 1 Borrower Information This is the same as the Borrower Information section of the URLA
Section 2 Financial Information ndash Assets and Liabilities Contains only the following statement for the additional Borrower to complete ldquoMy information for Section 2 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo The name of the other borrower is entered here
Complete a separate URLA for each BorrowermiddotThree or more Borrowers ndash Use any combination of URLA and URLA-Additional Borrower forms in accordance with the above examples
Section 3 Financial Information ndash Real Estate Contains only the following statement for the additional borrower to complete ldquoMy information for Section 3 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 4 Loan and Property Information Contains only the following statement for the additional borrower to complete ldquoMy information for Section 4 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 5 Declarations This is the same as the Declarations section of the URLA
Section 6 Acknowledgments and Agreements Contains only the following statement for the additional borrower to complete ldquoMy signature for Section 6 is on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 7 Military Service This is the same as the Military Service section of the URLA
Section 8 Demographic Information This is the same as the Demographic Information section on the URLA
Section 9 Loan Originator Information This is the same as the Loan Originator Information section of the URLA
Using the URLA and URLA ndash Additional Borrower Together The URLA and the URLA ndash Additional Borrower are used together to collect information for two Borrowers who have joint assets liabilities andor real estate information The URLA and URLA ndash Additional Borrower can also be used for Borrowers who do not have joint information but wish to combine their information on the URLA for ease of use Here are examples of how to use the URLA and URLA ndash Additional Borrower
For one borrower Complete the URLA
For two borrowers with joint financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you dont need to duplicate them on more than one URLA or o In cases where Borrowers are not collaborating when completing the loan application
joint assets liabilities and real estate may be duplicated on each URLA bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you do not need to duplicate them on more than one URLA or
o In cases where Borrowers are not collaborating when completing the loan application joint assets liabilities and real estate may be duplicated on each URLA
For two borrowers with separate financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower Report the assets liabilities and
real estate for the additional Borrower on the URLA or bull Complete a separate URLA for each Borrower
For three or more borrowers use any combination of URLA and URLA ndash Additional Borrower forms described for two borrowers
Uniform Residential Loan Application ndash Unmarried Addendum If any borrower listed on the URLA or URLA ndash Additional Borrower form selects Unmarried in Section 1 (Personal Information) the lender will complete this optional form
The information must be collected to determine how to apply state property laws that directly or indirectly affect creditworthiness including ensuring clear title
Uniform Residential Loan Application ndash Continuation Sheet Use the URLA ndash Continuation Sheet if you need more space to complete either the URLA or URLA ndash Additional Borrower forms
99177-URLAI-0215
HUD Addendum to Uniform Residential Loan Application OMB Approval No HUD 2502-0059 (exp )
Part I - Identifying Information HUDFHA Application for Insurance under the National Housing Act and Borrower Certification
FHA Case No (include any suffix) Mortgagee Case No
Mortgagee ID Sponsor ID Agent ID
Mortgagee Name Address (include ZIP Code) and Telephone Number
Type or print all entries clearly
Name and Address of Sponsor Name and Address of Agent
Borrowers Name amp Present Address (include ZIP Code) Property Address (include name of subdivision lot amp block no amp ZIP Code)
Sponsored Originations
Name of Third-Party Originator NMLS ID of Third-Party Originator
Part II - Borrower Consent for Social Security Administration to Verify Social Security Number I authorize the Social Security Administration (SSA) to verify my Social Security Number (SSN) to the Mortgagee and HUDFHA I authorize SSA to provide explanatory
information to HUDFHA in the event of a discrepancy This consent is valid for 180 days from the date signed unless indicated otherwise by the individual(s) named in this
loan application
Signature(s) of Borrower(s) - Read consent carefully Review accuracy of Social Security Number(s) provided on this application
Borrowerrsquos NameDate of BirthSocial Security Number
Co-Borrowerrsquos Name Date of BirthSocial Security Number
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
Part III - Borrower Notices Information and Acknowledgment Public Reporting Burden
Public reporting burden for this collection of information is estimated to average 10 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 conduct or sponsor and a person is not
required to respond to a collection of information unless that collection displays a valid OMB control number which can be located on the OMB Internet page at
httpwwwreginfogovpublicdoPRAMain
Privacy Act Information
The information requested on the Uniform Residential Loan Application and this Addendum is authorized by the National Housing Act of 1934 12 USC sect 1701 et seq The Debt
Collection Act of 1982 Pub L 97-365 and HUDrsquos Housing and Community Development Act of 1987 42 USC sect 3543 require persons applying for a federally insured loan to
furnish their SSN You must provide all the requested information including your SSN HUD may conduct a computer match to verify the information you provide HUD may
disclose certain information to Federal State and local agencies when relevant to civil criminal or regulatory investigations and prosecutions It will not otherwise be disclosed or
released outside of HUD except as required and permitted by law The information will be used to determine whether you qualify as a mortgagor Failure to provide any of the
requested information including SSN may result in disapproval of your loan application This is notice to you as required by the Right to Financial Privacy Act of 1978 that
HUDFHA has a right of access to financial records held by financial institutions in connection with the consideration or administration of assistance to you Financial records
involving your transaction will be available to HUDFHA without further notice or authorization but will not be disclosed or released by the institution to another Government Agency
or Department without your consent except as required or permitted by law
WARNING This warning applies to all certifications made in this document Anyone who knowingly submits a false claim or makes false statements is subject to criminal and civil penalties including confinement for up to 5 years fines and civil penalties 18 USC sectsect 287 1001 and 31 USC sect 3729
orm HUD-92900-A ( ) Page 1
Borrower Name ____________________________ FHA Case No __________________
Caution Delinquencies Defaults Foreclosures and Abuses Delinquencies defaults foreclosures and abuses of mortgage loans involving programs of the Federal Government can be costly and detrimental to your credit now and in the future The Mortgagee in this transaction its agents and assigns as well as the Federal Government its agencies agents and assigns are authorized to take any and all of the following actions in the event loan payments become delinquent on the mortgage loan described in the attached application (1) Report your name and account information to a credit bureau (2) Assess additional interest and penalty charges for the period of time that payment is not made (3) Assess charges to cover additional administrative costs incurred by the Federal Government to service your account (4) Offset amounts owed to you
under other Federal programs (5) Refer your account to a private attorney collection agency or mortgage servicing agency to collect the amount due foreclose
the mortgage sell the property and seek judgment against you for any deficiency (6) Refer your account to the Department of Justice (DOJ) for litigation in the
courts (7) If you are a current or retired Federal employee take action to offset your salary or civil service retirement benefits (8) Refer your debt to the Internal
Revenue Service for offset against any amount owed to you as an income tax refund and (9) Report any resulting written off debt of yours to the Internal Revenue Service as your taxable income All of these actions may be used to recover any debts owed when it is determined to be in the interest of the Mortgagee or Federal Government or both
As a mortgage loan borrower you will be legally obligated to make the mortgage payments called for by your mortgage loan contract The fact that you dispose of your property after the loan has been made will not relieve you of liability for making these payments Payment of the loan in full is ordinarily the way liability on a mortgage note is ended Some home buyers have the mistaken impression that if they sell their homes when they move to another locality or dispose of it for any other reasons they are no longer liable for the mortgage payments and that liability for these payments is solely that of the new owners Even though the new owners may agree in writing to assume liability for your mortgage payments this assumption agreement will not relieve you from liability to the holder of the note which you signed when you obtained the loan to buy the property Unless you are able to sell the property to a buyer who is acceptable to HUDFHA who will assume the payment of your obligation to the lender you will not be relieved from liability to repay any claim which HUDFHA may be required to pay your lender on account of default in your loan payments The amount of any such claim payment may be a debt owed by you to the Federal Government and subject to established collection procedures
Fair Housing Act I and anyone acting on my behalf are and will remain in compliance with the Fair Housing Act 42 USC sect 3604 et seq with respect to the dwelling or property covered by the loan and in the provision of services or facilities in connection therewith I recognize that any restrictive covenant on this property related to race color religion sex disability familial status or national origin is unlawful under the Fair Housing Act and unenforceable I further recognize that in addition to administrative action by HUD a civil action may be brought by the DOJ in any appropriate US court against any person responsible for a violation of the
applicable law
Certification and Acknowledgment All information in this application is given for the purpose of obtaining a loan to be insured under the National Housing Act and the information in the Uniform Residential Loan Application and this Addendum is true and complete to the best of my knowledge and belief Verification may be obtained from any source named herein I have read and understand the foregoing concerning my liability on the loan and Part III Borrower Notices Information and Acknowledgment
Signature(s) of Borrower(s) - Do not sign unless this application is fully completed Read the certification carefully and review accuracy of this application
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
orm HUD-92900-A ( Page 2
___________________________________
______________________________________________________
______________________________________________________________
- - - - - - - - - - - - - - - - - - - - - - -
Borrower Name ____________________________ FHA Case No __________________
Part IV - Direct Endorsement Approval for a HUD FHA-Insured Mortgage A Underwriting the Borrower
Date Mortgage Approved ______________________________ Date Approval Expires ______________________
For mortgages rated as an ldquoacceptrdquo or ldquoapproverdquo by FHAs TOTAL Mortgage Scorecard
The information submitted to TOTAL was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA4e Final Underwriting Decision (TOTAL) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee Representative Signature
Printed Name
Title
OR
For mortgages rated as a ldquoreferrdquo by FHAs TOTAL Mortgage Scorecard or manually underwritten by a Direct Endorsement underwriter I have personally reviewed and underwritten the borrowerrsquos credit application The information used to underwrite the borrower was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA5d Final Underwriting Decision (Manual) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
B Underwriting the Property
For all mortgages where FHA requires an appraisal I have personally reviewed and underwritten the appraisal according to FHA requirements I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
orm HUD-92900-A ( ) Page 3
Borrower Name ____________________________ FHA Case No __________________
Part V Mortgagees Certification
I have personally reviewed the mortgage documents and the application for insurance endorsement and This mortgage complies with SF Handbook 40001 Section IIA7 Post-Closing and Endorsement to the extent that no defect exists that would have changed the decision to endorse or submit the mortgage for insurance
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee
Name of Mortgageersquos Representative
Title of Mortgageersquos Representative
Signature of the Mortgageersquos Representative Date
orm HUD-92900-A ( ) Page 4
GENERAL AUTHORIZATION FOR A MORTGAGE LOAN ASSUMPTION
Applicant name(s)
Loan number
NOTICES AND DISCLOSURES
Non-discriminatory underwriting guidelines Anyone who inquires about the availability of credit from us has the right to receive a copy of our non-discriminatory underwriting guidelines To request a copy of these guidelines contact your Loan Processor
Attorney note Itrsquos the responsibility of our attorneys to protect our interest You may at your expense request an attorney to represent your interest
Notice to HUDFHA applicants As required by the Right to Financial Privacy Act of 1978 this notice is to inform you that the US Department of Housing and Urban Development (HUD)Federal Housing Administration (FHA) has a right of access to financial records held by financial institutions related to a request for assistance Financial records involving your assumption will be available to HUDFHA without further notice or authorization but wonrsquot be disclosed or released by us to another government agency or department without your consent except as required or permitted by law
Borrower consent to the use of tax return information I understand acknowledge and agree that the Lender and Other Loan Participants can obtain use and share tax return information for purposes of (i) providing an offer (ii) originating maintaining managing monitoring servicing selling insuring and securitizing a loan (iii) marketing or (iv) as otherwise permitted by applicable laws including state and federal privacy and data security laws The Lender includes the Lenderrsquos affiliates agents service providers and any of aforementioned partiesrsquo successors and assigns The Other Loan Participants includes any actual or potential owners of a loan resulting from your loan application or acquirers of any beneficial or other interest in the loan and mortgage insurer guarantor any servicers or service providers for these parties and any of aforementioned partiesrsquo successors and assigns
CERTIFICATION AND AUTHORIZATION
Environmental certification By signing below I represent and warrant that Irsquom not aware of any substances materials or products that may be an environmental hazard such as but not limited to asbestos formaldehyde radon gas lead-based paint fuel or chemical storage tanks (above or below ground) and contaminated soil or water on the property I acknowledge that Chase is relying on this representation and warranty as a material part of its loan application process I also am not aware of any landfill on any portion of the property
Exceptions to the above I further acknowledge (1) receipt of applicable disclosures from the seller in purchase transactions (2) that lead-based paint may exist in housing constructed prior to 1978 (3) that Chase performs no environmental investigation on my behalf and isnrsquot responsible for identifying lead-based paint or any other environmental conditions that might impact the property or its residents and (4) that it is my sole obligation to investigate for potential impact to the property from environmental conditions
Certifications I certify by signing below that (1) all of the loan application information provided is true and complete (2) I understand any intentional or negligent misrepresentation(s) of the information provided in conjunction with my application may result in civil liability andor 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 Chase its agents successors and assigns insurers and any other person who may suffer any loss due to reliance upon any misrepresentation that I have made on the application and (3) any significant change from the information provided at the time of application until the final loan application is signed may have a bearing on the approval of my application for a home loan
Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union
This question is asked because of state laws that extend the same or similar rights benefits and protections of spouses in a marriage to persons who are members of a partnership or union recognized under state law You should consult with your own legal advisor for advice regarding the rights protections benefits responsibilities obligations and duties of those who are registered domestic partners civil union partners or members of other unions recognized under applicable law
CREDIT AUTHORIZATION RELEASE
By signing below I authorize Chase andor my mortgage insurer (if any) to verify my past and present employment earnings records (including information contained in income tax returns that have been filed with the IRS) bank accounts stock holdings and any other information that it finds necessary to process my mortgage loan application or to review it for quality-control purposes I understand that a credit report will be ordered from a credit reporting agency for verification prior to loan closing as part of the application process and may be ordered after closing as part of the Lenderrsquos quality-control program A credit report may also be completed as part of the Lenderrsquos servicing or collection of the loan or in consideration of any other product or service that the Lender may consider offering me in the future and at any time throughout the life of the loan I understand that use of a photocopy of this form may be necessary to verify one or more of my credit references I understand that a photocopy or fax copy of this form will also serve as authorization
By signing below each applicant acknowledges (1) making the above certifications and authorizations and (2) that each applicant has received and understands the above notices and disclosures
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
You do not have to give us this information but if you donrsquot your application for approval as a borrower may be delayed or rejected The information requested in this form is authorized by Title 38 USC Chapter 37 (if VA) by 12 USC Section 1701 et seq (if HUDFHA) by 42 USC Section 1452b (if HUDCPD) and Title 42 USC 1471 et seq or 7 USC 1921 et seq (if USDA FHA)
Updated December 2021 99177-GA-0215
1b
2b
Form 4506-C (September 2020)
Department of the Treasury - Internal Revenue Service
IVES Request for Transcript of Tax Return OMB Number
1545-1872
Do not sign this form unless all applicable lines have been completed Request may be rejected if the form is incomplete or illegible
For more information about Form 4506-C visit wwwirsgov and search IVES
1a Name shown on tax return (if a joint return enter the name shown first)
First social security number on tax return individual taxpayer identification number or employer identification number (see instructions)
2a If a joint return enter spousersquos name shown on tax return Second social security number or individual taxpayer identification number if joint tax return
3 Current name address (including apt room or suite no) city state and ZIP code (see instructions)
4 Previous address shown on the last return filed if different from line 3 (see instructions)
5a IVES participant name address and SOR mailbox ID
DataVerify 875 Greentree Rd 8 Parkway Center Pittsburgh PA 15220
5b Customer file number (if applicable) (see instructions)
Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing (see instructions)
6 Transcript requested Enter the tax form number here (1040 1065 1120 etc) and check the appropriate box below Enter only one tax form number per request 1040
a Return Transcript which includes most of the line items of a tax return as filed with the IRS A tax return transcript does not reflect changes made to the account after the return is processed Transcripts are only available for the following returns Form 1040 series Form 1065 Form 1120 Form 1120-A Form 1120-H Form 1120-L and Form 1120S Return transcripts are available for the current year and returns processed during the prior 3 processing years
b Account Transcript which contains information on the financial status of the account such as payments made on the account penalty assessments and adjustments made by you or the IRS after the return was filed Return information is limited to items such as tax liability and estimated tax payments Account transcripts are available for most returns
c Record of Account which provides the most detailed information as it is a combination of the Return Transcript and the Account Transcript Available for current year and 3 prior tax years
7 Form W-2 Form 1099 series Form 1098 series or Form 5498 series transcript The IRS can provide a transcript that includes data from these information returns State or local information is not included with the Form W-2 information The IRS may be able to provide this transcript information for up to 10 years Information for the current year is generally not available until the year after it is filed with the IRS For example W-2 information for 2016 filed in 2017 will likely not be available from the IRS until 2018 If you need W-2 information for retirement purposes you should contact the Social Security Administration at 1-800-772-1213
Caution If you need a copy of Form W-2 or Form 1099 you should first contact the payer To get a copy of the Form W-2 or Form 1099 filed with your return you must use Form 4506 and request a copy of your return which includes all attachments
8 Year or period requested Enter the ending date of the tax year or period using the mmddyyyy format (see instructions)
12 31 2020 12 31 2019 12 31 2018 Caution Do not sign this form unless all applicable lines have been completed
Signature of taxpayer(s) I declare that I am either the taxpayer whose name is shown on line 1a or 2a or a person authorized to obtain the tax information requested If the request applies to a joint return at least one spouse must sign If signed by a corporate officer 1 percent or more shareholder partner managing member guardian tax matters partner executor receiver administrator trustee or party other than the taxpayer I certify that I have the authority to execute Form 4506-C on behalf of the taxpayer Note This form must be received by IRS within 120 days of the signature date
Signatory attests that heshe has read the attestation clause and upon so reading declares that heshe has the authority to sign the Form 4506-C See instructions
Sign Here
Signature (see instructions) Date Phone number of taxpayer on line 1a or 2a
PrintType name
Title (if line 1a above is a corporation partnership estate or trust)
Spousersquos signature Date
PrintType name
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020) For Privacy Act and Paperwork Reduction Act Notice see page 2
Instructions for Form 4506-C IVES Request for Transcript of Tax Return
Section references are to the Internal Revenue Code unless otherwise noted
Future Developments
For the latest information about Form 4506-C and its instructions go to wwwirsgov and search IVES Information about any recent developments affecting Form 4506-C (such as legislation enacted after we released it) will be posted on that page
Whats New Form 4506-C was created to be utilized by authorized IVES participants to order tax transcripts with the consent of the taxpayer
General Instructions
Caution Do not sign this form unless all applicable lines have been completed
Designated Recipient Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information received pursuant to the taxpayerrsquos consent and holds the recipient subject to penalties for any unauthorized access other use or redisclosure without the taxpayerrsquos express permission or request
Taxpayer Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information provided pursuant to your consent and holds the recipient subject to penalties brought by private right of action for any unauthorized access other use or redisclosure without your express permission or request
Purpose of form Use Form 4506-C to request tax return information through an authorized IVES participant You will designate an IVES participant to receive the information on line 5a
Note If you are unsure of which type of transcript you need check with the party requesting your tax information
Where to file The IVES participant will fax Form 4506-C with the approved IVES cover sheet to their assigned Service Center
Chart for ordering transcripts
If your assigned Service Center is
Fax the requests with the approved coversheet to
Austin Submission Processing Center
Austin IVES Team
844-249-6238
Fresno Submission Processing Center
Fresno IVES Team
844-249-6239
Kansas City Submission Processing Center
Kansas City IVES Team
844-249-8128
Ogden Submission Processing Center
Ogden IVES Team
844-249-8129
Specific Instructions
Line 1b Enter the social security number (SSN) or individual taxpayer identification number (ITIN) for the individual listed on line 1a or enter the employer identification number (EIN) for the business listed on line 1a
Line 3 Enter your current address If you use a PO box include it on this line
Line 4 Enter the address shown on the last return filed if different from the address entered on line 3
Note If the addresses on lines 3 and 4 are different and you have not changed your address with the IRS file Form 8822 Change of Address or Form 8822-BChange of Address or Responsible Party mdash Business with Form 4506-C
Line 5b Enter up to 10 numeric characters to create a unique customer file number that will appear on the transcript The customer file number cannot contain an SSN ITIN or EIN Completion of this line is not required
Note If you use an SSN name or combination of both we will not input the information and the customer file number will reflect a generic entry of 9999999999 on the transcript
Line 8 Enter the end date of the tax year or period requested in mmddyyyy format This may be a calendar year fiscal year or quarter Enter each quarter requested for quarterly returns Example Enter 12312018 for a calendar year 2018 Form 1040 transcript
Signature and date Form 4506-C must be signed and dated by the taxpayer listed on line 1a or 2a The IRS must receive Form 4506-C within 120 days of the date signed by the taxpayer or it will be rejected Ensure that all applicable lines including lines 5a through 8 are completed before signing
You must check the box in the signature area to acknowledge you have the authority to sign and request the information The form will not be processed if unchecked
Individuals Transcripts listed on on line 6 may be furnished to either spouse if jointly filed Only one signature is required Sign Form 4506-C exactly as your name appeared on the original return If you changed your name also sign your current name
Corporations Generally Form 4506-C can be signed by
(1) an officer having legal authority to bind the corporation (2) any person designated by the board of directors or other governing body or (3) any officer or employee on written request by any principal officer and attested to by the secretary or other officer A bona fide shareholder of record owning 1 percent or more of the outstanding stock of the corporation may submit a Form 4506-C but must provide documentation to support the requesters right to receive the information
Partnerships Generally Form 4506-C can be signed by any person who was a member of the partnership during any part of the tax period requested on line 8
All others See section 6103(e) if the taxpayer has died is insolvent is a dissolved corporation or if a trustee guardian executor receiver or administrator is acting for the taxpayer
Note If you are Heir at law Next of kin or Beneficiary you must be able to establish a material interest in the estate or trust
Documentation For entities other than individuals you must attach the authorization document For example this could be the letter from the principal officer authorizing an employee of the corporation or the letters testamentary authorizing an individual to act for an estate
Signature by a representative A representative can sign Form 4506-C for a taxpayer only if the taxpayer has specifically delegated this authority to the representative on Form 2848 line 5 The representative must attach Form 2848 showing the delegation to sign Form 4506-C
Privacy Act and Paperwork Reduction Act Notice We ask for the information on this form to establish your right to gain access to the requested tax information under the Internal Revenue Code We need this information to properly identify the tax information and respond to your request You are not required to request any transcript if you do request a transcript sections 6103 and 6109 and their regulations require you to provide this information including your SSN or EIN If you do not provide this information we may not be able to process your request Providing false or fraudulent information may subject you to penalties
Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and cities states the District of Columbia and US commonwealths and possessions for use in administering their tax laws We may also disclose this information to other countries under a tax treaty to federal and state agencies to enforce federal nontax criminal laws or to federal law enforcement and intelligence agencies to combat terrorism
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law Generally tax returns and return information are confidential as required by section 6103
The time needed to complete and file Form 4506-C will vary depending on individual circumstances The estimated average time is
Learning about the law or the form 10 min Preparing the form 12 min Copying assembling and sending the form to the IRS 20 min
If you have comments concerning the accuracy of these time estimates or suggestions for making Form 4506-C simpler we would be happy to hear from you You can write to
Internal Revenue Service Tax Forms and Publications Division 1111 Constitution Ave NW IR-6526 Washington DC 20224
Do not send the form to this address Instead see Where to file on this page
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020)
Rev April 2021 CHASEO Facts What does Chase do with your personal information
Why Financial companies choose how they share your personal information Federal law gives consumers the right to limit some but not all sharing Federal law also requires us to tell you how we collect share and protect your personal information Please read this notice carefully to understand what we do
What The types of personal information we collect and share depend on the product or service you have with us This information can include bull Social Security number and income bull account balances and transaction history bull credit history and payment history
How All financial companies need to share customers personal information to run their everyday business In the section below we list the reasons financial companies can share their customers personal information the reasons Chase chooses to share and whether you can limit this sharing
Reasons we can share your personal information Does Chase share
Can you limit this sharing
For our everyday business purposes - such as to process your transactions maintain your account(s) respond to court orders and legal investigations or report to credit bureaus
Yes No
For our marketing purposes - to offer our products and services to you
Yes No
For joint marketing with other financial companies Yes No
For our affiliates everyday business purposes - information about your transactions and experiences
Yes No
For our affiliates everyday business purposes - information about your creditworthiness
Yes Yes
For our affiliates to market to you Yes Yes
For nonaffiliates to market to you Yes Yes
a
0
To limit our sharing
bull Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
bull Visit us online chasecomprivacypreferences
Please note If you are a new customer we can begin sharing your information 30 days from the date we sent this notice When you are no longer our customer we continue to share your information as described in this notice However you can contact us at any time to limit our sharing
Questions
Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
PAGE 2
Who we are
Who is providing this notice The US consumer financial companies within the JPMorgan Chase amp Co family including JPMorgan Chase Bank NA Chase Insurance Agency Inc and JP Morgan Securities LLC
What we do
How does Chase protect my To protect your personal information from unauthorized access and use we personal information use security measures that comply with federal law These measures include
computer safeguards and secured files and buildings We authorize our employees to get your information only when they need it to do their work and we require companies that work for us to protect your information
How does Chase collect my We collect your personal information for example when you personal information bull open an account or make deposits or withdrawals from your account
bull pay your bills or apply for a loan bull use your credit or debit card We also collect your personal information from others such as credit bureaus affiliates or other companies
Why cant I limit all sharing Federal law gives you the right to limit only bull sharing for affiliates everyday business purposes - information about your
creditworthiness bull affiliates from using your information to market to you bull sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing See below for more on your rights under state law
What happens when I limit sharing for an account I hold jointly with someone else
Your choices will apply to everyone on your account
Definitions
Affiliates Companies related by common ownership or control They can be financial and non financial companies bull Our affiliates include companies with a Chase or JP Morgan name and financial companies such asjP Morgan Securities LLC
Nonaffiliates Companies not related by common ownership or control They can be financial and non financial companies bull Nonaffiliates we share with can include companies such as retailers auto dealers auto makers and membership clubs
Joint marketing A formal agreement between nonaffiliated financial companies that together market financial products or services to you bull Our joint marketing partners include categories of companies such as insurance companies
Other important information
VT Accounts with a Vermont mailing address are automatically treated as if they have limited the sharing as described on page 1 For joint marketing we will only disclose your name contact information and information about your transactions
NV We are providing you this notice pursuant to Nevada law If you prefer not to receive marketing calls from us you may be placed on our Internal Do Not Call List by calling 1-800-945-9470 or by writing to us at PO Box 734007 Dallas TX 75373-4007
For more information contact us at the address above or email PrivacylnfoJPMChasecom with Nevada Annual Notice in the subject line You may also contact the Nevada Attorney Generals office Bureau of Consumer Protection Office of the Nevada Attorney General 555 E Washington St Suite 3900 Las Vegas NV 89101 telephone number 1-702-486-3132 email BCPINFOagstatenvus
CA Accounts with a California mailing address are automatically treated as if they have limited the sharing with nonaffiliates as described on page 1 CA residents are provided a CA notice for additional choices
CHASE O
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
The following disclosure is required by the USA PATRIOT Act
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 opens an account
What this means to you When you 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 drivers
license or other identifying documents
99177-PAT-0215
VETERAN STATEMENT When this loan was opened the US Department of Veterans Affairs (VA) used the veteran borrowerrsquos entitlement which is a set amount the VA promises to repay a lender if the borrower defaults on the mortgage An assumption will modify who is obligated to pay the existing mortgage loan but all loan termsmdashincluding the entitlementmdashwill remain the same If the veteran borrower is being removed from the loan the entitlement would remain with whoever is assuming the loan because the loan will continue to be serviced by the VA If the applicant is also a veteran and can substitute his or her entitlement for the current entitlement then the current borrowerrsquos entitlement can be released
Please review the following questions and answer as appropriate This form requires completion by both the applicant(s) and current borrower(s)
1 Applicant to Complete
Are you (the applicant) currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the reverse side)
Yes (If yes please provide the information requested below answer the question in section 3 and sign and date this form at the bottom of the reverse side)
Name of applicant(s) who answered ldquoyesrdquo to the above question
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Are you receiving VA disability benefts
Applicant
Yes
No
Co-Applicant
Yes
No
Are you entitled to receive VA disability benefts Yes No Yes No
Have you received VA disability benefts in the past Yes No Yes No
Are you a surviving spouse of a veteran who died on active duty or as the result of a service-related disability
Yes No Yes No
Do you have any VA loans Yes No Yes No
2 Current Borrower to Complete
Is the current borrowerco-borrower currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the page)
Yes (If yes please answer the question in section 3 and sign and date this form at the bottom of the page)
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
________________________________________________________________________________________________
3 Applicant and Current Borrower to Complete
If the answer to the questions in section 1 and 2 are both yes please answer the following question After yoursquove reviewed and completed this entire form please sign and date at the bottom
Applicant Current Borrower
Do you want to apply for a substitution of entitlement Yes Yes No No
In order to complete a substitution of entitlement the veteran applicant must have suffcient entitlement to substitute for that of the current borrower Contact the VA Offce of Jurisdiction for your area for more information Also before the veteran applicant can substitute entitlement on a VA loan heshe must certify that the property securing the loan will be occupied as hisher primary residence Both the applicantrsquos and current borrowerrsquos original certifcate of eligibility will be required If your sales contract is contingent upon the restoration of entitlement please contact your VA Offce of Jurisdiction for complete procedures Otherwise the substitution will be completed after the loan has been approved and closed
Date Applicant printed name Applicant signature
Date Applicant printed name Applicant signature
Date Current Borrower printed name Current Borrower signature
Date Current Borrower printed name Current Borrower signature
Forms completed by Mail Phone
For Chase use only
Interviewer signature Date
99177-VS-0215
- Assumption Application Package_41521-noscannedpages-update-4pdf
-
- 1 FM203 Cover Pagepdf
- 2 FM202 Mortgage Assumption Application Package pagepdf
- 3 The Documents Youll need to Send Uspdf
- 4 FM201 FAQpdf
- 5 FM142 CIWpdf
- 6 FM126 URLApdf
- 7 FM130 URLA Instpdf
-
- Blank Page
-
- 8 92900a Addednum to Loan Applicationpdf
- 9 FM462 Gen Authpdf
- 10 FM220 4506-Cpdf
- 11 FM153 Chase Federal Privacy Noticepdf
- 12 FM144 Info on Opening a New Accountpdf
- 13 FM152 Veteran Statementpdf
-
- Date
- Loan number
- Applicant name
- Phone1
- Loan number 1
- Loan number 2
- Other
- Other_2
- 1
- 2
- undefined_7
- Available hours
- Available hours_2
- undefined_8
- Available hours_3
- undefined_9
- Current address 1
- Neither
- Available hours_4
- Available hours_5
- undefined_10
- Available hours_6
- 1_2
- 2_2
- undefined_11
- Available hours_7
- Available hours_8
- undefined_12
- Available hours_9
- FHA Case No include any suffix
- Mortgagee Case No
- Mortgagee ID
- Sponsor ID
- Agent ID
- Name and Address of Sponsor Name and Address of Agent
- Borrowers Name Present Address include ZIP Code Property Address
- include name of subdivision lot block no ZIP Code
- Name of ThirdParty Originator
- NMLS ID of ThirdParty Originator
- s application
- ty Number
- ty Number_2
- Date Signed_2
- Date Mortgage Approved
- Date Approval Expires
- Printed Name
- Title 1
- DEs ID Number
- DEs ID Number_2
- Mortgagee
- Name of Mortgagees Representative
- Title of Mortgagees Representative
- Signature of the Mortgagees Representative
- Date_2
- Applicant names 1
- Applicant names 2
- Applicant names 3
- Loan number_2
- Date_3
- Applicant printed name
- Social Security number
- Date_4
- Applicant printed name_2
- Social Security number_2
- Date_5
- Applicant printed name_3
- Social Security number_3
- Date_6
- Applicant printed name_4
- Social Security number_4
- 1a Name shown on tax return if a joint return enter the name shown first
- 1b First social security number on tax return individual taxpayer identification number or employer identification number see instructions
- 2a If a joint return enter spouses name shown on tax return
- 2b Second social security number or individual taxpayer identification number if joint tax return
- 4 Previous address shown on the last return filed if different from line 3 see instructions
- 5a IVES participant name address and SOR mailbox ID
- Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing see instructions
- Signature see instructions
- Date_7
- Phone number of taxpayer on line 1a or 2a
- PrintType name
- Here
- Spouses signature
- Date_8
- PrintType name_2
- Name
- Date of birth
- Service number
- Name_2
- Date of birth_2
- Service number_2
- Date_9
- Applicant printed name_5
- Date_10
- Applicant printed name_6
- Date_11
- Current Borrower printed name
- Date_12
- Current Borrower printed name_2
- Date_13
- Text3
- Text10
- undefined_13
- Text15
- undefined_14
- undefined_15
- undefined_16
- undefined_17
- undefined_18
- undefined_19
- undefined_20
- undefined_21
- undefined_23
- Reason for assumption Off
- Requestors relationship to owners Off
- Check one Off
- Check one1 Off
- Day1
- Evening
- Cell phone
- Check one2 Off
- Check one3 Off
- Check one4 Off
- Check one5 Off
- Text2-1
- Text2-2
- Text2-3
- Text2-4
- Text2-5
- Text2-6
- Text3-1
- Text3-2
- Text3-3
- Text3-4
- Text3-6
- Text3-7
- Text3-8
- Text3-9
- Text3-10
- Text3-11
- Text3-12
- Text3-13
- Text3-14
- Text3-15
- Text3-16
- Text3-17
- Text3-18
- Text3-19
- Text3-20
- Text3-21
- Text3-22
- Text3-23
- Text3-24
- Text3-25
- Text3-26
- Text3-27
- Text3-28
- Text3-29
- Text3-30
- Text3-31
- Text3-32
- Text3-33
- Text3-34
- Text3-35
- Text3-36
- Text3-37
- Text3-38
- Text3-39
- Text3-40
- Text3-41
- Text3-42
- Text3-43
- Text3-44
- Text3-45
- Text3-46
- Text3-47
- Text3-48
- Text3-49
- Text3-50
- Text3-51
- Text3-52
- Text3-53
- Text3-5
- Text3-54
- Text3-55
- Text3-56
- Citizenship Off
- Type of credit Off
- Marital Status Off
- Housing Off
- Housing1 Off
- ownership Off
- DNA1 Off
- DNA2 Off
- DNA3 Off
- family Off
- BO Off
- Total
- Text31
- Text32
- Text33
- Text34
- Text35
- Text36
- Text37
- Text38
- Text39
- Text310
- Text311
- Text312
- Text313
- Text314
- Text315
- Text316
- Text317
- Text318
- Text319
- ownership1 Off
- Total1
- Total1-2
- Check Box4-1 Off
- Text320
- Text321
- Text322
- Text323
- Text324
- Text325
- Text326
- Text327
- Text328
- Text329
- Check Box4-2 Off
- Check Box4-3 Off
- Check Box4-4 Off
- Check Box4-8 Off
- Check Box4-9 Off
- Text330
- Text331
- Text332
- Text333
- Text334
- Text335
- Text1-1
- Text1-2
- Text1-3
- Text1-4
- Text1-5
- Text1-6
- Text1-7
- Text1-8
- Text1-9
- Text1-10
- Text1-11
- Text1-12
- Text1-13
- Text1-14
- Text1-15
- Text1-16
- Text1-17
- Text1-18
- Text1-19
- Text1-20
- Text1-21
- Text1-22
- Text1-23
- Text1-24
- Text1-25
- Text1-26
- Text1-27
- Text1-28
- Text1-29
- Text1-30
- Text1-31
- Text1-32
- Text1-33
- Text1-34
- Text1-35
- Check Box3-2 Off
- Check Box2-1 Off
- Check Box2-2 Off
- Check Box2-3 Off
- Check Box2-4 Off
- Check Box2-5 Off
- Text1-36
- Text1-37
- Text1-38
- Text1-39
- Text1-40
- Text1-41
- Text1-42
- Text1-43
- Text1-44
- Text1-45
- Text1-46
- Text1-47
- Text1-48
- Text1-49
- Text1-50
- Text1-51
- Text1-52
- Text1-53
- Text1-54
- Text1-55
- Text1-56
- Text1-57
- Text1-58
- Text1-59
- Text1-60
- Text1-61
- Check Box3-11 Off
- A1
- A2
- A3
- A4
- A5
- A6
- A7
- A8
- A9
- A10
- A11
- A12
- Check Box3-1 Off
- Check Box30-1 Off
- Check Box30-2 Off
- Check Box30-4 Off
- Check Box30-5 Off
- Check Box30-7 Off
- Check Box30-8 Off
- Check Box30-9 Off
- Check Box30-10 Off
- Check Box30-11 Off
- Check Box30-12 Off
- A13
- A14
- A15
- A16
- A17 Off
- A18
- A19
- A20
- A21
- A22
- A23
- A24
- A25
- A26
- A27
- A28
- A29
- A30
- A31
- A32
- A33
- A34
- A35
- A36
- A37
- A38 Off
- A39
- A40
- A41
- A42
- A43
- A44
- A45
- A46
- A47
- A48
- A49
- A50
- A51
- A52
- A53
- A54
- A55
- A56
- A57
- A58
- A59
- A60
- A61
- A62
- A63
- A64
- A65
- A66
- A67
- A68
- A69
- A70
- A71
- A72
- A73
- A74
- Loan Purpose Off
- occupancy1 Off
- lien type Off
- lientype Off
- mixed use Off
- manufactured home Off
- deposit1 Off
- deposit2 Off
- B1
- B2
- B3
- B4
- B5
- B6
- B7
- B8
- B9
- B10
- fha Off
- Check Box51 Off
- B11
- B12
- B13
- B14
- B15
- B16
- B17
- B18
- B19 Off
- B20
- B21
- B22 Off
- B23
- B24
- B25
- B26
- B27
- B28
- A
-
- Will you occupy the property as your primary residence Off
- Will you occupy the property as your primary residence1 Off
-
- If yes have you had an ownership interest in another property in the last three years Off
- Text9-2
- B
-
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property Off
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property1 Off
-
- 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 Off
- 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 application1 Off
-
- 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 Off
- 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 application1 Off
-
- new credit Off
- 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) Off
- the Property Assessed Clean Energy Program)1 Off
-
- F
-
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application Off
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application1 Off
-
- G
-
- Are there any outstanding judgments against you Off
- Are there any outstanding judgments against you1 Off
-
- H
-
- Are you currently delinquent or in default on a Federal debt Off
- Are you currently delinquent or in default on a Federal debt1 Off
-
- I
-
- Are you a party to a lawsuit in which you potentially have any personal financial liability Off
- Are you a party to a lawsuit in which you potentially have any personal financial liability1 Off
-
- J
-
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years Off
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years1 Off
-
- 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 Off
- 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 due1 Off
-
- L
-
- Have you had property foreclosed upon in the last 7 years Off
- Have you had property foreclosed upon in the last 7 years1 Off
-
- M
-
- Have you declared bankruptcy within the past 7 years Off
- Have you declared bankruptcy within the past 7 years1 Off
-
- Check Box8-2 Off
- Check Box8-3 Off
- Check Box8-4 Off
- Text9-3
- Text9-5
- Text9-6
- Text97
- military Off
- ethnicity Off
- sex Off
- race Off
- demo Off
- Text12-1
- Check Box11-1 Off
- Check Box11-2 Off
- Check Box11-3 Off
- Check Box11-4 Off
- Check Box11-5 Off
- Check Box11-6 Off
- Check Box11-7 Off
- Check Box11-8 Off
- Check Box11-9 Off
- Text12-2
- Check Box11-10 Off
- Check Box11-11 Off
- Check Box11-12 Off
- Check Box11-13 Off
- Check Box11-14 Off
- Check Box11-15 Off
- Text12-3
- Check Box11-16 Off
- Check Box11-17 Off
- Check Box11-18 Off
- Check Box11-19 Off
- Check Box11-20 Off
- Check Box11-21 Off
- Check Box11-22 Off
- Check Box11-23 Off
- Text12-4
- Check Box11-24 Off
- Check Box11-25 Off
- Check Box11-26 Off
- Check Box11-27 Off
- Check Box11-28 Off
- Check Box11-29 Off
- Text12-5
- Check Box11-30 Off
- Check Box11-31 Off
- citizen Off
- credit Off
- marital status1 Off
- housing-1 Off
- housing-2 Off
- own Off
- C1
- C2
- C3
- C6
- C7
- C8
- C9
- C10
- C11
- C12
- C13
- C14
- C15
- C16
- C17
- C18
- C19
- C20
- C21
- C22
- C23
- C24
- C25
- C26
- C27
- C28
- C29
- C30
- C31
- C32
- C33
- C34
- C35
- Check Box-2 Off
- C36
- C37
- C38
- C39
- C4
- C40
- C41
- C42
- C43
- C44
- C45
- C46
- C47
- Check Box-3 Off
- Check Box-4 Off
- C48
- C49
- C5
- C50
- C51
- C52
- C53
- C54
- C55
- Check Box-1-1 Off
- own1 Off
- Check Box-1 Off
- D1 Off
- D2
- D3
- D4
- D5
- D6
- D7
- D8
- D9
- D10
- D11
- D12
- D13
- D14 Off
- D15 Off
- D16
- D17
- D18
- D19
- D20
- D21
- D22
- D23
- D24 Off
- D25
- D26
- D27
- D28
- D29
- D30
- D31
- D32
- D33
- D34
- D35 Off
- D36
- D37 Off
- D38
- D39
- D40
- D41
- D42
- D43
- D44
- D45
- D46
- D47
- If yes have you had an ownership interest in another property in the last three years1 Off
- new credit1 Off
- Check Box8-1 Off
- Check Box8-1-2 Off
- Check Box8-1-1 Off
- Check Box8-1-3 Off
- Check Box8-1-4 Off
- Military Service mdash Did you (or your deceased spouse) ever serve or are you currently serving in the United States Armed Forces 1 Off
- Check1 Off
- Text9-1-1
- Check2 Off
- Check3 Off
- Check4 Off
- Text9-1
- E1
- E2
- E3
- Was the ethnicity of the Borrower collected on the basis of visual observation or surname1 Off
- Was the sex of the Borrower collected on the basis of visual observation or surname1 Off
- Was the race of the Borrower collected on the basis of visual observation or surname1 Off
- The Demographic Information was provided through1 Off
- F1 Off
- F2 Off
- F3 Off
- F4 Off
- F5 Off
- F6
- F7 Off
- F8 Off
- F9 Off
- F10 Off
- F11 Off
- F12 Off
- F13
- F14 Off
- F15 Off
- F16 Off
- F17 Off
- F18 Off
- F19 Off
- F20 Off
- F21 Off
- F22
- F23 Off
- F24 Off
- F25 Off
- F26 Off
- F27 Off
- F28 Off
- F29
- F30 Off
- F31 Off
- undefined_13-1
- undefined_13-2
- undefined_14-1
- undefined_15-1
- undefined_16-1
- undefined_17-1
- undefined_18-1
- undefined_19-1
- undefined_21-1
- undefined_20-1
- undefined_23-1
- undefined_13_1
- Single-Two Off
- Refi type Off
- refi program Off
- Estate Off
- Title held Off
- Trust Information Off
- Indian Country Land Tenure Off
- Mortgage Type Applied For Off
- Mortgage Lien Type Off
- Amortization Type Off
- G1 Off
- G2 Off
- G3 Off
- G4 Off
- G5 Off
- G6
- G7
- G8
- G9
- G10 Off
- G11 Off
- G12 Off
- G13 Off
- G14 Off
- G15 Off
- G16
- G17
- G18
- G19
- G20
- G21
- G22
- G23 Off
- G24
- G25 Off
- G26
- G27 Off
- G28 Off
- G29
- G30 Off
- G31
- G32 Off
- G33
- G34
- G35
- G36
- G37
- G38
- G39
- G40
- G41
- G42
- Property Held
- refi
- Text18-1
- Text18-2
- Text18-3
- Text18-4
- Text18-5
- Text18-6
- Text18-7
- Text18-8
- Text18-9
- Text18-10
- Text18-11
- Text18-12
- Text18-13
- Text18-14
- Text18-15
- Text18-16
- Text18-17
- Text18-18
- Text18-19
- Lender
- case no
- If you selected ldquoUnmarriedrdquo in Section 1 is there a person who is not your legal spouse but who currently has real property rights similar to those of a legal spouse Off
- Relationship and State Off
- Other-5
- Text19-1
- BName
- Additional Information
- ABN
- Additional Information1
- BSign
- BSDate
- ABSign
- ABDate
- MortageeNameAddress
- NAmeAddress
- Bname1
- DOB1
- DOB2
- SignOfBorr1
- SignOfBorr
- Date Signed
- SignOfBorr2
- SignOfBorr3
- Date Signed3
- Date Signed4
- MortgageeRepSign
- DirectSign
- DirectSign1
- Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union Off
- AppSign
- AppSign1
- AppSign2
- AppSign3
- Nopage38 Off
- Yespage38 Off
- Yes1 Off
- No1 Off
- Yes2 Off
- Yes3 Off
- Yes4 Off
- Yes5 Off
- Yes6 Off
- Yes7 Off
- Yes8 Off
- Yes9 Off
- Yes10 Off
- No2 Off
- No3 Off
- No4 Off
- No5 Off
- No6 Off
- No7 Off
- No8 Off
- No9 Off
- No10 Off
- BorrowerNo Off
- BorrowerYes Off
- AppSignature
- AppSignature1
- CurrentSign
- CurrentSign1
- InterviewSign
- Yes_1 Off
- No_1 Off
- Yes_2 Off
- No_2 Off
- Mail Off
- Phone Off
Section 3 Financial Information mdash Real Estatethis section asks youtolist all properties you currently ownand what you owe onthem donot own anyreal estate
3a Property You Own If you are refinancinglist the property you are refinancing FIRST
Address Street Unit
City State ZIP Country
Sol Intended Occupancyinvestment PrimaryResidence SecondHome Other
Monthly InsuranceTaxesAssociation Duesetcifnot included in MonthlyMortgage Payment
For 2-4 Unit Primary or Investment PropertyStatus SoldPending Saleor Retained
=Monthly RentalIncomeProperty Value
$ $ $
Mortgage Loanson this Property Does not apply
MonthlyMortgagePayment
Type FHA VAConventionalUSDA-RD Other|
To be paid offator before closing
Credit Limit(ifapplicable)Creditor Name Account Number Unpaid Balance
$ $ $
$ $ $
3b IF APPLICABLE Complete Information for Additional Property Does not apply
Address Street Unit
City State ZIP Country
ldquoSold Intended Occupancyinvestment PrimaryResidence SecondHome Other
Monthly Insurance TaxesAssociation Duesetcifnot included in MonthlyMortgage Payment
For 2-4 Unit Primary or Investment PropertyStatus SoldPendingSaleor Retained
Monthly RentalIncomeProperty Value
$ $ $
Mortgage Loanson this Property Does not apply
Monthly
Mortgage
Payment
Type FHA VA
Conventional
USDA-RD Other|
To be paid offat
or before closing
Credit Limit
(ifapplicable)Creditor Name Account Number Unpaid Balance
$ $ $
$ $ $
$ $ $
$ $ $
$ $ $
3c IF APPLICABLE Complete Information for Additional Property Does not apply
Address Street Unit
City State ZIP Country
Intended Occupancyinvestment PrimaryResidence SecondHome Other
Monthly Insurance TaxesAssociation Duesetcifnot included in MonthlyMortgage Payment
For 2-4 Unit Primary or Investment PropertyStatus SoldPending Saleor Retained
Monthly RentalIncomeProperty Value
Mortgage Loanson this Property Does not apply
MonthlyMortgagePayment
Type FHA VAConventionalUSDA-RD Other|
To be paid offator before closing
Credit Limit(ifapplicable)Creditor Name Account Number Unpaid Balance
Borrower Name
Uniform Residential Loan Application
Freddie Mac Form 65 +raquo Fannie Mae Form 1003
Effective 12021
Section 4 Loan and Property Informationthis section asks about the loanrsquos purpose and the property youwantto purchase orrefinance
4a Loan and Property Information
LoanAmount $ Loan Purpose Purchase efinance Other(specify)
Property Address Street Unit
City State ZIP County
Numberof Units Property Value $
Occupancy Primary Residence Second Home InvestmentProperty FHA Secondary Residence
1 Mixed-Use PropertyIf you will occupy the propertywill you set aside space within the property to operate
your ownbusiness(eg daycare facility medicaloffice beautybarber shop)NO YES
2 Manufactured HomeIs the property a manufactured home(eg a factory built dwelling built on a permanentchassis) NO YES
4b Other New Mortgage Loansonthe Property Youare Buying or Refinancing Does not apply
LoanAmountAmountto be Drawn
Credit Limit(ifapplicable)Creditor Name Lien Type Monthly Payment
First Lien Subordinate Lien $ $ $
$ $ $First Lien SubordinateLien
4c Rental Income on the Property You Wantto Purchase For Purchase Only Does not apply
Completeif the property is a 2-4 Unit Primary Residence or an Investment Property Amount
Expected Monthly Rental Income $
Doesnot apply4d Gifts or Grants You Have Been GivenorWill Receive for this Loan
Includeall gifts and grants below Under Source choose from the sourceslisted here
Community Nonprofitlaquo Employer
raquo Federal Agencyraquo Local Agency
- Relative+ Religious Nonprofit
+ State Agency+ Unmarried Partner
raquo Lender Other
Asset TypeCash Gift Gift of Equity Grant DepositedNot Deposited Source - uselist above Cash or Market Value
Deposited Not Deposited $
$Deposited Not Deposited
Borrower Name
Uniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 5 DeclarationsThis section asks youspecific questions about the property your funding and yourpastfinancial history
5aAboutthis Property and Your Moneyfor this Loan
A Will you occupy the property as your primary residence
If YES have you had an ownershipinterest 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 investmentproperty(IP)
(2) How did you holdtitle to the property by yourself (S) jointly with your spouse(SP) or jointly with another person (O)
YESYES
B If this is a Purchase Transaction Do you have a family relationship or businessaffiliation with the seller of the property NO YES
C Are you borrowing any moneyforthis real estate transaction (eg money foryour closing costs or down payment) orobtaining any moneyfrom anotherparty such astheseller or realtor that you have notdisclosed on this loan application NO YES
If YES what is the amountof this money $
D 1 Have you orwill you be applying for a mortgage loan on anotherproperty (not the property securing this loan) on or
before closing this transaction that is not disclosed on this loan application
NO YES
2 Have you orwill you be applying for any newcredit (eg installment loan credit card etc) on or before closing this loan that
is not disclosed on this application
No YES
E Will this property be subject to a lien that could take priority over the first mortgagelien such as a clean energylien paid
through yourproperty taxes(eg the PropertyAssessed Clean Energy Program)NO YES
5b About YourFinances
F Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application NO YES
G Are there any outstanding judgments against you No YES
H Areyou currently delinquentor in default on a Federal debt No YES
I Areyou a party to a lawsuit in which you potentially have any personalfinancialliability NO YES
J Have you conveyedtitle to any property in lieu of foreclosure in the past 7 years NO YES
K Within the past 7 years have you completed a pre-foreclosure sale or short sale whereby the property wassold to a
third party and the Lenderagreed to acceptless than the outstanding mortgage balance due
NO YES
L Have you hadproperty foreclosed uponin thelast 7 years NO YES
M Have you declared bankruptcy within the past 7 years ONO YESIf YES identify the type(s) of bankruptcy Chapter7 Chapter11 Chapter12 Chapter 13
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 6 Acknowledgments and AgreementsThis section tells you about yourlegal obligations whenyousign this application
Acknowledgments and Agreements
Definitions- Lenderincludes the Lenderrsquos agents service providers and any oftheir successors andassigns
Other Loan Participantsrdquo includes(i) any actual or potential owners of
a loan resulting from this application (the ldquoLoanrsquo)(ii) acquirers ofany beneficial or other interest in the Loan(iii) any mortgageinsurer(iv) any guarantor (v) any servicer of the Loan and (vi) any of theseparties service providers successors or assigns
I agree to acknowledgeand representthe following
(1) The Complete Informationfor this Application- The information | have providedin this application is true accurate
and completeas of the date | signed this application
laquo If the information | submitted changesor | have new information
before closing of the Loan | must change and supplementthis
application including providing any updatedsupplementedrealestate sales contract
- For purchase transactions The terms and conditionsof anyrealestate sales contract signed by mein connection with this application
are true accurate and complete to the best of my knowledge andbelief | have not entered into any other agreement written ororal inconnection withthis real estate transaction
- The Lender and OtherLoan Participants mayrely on the informationcontainedin the application before and after closing of the Loan
- Any intentional or negligent misrepresentation of information may
result in the impositionof(a) civil liability on me including monetary damagesif a
person suffers any loss because the person relied on anymisrepresentation that | have made onthis application andor
(b) criminal penalties on me including but not limited to fine orimprisonment or both underthe provisions of Federal law(18 USC sectsect 1001 et seq)
(2) The Propertyrsquos SecurityThe Loan | have applied for in this application will be secured by
a mortgage or deedoftrust which provides the Lendera security
interest in the property described in this application
(3) The Propertys Appraisal Value and Condition- Any appraisal or value of the property obtained by the Lenderis
for use by the Lender and OtherLoanParticipantslaquoThe Lender and OtherLoan Participants have not made anyrepresentation or warranty express or implied to me about the
propertyits conditionorits value
(4) Electronic Records and Signatures- The Lender and OtherLoan Participants may keep any paper record
andorelectronic record of this application whether or not the Loan
is approved
BorrowerSignature
- If this application is created as (or converted into) an ldquoelectronicapplicationrdquo | consent to the use of ldquoelectronic recordsrdquo and
ldquoelectronic signaturesrdquo as the termsare defined in and governed byapplicable Federal andorstate electronic transactions laws
| intend to sign and have signedthis application either using my(a) electronic signature or(b) a written signature and agreethatif a paper version ofthis
application is converted into an electronic application theapplication will be an electronic record and the representationof my written signature on this application will be my binding
electronic signature- | agree that the applicationif delivered or transmitted to the Lenderor Other Loan Participants as an electronic record with myelectronicsignaturewill be as effective and enforceable as a paperapplicationsigned by mein writing
(5) Delinquencylaquo The Lender and OtherLoan Participants may report information about
my accountto credit bureaus Late payments missed paymentsorother defaults on my account maybereflected in my credit report andwill likely affect my credit score
- If | have trouble making my payments | understand that | may contacta HUD-approved housing counseling organization for advice about
actions I can take to meet my mortgageobligations
(6) Authorization for Use and Sharing of InformationBy signing belowin addition to the representations and agreementsmade above| expressly authorize the Lender and Other LoanParticipants to obtain use and share with each other(i) the loan
application and related loan information and documentation(ii) aconsumercredit report on me and(iii) my tax return information asnecessary to perform theactionslisted belowfor so long as they havean interest in my loanorits servicing
(a) process and underwrite myloan(b) verify any data contained in my consumercredit 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 analysisandreviews
(e) perform analysis and modeling for risk assessments(f) monitor the accountfor this loan for potential delinquencies and
determineanyassistance that may beavailable to me and
(g) other actions permissible under applicable law
Date (mmddyyyy)
Additional Borrower Signature Date (mmddyyyy)
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 7 Military ServiceThis section asks questions about your(or your deceased spouses) military service
Military Service of Borrower
Military Service mdash Did you (or your deceased spouse) everserve or are you currently serving in the United States Armed Forces NO YES
If YES check allthat apply Currently serving on active duty with projected expiration date of servicetour (mmddyyyy)
Currently retired discharged or separated from service
Only period of service was as a non-activated memberof the Reserve or National GuardSurviving spouse
Section 8 Demographic InformationThis section asks about your ethnicity sex and race
Demographic Information of Borrower
The purposeofcollecting this informationis to help ensure thatall applicants are treated fairly and that the housing needs of communities
and neighborhoodsare beingfulfilled 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 mayselect one or more designationsfor
Ethnicity and one or more designationsfor Race The law provides that we maynotdiscriminate on the basis of this information or onwhetheryou chooseto provideit However if you choose not to provide the information and you have madethis application in person Federal
regulations require us to note your ethnicity sex and race on thebasis of visual observation or surname Thelaw also provides that we may notdiscriminate on the basis of age or marital status information you providein this application If you do not wish to provide someorall of this
information please check below
Ethnicity Check one or more Race Check one or moreHispanic or Latino AmericanIndian or Alaska Native - Print nameofenrolled
or principaltribe Mexican PuertoRican CubanOther Hispanic or Latino - Print origin Asian
Asian Indian Chinese Filipino
Japanese Korean Vietnamese
OtherAsian mdash Print race
For example Hmong Laotian Thai Pakistani Cambodian and so on
Black or African American
Native Hawaiian or OtherPacific Islander
Native Hawaiian GuamanianorChamorro Samoan
For exampleArgentinean Colombian Dominican Nicaraguan
Salvadoran Spaniard andso on
Not Hispanic or Latino
| do not wish to providethis information
5Female OtherPacific Islander mdash Print race
Male For example Fijian Tongan and so on| do not wish to providethis information white
| do not wish to providethis information
Wasthe ethnicity of the Borrowercollected on the basis of visual observation or surname )NO YESWasthe sex of the Borrowercollected on the basis of visual observation or surname NO YESWastherace of the Borrowercollected on the basis of visual observation or surname NO YES
Face-to-Face Interview (includes Electronic Media w Video Component) TelephoneInterview Faxor Mail Email or Internet
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
ReelTemCrCL
Loan Originator Organization Name
Address
Loan Originator Organization NMLSR ID State License ID
Loan Originator Name
Loan Originator NMLSR ID State License ID
Date (mmddyyyy)
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Uniform Residential Loan Application mdash Additional BorrowerVerify and complete the information onthis application as directed by your Lender
Section 1 Borrower Informationthis section asks about yourpersonal information and your income fromemploymentandother sources such as retirement that you want considered to qualify for this loan
1a Personal Information
Name(First Middle Last Suffix)
Alternate Names - List any namesby which you are known or any namesunder which credit was previously received (First Middle Last Suffix)
Social Security Number - -(or Individual TaxpayerIdentification Number)
Dateof Birth Citizenship(mmddyyyy)
USCitizenPermanentResidentAlienNon-Permanent ResidentAlien
Type ofCredit| am applying for individualcredit
lam applying forjoint credit Total Number of Borrowers
Each Borrowerintendsto applyfor joint credit Your initials
List Name(s) of Other Borrower(s) Applying for this Loan
(First Middle Last Suffix) - Use a separator between names
Marital Status Dependents(notlisted by another Borrower)
Contact Information
Married Number _ Home Phone ( ) -
( ) _
( ) -mdash_ mdash_
Separated Ages CellPhone
Unmarried ens Work Phone Ext(Single Divorced WidowedCivil Union Domestic Partnership Registered
Reciprocal Beneficiary Relationship)lsquol
Emal
Current Address
Street Unit
City State ZIP Country
How Long at Current Address=Years mdashMonths Housing Noprimary housing expense Own Rent($ month)
If at Current Address for LESS than 2 yearslist Former Address Does not apply
Street Unit
City State ZIP Country
How Long at Former Address Years mdashMonths Housing Noprimary housing expense Own month)
Mailing Address- ifdifferent from CurrentAddress Does not apply
Street Unit
City State ZIP Country
eeeeCeeteiChuraleCme Doesnot apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base S$month
City State ZIP Country Overtime =$_____monthBonus $ month
Position orTitle Checkif this statementapplies Commission sect month| am employedby a family memberpropertyseller real estate agent or otherparty to the transaction
TTStart Date ____ (mmddyy) Military
Entitlements$_How longin this line of work Years =Months mdash monthSS
Other $ monthCheckif you are the BusinessOwnerorSelf-Employed
| have an ownershipshare ofless than 25 Monthly Income(or Loss) mdashmdash| have an ownership share of 25 or more $ TOTAL $ 000month
Uniform Residential Loan Application mdash Additional Borrower
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
CoeeeMCMCmeticlm tu)Comiteteilteeilelie mieit
Does not apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base
OvertimeBonus
Commission
MilitaryEntitlements
Other
$ month
$ month$ month
$ month
$ month
$ month
City State ZIP Country
Position orTitle ose if this statement applieslam employed by a family memberpropertyseller real estate agent or otherparty to the transaction
Start Date (mmddyy)How long in this line of work Years =Months
Checkif you are the Business
Owneror Self-Employed| have an ownershipshare of less than 25 Monthly Income(or Loss)
Ihave an ownership share of 25 or more $ TOTAL$ 000month
CPONMeeeMummaTestetiersdeere lire miret Does not apply
Provideat least 2 years of current and previous employment and income
Employeror Business Name Previous Gross MonthlyStreet Unit Income s month
City State ZIP Country
Position or Title
Start Date
End Date
Checkif you were the BusinessOwneror Self-Employed
(mmddyyyy)
(mmddyyyy) 1e Income from Other Sources Does not apply
Include incomefrom other sources below Under Income Source choose from the sourceslisted herelaquo Alimonylaquo Automobile Allowanceraquo Boarder Incomelaquo Capital Gains
Child Support+ Disability+ Foster Care Housing or Parsonage
+ Interest and DividendslaquoMortgage Credit Certificate Mortgage DifferentialPayments
laquo Notes Receivable+ Public Assistancelaquo Retirement(eg Pension IRA)
+raquo Royalty Payments Separate Maintenance
+ Social Security
raquo Trust
+ UnemploymentBenefits
laquo VA Compensation
laquo Other
NOTE Revealalimony child support separate maintenance or other income ONLYIFyou wantit considered in determining yourqualification
for this loan
Income Source - uselist above Monthly Income
$
$
$
$ 000Provide TOTAL AmountHere|
Section 2 Financial Information mdash Assets andLiabilities
Myinformation for Section 2 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 3 Financial Information mdash Real Estate
Myinformation for Section 3 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 4 Loan and Property Information
Myinformation for Section 4 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 5 DeclarationsThis section asks you specific questions about the property your funding and your past
financial history
5aAboutthis Property and Your Moneyforthis Loan
A Will you occupy the property as your primary residence NO YES
If YES have you had an ownershipinterest in another property in the last three years NO YES
If YES complete (1) and (2) below
(1)What type of property did you ownprimary residence (PR) FHA secondary residence (SR) second home(SH)
or investmentproperty (IP)
(2) How did you holdtitle to the property by yourself (S) jointly with your spouse(SP) or jointly with another person (O)
B If this is a Purchase Transaction Do you have a family relationship or businessaffiliation with the seller of the property NO YES Cc Are you borrowing any moneyforthis real estate transaction (eg money foryour closing costs or down payment) or
obtaining any moneyfrom anotherparty suchastheselleror realtor that you have not disclosed on this loan application NO YES
If YES whatis the amountof this money $
D 1 Have youorwill you be applying for a mortgage loan on anotherproperty (not the property securing this loan) on orbefore closing this transaction that is not disclosed on this loan application
NO YES
2 Have you orwill you be applying for any newcredit (eg installment loan credit card etc) on or before closing this loan that wsis not disclosed on this application
NO YES
E Will this property be subject to a lien that could take priority over thefirst mortgagelien such as a clean energylien paid
through yourproperty taxes(eg the PropertyAssessed Clean Energy Program)No YES
EK) Veli ellim ait
F Areyou a co-signer or guarantor on any debtor loan thatis not disclosed on this application NO ES
G Are there any outstanding judgments against you NO YES
H Are you currently delinquentor in default on a Federal debt NO YES
I Are you a party to a lawsuit in which you potentially have any personalfinancialliability NO YES
J Have you conveyedtitle to any property in lieu of foreclosure in the past 7 years NO YES
K Within the past 7 years have you completed a pre-foreclosure sale or short sale whereby the property wassold to a
third party and the Lender agreed to acceptless than the outstanding mortgage balance due
No YES
L Have you had property foreclosed uponin thelast 7 years NO YES
M Have you declared bankruptcy within the past 7 years no vESIf YES identify the type(s) of bankruptcy Chapter 7 Chapter11 Chapter12 Chapter 13
Section 6 Acknowledgements and AgreementsMy signature for Section 6 is on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 7 Military Service This section asks questions about your(or your deceased spouses) military service
Military Service of Borrower
Military Service mdash Did you (or your deceased spouse)everserve or are you currently serving in the United States Armed Forces NO YES
IfYES check allthat apply Currently serving on active duty with projected expiration date of servicetour (mmddyyyy)
Currently retired discharged or separated from service nnOnly period of service was as a non-activated memberofthe Reserve or National GuardSurviving spouse
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 8 Demographic InformationThis section asks about your ethnicity sex and race
Demographic Information of Borrower
The purposeofcollecting this information is to help ensure thatall applicants are treated fairly and that the housing needs of communities
and neighborhoodsare beingfulfilled 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 providethis information but are encouraged to do so You mayselect one or more designationsfor
Ethnicity and one or more designationsfor Race The law provides that we maynotdiscriminate onthe basis of this information or onwhetheryou chooseto provideit However if you choose notto provide the information and you have madethis application in person Federal
regulations require us to note yourethnicity sex and race on the basis of visual observation or surname The law also provides that we may notdiscriminate on the basis of age or marital status information you providein this application If you do not wish to provide someorall of this
information please check below
Ethnicity Check one or more Race Check one or moreHispanic or Latino AmericanIndian or Alaska Native - Print nameofenrolled
or principaltribeMexican PuertoRican Cuban
OtherHispanic or Latino - Printorigin siansian Indian Chinese Filipino
For exampleArgentinean Colombian Dominican NicaraguanSalvadoran Spaniard andso on
Japanese Korean VietnameseOtherAsian - Print race Forexample Hmong Laotian Thai Pakistani Cambodian andso on
Black or African American
Native Hawaiian or OtherPacific Islander
Native Hawaiian GuamanianorChamorro Samoan
OtherPacific Islander mdash Print race
Not Hispanic or Latino
| do not wish to providethis information
Sex
Female
Male
| do not wish to providethis informationFor example Fijian Tongan and so on
White
| do not wish to providethis information
Wasthe ethnicity of the Borrowercollected on thebasis of visual observation or surnameWasthesex of the Borrowercollected on the basis of visual observation or surnameWastherace of the Borrowercollected on the basis of visual observation or surname
)NO YESNO YESNO YES
Face-to-Face Interview (includes Electronic Media w Video Component) Telephone Interview Faxor Mail Email or Internet
Loan Originator Organization Name
Address
Loan Originator Organization NMLSR ID State License ID
Loan Originator Name
Loan Originator NMLSR ID State License ID
Email Phone (
Signature Date (mmddyyyy)
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Pe)aae-emeet)
Community Property State
At least one borrowerlives in a community propertystateThe property is in a community property state
Transaction DetailConversion of Contract for Deed or Land ContractRenovationConstruction-ConversionConstruction-to-Permanent
Single-Closing Two-ClosingConstructionImprovementCosts $
LotAcquired Date
Original Cost of Lot $(mmddyyyy)
Refinance Program
Full DocumentationInterest Rate ReductionStreamlined without Appraisal
Other
Refinance Type
NoCash OutLimited Cash OutCash Out
Energy Improvement
Mortgageloanwill finance energy-related improvements
Propertyis currently subject to a lien that could take priority ovethe first mortgagelien such as a clean energylien paid for througproperty taxes(eg the PropertyAssessed Clean Energyprogram)
Project Type Condominium Cooperative Planned Unit Development (PUD) Propertyis notlocatedin a project
Peiwlivcestetece)a)
Title to the Property Will be Held in What Name(s)
For RefinanceTitle to the Property is Currently Held in What Name(s
Trust Information
tle Will be Held byan Inter Vivos (Living) Trust
Title Will be Held by a Land TrustLeasehold Expiration Date
Mannerin WhichTitle Will be Held Indian Country Land Tenure
Sole OwnershipLife EstateTenancy in Common
Joint Tenancywith Right of Survivorship]Tenancybythe EntiretyOther
Fee Simple Ona ReservationIndividualTrust Land (AllottedRestricted)Tribal Trust Land On a ReservationTribal Trust Land Off ReservationAlaska Native Corporation Land
Estate Will be Held in
Fee Simple(mmddyyyy)
3 Mortgage LoanInformation
Termsof Loan
Note Rate
Loan Term (months)
MortgageLien Type
First LienSubordinate Lien
Mortgage Type Applied For
Conventional USDA-RDFHA VA Other
Amortization Type
Fixed RateAdjustable Rate
If Adjustable Rate
Initial Period Prior to First Adjustment
Subsequent AdjustmentPeriod
Proposed Monthly Paymentfor Property
First Mortgage (P amp I) $
Subordinate Lien(s) (P amp |) $
Other(explain)
Homeowners Insurance $(months)
(months)
Loan Features Property Taxes $
Balloon Balloon Term (months)
Interest Only Interest OnlyTermNegative AmortizationPrepaymentPenalty Prepayment Penalty Term (months) Other
Temporary Interest Rate BuydownInitial Buydown Rate TOTALOther(explain)
Mortgage Insurance $
AssociationProject Dues (Condo Co-Op PUD) $
Supplemental Property Insurance $
(months)
Borrower Name(s)Uniform Residential Loan Application mdash LenderLoan Information
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
L4 Qualifying the Borrower - Minimum Required Funds or Cash Back
DUEFROM BORROWER(S)
A Sales Contract Price
B Improvements Renovations and Repairs
C Land(ifacquired separately)
D For Refinance Balance of Mortgage Loanson the Propertyto be paid off in the Transaction
(See Table 3a Property You Own)
E Credit Cards and Other Debts Paid Off
(See Table 2c Liabilities mdash Credit Cards Other Debts and Leases that You Owe)
F BorrowerClosing Costs (including Prepaid andInitial Escrow Payments)
G Discount Points
HTOTAL DUE FROM BORROWER(s)(Total of A thru G)
TOTALMORTGAGE LOANS
Loan Amount
Loan AmountExcluding Financed Mortgage Insurance (or Mortgage Insurance Equivalent) $
Financed Mortgage Insurance (or Mortgage Insurance Equivalent) Amount $
Other New Mortgage Loanson the Property the Borrower(s) is Buying or Refinancing(See Table 4b Other New MortgageLoanson the Property You are Buying or Refinancing)
KTOTAL MORTGAGELOANS(Totalof| and J)
TOTALCREDITS
L Seller Credits (Enter the amountofBorrower(s) costs paid by the property seller)
MOtherCredits (Enter the sum ofall other credits mdash BorrowerPaid Fees Earnest Money EmployerAssistedHousing Lease Purchase Fund Lot Equity Relocation Funds Sweat Equity Trade Equity Other)
NTOTAL CREDITS(Total of L and M)
CALCULATION
TOTAL DUE FROM BORROWER(s)(Line H)
LESSTOTAL MORTGAGELOANS(Line K) AND TOTAL CREDITS(Line N)
Cash FromTothe Borrower(Line H minusLine K and Line N)NOTE This amountdoesnotinclude reservesor other funds that may be required by the Lenderto be verified
Borrower Name(s)Uniform Residential Loan Application mdash LenderLoan Information
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
Uniform Residential Loan Application mdash Unmarried Addendum
eeCeceetatimC elitleeComeLy
Lenders Instructions for Using the Unmarried Addendum
The Lender may use the Unmarried Addendum only when a Borrowerselected ldquoUnmarriedrdquoin Section 1 and the information collected is
necessary to determine howState property lawsdirectly or indirectly affecting creditworthiness apply including ensuring clear title
For example the Lender may use the Unmarried Addendum whentheBorrowerresides in a State that recognizescivil unions domestic
partnerships or registered reciprocal beneficiary relationships or when the property is located in such a State ldquoStaterdquo meansanystate the
District of Columbia the Commonwealth of Puerto Rico or anyterritory or possession of the United States
Ifyou selected ldquoUnmarriedrdquoin Section 1 is there a person whois not your legal spouse but whocurrently has real property rights similar to
those of a legal spouse +=) NOQ YES
If YES indicate the type of relationship and the State in which the relationship was formed For example indicate if you are in a
civil union domestic partnership registered reciprocal beneficiary relationship or other relationship recognized by the State in which you
currently reside or where the property is located
O Civil Union copy Domestic Partnership copy Registered Reciprocal Beneficiary Relationship copy) Other(explain)
Statea]
Borrower NameUniform Residential Loan Application mdash Unmarried Addendum
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Uniform Residential Loan Application mdash Continuation Sheet
Use this continuation sheet if you need more space to complete the Uniform Residential Loan Application
Borrower Name(First Middle Last Suffix )
Additional Information
Additional Borrower Name(First Middle Last Suffix )
Additional Information
IWefully understand thatit is a federal crime punishable by fine or imprisonment or both to knowingly make anyfalse statements concerningany of the abovefacts as applicable underthe provisions of federal law (18 USC sectsect 1001 et seq)
BorrowerSignature Date (mmddyyyy)
Additional Borrower Signature Date (mmddyyyy)
Uniform Residential Loan Application mdash Continuation SheetFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
INSTRUCTIONS FOR COMPLETING THE UNIFORM RESIDENTIAL LOAN APPLICATION
Use the instructions below to complete the enclosed Uniform Residential Loan Application (Freddie Mac Form 65Fannie Mae Form 1003) To avoid any delays in your application review please provide all of the requested information
If you need to make a correction on the application draw a line through the incorrect text and mark your initials beside the change Donrsquot use correction tape or fluid The application must be completed signed and dated in ink
The Uniform Residential Loan Application (URLA)
The URLA contains the following sections Section 1 Borrower Information Please provide your personal information income and employment
Section 2 Financial Information ndash Assets and Liabilities Please provide information about your financial assets personal financial obligations and debts you owe
Section 3 Financial Information ndash Real Estate Please provide information about property you own and the debts and expenses related to the property
Section 4 Loan and Property Information Please provide information about the loan purpose and the property you are buying or refinancing
Section 5 Declarations Please answer questions about the property how the property will be financed and your past financial history
Section 6 Acknowledgments and Agreements Informs you of your legal obligations related to the mortgage application and asks that you acknowledge certain information will be obtained used and shared
Section 7 Military Service Please provide information about your (or your deceased spousersquos) military service
Section 8 Demographic Information Requests information the Lender is required by law to ask you
Section 9 Loan Originator Information Will be completed by Chase
Uniform Residential Loan Application ndash Additional Borrower
The URLA ndash Additional Borrower contains the following sections Section 1 Borrower Information This is the same as the Borrower Information section of the URLA
Section 2 Financial Information ndash Assets and Liabilities Contains only the following statement for the additional Borrower to complete ldquoMy information for Section 2 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo The name of the other borrower is entered here
Complete a separate URLA for each BorrowermiddotThree or more Borrowers ndash Use any combination of URLA and URLA-Additional Borrower forms in accordance with the above examples
Section 3 Financial Information ndash Real Estate Contains only the following statement for the additional borrower to complete ldquoMy information for Section 3 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 4 Loan and Property Information Contains only the following statement for the additional borrower to complete ldquoMy information for Section 4 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 5 Declarations This is the same as the Declarations section of the URLA
Section 6 Acknowledgments and Agreements Contains only the following statement for the additional borrower to complete ldquoMy signature for Section 6 is on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 7 Military Service This is the same as the Military Service section of the URLA
Section 8 Demographic Information This is the same as the Demographic Information section on the URLA
Section 9 Loan Originator Information This is the same as the Loan Originator Information section of the URLA
Using the URLA and URLA ndash Additional Borrower Together The URLA and the URLA ndash Additional Borrower are used together to collect information for two Borrowers who have joint assets liabilities andor real estate information The URLA and URLA ndash Additional Borrower can also be used for Borrowers who do not have joint information but wish to combine their information on the URLA for ease of use Here are examples of how to use the URLA and URLA ndash Additional Borrower
For one borrower Complete the URLA
For two borrowers with joint financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you dont need to duplicate them on more than one URLA or o In cases where Borrowers are not collaborating when completing the loan application
joint assets liabilities and real estate may be duplicated on each URLA bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you do not need to duplicate them on more than one URLA or
o In cases where Borrowers are not collaborating when completing the loan application joint assets liabilities and real estate may be duplicated on each URLA
For two borrowers with separate financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower Report the assets liabilities and
real estate for the additional Borrower on the URLA or bull Complete a separate URLA for each Borrower
For three or more borrowers use any combination of URLA and URLA ndash Additional Borrower forms described for two borrowers
Uniform Residential Loan Application ndash Unmarried Addendum If any borrower listed on the URLA or URLA ndash Additional Borrower form selects Unmarried in Section 1 (Personal Information) the lender will complete this optional form
The information must be collected to determine how to apply state property laws that directly or indirectly affect creditworthiness including ensuring clear title
Uniform Residential Loan Application ndash Continuation Sheet Use the URLA ndash Continuation Sheet if you need more space to complete either the URLA or URLA ndash Additional Borrower forms
99177-URLAI-0215
HUD Addendum to Uniform Residential Loan Application OMB Approval No HUD 2502-0059 (exp )
Part I - Identifying Information HUDFHA Application for Insurance under the National Housing Act and Borrower Certification
FHA Case No (include any suffix) Mortgagee Case No
Mortgagee ID Sponsor ID Agent ID
Mortgagee Name Address (include ZIP Code) and Telephone Number
Type or print all entries clearly
Name and Address of Sponsor Name and Address of Agent
Borrowers Name amp Present Address (include ZIP Code) Property Address (include name of subdivision lot amp block no amp ZIP Code)
Sponsored Originations
Name of Third-Party Originator NMLS ID of Third-Party Originator
Part II - Borrower Consent for Social Security Administration to Verify Social Security Number I authorize the Social Security Administration (SSA) to verify my Social Security Number (SSN) to the Mortgagee and HUDFHA I authorize SSA to provide explanatory
information to HUDFHA in the event of a discrepancy This consent is valid for 180 days from the date signed unless indicated otherwise by the individual(s) named in this
loan application
Signature(s) of Borrower(s) - Read consent carefully Review accuracy of Social Security Number(s) provided on this application
Borrowerrsquos NameDate of BirthSocial Security Number
Co-Borrowerrsquos Name Date of BirthSocial Security Number
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
Part III - Borrower Notices Information and Acknowledgment Public Reporting Burden
Public reporting burden for this collection of information is estimated to average 10 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 conduct or sponsor and a person is not
required to respond to a collection of information unless that collection displays a valid OMB control number which can be located on the OMB Internet page at
httpwwwreginfogovpublicdoPRAMain
Privacy Act Information
The information requested on the Uniform Residential Loan Application and this Addendum is authorized by the National Housing Act of 1934 12 USC sect 1701 et seq The Debt
Collection Act of 1982 Pub L 97-365 and HUDrsquos Housing and Community Development Act of 1987 42 USC sect 3543 require persons applying for a federally insured loan to
furnish their SSN You must provide all the requested information including your SSN HUD may conduct a computer match to verify the information you provide HUD may
disclose certain information to Federal State and local agencies when relevant to civil criminal or regulatory investigations and prosecutions It will not otherwise be disclosed or
released outside of HUD except as required and permitted by law The information will be used to determine whether you qualify as a mortgagor Failure to provide any of the
requested information including SSN may result in disapproval of your loan application This is notice to you as required by the Right to Financial Privacy Act of 1978 that
HUDFHA has a right of access to financial records held by financial institutions in connection with the consideration or administration of assistance to you Financial records
involving your transaction will be available to HUDFHA without further notice or authorization but will not be disclosed or released by the institution to another Government Agency
or Department without your consent except as required or permitted by law
WARNING This warning applies to all certifications made in this document Anyone who knowingly submits a false claim or makes false statements is subject to criminal and civil penalties including confinement for up to 5 years fines and civil penalties 18 USC sectsect 287 1001 and 31 USC sect 3729
orm HUD-92900-A ( ) Page 1
Borrower Name ____________________________ FHA Case No __________________
Caution Delinquencies Defaults Foreclosures and Abuses Delinquencies defaults foreclosures and abuses of mortgage loans involving programs of the Federal Government can be costly and detrimental to your credit now and in the future The Mortgagee in this transaction its agents and assigns as well as the Federal Government its agencies agents and assigns are authorized to take any and all of the following actions in the event loan payments become delinquent on the mortgage loan described in the attached application (1) Report your name and account information to a credit bureau (2) Assess additional interest and penalty charges for the period of time that payment is not made (3) Assess charges to cover additional administrative costs incurred by the Federal Government to service your account (4) Offset amounts owed to you
under other Federal programs (5) Refer your account to a private attorney collection agency or mortgage servicing agency to collect the amount due foreclose
the mortgage sell the property and seek judgment against you for any deficiency (6) Refer your account to the Department of Justice (DOJ) for litigation in the
courts (7) If you are a current or retired Federal employee take action to offset your salary or civil service retirement benefits (8) Refer your debt to the Internal
Revenue Service for offset against any amount owed to you as an income tax refund and (9) Report any resulting written off debt of yours to the Internal Revenue Service as your taxable income All of these actions may be used to recover any debts owed when it is determined to be in the interest of the Mortgagee or Federal Government or both
As a mortgage loan borrower you will be legally obligated to make the mortgage payments called for by your mortgage loan contract The fact that you dispose of your property after the loan has been made will not relieve you of liability for making these payments Payment of the loan in full is ordinarily the way liability on a mortgage note is ended Some home buyers have the mistaken impression that if they sell their homes when they move to another locality or dispose of it for any other reasons they are no longer liable for the mortgage payments and that liability for these payments is solely that of the new owners Even though the new owners may agree in writing to assume liability for your mortgage payments this assumption agreement will not relieve you from liability to the holder of the note which you signed when you obtained the loan to buy the property Unless you are able to sell the property to a buyer who is acceptable to HUDFHA who will assume the payment of your obligation to the lender you will not be relieved from liability to repay any claim which HUDFHA may be required to pay your lender on account of default in your loan payments The amount of any such claim payment may be a debt owed by you to the Federal Government and subject to established collection procedures
Fair Housing Act I and anyone acting on my behalf are and will remain in compliance with the Fair Housing Act 42 USC sect 3604 et seq with respect to the dwelling or property covered by the loan and in the provision of services or facilities in connection therewith I recognize that any restrictive covenant on this property related to race color religion sex disability familial status or national origin is unlawful under the Fair Housing Act and unenforceable I further recognize that in addition to administrative action by HUD a civil action may be brought by the DOJ in any appropriate US court against any person responsible for a violation of the
applicable law
Certification and Acknowledgment All information in this application is given for the purpose of obtaining a loan to be insured under the National Housing Act and the information in the Uniform Residential Loan Application and this Addendum is true and complete to the best of my knowledge and belief Verification may be obtained from any source named herein I have read and understand the foregoing concerning my liability on the loan and Part III Borrower Notices Information and Acknowledgment
Signature(s) of Borrower(s) - Do not sign unless this application is fully completed Read the certification carefully and review accuracy of this application
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
orm HUD-92900-A ( Page 2
___________________________________
______________________________________________________
______________________________________________________________
- - - - - - - - - - - - - - - - - - - - - - -
Borrower Name ____________________________ FHA Case No __________________
Part IV - Direct Endorsement Approval for a HUD FHA-Insured Mortgage A Underwriting the Borrower
Date Mortgage Approved ______________________________ Date Approval Expires ______________________
For mortgages rated as an ldquoacceptrdquo or ldquoapproverdquo by FHAs TOTAL Mortgage Scorecard
The information submitted to TOTAL was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA4e Final Underwriting Decision (TOTAL) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee Representative Signature
Printed Name
Title
OR
For mortgages rated as a ldquoreferrdquo by FHAs TOTAL Mortgage Scorecard or manually underwritten by a Direct Endorsement underwriter I have personally reviewed and underwritten the borrowerrsquos credit application The information used to underwrite the borrower was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA5d Final Underwriting Decision (Manual) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
B Underwriting the Property
For all mortgages where FHA requires an appraisal I have personally reviewed and underwritten the appraisal according to FHA requirements I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
orm HUD-92900-A ( ) Page 3
Borrower Name ____________________________ FHA Case No __________________
Part V Mortgagees Certification
I have personally reviewed the mortgage documents and the application for insurance endorsement and This mortgage complies with SF Handbook 40001 Section IIA7 Post-Closing and Endorsement to the extent that no defect exists that would have changed the decision to endorse or submit the mortgage for insurance
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee
Name of Mortgageersquos Representative
Title of Mortgageersquos Representative
Signature of the Mortgageersquos Representative Date
orm HUD-92900-A ( ) Page 4
GENERAL AUTHORIZATION FOR A MORTGAGE LOAN ASSUMPTION
Applicant name(s)
Loan number
NOTICES AND DISCLOSURES
Non-discriminatory underwriting guidelines Anyone who inquires about the availability of credit from us has the right to receive a copy of our non-discriminatory underwriting guidelines To request a copy of these guidelines contact your Loan Processor
Attorney note Itrsquos the responsibility of our attorneys to protect our interest You may at your expense request an attorney to represent your interest
Notice to HUDFHA applicants As required by the Right to Financial Privacy Act of 1978 this notice is to inform you that the US Department of Housing and Urban Development (HUD)Federal Housing Administration (FHA) has a right of access to financial records held by financial institutions related to a request for assistance Financial records involving your assumption will be available to HUDFHA without further notice or authorization but wonrsquot be disclosed or released by us to another government agency or department without your consent except as required or permitted by law
Borrower consent to the use of tax return information I understand acknowledge and agree that the Lender and Other Loan Participants can obtain use and share tax return information for purposes of (i) providing an offer (ii) originating maintaining managing monitoring servicing selling insuring and securitizing a loan (iii) marketing or (iv) as otherwise permitted by applicable laws including state and federal privacy and data security laws The Lender includes the Lenderrsquos affiliates agents service providers and any of aforementioned partiesrsquo successors and assigns The Other Loan Participants includes any actual or potential owners of a loan resulting from your loan application or acquirers of any beneficial or other interest in the loan and mortgage insurer guarantor any servicers or service providers for these parties and any of aforementioned partiesrsquo successors and assigns
CERTIFICATION AND AUTHORIZATION
Environmental certification By signing below I represent and warrant that Irsquom not aware of any substances materials or products that may be an environmental hazard such as but not limited to asbestos formaldehyde radon gas lead-based paint fuel or chemical storage tanks (above or below ground) and contaminated soil or water on the property I acknowledge that Chase is relying on this representation and warranty as a material part of its loan application process I also am not aware of any landfill on any portion of the property
Exceptions to the above I further acknowledge (1) receipt of applicable disclosures from the seller in purchase transactions (2) that lead-based paint may exist in housing constructed prior to 1978 (3) that Chase performs no environmental investigation on my behalf and isnrsquot responsible for identifying lead-based paint or any other environmental conditions that might impact the property or its residents and (4) that it is my sole obligation to investigate for potential impact to the property from environmental conditions
Certifications I certify by signing below that (1) all of the loan application information provided is true and complete (2) I understand any intentional or negligent misrepresentation(s) of the information provided in conjunction with my application may result in civil liability andor 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 Chase its agents successors and assigns insurers and any other person who may suffer any loss due to reliance upon any misrepresentation that I have made on the application and (3) any significant change from the information provided at the time of application until the final loan application is signed may have a bearing on the approval of my application for a home loan
Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union
This question is asked because of state laws that extend the same or similar rights benefits and protections of spouses in a marriage to persons who are members of a partnership or union recognized under state law You should consult with your own legal advisor for advice regarding the rights protections benefits responsibilities obligations and duties of those who are registered domestic partners civil union partners or members of other unions recognized under applicable law
CREDIT AUTHORIZATION RELEASE
By signing below I authorize Chase andor my mortgage insurer (if any) to verify my past and present employment earnings records (including information contained in income tax returns that have been filed with the IRS) bank accounts stock holdings and any other information that it finds necessary to process my mortgage loan application or to review it for quality-control purposes I understand that a credit report will be ordered from a credit reporting agency for verification prior to loan closing as part of the application process and may be ordered after closing as part of the Lenderrsquos quality-control program A credit report may also be completed as part of the Lenderrsquos servicing or collection of the loan or in consideration of any other product or service that the Lender may consider offering me in the future and at any time throughout the life of the loan I understand that use of a photocopy of this form may be necessary to verify one or more of my credit references I understand that a photocopy or fax copy of this form will also serve as authorization
By signing below each applicant acknowledges (1) making the above certifications and authorizations and (2) that each applicant has received and understands the above notices and disclosures
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
You do not have to give us this information but if you donrsquot your application for approval as a borrower may be delayed or rejected The information requested in this form is authorized by Title 38 USC Chapter 37 (if VA) by 12 USC Section 1701 et seq (if HUDFHA) by 42 USC Section 1452b (if HUDCPD) and Title 42 USC 1471 et seq or 7 USC 1921 et seq (if USDA FHA)
Updated December 2021 99177-GA-0215
1b
2b
Form 4506-C (September 2020)
Department of the Treasury - Internal Revenue Service
IVES Request for Transcript of Tax Return OMB Number
1545-1872
Do not sign this form unless all applicable lines have been completed Request may be rejected if the form is incomplete or illegible
For more information about Form 4506-C visit wwwirsgov and search IVES
1a Name shown on tax return (if a joint return enter the name shown first)
First social security number on tax return individual taxpayer identification number or employer identification number (see instructions)
2a If a joint return enter spousersquos name shown on tax return Second social security number or individual taxpayer identification number if joint tax return
3 Current name address (including apt room or suite no) city state and ZIP code (see instructions)
4 Previous address shown on the last return filed if different from line 3 (see instructions)
5a IVES participant name address and SOR mailbox ID
DataVerify 875 Greentree Rd 8 Parkway Center Pittsburgh PA 15220
5b Customer file number (if applicable) (see instructions)
Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing (see instructions)
6 Transcript requested Enter the tax form number here (1040 1065 1120 etc) and check the appropriate box below Enter only one tax form number per request 1040
a Return Transcript which includes most of the line items of a tax return as filed with the IRS A tax return transcript does not reflect changes made to the account after the return is processed Transcripts are only available for the following returns Form 1040 series Form 1065 Form 1120 Form 1120-A Form 1120-H Form 1120-L and Form 1120S Return transcripts are available for the current year and returns processed during the prior 3 processing years
b Account Transcript which contains information on the financial status of the account such as payments made on the account penalty assessments and adjustments made by you or the IRS after the return was filed Return information is limited to items such as tax liability and estimated tax payments Account transcripts are available for most returns
c Record of Account which provides the most detailed information as it is a combination of the Return Transcript and the Account Transcript Available for current year and 3 prior tax years
7 Form W-2 Form 1099 series Form 1098 series or Form 5498 series transcript The IRS can provide a transcript that includes data from these information returns State or local information is not included with the Form W-2 information The IRS may be able to provide this transcript information for up to 10 years Information for the current year is generally not available until the year after it is filed with the IRS For example W-2 information for 2016 filed in 2017 will likely not be available from the IRS until 2018 If you need W-2 information for retirement purposes you should contact the Social Security Administration at 1-800-772-1213
Caution If you need a copy of Form W-2 or Form 1099 you should first contact the payer To get a copy of the Form W-2 or Form 1099 filed with your return you must use Form 4506 and request a copy of your return which includes all attachments
8 Year or period requested Enter the ending date of the tax year or period using the mmddyyyy format (see instructions)
12 31 2020 12 31 2019 12 31 2018 Caution Do not sign this form unless all applicable lines have been completed
Signature of taxpayer(s) I declare that I am either the taxpayer whose name is shown on line 1a or 2a or a person authorized to obtain the tax information requested If the request applies to a joint return at least one spouse must sign If signed by a corporate officer 1 percent or more shareholder partner managing member guardian tax matters partner executor receiver administrator trustee or party other than the taxpayer I certify that I have the authority to execute Form 4506-C on behalf of the taxpayer Note This form must be received by IRS within 120 days of the signature date
Signatory attests that heshe has read the attestation clause and upon so reading declares that heshe has the authority to sign the Form 4506-C See instructions
Sign Here
Signature (see instructions) Date Phone number of taxpayer on line 1a or 2a
PrintType name
Title (if line 1a above is a corporation partnership estate or trust)
Spousersquos signature Date
PrintType name
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020) For Privacy Act and Paperwork Reduction Act Notice see page 2
Instructions for Form 4506-C IVES Request for Transcript of Tax Return
Section references are to the Internal Revenue Code unless otherwise noted
Future Developments
For the latest information about Form 4506-C and its instructions go to wwwirsgov and search IVES Information about any recent developments affecting Form 4506-C (such as legislation enacted after we released it) will be posted on that page
Whats New Form 4506-C was created to be utilized by authorized IVES participants to order tax transcripts with the consent of the taxpayer
General Instructions
Caution Do not sign this form unless all applicable lines have been completed
Designated Recipient Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information received pursuant to the taxpayerrsquos consent and holds the recipient subject to penalties for any unauthorized access other use or redisclosure without the taxpayerrsquos express permission or request
Taxpayer Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information provided pursuant to your consent and holds the recipient subject to penalties brought by private right of action for any unauthorized access other use or redisclosure without your express permission or request
Purpose of form Use Form 4506-C to request tax return information through an authorized IVES participant You will designate an IVES participant to receive the information on line 5a
Note If you are unsure of which type of transcript you need check with the party requesting your tax information
Where to file The IVES participant will fax Form 4506-C with the approved IVES cover sheet to their assigned Service Center
Chart for ordering transcripts
If your assigned Service Center is
Fax the requests with the approved coversheet to
Austin Submission Processing Center
Austin IVES Team
844-249-6238
Fresno Submission Processing Center
Fresno IVES Team
844-249-6239
Kansas City Submission Processing Center
Kansas City IVES Team
844-249-8128
Ogden Submission Processing Center
Ogden IVES Team
844-249-8129
Specific Instructions
Line 1b Enter the social security number (SSN) or individual taxpayer identification number (ITIN) for the individual listed on line 1a or enter the employer identification number (EIN) for the business listed on line 1a
Line 3 Enter your current address If you use a PO box include it on this line
Line 4 Enter the address shown on the last return filed if different from the address entered on line 3
Note If the addresses on lines 3 and 4 are different and you have not changed your address with the IRS file Form 8822 Change of Address or Form 8822-BChange of Address or Responsible Party mdash Business with Form 4506-C
Line 5b Enter up to 10 numeric characters to create a unique customer file number that will appear on the transcript The customer file number cannot contain an SSN ITIN or EIN Completion of this line is not required
Note If you use an SSN name or combination of both we will not input the information and the customer file number will reflect a generic entry of 9999999999 on the transcript
Line 8 Enter the end date of the tax year or period requested in mmddyyyy format This may be a calendar year fiscal year or quarter Enter each quarter requested for quarterly returns Example Enter 12312018 for a calendar year 2018 Form 1040 transcript
Signature and date Form 4506-C must be signed and dated by the taxpayer listed on line 1a or 2a The IRS must receive Form 4506-C within 120 days of the date signed by the taxpayer or it will be rejected Ensure that all applicable lines including lines 5a through 8 are completed before signing
You must check the box in the signature area to acknowledge you have the authority to sign and request the information The form will not be processed if unchecked
Individuals Transcripts listed on on line 6 may be furnished to either spouse if jointly filed Only one signature is required Sign Form 4506-C exactly as your name appeared on the original return If you changed your name also sign your current name
Corporations Generally Form 4506-C can be signed by
(1) an officer having legal authority to bind the corporation (2) any person designated by the board of directors or other governing body or (3) any officer or employee on written request by any principal officer and attested to by the secretary or other officer A bona fide shareholder of record owning 1 percent or more of the outstanding stock of the corporation may submit a Form 4506-C but must provide documentation to support the requesters right to receive the information
Partnerships Generally Form 4506-C can be signed by any person who was a member of the partnership during any part of the tax period requested on line 8
All others See section 6103(e) if the taxpayer has died is insolvent is a dissolved corporation or if a trustee guardian executor receiver or administrator is acting for the taxpayer
Note If you are Heir at law Next of kin or Beneficiary you must be able to establish a material interest in the estate or trust
Documentation For entities other than individuals you must attach the authorization document For example this could be the letter from the principal officer authorizing an employee of the corporation or the letters testamentary authorizing an individual to act for an estate
Signature by a representative A representative can sign Form 4506-C for a taxpayer only if the taxpayer has specifically delegated this authority to the representative on Form 2848 line 5 The representative must attach Form 2848 showing the delegation to sign Form 4506-C
Privacy Act and Paperwork Reduction Act Notice We ask for the information on this form to establish your right to gain access to the requested tax information under the Internal Revenue Code We need this information to properly identify the tax information and respond to your request You are not required to request any transcript if you do request a transcript sections 6103 and 6109 and their regulations require you to provide this information including your SSN or EIN If you do not provide this information we may not be able to process your request Providing false or fraudulent information may subject you to penalties
Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and cities states the District of Columbia and US commonwealths and possessions for use in administering their tax laws We may also disclose this information to other countries under a tax treaty to federal and state agencies to enforce federal nontax criminal laws or to federal law enforcement and intelligence agencies to combat terrorism
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law Generally tax returns and return information are confidential as required by section 6103
The time needed to complete and file Form 4506-C will vary depending on individual circumstances The estimated average time is
Learning about the law or the form 10 min Preparing the form 12 min Copying assembling and sending the form to the IRS 20 min
If you have comments concerning the accuracy of these time estimates or suggestions for making Form 4506-C simpler we would be happy to hear from you You can write to
Internal Revenue Service Tax Forms and Publications Division 1111 Constitution Ave NW IR-6526 Washington DC 20224
Do not send the form to this address Instead see Where to file on this page
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020)
Rev April 2021 CHASEO Facts What does Chase do with your personal information
Why Financial companies choose how they share your personal information Federal law gives consumers the right to limit some but not all sharing Federal law also requires us to tell you how we collect share and protect your personal information Please read this notice carefully to understand what we do
What The types of personal information we collect and share depend on the product or service you have with us This information can include bull Social Security number and income bull account balances and transaction history bull credit history and payment history
How All financial companies need to share customers personal information to run their everyday business In the section below we list the reasons financial companies can share their customers personal information the reasons Chase chooses to share and whether you can limit this sharing
Reasons we can share your personal information Does Chase share
Can you limit this sharing
For our everyday business purposes - such as to process your transactions maintain your account(s) respond to court orders and legal investigations or report to credit bureaus
Yes No
For our marketing purposes - to offer our products and services to you
Yes No
For joint marketing with other financial companies Yes No
For our affiliates everyday business purposes - information about your transactions and experiences
Yes No
For our affiliates everyday business purposes - information about your creditworthiness
Yes Yes
For our affiliates to market to you Yes Yes
For nonaffiliates to market to you Yes Yes
a
0
To limit our sharing
bull Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
bull Visit us online chasecomprivacypreferences
Please note If you are a new customer we can begin sharing your information 30 days from the date we sent this notice When you are no longer our customer we continue to share your information as described in this notice However you can contact us at any time to limit our sharing
Questions
Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
PAGE 2
Who we are
Who is providing this notice The US consumer financial companies within the JPMorgan Chase amp Co family including JPMorgan Chase Bank NA Chase Insurance Agency Inc and JP Morgan Securities LLC
What we do
How does Chase protect my To protect your personal information from unauthorized access and use we personal information use security measures that comply with federal law These measures include
computer safeguards and secured files and buildings We authorize our employees to get your information only when they need it to do their work and we require companies that work for us to protect your information
How does Chase collect my We collect your personal information for example when you personal information bull open an account or make deposits or withdrawals from your account
bull pay your bills or apply for a loan bull use your credit or debit card We also collect your personal information from others such as credit bureaus affiliates or other companies
Why cant I limit all sharing Federal law gives you the right to limit only bull sharing for affiliates everyday business purposes - information about your
creditworthiness bull affiliates from using your information to market to you bull sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing See below for more on your rights under state law
What happens when I limit sharing for an account I hold jointly with someone else
Your choices will apply to everyone on your account
Definitions
Affiliates Companies related by common ownership or control They can be financial and non financial companies bull Our affiliates include companies with a Chase or JP Morgan name and financial companies such asjP Morgan Securities LLC
Nonaffiliates Companies not related by common ownership or control They can be financial and non financial companies bull Nonaffiliates we share with can include companies such as retailers auto dealers auto makers and membership clubs
Joint marketing A formal agreement between nonaffiliated financial companies that together market financial products or services to you bull Our joint marketing partners include categories of companies such as insurance companies
Other important information
VT Accounts with a Vermont mailing address are automatically treated as if they have limited the sharing as described on page 1 For joint marketing we will only disclose your name contact information and information about your transactions
NV We are providing you this notice pursuant to Nevada law If you prefer not to receive marketing calls from us you may be placed on our Internal Do Not Call List by calling 1-800-945-9470 or by writing to us at PO Box 734007 Dallas TX 75373-4007
For more information contact us at the address above or email PrivacylnfoJPMChasecom with Nevada Annual Notice in the subject line You may also contact the Nevada Attorney Generals office Bureau of Consumer Protection Office of the Nevada Attorney General 555 E Washington St Suite 3900 Las Vegas NV 89101 telephone number 1-702-486-3132 email BCPINFOagstatenvus
CA Accounts with a California mailing address are automatically treated as if they have limited the sharing with nonaffiliates as described on page 1 CA residents are provided a CA notice for additional choices
CHASE O
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
The following disclosure is required by the USA PATRIOT Act
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 opens an account
What this means to you When you 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 drivers
license or other identifying documents
99177-PAT-0215
VETERAN STATEMENT When this loan was opened the US Department of Veterans Affairs (VA) used the veteran borrowerrsquos entitlement which is a set amount the VA promises to repay a lender if the borrower defaults on the mortgage An assumption will modify who is obligated to pay the existing mortgage loan but all loan termsmdashincluding the entitlementmdashwill remain the same If the veteran borrower is being removed from the loan the entitlement would remain with whoever is assuming the loan because the loan will continue to be serviced by the VA If the applicant is also a veteran and can substitute his or her entitlement for the current entitlement then the current borrowerrsquos entitlement can be released
Please review the following questions and answer as appropriate This form requires completion by both the applicant(s) and current borrower(s)
1 Applicant to Complete
Are you (the applicant) currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the reverse side)
Yes (If yes please provide the information requested below answer the question in section 3 and sign and date this form at the bottom of the reverse side)
Name of applicant(s) who answered ldquoyesrdquo to the above question
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Are you receiving VA disability benefts
Applicant
Yes
No
Co-Applicant
Yes
No
Are you entitled to receive VA disability benefts Yes No Yes No
Have you received VA disability benefts in the past Yes No Yes No
Are you a surviving spouse of a veteran who died on active duty or as the result of a service-related disability
Yes No Yes No
Do you have any VA loans Yes No Yes No
2 Current Borrower to Complete
Is the current borrowerco-borrower currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the page)
Yes (If yes please answer the question in section 3 and sign and date this form at the bottom of the page)
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
________________________________________________________________________________________________
3 Applicant and Current Borrower to Complete
If the answer to the questions in section 1 and 2 are both yes please answer the following question After yoursquove reviewed and completed this entire form please sign and date at the bottom
Applicant Current Borrower
Do you want to apply for a substitution of entitlement Yes Yes No No
In order to complete a substitution of entitlement the veteran applicant must have suffcient entitlement to substitute for that of the current borrower Contact the VA Offce of Jurisdiction for your area for more information Also before the veteran applicant can substitute entitlement on a VA loan heshe must certify that the property securing the loan will be occupied as hisher primary residence Both the applicantrsquos and current borrowerrsquos original certifcate of eligibility will be required If your sales contract is contingent upon the restoration of entitlement please contact your VA Offce of Jurisdiction for complete procedures Otherwise the substitution will be completed after the loan has been approved and closed
Date Applicant printed name Applicant signature
Date Applicant printed name Applicant signature
Date Current Borrower printed name Current Borrower signature
Date Current Borrower printed name Current Borrower signature
Forms completed by Mail Phone
For Chase use only
Interviewer signature Date
99177-VS-0215
- Assumption Application Package_41521-noscannedpages-update-4pdf
-
- 1 FM203 Cover Pagepdf
- 2 FM202 Mortgage Assumption Application Package pagepdf
- 3 The Documents Youll need to Send Uspdf
- 4 FM201 FAQpdf
- 5 FM142 CIWpdf
- 6 FM126 URLApdf
- 7 FM130 URLA Instpdf
-
- Blank Page
-
- 8 92900a Addednum to Loan Applicationpdf
- 9 FM462 Gen Authpdf
- 10 FM220 4506-Cpdf
- 11 FM153 Chase Federal Privacy Noticepdf
- 12 FM144 Info on Opening a New Accountpdf
- 13 FM152 Veteran Statementpdf
-
- Date
- Loan number
- Applicant name
- Phone1
- Loan number 1
- Loan number 2
- Other
- Other_2
- 1
- 2
- undefined_7
- Available hours
- Available hours_2
- undefined_8
- Available hours_3
- undefined_9
- Current address 1
- Neither
- Available hours_4
- Available hours_5
- undefined_10
- Available hours_6
- 1_2
- 2_2
- undefined_11
- Available hours_7
- Available hours_8
- undefined_12
- Available hours_9
- FHA Case No include any suffix
- Mortgagee Case No
- Mortgagee ID
- Sponsor ID
- Agent ID
- Name and Address of Sponsor Name and Address of Agent
- Borrowers Name Present Address include ZIP Code Property Address
- include name of subdivision lot block no ZIP Code
- Name of ThirdParty Originator
- NMLS ID of ThirdParty Originator
- s application
- ty Number
- ty Number_2
- Date Signed_2
- Date Mortgage Approved
- Date Approval Expires
- Printed Name
- Title 1
- DEs ID Number
- DEs ID Number_2
- Mortgagee
- Name of Mortgagees Representative
- Title of Mortgagees Representative
- Signature of the Mortgagees Representative
- Date_2
- Applicant names 1
- Applicant names 2
- Applicant names 3
- Loan number_2
- Date_3
- Applicant printed name
- Social Security number
- Date_4
- Applicant printed name_2
- Social Security number_2
- Date_5
- Applicant printed name_3
- Social Security number_3
- Date_6
- Applicant printed name_4
- Social Security number_4
- 1a Name shown on tax return if a joint return enter the name shown first
- 1b First social security number on tax return individual taxpayer identification number or employer identification number see instructions
- 2a If a joint return enter spouses name shown on tax return
- 2b Second social security number or individual taxpayer identification number if joint tax return
- 4 Previous address shown on the last return filed if different from line 3 see instructions
- 5a IVES participant name address and SOR mailbox ID
- Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing see instructions
- Signature see instructions
- Date_7
- Phone number of taxpayer on line 1a or 2a
- PrintType name
- Here
- Spouses signature
- Date_8
- PrintType name_2
- Name
- Date of birth
- Service number
- Name_2
- Date of birth_2
- Service number_2
- Date_9
- Applicant printed name_5
- Date_10
- Applicant printed name_6
- Date_11
- Current Borrower printed name
- Date_12
- Current Borrower printed name_2
- Date_13
- Text3
- Text10
- undefined_13
- Text15
- undefined_14
- undefined_15
- undefined_16
- undefined_17
- undefined_18
- undefined_19
- undefined_20
- undefined_21
- undefined_23
- Reason for assumption Off
- Requestors relationship to owners Off
- Check one Off
- Check one1 Off
- Day1
- Evening
- Cell phone
- Check one2 Off
- Check one3 Off
- Check one4 Off
- Check one5 Off
- Text2-1
- Text2-2
- Text2-3
- Text2-4
- Text2-5
- Text2-6
- Text3-1
- Text3-2
- Text3-3
- Text3-4
- Text3-6
- Text3-7
- Text3-8
- Text3-9
- Text3-10
- Text3-11
- Text3-12
- Text3-13
- Text3-14
- Text3-15
- Text3-16
- Text3-17
- Text3-18
- Text3-19
- Text3-20
- Text3-21
- Text3-22
- Text3-23
- Text3-24
- Text3-25
- Text3-26
- Text3-27
- Text3-28
- Text3-29
- Text3-30
- Text3-31
- Text3-32
- Text3-33
- Text3-34
- Text3-35
- Text3-36
- Text3-37
- Text3-38
- Text3-39
- Text3-40
- Text3-41
- Text3-42
- Text3-43
- Text3-44
- Text3-45
- Text3-46
- Text3-47
- Text3-48
- Text3-49
- Text3-50
- Text3-51
- Text3-52
- Text3-53
- Text3-5
- Text3-54
- Text3-55
- Text3-56
- Citizenship Off
- Type of credit Off
- Marital Status Off
- Housing Off
- Housing1 Off
- ownership Off
- DNA1 Off
- DNA2 Off
- DNA3 Off
- family Off
- BO Off
- Total
- Text31
- Text32
- Text33
- Text34
- Text35
- Text36
- Text37
- Text38
- Text39
- Text310
- Text311
- Text312
- Text313
- Text314
- Text315
- Text316
- Text317
- Text318
- Text319
- ownership1 Off
- Total1
- Total1-2
- Check Box4-1 Off
- Text320
- Text321
- Text322
- Text323
- Text324
- Text325
- Text326
- Text327
- Text328
- Text329
- Check Box4-2 Off
- Check Box4-3 Off
- Check Box4-4 Off
- Check Box4-8 Off
- Check Box4-9 Off
- Text330
- Text331
- Text332
- Text333
- Text334
- Text335
- Text1-1
- Text1-2
- Text1-3
- Text1-4
- Text1-5
- Text1-6
- Text1-7
- Text1-8
- Text1-9
- Text1-10
- Text1-11
- Text1-12
- Text1-13
- Text1-14
- Text1-15
- Text1-16
- Text1-17
- Text1-18
- Text1-19
- Text1-20
- Text1-21
- Text1-22
- Text1-23
- Text1-24
- Text1-25
- Text1-26
- Text1-27
- Text1-28
- Text1-29
- Text1-30
- Text1-31
- Text1-32
- Text1-33
- Text1-34
- Text1-35
- Check Box3-2 Off
- Check Box2-1 Off
- Check Box2-2 Off
- Check Box2-3 Off
- Check Box2-4 Off
- Check Box2-5 Off
- Text1-36
- Text1-37
- Text1-38
- Text1-39
- Text1-40
- Text1-41
- Text1-42
- Text1-43
- Text1-44
- Text1-45
- Text1-46
- Text1-47
- Text1-48
- Text1-49
- Text1-50
- Text1-51
- Text1-52
- Text1-53
- Text1-54
- Text1-55
- Text1-56
- Text1-57
- Text1-58
- Text1-59
- Text1-60
- Text1-61
- Check Box3-11 Off
- A1
- A2
- A3
- A4
- A5
- A6
- A7
- A8
- A9
- A10
- A11
- A12
- Check Box3-1 Off
- Check Box30-1 Off
- Check Box30-2 Off
- Check Box30-4 Off
- Check Box30-5 Off
- Check Box30-7 Off
- Check Box30-8 Off
- Check Box30-9 Off
- Check Box30-10 Off
- Check Box30-11 Off
- Check Box30-12 Off
- A13
- A14
- A15
- A16
- A17 Off
- A18
- A19
- A20
- A21
- A22
- A23
- A24
- A25
- A26
- A27
- A28
- A29
- A30
- A31
- A32
- A33
- A34
- A35
- A36
- A37
- A38 Off
- A39
- A40
- A41
- A42
- A43
- A44
- A45
- A46
- A47
- A48
- A49
- A50
- A51
- A52
- A53
- A54
- A55
- A56
- A57
- A58
- A59
- A60
- A61
- A62
- A63
- A64
- A65
- A66
- A67
- A68
- A69
- A70
- A71
- A72
- A73
- A74
- Loan Purpose Off
- occupancy1 Off
- lien type Off
- lientype Off
- mixed use Off
- manufactured home Off
- deposit1 Off
- deposit2 Off
- B1
- B2
- B3
- B4
- B5
- B6
- B7
- B8
- B9
- B10
- fha Off
- Check Box51 Off
- B11
- B12
- B13
- B14
- B15
- B16
- B17
- B18
- B19 Off
- B20
- B21
- B22 Off
- B23
- B24
- B25
- B26
- B27
- B28
- A
-
- Will you occupy the property as your primary residence Off
- Will you occupy the property as your primary residence1 Off
-
- If yes have you had an ownership interest in another property in the last three years Off
- Text9-2
- B
-
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property Off
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property1 Off
-
- 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 Off
- 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 application1 Off
-
- 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 Off
- 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 application1 Off
-
- new credit Off
- 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) Off
- the Property Assessed Clean Energy Program)1 Off
-
- F
-
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application Off
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application1 Off
-
- G
-
- Are there any outstanding judgments against you Off
- Are there any outstanding judgments against you1 Off
-
- H
-
- Are you currently delinquent or in default on a Federal debt Off
- Are you currently delinquent or in default on a Federal debt1 Off
-
- I
-
- Are you a party to a lawsuit in which you potentially have any personal financial liability Off
- Are you a party to a lawsuit in which you potentially have any personal financial liability1 Off
-
- J
-
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years Off
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years1 Off
-
- 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 Off
- 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 due1 Off
-
- L
-
- Have you had property foreclosed upon in the last 7 years Off
- Have you had property foreclosed upon in the last 7 years1 Off
-
- M
-
- Have you declared bankruptcy within the past 7 years Off
- Have you declared bankruptcy within the past 7 years1 Off
-
- Check Box8-2 Off
- Check Box8-3 Off
- Check Box8-4 Off
- Text9-3
- Text9-5
- Text9-6
- Text97
- military Off
- ethnicity Off
- sex Off
- race Off
- demo Off
- Text12-1
- Check Box11-1 Off
- Check Box11-2 Off
- Check Box11-3 Off
- Check Box11-4 Off
- Check Box11-5 Off
- Check Box11-6 Off
- Check Box11-7 Off
- Check Box11-8 Off
- Check Box11-9 Off
- Text12-2
- Check Box11-10 Off
- Check Box11-11 Off
- Check Box11-12 Off
- Check Box11-13 Off
- Check Box11-14 Off
- Check Box11-15 Off
- Text12-3
- Check Box11-16 Off
- Check Box11-17 Off
- Check Box11-18 Off
- Check Box11-19 Off
- Check Box11-20 Off
- Check Box11-21 Off
- Check Box11-22 Off
- Check Box11-23 Off
- Text12-4
- Check Box11-24 Off
- Check Box11-25 Off
- Check Box11-26 Off
- Check Box11-27 Off
- Check Box11-28 Off
- Check Box11-29 Off
- Text12-5
- Check Box11-30 Off
- Check Box11-31 Off
- citizen Off
- credit Off
- marital status1 Off
- housing-1 Off
- housing-2 Off
- own Off
- C1
- C2
- C3
- C6
- C7
- C8
- C9
- C10
- C11
- C12
- C13
- C14
- C15
- C16
- C17
- C18
- C19
- C20
- C21
- C22
- C23
- C24
- C25
- C26
- C27
- C28
- C29
- C30
- C31
- C32
- C33
- C34
- C35
- Check Box-2 Off
- C36
- C37
- C38
- C39
- C4
- C40
- C41
- C42
- C43
- C44
- C45
- C46
- C47
- Check Box-3 Off
- Check Box-4 Off
- C48
- C49
- C5
- C50
- C51
- C52
- C53
- C54
- C55
- Check Box-1-1 Off
- own1 Off
- Check Box-1 Off
- D1 Off
- D2
- D3
- D4
- D5
- D6
- D7
- D8
- D9
- D10
- D11
- D12
- D13
- D14 Off
- D15 Off
- D16
- D17
- D18
- D19
- D20
- D21
- D22
- D23
- D24 Off
- D25
- D26
- D27
- D28
- D29
- D30
- D31
- D32
- D33
- D34
- D35 Off
- D36
- D37 Off
- D38
- D39
- D40
- D41
- D42
- D43
- D44
- D45
- D46
- D47
- If yes have you had an ownership interest in another property in the last three years1 Off
- new credit1 Off
- Check Box8-1 Off
- Check Box8-1-2 Off
- Check Box8-1-1 Off
- Check Box8-1-3 Off
- Check Box8-1-4 Off
- Military Service mdash Did you (or your deceased spouse) ever serve or are you currently serving in the United States Armed Forces 1 Off
- Check1 Off
- Text9-1-1
- Check2 Off
- Check3 Off
- Check4 Off
- Text9-1
- E1
- E2
- E3
- Was the ethnicity of the Borrower collected on the basis of visual observation or surname1 Off
- Was the sex of the Borrower collected on the basis of visual observation or surname1 Off
- Was the race of the Borrower collected on the basis of visual observation or surname1 Off
- The Demographic Information was provided through1 Off
- F1 Off
- F2 Off
- F3 Off
- F4 Off
- F5 Off
- F6
- F7 Off
- F8 Off
- F9 Off
- F10 Off
- F11 Off
- F12 Off
- F13
- F14 Off
- F15 Off
- F16 Off
- F17 Off
- F18 Off
- F19 Off
- F20 Off
- F21 Off
- F22
- F23 Off
- F24 Off
- F25 Off
- F26 Off
- F27 Off
- F28 Off
- F29
- F30 Off
- F31 Off
- undefined_13-1
- undefined_13-2
- undefined_14-1
- undefined_15-1
- undefined_16-1
- undefined_17-1
- undefined_18-1
- undefined_19-1
- undefined_21-1
- undefined_20-1
- undefined_23-1
- undefined_13_1
- Single-Two Off
- Refi type Off
- refi program Off
- Estate Off
- Title held Off
- Trust Information Off
- Indian Country Land Tenure Off
- Mortgage Type Applied For Off
- Mortgage Lien Type Off
- Amortization Type Off
- G1 Off
- G2 Off
- G3 Off
- G4 Off
- G5 Off
- G6
- G7
- G8
- G9
- G10 Off
- G11 Off
- G12 Off
- G13 Off
- G14 Off
- G15 Off
- G16
- G17
- G18
- G19
- G20
- G21
- G22
- G23 Off
- G24
- G25 Off
- G26
- G27 Off
- G28 Off
- G29
- G30 Off
- G31
- G32 Off
- G33
- G34
- G35
- G36
- G37
- G38
- G39
- G40
- G41
- G42
- Property Held
- refi
- Text18-1
- Text18-2
- Text18-3
- Text18-4
- Text18-5
- Text18-6
- Text18-7
- Text18-8
- Text18-9
- Text18-10
- Text18-11
- Text18-12
- Text18-13
- Text18-14
- Text18-15
- Text18-16
- Text18-17
- Text18-18
- Text18-19
- Lender
- case no
- If you selected ldquoUnmarriedrdquo in Section 1 is there a person who is not your legal spouse but who currently has real property rights similar to those of a legal spouse Off
- Relationship and State Off
- Other-5
- Text19-1
- BName
- Additional Information
- ABN
- Additional Information1
- BSign
- BSDate
- ABSign
- ABDate
- MortageeNameAddress
- NAmeAddress
- Bname1
- DOB1
- DOB2
- SignOfBorr1
- SignOfBorr
- Date Signed
- SignOfBorr2
- SignOfBorr3
- Date Signed3
- Date Signed4
- MortgageeRepSign
- DirectSign
- DirectSign1
- Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union Off
- AppSign
- AppSign1
- AppSign2
- AppSign3
- Nopage38 Off
- Yespage38 Off
- Yes1 Off
- No1 Off
- Yes2 Off
- Yes3 Off
- Yes4 Off
- Yes5 Off
- Yes6 Off
- Yes7 Off
- Yes8 Off
- Yes9 Off
- Yes10 Off
- No2 Off
- No3 Off
- No4 Off
- No5 Off
- No6 Off
- No7 Off
- No8 Off
- No9 Off
- No10 Off
- BorrowerNo Off
- BorrowerYes Off
- AppSignature
- AppSignature1
- CurrentSign
- CurrentSign1
- InterviewSign
- Yes_1 Off
- No_1 Off
- Yes_2 Off
- No_2 Off
- Mail Off
- Phone Off
Section 4 Loan and Property Informationthis section asks about the loanrsquos purpose and the property youwantto purchase orrefinance
4a Loan and Property Information
LoanAmount $ Loan Purpose Purchase efinance Other(specify)
Property Address Street Unit
City State ZIP County
Numberof Units Property Value $
Occupancy Primary Residence Second Home InvestmentProperty FHA Secondary Residence
1 Mixed-Use PropertyIf you will occupy the propertywill you set aside space within the property to operate
your ownbusiness(eg daycare facility medicaloffice beautybarber shop)NO YES
2 Manufactured HomeIs the property a manufactured home(eg a factory built dwelling built on a permanentchassis) NO YES
4b Other New Mortgage Loansonthe Property Youare Buying or Refinancing Does not apply
LoanAmountAmountto be Drawn
Credit Limit(ifapplicable)Creditor Name Lien Type Monthly Payment
First Lien Subordinate Lien $ $ $
$ $ $First Lien SubordinateLien
4c Rental Income on the Property You Wantto Purchase For Purchase Only Does not apply
Completeif the property is a 2-4 Unit Primary Residence or an Investment Property Amount
Expected Monthly Rental Income $
Doesnot apply4d Gifts or Grants You Have Been GivenorWill Receive for this Loan
Includeall gifts and grants below Under Source choose from the sourceslisted here
Community Nonprofitlaquo Employer
raquo Federal Agencyraquo Local Agency
- Relative+ Religious Nonprofit
+ State Agency+ Unmarried Partner
raquo Lender Other
Asset TypeCash Gift Gift of Equity Grant DepositedNot Deposited Source - uselist above Cash or Market Value
Deposited Not Deposited $
$Deposited Not Deposited
Borrower Name
Uniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 5 DeclarationsThis section asks youspecific questions about the property your funding and yourpastfinancial history
5aAboutthis Property and Your Moneyfor this Loan
A Will you occupy the property as your primary residence
If YES have you had an ownershipinterest 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 investmentproperty(IP)
(2) How did you holdtitle to the property by yourself (S) jointly with your spouse(SP) or jointly with another person (O)
YESYES
B If this is a Purchase Transaction Do you have a family relationship or businessaffiliation with the seller of the property NO YES
C Are you borrowing any moneyforthis real estate transaction (eg money foryour closing costs or down payment) orobtaining any moneyfrom anotherparty such astheseller or realtor that you have notdisclosed on this loan application NO YES
If YES what is the amountof this money $
D 1 Have you orwill you be applying for a mortgage loan on anotherproperty (not the property securing this loan) on or
before closing this transaction that is not disclosed on this loan application
NO YES
2 Have you orwill you be applying for any newcredit (eg installment loan credit card etc) on or before closing this loan that
is not disclosed on this application
No YES
E Will this property be subject to a lien that could take priority over the first mortgagelien such as a clean energylien paid
through yourproperty taxes(eg the PropertyAssessed Clean Energy Program)NO YES
5b About YourFinances
F Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application NO YES
G Are there any outstanding judgments against you No YES
H Areyou currently delinquentor in default on a Federal debt No YES
I Areyou a party to a lawsuit in which you potentially have any personalfinancialliability NO YES
J Have you conveyedtitle to any property in lieu of foreclosure in the past 7 years NO YES
K Within the past 7 years have you completed a pre-foreclosure sale or short sale whereby the property wassold to a
third party and the Lenderagreed to acceptless than the outstanding mortgage balance due
NO YES
L Have you hadproperty foreclosed uponin thelast 7 years NO YES
M Have you declared bankruptcy within the past 7 years ONO YESIf YES identify the type(s) of bankruptcy Chapter7 Chapter11 Chapter12 Chapter 13
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 6 Acknowledgments and AgreementsThis section tells you about yourlegal obligations whenyousign this application
Acknowledgments and Agreements
Definitions- Lenderincludes the Lenderrsquos agents service providers and any oftheir successors andassigns
Other Loan Participantsrdquo includes(i) any actual or potential owners of
a loan resulting from this application (the ldquoLoanrsquo)(ii) acquirers ofany beneficial or other interest in the Loan(iii) any mortgageinsurer(iv) any guarantor (v) any servicer of the Loan and (vi) any of theseparties service providers successors or assigns
I agree to acknowledgeand representthe following
(1) The Complete Informationfor this Application- The information | have providedin this application is true accurate
and completeas of the date | signed this application
laquo If the information | submitted changesor | have new information
before closing of the Loan | must change and supplementthis
application including providing any updatedsupplementedrealestate sales contract
- For purchase transactions The terms and conditionsof anyrealestate sales contract signed by mein connection with this application
are true accurate and complete to the best of my knowledge andbelief | have not entered into any other agreement written ororal inconnection withthis real estate transaction
- The Lender and OtherLoan Participants mayrely on the informationcontainedin the application before and after closing of the Loan
- Any intentional or negligent misrepresentation of information may
result in the impositionof(a) civil liability on me including monetary damagesif a
person suffers any loss because the person relied on anymisrepresentation that | have made onthis application andor
(b) criminal penalties on me including but not limited to fine orimprisonment or both underthe provisions of Federal law(18 USC sectsect 1001 et seq)
(2) The Propertyrsquos SecurityThe Loan | have applied for in this application will be secured by
a mortgage or deedoftrust which provides the Lendera security
interest in the property described in this application
(3) The Propertys Appraisal Value and Condition- Any appraisal or value of the property obtained by the Lenderis
for use by the Lender and OtherLoanParticipantslaquoThe Lender and OtherLoan Participants have not made anyrepresentation or warranty express or implied to me about the
propertyits conditionorits value
(4) Electronic Records and Signatures- The Lender and OtherLoan Participants may keep any paper record
andorelectronic record of this application whether or not the Loan
is approved
BorrowerSignature
- If this application is created as (or converted into) an ldquoelectronicapplicationrdquo | consent to the use of ldquoelectronic recordsrdquo and
ldquoelectronic signaturesrdquo as the termsare defined in and governed byapplicable Federal andorstate electronic transactions laws
| intend to sign and have signedthis application either using my(a) electronic signature or(b) a written signature and agreethatif a paper version ofthis
application is converted into an electronic application theapplication will be an electronic record and the representationof my written signature on this application will be my binding
electronic signature- | agree that the applicationif delivered or transmitted to the Lenderor Other Loan Participants as an electronic record with myelectronicsignaturewill be as effective and enforceable as a paperapplicationsigned by mein writing
(5) Delinquencylaquo The Lender and OtherLoan Participants may report information about
my accountto credit bureaus Late payments missed paymentsorother defaults on my account maybereflected in my credit report andwill likely affect my credit score
- If | have trouble making my payments | understand that | may contacta HUD-approved housing counseling organization for advice about
actions I can take to meet my mortgageobligations
(6) Authorization for Use and Sharing of InformationBy signing belowin addition to the representations and agreementsmade above| expressly authorize the Lender and Other LoanParticipants to obtain use and share with each other(i) the loan
application and related loan information and documentation(ii) aconsumercredit report on me and(iii) my tax return information asnecessary to perform theactionslisted belowfor so long as they havean interest in my loanorits servicing
(a) process and underwrite myloan(b) verify any data contained in my consumercredit 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 analysisandreviews
(e) perform analysis and modeling for risk assessments(f) monitor the accountfor this loan for potential delinquencies and
determineanyassistance that may beavailable to me and
(g) other actions permissible under applicable law
Date (mmddyyyy)
Additional Borrower Signature Date (mmddyyyy)
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 7 Military ServiceThis section asks questions about your(or your deceased spouses) military service
Military Service of Borrower
Military Service mdash Did you (or your deceased spouse) everserve or are you currently serving in the United States Armed Forces NO YES
If YES check allthat apply Currently serving on active duty with projected expiration date of servicetour (mmddyyyy)
Currently retired discharged or separated from service
Only period of service was as a non-activated memberof the Reserve or National GuardSurviving spouse
Section 8 Demographic InformationThis section asks about your ethnicity sex and race
Demographic Information of Borrower
The purposeofcollecting this informationis to help ensure thatall applicants are treated fairly and that the housing needs of communities
and neighborhoodsare beingfulfilled 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 mayselect one or more designationsfor
Ethnicity and one or more designationsfor Race The law provides that we maynotdiscriminate on the basis of this information or onwhetheryou chooseto provideit However if you choose not to provide the information and you have madethis application in person Federal
regulations require us to note your ethnicity sex and race on thebasis of visual observation or surname Thelaw also provides that we may notdiscriminate on the basis of age or marital status information you providein this application If you do not wish to provide someorall of this
information please check below
Ethnicity Check one or more Race Check one or moreHispanic or Latino AmericanIndian or Alaska Native - Print nameofenrolled
or principaltribe Mexican PuertoRican CubanOther Hispanic or Latino - Print origin Asian
Asian Indian Chinese Filipino
Japanese Korean Vietnamese
OtherAsian mdash Print race
For example Hmong Laotian Thai Pakistani Cambodian and so on
Black or African American
Native Hawaiian or OtherPacific Islander
Native Hawaiian GuamanianorChamorro Samoan
For exampleArgentinean Colombian Dominican Nicaraguan
Salvadoran Spaniard andso on
Not Hispanic or Latino
| do not wish to providethis information
5Female OtherPacific Islander mdash Print race
Male For example Fijian Tongan and so on| do not wish to providethis information white
| do not wish to providethis information
Wasthe ethnicity of the Borrowercollected on the basis of visual observation or surname )NO YESWasthe sex of the Borrowercollected on the basis of visual observation or surname NO YESWastherace of the Borrowercollected on the basis of visual observation or surname NO YES
Face-to-Face Interview (includes Electronic Media w Video Component) TelephoneInterview Faxor Mail Email or Internet
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
ReelTemCrCL
Loan Originator Organization Name
Address
Loan Originator Organization NMLSR ID State License ID
Loan Originator Name
Loan Originator NMLSR ID State License ID
Date (mmddyyyy)
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Uniform Residential Loan Application mdash Additional BorrowerVerify and complete the information onthis application as directed by your Lender
Section 1 Borrower Informationthis section asks about yourpersonal information and your income fromemploymentandother sources such as retirement that you want considered to qualify for this loan
1a Personal Information
Name(First Middle Last Suffix)
Alternate Names - List any namesby which you are known or any namesunder which credit was previously received (First Middle Last Suffix)
Social Security Number - -(or Individual TaxpayerIdentification Number)
Dateof Birth Citizenship(mmddyyyy)
USCitizenPermanentResidentAlienNon-Permanent ResidentAlien
Type ofCredit| am applying for individualcredit
lam applying forjoint credit Total Number of Borrowers
Each Borrowerintendsto applyfor joint credit Your initials
List Name(s) of Other Borrower(s) Applying for this Loan
(First Middle Last Suffix) - Use a separator between names
Marital Status Dependents(notlisted by another Borrower)
Contact Information
Married Number _ Home Phone ( ) -
( ) _
( ) -mdash_ mdash_
Separated Ages CellPhone
Unmarried ens Work Phone Ext(Single Divorced WidowedCivil Union Domestic Partnership Registered
Reciprocal Beneficiary Relationship)lsquol
Emal
Current Address
Street Unit
City State ZIP Country
How Long at Current Address=Years mdashMonths Housing Noprimary housing expense Own Rent($ month)
If at Current Address for LESS than 2 yearslist Former Address Does not apply
Street Unit
City State ZIP Country
How Long at Former Address Years mdashMonths Housing Noprimary housing expense Own month)
Mailing Address- ifdifferent from CurrentAddress Does not apply
Street Unit
City State ZIP Country
eeeeCeeteiChuraleCme Doesnot apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base S$month
City State ZIP Country Overtime =$_____monthBonus $ month
Position orTitle Checkif this statementapplies Commission sect month| am employedby a family memberpropertyseller real estate agent or otherparty to the transaction
TTStart Date ____ (mmddyy) Military
Entitlements$_How longin this line of work Years =Months mdash monthSS
Other $ monthCheckif you are the BusinessOwnerorSelf-Employed
| have an ownershipshare ofless than 25 Monthly Income(or Loss) mdashmdash| have an ownership share of 25 or more $ TOTAL $ 000month
Uniform Residential Loan Application mdash Additional Borrower
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
CoeeeMCMCmeticlm tu)Comiteteilteeilelie mieit
Does not apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base
OvertimeBonus
Commission
MilitaryEntitlements
Other
$ month
$ month$ month
$ month
$ month
$ month
City State ZIP Country
Position orTitle ose if this statement applieslam employed by a family memberpropertyseller real estate agent or otherparty to the transaction
Start Date (mmddyy)How long in this line of work Years =Months
Checkif you are the Business
Owneror Self-Employed| have an ownershipshare of less than 25 Monthly Income(or Loss)
Ihave an ownership share of 25 or more $ TOTAL$ 000month
CPONMeeeMummaTestetiersdeere lire miret Does not apply
Provideat least 2 years of current and previous employment and income
Employeror Business Name Previous Gross MonthlyStreet Unit Income s month
City State ZIP Country
Position or Title
Start Date
End Date
Checkif you were the BusinessOwneror Self-Employed
(mmddyyyy)
(mmddyyyy) 1e Income from Other Sources Does not apply
Include incomefrom other sources below Under Income Source choose from the sourceslisted herelaquo Alimonylaquo Automobile Allowanceraquo Boarder Incomelaquo Capital Gains
Child Support+ Disability+ Foster Care Housing or Parsonage
+ Interest and DividendslaquoMortgage Credit Certificate Mortgage DifferentialPayments
laquo Notes Receivable+ Public Assistancelaquo Retirement(eg Pension IRA)
+raquo Royalty Payments Separate Maintenance
+ Social Security
raquo Trust
+ UnemploymentBenefits
laquo VA Compensation
laquo Other
NOTE Revealalimony child support separate maintenance or other income ONLYIFyou wantit considered in determining yourqualification
for this loan
Income Source - uselist above Monthly Income
$
$
$
$ 000Provide TOTAL AmountHere|
Section 2 Financial Information mdash Assets andLiabilities
Myinformation for Section 2 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 3 Financial Information mdash Real Estate
Myinformation for Section 3 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 4 Loan and Property Information
Myinformation for Section 4 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 5 DeclarationsThis section asks you specific questions about the property your funding and your past
financial history
5aAboutthis Property and Your Moneyforthis Loan
A Will you occupy the property as your primary residence NO YES
If YES have you had an ownershipinterest in another property in the last three years NO YES
If YES complete (1) and (2) below
(1)What type of property did you ownprimary residence (PR) FHA secondary residence (SR) second home(SH)
or investmentproperty (IP)
(2) How did you holdtitle to the property by yourself (S) jointly with your spouse(SP) or jointly with another person (O)
B If this is a Purchase Transaction Do you have a family relationship or businessaffiliation with the seller of the property NO YES Cc Are you borrowing any moneyforthis real estate transaction (eg money foryour closing costs or down payment) or
obtaining any moneyfrom anotherparty suchastheselleror realtor that you have not disclosed on this loan application NO YES
If YES whatis the amountof this money $
D 1 Have youorwill you be applying for a mortgage loan on anotherproperty (not the property securing this loan) on orbefore closing this transaction that is not disclosed on this loan application
NO YES
2 Have you orwill you be applying for any newcredit (eg installment loan credit card etc) on or before closing this loan that wsis not disclosed on this application
NO YES
E Will this property be subject to a lien that could take priority over thefirst mortgagelien such as a clean energylien paid
through yourproperty taxes(eg the PropertyAssessed Clean Energy Program)No YES
EK) Veli ellim ait
F Areyou a co-signer or guarantor on any debtor loan thatis not disclosed on this application NO ES
G Are there any outstanding judgments against you NO YES
H Are you currently delinquentor in default on a Federal debt NO YES
I Are you a party to a lawsuit in which you potentially have any personalfinancialliability NO YES
J Have you conveyedtitle to any property in lieu of foreclosure in the past 7 years NO YES
K Within the past 7 years have you completed a pre-foreclosure sale or short sale whereby the property wassold to a
third party and the Lender agreed to acceptless than the outstanding mortgage balance due
No YES
L Have you had property foreclosed uponin thelast 7 years NO YES
M Have you declared bankruptcy within the past 7 years no vESIf YES identify the type(s) of bankruptcy Chapter 7 Chapter11 Chapter12 Chapter 13
Section 6 Acknowledgements and AgreementsMy signature for Section 6 is on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 7 Military Service This section asks questions about your(or your deceased spouses) military service
Military Service of Borrower
Military Service mdash Did you (or your deceased spouse)everserve or are you currently serving in the United States Armed Forces NO YES
IfYES check allthat apply Currently serving on active duty with projected expiration date of servicetour (mmddyyyy)
Currently retired discharged or separated from service nnOnly period of service was as a non-activated memberofthe Reserve or National GuardSurviving spouse
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 8 Demographic InformationThis section asks about your ethnicity sex and race
Demographic Information of Borrower
The purposeofcollecting this information is to help ensure thatall applicants are treated fairly and that the housing needs of communities
and neighborhoodsare beingfulfilled 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 providethis information but are encouraged to do so You mayselect one or more designationsfor
Ethnicity and one or more designationsfor Race The law provides that we maynotdiscriminate onthe basis of this information or onwhetheryou chooseto provideit However if you choose notto provide the information and you have madethis application in person Federal
regulations require us to note yourethnicity sex and race on the basis of visual observation or surname The law also provides that we may notdiscriminate on the basis of age or marital status information you providein this application If you do not wish to provide someorall of this
information please check below
Ethnicity Check one or more Race Check one or moreHispanic or Latino AmericanIndian or Alaska Native - Print nameofenrolled
or principaltribeMexican PuertoRican Cuban
OtherHispanic or Latino - Printorigin siansian Indian Chinese Filipino
For exampleArgentinean Colombian Dominican NicaraguanSalvadoran Spaniard andso on
Japanese Korean VietnameseOtherAsian - Print race Forexample Hmong Laotian Thai Pakistani Cambodian andso on
Black or African American
Native Hawaiian or OtherPacific Islander
Native Hawaiian GuamanianorChamorro Samoan
OtherPacific Islander mdash Print race
Not Hispanic or Latino
| do not wish to providethis information
Sex
Female
Male
| do not wish to providethis informationFor example Fijian Tongan and so on
White
| do not wish to providethis information
Wasthe ethnicity of the Borrowercollected on thebasis of visual observation or surnameWasthesex of the Borrowercollected on the basis of visual observation or surnameWastherace of the Borrowercollected on the basis of visual observation or surname
)NO YESNO YESNO YES
Face-to-Face Interview (includes Electronic Media w Video Component) Telephone Interview Faxor Mail Email or Internet
Loan Originator Organization Name
Address
Loan Originator Organization NMLSR ID State License ID
Loan Originator Name
Loan Originator NMLSR ID State License ID
Email Phone (
Signature Date (mmddyyyy)
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Pe)aae-emeet)
Community Property State
At least one borrowerlives in a community propertystateThe property is in a community property state
Transaction DetailConversion of Contract for Deed or Land ContractRenovationConstruction-ConversionConstruction-to-Permanent
Single-Closing Two-ClosingConstructionImprovementCosts $
LotAcquired Date
Original Cost of Lot $(mmddyyyy)
Refinance Program
Full DocumentationInterest Rate ReductionStreamlined without Appraisal
Other
Refinance Type
NoCash OutLimited Cash OutCash Out
Energy Improvement
Mortgageloanwill finance energy-related improvements
Propertyis currently subject to a lien that could take priority ovethe first mortgagelien such as a clean energylien paid for througproperty taxes(eg the PropertyAssessed Clean Energyprogram)
Project Type Condominium Cooperative Planned Unit Development (PUD) Propertyis notlocatedin a project
Peiwlivcestetece)a)
Title to the Property Will be Held in What Name(s)
For RefinanceTitle to the Property is Currently Held in What Name(s
Trust Information
tle Will be Held byan Inter Vivos (Living) Trust
Title Will be Held by a Land TrustLeasehold Expiration Date
Mannerin WhichTitle Will be Held Indian Country Land Tenure
Sole OwnershipLife EstateTenancy in Common
Joint Tenancywith Right of Survivorship]Tenancybythe EntiretyOther
Fee Simple Ona ReservationIndividualTrust Land (AllottedRestricted)Tribal Trust Land On a ReservationTribal Trust Land Off ReservationAlaska Native Corporation Land
Estate Will be Held in
Fee Simple(mmddyyyy)
3 Mortgage LoanInformation
Termsof Loan
Note Rate
Loan Term (months)
MortgageLien Type
First LienSubordinate Lien
Mortgage Type Applied For
Conventional USDA-RDFHA VA Other
Amortization Type
Fixed RateAdjustable Rate
If Adjustable Rate
Initial Period Prior to First Adjustment
Subsequent AdjustmentPeriod
Proposed Monthly Paymentfor Property
First Mortgage (P amp I) $
Subordinate Lien(s) (P amp |) $
Other(explain)
Homeowners Insurance $(months)
(months)
Loan Features Property Taxes $
Balloon Balloon Term (months)
Interest Only Interest OnlyTermNegative AmortizationPrepaymentPenalty Prepayment Penalty Term (months) Other
Temporary Interest Rate BuydownInitial Buydown Rate TOTALOther(explain)
Mortgage Insurance $
AssociationProject Dues (Condo Co-Op PUD) $
Supplemental Property Insurance $
(months)
Borrower Name(s)Uniform Residential Loan Application mdash LenderLoan Information
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
L4 Qualifying the Borrower - Minimum Required Funds or Cash Back
DUEFROM BORROWER(S)
A Sales Contract Price
B Improvements Renovations and Repairs
C Land(ifacquired separately)
D For Refinance Balance of Mortgage Loanson the Propertyto be paid off in the Transaction
(See Table 3a Property You Own)
E Credit Cards and Other Debts Paid Off
(See Table 2c Liabilities mdash Credit Cards Other Debts and Leases that You Owe)
F BorrowerClosing Costs (including Prepaid andInitial Escrow Payments)
G Discount Points
HTOTAL DUE FROM BORROWER(s)(Total of A thru G)
TOTALMORTGAGE LOANS
Loan Amount
Loan AmountExcluding Financed Mortgage Insurance (or Mortgage Insurance Equivalent) $
Financed Mortgage Insurance (or Mortgage Insurance Equivalent) Amount $
Other New Mortgage Loanson the Property the Borrower(s) is Buying or Refinancing(See Table 4b Other New MortgageLoanson the Property You are Buying or Refinancing)
KTOTAL MORTGAGELOANS(Totalof| and J)
TOTALCREDITS
L Seller Credits (Enter the amountofBorrower(s) costs paid by the property seller)
MOtherCredits (Enter the sum ofall other credits mdash BorrowerPaid Fees Earnest Money EmployerAssistedHousing Lease Purchase Fund Lot Equity Relocation Funds Sweat Equity Trade Equity Other)
NTOTAL CREDITS(Total of L and M)
CALCULATION
TOTAL DUE FROM BORROWER(s)(Line H)
LESSTOTAL MORTGAGELOANS(Line K) AND TOTAL CREDITS(Line N)
Cash FromTothe Borrower(Line H minusLine K and Line N)NOTE This amountdoesnotinclude reservesor other funds that may be required by the Lenderto be verified
Borrower Name(s)Uniform Residential Loan Application mdash LenderLoan Information
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
Uniform Residential Loan Application mdash Unmarried Addendum
eeCeceetatimC elitleeComeLy
Lenders Instructions for Using the Unmarried Addendum
The Lender may use the Unmarried Addendum only when a Borrowerselected ldquoUnmarriedrdquoin Section 1 and the information collected is
necessary to determine howState property lawsdirectly or indirectly affecting creditworthiness apply including ensuring clear title
For example the Lender may use the Unmarried Addendum whentheBorrowerresides in a State that recognizescivil unions domestic
partnerships or registered reciprocal beneficiary relationships or when the property is located in such a State ldquoStaterdquo meansanystate the
District of Columbia the Commonwealth of Puerto Rico or anyterritory or possession of the United States
Ifyou selected ldquoUnmarriedrdquoin Section 1 is there a person whois not your legal spouse but whocurrently has real property rights similar to
those of a legal spouse +=) NOQ YES
If YES indicate the type of relationship and the State in which the relationship was formed For example indicate if you are in a
civil union domestic partnership registered reciprocal beneficiary relationship or other relationship recognized by the State in which you
currently reside or where the property is located
O Civil Union copy Domestic Partnership copy Registered Reciprocal Beneficiary Relationship copy) Other(explain)
Statea]
Borrower NameUniform Residential Loan Application mdash Unmarried Addendum
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Uniform Residential Loan Application mdash Continuation Sheet
Use this continuation sheet if you need more space to complete the Uniform Residential Loan Application
Borrower Name(First Middle Last Suffix )
Additional Information
Additional Borrower Name(First Middle Last Suffix )
Additional Information
IWefully understand thatit is a federal crime punishable by fine or imprisonment or both to knowingly make anyfalse statements concerningany of the abovefacts as applicable underthe provisions of federal law (18 USC sectsect 1001 et seq)
BorrowerSignature Date (mmddyyyy)
Additional Borrower Signature Date (mmddyyyy)
Uniform Residential Loan Application mdash Continuation SheetFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
INSTRUCTIONS FOR COMPLETING THE UNIFORM RESIDENTIAL LOAN APPLICATION
Use the instructions below to complete the enclosed Uniform Residential Loan Application (Freddie Mac Form 65Fannie Mae Form 1003) To avoid any delays in your application review please provide all of the requested information
If you need to make a correction on the application draw a line through the incorrect text and mark your initials beside the change Donrsquot use correction tape or fluid The application must be completed signed and dated in ink
The Uniform Residential Loan Application (URLA)
The URLA contains the following sections Section 1 Borrower Information Please provide your personal information income and employment
Section 2 Financial Information ndash Assets and Liabilities Please provide information about your financial assets personal financial obligations and debts you owe
Section 3 Financial Information ndash Real Estate Please provide information about property you own and the debts and expenses related to the property
Section 4 Loan and Property Information Please provide information about the loan purpose and the property you are buying or refinancing
Section 5 Declarations Please answer questions about the property how the property will be financed and your past financial history
Section 6 Acknowledgments and Agreements Informs you of your legal obligations related to the mortgage application and asks that you acknowledge certain information will be obtained used and shared
Section 7 Military Service Please provide information about your (or your deceased spousersquos) military service
Section 8 Demographic Information Requests information the Lender is required by law to ask you
Section 9 Loan Originator Information Will be completed by Chase
Uniform Residential Loan Application ndash Additional Borrower
The URLA ndash Additional Borrower contains the following sections Section 1 Borrower Information This is the same as the Borrower Information section of the URLA
Section 2 Financial Information ndash Assets and Liabilities Contains only the following statement for the additional Borrower to complete ldquoMy information for Section 2 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo The name of the other borrower is entered here
Complete a separate URLA for each BorrowermiddotThree or more Borrowers ndash Use any combination of URLA and URLA-Additional Borrower forms in accordance with the above examples
Section 3 Financial Information ndash Real Estate Contains only the following statement for the additional borrower to complete ldquoMy information for Section 3 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 4 Loan and Property Information Contains only the following statement for the additional borrower to complete ldquoMy information for Section 4 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 5 Declarations This is the same as the Declarations section of the URLA
Section 6 Acknowledgments and Agreements Contains only the following statement for the additional borrower to complete ldquoMy signature for Section 6 is on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 7 Military Service This is the same as the Military Service section of the URLA
Section 8 Demographic Information This is the same as the Demographic Information section on the URLA
Section 9 Loan Originator Information This is the same as the Loan Originator Information section of the URLA
Using the URLA and URLA ndash Additional Borrower Together The URLA and the URLA ndash Additional Borrower are used together to collect information for two Borrowers who have joint assets liabilities andor real estate information The URLA and URLA ndash Additional Borrower can also be used for Borrowers who do not have joint information but wish to combine their information on the URLA for ease of use Here are examples of how to use the URLA and URLA ndash Additional Borrower
For one borrower Complete the URLA
For two borrowers with joint financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you dont need to duplicate them on more than one URLA or o In cases where Borrowers are not collaborating when completing the loan application
joint assets liabilities and real estate may be duplicated on each URLA bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you do not need to duplicate them on more than one URLA or
o In cases where Borrowers are not collaborating when completing the loan application joint assets liabilities and real estate may be duplicated on each URLA
For two borrowers with separate financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower Report the assets liabilities and
real estate for the additional Borrower on the URLA or bull Complete a separate URLA for each Borrower
For three or more borrowers use any combination of URLA and URLA ndash Additional Borrower forms described for two borrowers
Uniform Residential Loan Application ndash Unmarried Addendum If any borrower listed on the URLA or URLA ndash Additional Borrower form selects Unmarried in Section 1 (Personal Information) the lender will complete this optional form
The information must be collected to determine how to apply state property laws that directly or indirectly affect creditworthiness including ensuring clear title
Uniform Residential Loan Application ndash Continuation Sheet Use the URLA ndash Continuation Sheet if you need more space to complete either the URLA or URLA ndash Additional Borrower forms
99177-URLAI-0215
HUD Addendum to Uniform Residential Loan Application OMB Approval No HUD 2502-0059 (exp )
Part I - Identifying Information HUDFHA Application for Insurance under the National Housing Act and Borrower Certification
FHA Case No (include any suffix) Mortgagee Case No
Mortgagee ID Sponsor ID Agent ID
Mortgagee Name Address (include ZIP Code) and Telephone Number
Type or print all entries clearly
Name and Address of Sponsor Name and Address of Agent
Borrowers Name amp Present Address (include ZIP Code) Property Address (include name of subdivision lot amp block no amp ZIP Code)
Sponsored Originations
Name of Third-Party Originator NMLS ID of Third-Party Originator
Part II - Borrower Consent for Social Security Administration to Verify Social Security Number I authorize the Social Security Administration (SSA) to verify my Social Security Number (SSN) to the Mortgagee and HUDFHA I authorize SSA to provide explanatory
information to HUDFHA in the event of a discrepancy This consent is valid for 180 days from the date signed unless indicated otherwise by the individual(s) named in this
loan application
Signature(s) of Borrower(s) - Read consent carefully Review accuracy of Social Security Number(s) provided on this application
Borrowerrsquos NameDate of BirthSocial Security Number
Co-Borrowerrsquos Name Date of BirthSocial Security Number
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
Part III - Borrower Notices Information and Acknowledgment Public Reporting Burden
Public reporting burden for this collection of information is estimated to average 10 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 conduct or sponsor and a person is not
required to respond to a collection of information unless that collection displays a valid OMB control number which can be located on the OMB Internet page at
httpwwwreginfogovpublicdoPRAMain
Privacy Act Information
The information requested on the Uniform Residential Loan Application and this Addendum is authorized by the National Housing Act of 1934 12 USC sect 1701 et seq The Debt
Collection Act of 1982 Pub L 97-365 and HUDrsquos Housing and Community Development Act of 1987 42 USC sect 3543 require persons applying for a federally insured loan to
furnish their SSN You must provide all the requested information including your SSN HUD may conduct a computer match to verify the information you provide HUD may
disclose certain information to Federal State and local agencies when relevant to civil criminal or regulatory investigations and prosecutions It will not otherwise be disclosed or
released outside of HUD except as required and permitted by law The information will be used to determine whether you qualify as a mortgagor Failure to provide any of the
requested information including SSN may result in disapproval of your loan application This is notice to you as required by the Right to Financial Privacy Act of 1978 that
HUDFHA has a right of access to financial records held by financial institutions in connection with the consideration or administration of assistance to you Financial records
involving your transaction will be available to HUDFHA without further notice or authorization but will not be disclosed or released by the institution to another Government Agency
or Department without your consent except as required or permitted by law
WARNING This warning applies to all certifications made in this document Anyone who knowingly submits a false claim or makes false statements is subject to criminal and civil penalties including confinement for up to 5 years fines and civil penalties 18 USC sectsect 287 1001 and 31 USC sect 3729
orm HUD-92900-A ( ) Page 1
Borrower Name ____________________________ FHA Case No __________________
Caution Delinquencies Defaults Foreclosures and Abuses Delinquencies defaults foreclosures and abuses of mortgage loans involving programs of the Federal Government can be costly and detrimental to your credit now and in the future The Mortgagee in this transaction its agents and assigns as well as the Federal Government its agencies agents and assigns are authorized to take any and all of the following actions in the event loan payments become delinquent on the mortgage loan described in the attached application (1) Report your name and account information to a credit bureau (2) Assess additional interest and penalty charges for the period of time that payment is not made (3) Assess charges to cover additional administrative costs incurred by the Federal Government to service your account (4) Offset amounts owed to you
under other Federal programs (5) Refer your account to a private attorney collection agency or mortgage servicing agency to collect the amount due foreclose
the mortgage sell the property and seek judgment against you for any deficiency (6) Refer your account to the Department of Justice (DOJ) for litigation in the
courts (7) If you are a current or retired Federal employee take action to offset your salary or civil service retirement benefits (8) Refer your debt to the Internal
Revenue Service for offset against any amount owed to you as an income tax refund and (9) Report any resulting written off debt of yours to the Internal Revenue Service as your taxable income All of these actions may be used to recover any debts owed when it is determined to be in the interest of the Mortgagee or Federal Government or both
As a mortgage loan borrower you will be legally obligated to make the mortgage payments called for by your mortgage loan contract The fact that you dispose of your property after the loan has been made will not relieve you of liability for making these payments Payment of the loan in full is ordinarily the way liability on a mortgage note is ended Some home buyers have the mistaken impression that if they sell their homes when they move to another locality or dispose of it for any other reasons they are no longer liable for the mortgage payments and that liability for these payments is solely that of the new owners Even though the new owners may agree in writing to assume liability for your mortgage payments this assumption agreement will not relieve you from liability to the holder of the note which you signed when you obtained the loan to buy the property Unless you are able to sell the property to a buyer who is acceptable to HUDFHA who will assume the payment of your obligation to the lender you will not be relieved from liability to repay any claim which HUDFHA may be required to pay your lender on account of default in your loan payments The amount of any such claim payment may be a debt owed by you to the Federal Government and subject to established collection procedures
Fair Housing Act I and anyone acting on my behalf are and will remain in compliance with the Fair Housing Act 42 USC sect 3604 et seq with respect to the dwelling or property covered by the loan and in the provision of services or facilities in connection therewith I recognize that any restrictive covenant on this property related to race color religion sex disability familial status or national origin is unlawful under the Fair Housing Act and unenforceable I further recognize that in addition to administrative action by HUD a civil action may be brought by the DOJ in any appropriate US court against any person responsible for a violation of the
applicable law
Certification and Acknowledgment All information in this application is given for the purpose of obtaining a loan to be insured under the National Housing Act and the information in the Uniform Residential Loan Application and this Addendum is true and complete to the best of my knowledge and belief Verification may be obtained from any source named herein I have read and understand the foregoing concerning my liability on the loan and Part III Borrower Notices Information and Acknowledgment
Signature(s) of Borrower(s) - Do not sign unless this application is fully completed Read the certification carefully and review accuracy of this application
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
orm HUD-92900-A ( Page 2
___________________________________
______________________________________________________
______________________________________________________________
- - - - - - - - - - - - - - - - - - - - - - -
Borrower Name ____________________________ FHA Case No __________________
Part IV - Direct Endorsement Approval for a HUD FHA-Insured Mortgage A Underwriting the Borrower
Date Mortgage Approved ______________________________ Date Approval Expires ______________________
For mortgages rated as an ldquoacceptrdquo or ldquoapproverdquo by FHAs TOTAL Mortgage Scorecard
The information submitted to TOTAL was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA4e Final Underwriting Decision (TOTAL) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee Representative Signature
Printed Name
Title
OR
For mortgages rated as a ldquoreferrdquo by FHAs TOTAL Mortgage Scorecard or manually underwritten by a Direct Endorsement underwriter I have personally reviewed and underwritten the borrowerrsquos credit application The information used to underwrite the borrower was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA5d Final Underwriting Decision (Manual) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
B Underwriting the Property
For all mortgages where FHA requires an appraisal I have personally reviewed and underwritten the appraisal according to FHA requirements I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
orm HUD-92900-A ( ) Page 3
Borrower Name ____________________________ FHA Case No __________________
Part V Mortgagees Certification
I have personally reviewed the mortgage documents and the application for insurance endorsement and This mortgage complies with SF Handbook 40001 Section IIA7 Post-Closing and Endorsement to the extent that no defect exists that would have changed the decision to endorse or submit the mortgage for insurance
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee
Name of Mortgageersquos Representative
Title of Mortgageersquos Representative
Signature of the Mortgageersquos Representative Date
orm HUD-92900-A ( ) Page 4
GENERAL AUTHORIZATION FOR A MORTGAGE LOAN ASSUMPTION
Applicant name(s)
Loan number
NOTICES AND DISCLOSURES
Non-discriminatory underwriting guidelines Anyone who inquires about the availability of credit from us has the right to receive a copy of our non-discriminatory underwriting guidelines To request a copy of these guidelines contact your Loan Processor
Attorney note Itrsquos the responsibility of our attorneys to protect our interest You may at your expense request an attorney to represent your interest
Notice to HUDFHA applicants As required by the Right to Financial Privacy Act of 1978 this notice is to inform you that the US Department of Housing and Urban Development (HUD)Federal Housing Administration (FHA) has a right of access to financial records held by financial institutions related to a request for assistance Financial records involving your assumption will be available to HUDFHA without further notice or authorization but wonrsquot be disclosed or released by us to another government agency or department without your consent except as required or permitted by law
Borrower consent to the use of tax return information I understand acknowledge and agree that the Lender and Other Loan Participants can obtain use and share tax return information for purposes of (i) providing an offer (ii) originating maintaining managing monitoring servicing selling insuring and securitizing a loan (iii) marketing or (iv) as otherwise permitted by applicable laws including state and federal privacy and data security laws The Lender includes the Lenderrsquos affiliates agents service providers and any of aforementioned partiesrsquo successors and assigns The Other Loan Participants includes any actual or potential owners of a loan resulting from your loan application or acquirers of any beneficial or other interest in the loan and mortgage insurer guarantor any servicers or service providers for these parties and any of aforementioned partiesrsquo successors and assigns
CERTIFICATION AND AUTHORIZATION
Environmental certification By signing below I represent and warrant that Irsquom not aware of any substances materials or products that may be an environmental hazard such as but not limited to asbestos formaldehyde radon gas lead-based paint fuel or chemical storage tanks (above or below ground) and contaminated soil or water on the property I acknowledge that Chase is relying on this representation and warranty as a material part of its loan application process I also am not aware of any landfill on any portion of the property
Exceptions to the above I further acknowledge (1) receipt of applicable disclosures from the seller in purchase transactions (2) that lead-based paint may exist in housing constructed prior to 1978 (3) that Chase performs no environmental investigation on my behalf and isnrsquot responsible for identifying lead-based paint or any other environmental conditions that might impact the property or its residents and (4) that it is my sole obligation to investigate for potential impact to the property from environmental conditions
Certifications I certify by signing below that (1) all of the loan application information provided is true and complete (2) I understand any intentional or negligent misrepresentation(s) of the information provided in conjunction with my application may result in civil liability andor 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 Chase its agents successors and assigns insurers and any other person who may suffer any loss due to reliance upon any misrepresentation that I have made on the application and (3) any significant change from the information provided at the time of application until the final loan application is signed may have a bearing on the approval of my application for a home loan
Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union
This question is asked because of state laws that extend the same or similar rights benefits and protections of spouses in a marriage to persons who are members of a partnership or union recognized under state law You should consult with your own legal advisor for advice regarding the rights protections benefits responsibilities obligations and duties of those who are registered domestic partners civil union partners or members of other unions recognized under applicable law
CREDIT AUTHORIZATION RELEASE
By signing below I authorize Chase andor my mortgage insurer (if any) to verify my past and present employment earnings records (including information contained in income tax returns that have been filed with the IRS) bank accounts stock holdings and any other information that it finds necessary to process my mortgage loan application or to review it for quality-control purposes I understand that a credit report will be ordered from a credit reporting agency for verification prior to loan closing as part of the application process and may be ordered after closing as part of the Lenderrsquos quality-control program A credit report may also be completed as part of the Lenderrsquos servicing or collection of the loan or in consideration of any other product or service that the Lender may consider offering me in the future and at any time throughout the life of the loan I understand that use of a photocopy of this form may be necessary to verify one or more of my credit references I understand that a photocopy or fax copy of this form will also serve as authorization
By signing below each applicant acknowledges (1) making the above certifications and authorizations and (2) that each applicant has received and understands the above notices and disclosures
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
You do not have to give us this information but if you donrsquot your application for approval as a borrower may be delayed or rejected The information requested in this form is authorized by Title 38 USC Chapter 37 (if VA) by 12 USC Section 1701 et seq (if HUDFHA) by 42 USC Section 1452b (if HUDCPD) and Title 42 USC 1471 et seq or 7 USC 1921 et seq (if USDA FHA)
Updated December 2021 99177-GA-0215
1b
2b
Form 4506-C (September 2020)
Department of the Treasury - Internal Revenue Service
IVES Request for Transcript of Tax Return OMB Number
1545-1872
Do not sign this form unless all applicable lines have been completed Request may be rejected if the form is incomplete or illegible
For more information about Form 4506-C visit wwwirsgov and search IVES
1a Name shown on tax return (if a joint return enter the name shown first)
First social security number on tax return individual taxpayer identification number or employer identification number (see instructions)
2a If a joint return enter spousersquos name shown on tax return Second social security number or individual taxpayer identification number if joint tax return
3 Current name address (including apt room or suite no) city state and ZIP code (see instructions)
4 Previous address shown on the last return filed if different from line 3 (see instructions)
5a IVES participant name address and SOR mailbox ID
DataVerify 875 Greentree Rd 8 Parkway Center Pittsburgh PA 15220
5b Customer file number (if applicable) (see instructions)
Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing (see instructions)
6 Transcript requested Enter the tax form number here (1040 1065 1120 etc) and check the appropriate box below Enter only one tax form number per request 1040
a Return Transcript which includes most of the line items of a tax return as filed with the IRS A tax return transcript does not reflect changes made to the account after the return is processed Transcripts are only available for the following returns Form 1040 series Form 1065 Form 1120 Form 1120-A Form 1120-H Form 1120-L and Form 1120S Return transcripts are available for the current year and returns processed during the prior 3 processing years
b Account Transcript which contains information on the financial status of the account such as payments made on the account penalty assessments and adjustments made by you or the IRS after the return was filed Return information is limited to items such as tax liability and estimated tax payments Account transcripts are available for most returns
c Record of Account which provides the most detailed information as it is a combination of the Return Transcript and the Account Transcript Available for current year and 3 prior tax years
7 Form W-2 Form 1099 series Form 1098 series or Form 5498 series transcript The IRS can provide a transcript that includes data from these information returns State or local information is not included with the Form W-2 information The IRS may be able to provide this transcript information for up to 10 years Information for the current year is generally not available until the year after it is filed with the IRS For example W-2 information for 2016 filed in 2017 will likely not be available from the IRS until 2018 If you need W-2 information for retirement purposes you should contact the Social Security Administration at 1-800-772-1213
Caution If you need a copy of Form W-2 or Form 1099 you should first contact the payer To get a copy of the Form W-2 or Form 1099 filed with your return you must use Form 4506 and request a copy of your return which includes all attachments
8 Year or period requested Enter the ending date of the tax year or period using the mmddyyyy format (see instructions)
12 31 2020 12 31 2019 12 31 2018 Caution Do not sign this form unless all applicable lines have been completed
Signature of taxpayer(s) I declare that I am either the taxpayer whose name is shown on line 1a or 2a or a person authorized to obtain the tax information requested If the request applies to a joint return at least one spouse must sign If signed by a corporate officer 1 percent or more shareholder partner managing member guardian tax matters partner executor receiver administrator trustee or party other than the taxpayer I certify that I have the authority to execute Form 4506-C on behalf of the taxpayer Note This form must be received by IRS within 120 days of the signature date
Signatory attests that heshe has read the attestation clause and upon so reading declares that heshe has the authority to sign the Form 4506-C See instructions
Sign Here
Signature (see instructions) Date Phone number of taxpayer on line 1a or 2a
PrintType name
Title (if line 1a above is a corporation partnership estate or trust)
Spousersquos signature Date
PrintType name
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020) For Privacy Act and Paperwork Reduction Act Notice see page 2
Instructions for Form 4506-C IVES Request for Transcript of Tax Return
Section references are to the Internal Revenue Code unless otherwise noted
Future Developments
For the latest information about Form 4506-C and its instructions go to wwwirsgov and search IVES Information about any recent developments affecting Form 4506-C (such as legislation enacted after we released it) will be posted on that page
Whats New Form 4506-C was created to be utilized by authorized IVES participants to order tax transcripts with the consent of the taxpayer
General Instructions
Caution Do not sign this form unless all applicable lines have been completed
Designated Recipient Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information received pursuant to the taxpayerrsquos consent and holds the recipient subject to penalties for any unauthorized access other use or redisclosure without the taxpayerrsquos express permission or request
Taxpayer Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information provided pursuant to your consent and holds the recipient subject to penalties brought by private right of action for any unauthorized access other use or redisclosure without your express permission or request
Purpose of form Use Form 4506-C to request tax return information through an authorized IVES participant You will designate an IVES participant to receive the information on line 5a
Note If you are unsure of which type of transcript you need check with the party requesting your tax information
Where to file The IVES participant will fax Form 4506-C with the approved IVES cover sheet to their assigned Service Center
Chart for ordering transcripts
If your assigned Service Center is
Fax the requests with the approved coversheet to
Austin Submission Processing Center
Austin IVES Team
844-249-6238
Fresno Submission Processing Center
Fresno IVES Team
844-249-6239
Kansas City Submission Processing Center
Kansas City IVES Team
844-249-8128
Ogden Submission Processing Center
Ogden IVES Team
844-249-8129
Specific Instructions
Line 1b Enter the social security number (SSN) or individual taxpayer identification number (ITIN) for the individual listed on line 1a or enter the employer identification number (EIN) for the business listed on line 1a
Line 3 Enter your current address If you use a PO box include it on this line
Line 4 Enter the address shown on the last return filed if different from the address entered on line 3
Note If the addresses on lines 3 and 4 are different and you have not changed your address with the IRS file Form 8822 Change of Address or Form 8822-BChange of Address or Responsible Party mdash Business with Form 4506-C
Line 5b Enter up to 10 numeric characters to create a unique customer file number that will appear on the transcript The customer file number cannot contain an SSN ITIN or EIN Completion of this line is not required
Note If you use an SSN name or combination of both we will not input the information and the customer file number will reflect a generic entry of 9999999999 on the transcript
Line 8 Enter the end date of the tax year or period requested in mmddyyyy format This may be a calendar year fiscal year or quarter Enter each quarter requested for quarterly returns Example Enter 12312018 for a calendar year 2018 Form 1040 transcript
Signature and date Form 4506-C must be signed and dated by the taxpayer listed on line 1a or 2a The IRS must receive Form 4506-C within 120 days of the date signed by the taxpayer or it will be rejected Ensure that all applicable lines including lines 5a through 8 are completed before signing
You must check the box in the signature area to acknowledge you have the authority to sign and request the information The form will not be processed if unchecked
Individuals Transcripts listed on on line 6 may be furnished to either spouse if jointly filed Only one signature is required Sign Form 4506-C exactly as your name appeared on the original return If you changed your name also sign your current name
Corporations Generally Form 4506-C can be signed by
(1) an officer having legal authority to bind the corporation (2) any person designated by the board of directors or other governing body or (3) any officer or employee on written request by any principal officer and attested to by the secretary or other officer A bona fide shareholder of record owning 1 percent or more of the outstanding stock of the corporation may submit a Form 4506-C but must provide documentation to support the requesters right to receive the information
Partnerships Generally Form 4506-C can be signed by any person who was a member of the partnership during any part of the tax period requested on line 8
All others See section 6103(e) if the taxpayer has died is insolvent is a dissolved corporation or if a trustee guardian executor receiver or administrator is acting for the taxpayer
Note If you are Heir at law Next of kin or Beneficiary you must be able to establish a material interest in the estate or trust
Documentation For entities other than individuals you must attach the authorization document For example this could be the letter from the principal officer authorizing an employee of the corporation or the letters testamentary authorizing an individual to act for an estate
Signature by a representative A representative can sign Form 4506-C for a taxpayer only if the taxpayer has specifically delegated this authority to the representative on Form 2848 line 5 The representative must attach Form 2848 showing the delegation to sign Form 4506-C
Privacy Act and Paperwork Reduction Act Notice We ask for the information on this form to establish your right to gain access to the requested tax information under the Internal Revenue Code We need this information to properly identify the tax information and respond to your request You are not required to request any transcript if you do request a transcript sections 6103 and 6109 and their regulations require you to provide this information including your SSN or EIN If you do not provide this information we may not be able to process your request Providing false or fraudulent information may subject you to penalties
Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and cities states the District of Columbia and US commonwealths and possessions for use in administering their tax laws We may also disclose this information to other countries under a tax treaty to federal and state agencies to enforce federal nontax criminal laws or to federal law enforcement and intelligence agencies to combat terrorism
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law Generally tax returns and return information are confidential as required by section 6103
The time needed to complete and file Form 4506-C will vary depending on individual circumstances The estimated average time is
Learning about the law or the form 10 min Preparing the form 12 min Copying assembling and sending the form to the IRS 20 min
If you have comments concerning the accuracy of these time estimates or suggestions for making Form 4506-C simpler we would be happy to hear from you You can write to
Internal Revenue Service Tax Forms and Publications Division 1111 Constitution Ave NW IR-6526 Washington DC 20224
Do not send the form to this address Instead see Where to file on this page
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020)
Rev April 2021 CHASEO Facts What does Chase do with your personal information
Why Financial companies choose how they share your personal information Federal law gives consumers the right to limit some but not all sharing Federal law also requires us to tell you how we collect share and protect your personal information Please read this notice carefully to understand what we do
What The types of personal information we collect and share depend on the product or service you have with us This information can include bull Social Security number and income bull account balances and transaction history bull credit history and payment history
How All financial companies need to share customers personal information to run their everyday business In the section below we list the reasons financial companies can share their customers personal information the reasons Chase chooses to share and whether you can limit this sharing
Reasons we can share your personal information Does Chase share
Can you limit this sharing
For our everyday business purposes - such as to process your transactions maintain your account(s) respond to court orders and legal investigations or report to credit bureaus
Yes No
For our marketing purposes - to offer our products and services to you
Yes No
For joint marketing with other financial companies Yes No
For our affiliates everyday business purposes - information about your transactions and experiences
Yes No
For our affiliates everyday business purposes - information about your creditworthiness
Yes Yes
For our affiliates to market to you Yes Yes
For nonaffiliates to market to you Yes Yes
a
0
To limit our sharing
bull Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
bull Visit us online chasecomprivacypreferences
Please note If you are a new customer we can begin sharing your information 30 days from the date we sent this notice When you are no longer our customer we continue to share your information as described in this notice However you can contact us at any time to limit our sharing
Questions
Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
PAGE 2
Who we are
Who is providing this notice The US consumer financial companies within the JPMorgan Chase amp Co family including JPMorgan Chase Bank NA Chase Insurance Agency Inc and JP Morgan Securities LLC
What we do
How does Chase protect my To protect your personal information from unauthorized access and use we personal information use security measures that comply with federal law These measures include
computer safeguards and secured files and buildings We authorize our employees to get your information only when they need it to do their work and we require companies that work for us to protect your information
How does Chase collect my We collect your personal information for example when you personal information bull open an account or make deposits or withdrawals from your account
bull pay your bills or apply for a loan bull use your credit or debit card We also collect your personal information from others such as credit bureaus affiliates or other companies
Why cant I limit all sharing Federal law gives you the right to limit only bull sharing for affiliates everyday business purposes - information about your
creditworthiness bull affiliates from using your information to market to you bull sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing See below for more on your rights under state law
What happens when I limit sharing for an account I hold jointly with someone else
Your choices will apply to everyone on your account
Definitions
Affiliates Companies related by common ownership or control They can be financial and non financial companies bull Our affiliates include companies with a Chase or JP Morgan name and financial companies such asjP Morgan Securities LLC
Nonaffiliates Companies not related by common ownership or control They can be financial and non financial companies bull Nonaffiliates we share with can include companies such as retailers auto dealers auto makers and membership clubs
Joint marketing A formal agreement between nonaffiliated financial companies that together market financial products or services to you bull Our joint marketing partners include categories of companies such as insurance companies
Other important information
VT Accounts with a Vermont mailing address are automatically treated as if they have limited the sharing as described on page 1 For joint marketing we will only disclose your name contact information and information about your transactions
NV We are providing you this notice pursuant to Nevada law If you prefer not to receive marketing calls from us you may be placed on our Internal Do Not Call List by calling 1-800-945-9470 or by writing to us at PO Box 734007 Dallas TX 75373-4007
For more information contact us at the address above or email PrivacylnfoJPMChasecom with Nevada Annual Notice in the subject line You may also contact the Nevada Attorney Generals office Bureau of Consumer Protection Office of the Nevada Attorney General 555 E Washington St Suite 3900 Las Vegas NV 89101 telephone number 1-702-486-3132 email BCPINFOagstatenvus
CA Accounts with a California mailing address are automatically treated as if they have limited the sharing with nonaffiliates as described on page 1 CA residents are provided a CA notice for additional choices
CHASE O
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
The following disclosure is required by the USA PATRIOT Act
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 opens an account
What this means to you When you 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 drivers
license or other identifying documents
99177-PAT-0215
VETERAN STATEMENT When this loan was opened the US Department of Veterans Affairs (VA) used the veteran borrowerrsquos entitlement which is a set amount the VA promises to repay a lender if the borrower defaults on the mortgage An assumption will modify who is obligated to pay the existing mortgage loan but all loan termsmdashincluding the entitlementmdashwill remain the same If the veteran borrower is being removed from the loan the entitlement would remain with whoever is assuming the loan because the loan will continue to be serviced by the VA If the applicant is also a veteran and can substitute his or her entitlement for the current entitlement then the current borrowerrsquos entitlement can be released
Please review the following questions and answer as appropriate This form requires completion by both the applicant(s) and current borrower(s)
1 Applicant to Complete
Are you (the applicant) currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the reverse side)
Yes (If yes please provide the information requested below answer the question in section 3 and sign and date this form at the bottom of the reverse side)
Name of applicant(s) who answered ldquoyesrdquo to the above question
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Are you receiving VA disability benefts
Applicant
Yes
No
Co-Applicant
Yes
No
Are you entitled to receive VA disability benefts Yes No Yes No
Have you received VA disability benefts in the past Yes No Yes No
Are you a surviving spouse of a veteran who died on active duty or as the result of a service-related disability
Yes No Yes No
Do you have any VA loans Yes No Yes No
2 Current Borrower to Complete
Is the current borrowerco-borrower currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the page)
Yes (If yes please answer the question in section 3 and sign and date this form at the bottom of the page)
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
________________________________________________________________________________________________
3 Applicant and Current Borrower to Complete
If the answer to the questions in section 1 and 2 are both yes please answer the following question After yoursquove reviewed and completed this entire form please sign and date at the bottom
Applicant Current Borrower
Do you want to apply for a substitution of entitlement Yes Yes No No
In order to complete a substitution of entitlement the veteran applicant must have suffcient entitlement to substitute for that of the current borrower Contact the VA Offce of Jurisdiction for your area for more information Also before the veteran applicant can substitute entitlement on a VA loan heshe must certify that the property securing the loan will be occupied as hisher primary residence Both the applicantrsquos and current borrowerrsquos original certifcate of eligibility will be required If your sales contract is contingent upon the restoration of entitlement please contact your VA Offce of Jurisdiction for complete procedures Otherwise the substitution will be completed after the loan has been approved and closed
Date Applicant printed name Applicant signature
Date Applicant printed name Applicant signature
Date Current Borrower printed name Current Borrower signature
Date Current Borrower printed name Current Borrower signature
Forms completed by Mail Phone
For Chase use only
Interviewer signature Date
99177-VS-0215
- Assumption Application Package_41521-noscannedpages-update-4pdf
-
- 1 FM203 Cover Pagepdf
- 2 FM202 Mortgage Assumption Application Package pagepdf
- 3 The Documents Youll need to Send Uspdf
- 4 FM201 FAQpdf
- 5 FM142 CIWpdf
- 6 FM126 URLApdf
- 7 FM130 URLA Instpdf
-
- Blank Page
-
- 8 92900a Addednum to Loan Applicationpdf
- 9 FM462 Gen Authpdf
- 10 FM220 4506-Cpdf
- 11 FM153 Chase Federal Privacy Noticepdf
- 12 FM144 Info on Opening a New Accountpdf
- 13 FM152 Veteran Statementpdf
-
- Date
- Loan number
- Applicant name
- Phone1
- Loan number 1
- Loan number 2
- Other
- Other_2
- 1
- 2
- undefined_7
- Available hours
- Available hours_2
- undefined_8
- Available hours_3
- undefined_9
- Current address 1
- Neither
- Available hours_4
- Available hours_5
- undefined_10
- Available hours_6
- 1_2
- 2_2
- undefined_11
- Available hours_7
- Available hours_8
- undefined_12
- Available hours_9
- FHA Case No include any suffix
- Mortgagee Case No
- Mortgagee ID
- Sponsor ID
- Agent ID
- Name and Address of Sponsor Name and Address of Agent
- Borrowers Name Present Address include ZIP Code Property Address
- include name of subdivision lot block no ZIP Code
- Name of ThirdParty Originator
- NMLS ID of ThirdParty Originator
- s application
- ty Number
- ty Number_2
- Date Signed_2
- Date Mortgage Approved
- Date Approval Expires
- Printed Name
- Title 1
- DEs ID Number
- DEs ID Number_2
- Mortgagee
- Name of Mortgagees Representative
- Title of Mortgagees Representative
- Signature of the Mortgagees Representative
- Date_2
- Applicant names 1
- Applicant names 2
- Applicant names 3
- Loan number_2
- Date_3
- Applicant printed name
- Social Security number
- Date_4
- Applicant printed name_2
- Social Security number_2
- Date_5
- Applicant printed name_3
- Social Security number_3
- Date_6
- Applicant printed name_4
- Social Security number_4
- 1a Name shown on tax return if a joint return enter the name shown first
- 1b First social security number on tax return individual taxpayer identification number or employer identification number see instructions
- 2a If a joint return enter spouses name shown on tax return
- 2b Second social security number or individual taxpayer identification number if joint tax return
- 4 Previous address shown on the last return filed if different from line 3 see instructions
- 5a IVES participant name address and SOR mailbox ID
- Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing see instructions
- Signature see instructions
- Date_7
- Phone number of taxpayer on line 1a or 2a
- PrintType name
- Here
- Spouses signature
- Date_8
- PrintType name_2
- Name
- Date of birth
- Service number
- Name_2
- Date of birth_2
- Service number_2
- Date_9
- Applicant printed name_5
- Date_10
- Applicant printed name_6
- Date_11
- Current Borrower printed name
- Date_12
- Current Borrower printed name_2
- Date_13
- Text3
- Text10
- undefined_13
- Text15
- undefined_14
- undefined_15
- undefined_16
- undefined_17
- undefined_18
- undefined_19
- undefined_20
- undefined_21
- undefined_23
- Reason for assumption Off
- Requestors relationship to owners Off
- Check one Off
- Check one1 Off
- Day1
- Evening
- Cell phone
- Check one2 Off
- Check one3 Off
- Check one4 Off
- Check one5 Off
- Text2-1
- Text2-2
- Text2-3
- Text2-4
- Text2-5
- Text2-6
- Text3-1
- Text3-2
- Text3-3
- Text3-4
- Text3-6
- Text3-7
- Text3-8
- Text3-9
- Text3-10
- Text3-11
- Text3-12
- Text3-13
- Text3-14
- Text3-15
- Text3-16
- Text3-17
- Text3-18
- Text3-19
- Text3-20
- Text3-21
- Text3-22
- Text3-23
- Text3-24
- Text3-25
- Text3-26
- Text3-27
- Text3-28
- Text3-29
- Text3-30
- Text3-31
- Text3-32
- Text3-33
- Text3-34
- Text3-35
- Text3-36
- Text3-37
- Text3-38
- Text3-39
- Text3-40
- Text3-41
- Text3-42
- Text3-43
- Text3-44
- Text3-45
- Text3-46
- Text3-47
- Text3-48
- Text3-49
- Text3-50
- Text3-51
- Text3-52
- Text3-53
- Text3-5
- Text3-54
- Text3-55
- Text3-56
- Citizenship Off
- Type of credit Off
- Marital Status Off
- Housing Off
- Housing1 Off
- ownership Off
- DNA1 Off
- DNA2 Off
- DNA3 Off
- family Off
- BO Off
- Total
- Text31
- Text32
- Text33
- Text34
- Text35
- Text36
- Text37
- Text38
- Text39
- Text310
- Text311
- Text312
- Text313
- Text314
- Text315
- Text316
- Text317
- Text318
- Text319
- ownership1 Off
- Total1
- Total1-2
- Check Box4-1 Off
- Text320
- Text321
- Text322
- Text323
- Text324
- Text325
- Text326
- Text327
- Text328
- Text329
- Check Box4-2 Off
- Check Box4-3 Off
- Check Box4-4 Off
- Check Box4-8 Off
- Check Box4-9 Off
- Text330
- Text331
- Text332
- Text333
- Text334
- Text335
- Text1-1
- Text1-2
- Text1-3
- Text1-4
- Text1-5
- Text1-6
- Text1-7
- Text1-8
- Text1-9
- Text1-10
- Text1-11
- Text1-12
- Text1-13
- Text1-14
- Text1-15
- Text1-16
- Text1-17
- Text1-18
- Text1-19
- Text1-20
- Text1-21
- Text1-22
- Text1-23
- Text1-24
- Text1-25
- Text1-26
- Text1-27
- Text1-28
- Text1-29
- Text1-30
- Text1-31
- Text1-32
- Text1-33
- Text1-34
- Text1-35
- Check Box3-2 Off
- Check Box2-1 Off
- Check Box2-2 Off
- Check Box2-3 Off
- Check Box2-4 Off
- Check Box2-5 Off
- Text1-36
- Text1-37
- Text1-38
- Text1-39
- Text1-40
- Text1-41
- Text1-42
- Text1-43
- Text1-44
- Text1-45
- Text1-46
- Text1-47
- Text1-48
- Text1-49
- Text1-50
- Text1-51
- Text1-52
- Text1-53
- Text1-54
- Text1-55
- Text1-56
- Text1-57
- Text1-58
- Text1-59
- Text1-60
- Text1-61
- Check Box3-11 Off
- A1
- A2
- A3
- A4
- A5
- A6
- A7
- A8
- A9
- A10
- A11
- A12
- Check Box3-1 Off
- Check Box30-1 Off
- Check Box30-2 Off
- Check Box30-4 Off
- Check Box30-5 Off
- Check Box30-7 Off
- Check Box30-8 Off
- Check Box30-9 Off
- Check Box30-10 Off
- Check Box30-11 Off
- Check Box30-12 Off
- A13
- A14
- A15
- A16
- A17 Off
- A18
- A19
- A20
- A21
- A22
- A23
- A24
- A25
- A26
- A27
- A28
- A29
- A30
- A31
- A32
- A33
- A34
- A35
- A36
- A37
- A38 Off
- A39
- A40
- A41
- A42
- A43
- A44
- A45
- A46
- A47
- A48
- A49
- A50
- A51
- A52
- A53
- A54
- A55
- A56
- A57
- A58
- A59
- A60
- A61
- A62
- A63
- A64
- A65
- A66
- A67
- A68
- A69
- A70
- A71
- A72
- A73
- A74
- Loan Purpose Off
- occupancy1 Off
- lien type Off
- lientype Off
- mixed use Off
- manufactured home Off
- deposit1 Off
- deposit2 Off
- B1
- B2
- B3
- B4
- B5
- B6
- B7
- B8
- B9
- B10
- fha Off
- Check Box51 Off
- B11
- B12
- B13
- B14
- B15
- B16
- B17
- B18
- B19 Off
- B20
- B21
- B22 Off
- B23
- B24
- B25
- B26
- B27
- B28
- A
-
- Will you occupy the property as your primary residence Off
- Will you occupy the property as your primary residence1 Off
-
- If yes have you had an ownership interest in another property in the last three years Off
- Text9-2
- B
-
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property Off
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property1 Off
-
- 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 Off
- 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 application1 Off
-
- 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 Off
- 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 application1 Off
-
- new credit Off
- 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) Off
- the Property Assessed Clean Energy Program)1 Off
-
- F
-
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application Off
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application1 Off
-
- G
-
- Are there any outstanding judgments against you Off
- Are there any outstanding judgments against you1 Off
-
- H
-
- Are you currently delinquent or in default on a Federal debt Off
- Are you currently delinquent or in default on a Federal debt1 Off
-
- I
-
- Are you a party to a lawsuit in which you potentially have any personal financial liability Off
- Are you a party to a lawsuit in which you potentially have any personal financial liability1 Off
-
- J
-
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years Off
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years1 Off
-
- 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 Off
- 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 due1 Off
-
- L
-
- Have you had property foreclosed upon in the last 7 years Off
- Have you had property foreclosed upon in the last 7 years1 Off
-
- M
-
- Have you declared bankruptcy within the past 7 years Off
- Have you declared bankruptcy within the past 7 years1 Off
-
- Check Box8-2 Off
- Check Box8-3 Off
- Check Box8-4 Off
- Text9-3
- Text9-5
- Text9-6
- Text97
- military Off
- ethnicity Off
- sex Off
- race Off
- demo Off
- Text12-1
- Check Box11-1 Off
- Check Box11-2 Off
- Check Box11-3 Off
- Check Box11-4 Off
- Check Box11-5 Off
- Check Box11-6 Off
- Check Box11-7 Off
- Check Box11-8 Off
- Check Box11-9 Off
- Text12-2
- Check Box11-10 Off
- Check Box11-11 Off
- Check Box11-12 Off
- Check Box11-13 Off
- Check Box11-14 Off
- Check Box11-15 Off
- Text12-3
- Check Box11-16 Off
- Check Box11-17 Off
- Check Box11-18 Off
- Check Box11-19 Off
- Check Box11-20 Off
- Check Box11-21 Off
- Check Box11-22 Off
- Check Box11-23 Off
- Text12-4
- Check Box11-24 Off
- Check Box11-25 Off
- Check Box11-26 Off
- Check Box11-27 Off
- Check Box11-28 Off
- Check Box11-29 Off
- Text12-5
- Check Box11-30 Off
- Check Box11-31 Off
- citizen Off
- credit Off
- marital status1 Off
- housing-1 Off
- housing-2 Off
- own Off
- C1
- C2
- C3
- C6
- C7
- C8
- C9
- C10
- C11
- C12
- C13
- C14
- C15
- C16
- C17
- C18
- C19
- C20
- C21
- C22
- C23
- C24
- C25
- C26
- C27
- C28
- C29
- C30
- C31
- C32
- C33
- C34
- C35
- Check Box-2 Off
- C36
- C37
- C38
- C39
- C4
- C40
- C41
- C42
- C43
- C44
- C45
- C46
- C47
- Check Box-3 Off
- Check Box-4 Off
- C48
- C49
- C5
- C50
- C51
- C52
- C53
- C54
- C55
- Check Box-1-1 Off
- own1 Off
- Check Box-1 Off
- D1 Off
- D2
- D3
- D4
- D5
- D6
- D7
- D8
- D9
- D10
- D11
- D12
- D13
- D14 Off
- D15 Off
- D16
- D17
- D18
- D19
- D20
- D21
- D22
- D23
- D24 Off
- D25
- D26
- D27
- D28
- D29
- D30
- D31
- D32
- D33
- D34
- D35 Off
- D36
- D37 Off
- D38
- D39
- D40
- D41
- D42
- D43
- D44
- D45
- D46
- D47
- If yes have you had an ownership interest in another property in the last three years1 Off
- new credit1 Off
- Check Box8-1 Off
- Check Box8-1-2 Off
- Check Box8-1-1 Off
- Check Box8-1-3 Off
- Check Box8-1-4 Off
- Military Service mdash Did you (or your deceased spouse) ever serve or are you currently serving in the United States Armed Forces 1 Off
- Check1 Off
- Text9-1-1
- Check2 Off
- Check3 Off
- Check4 Off
- Text9-1
- E1
- E2
- E3
- Was the ethnicity of the Borrower collected on the basis of visual observation or surname1 Off
- Was the sex of the Borrower collected on the basis of visual observation or surname1 Off
- Was the race of the Borrower collected on the basis of visual observation or surname1 Off
- The Demographic Information was provided through1 Off
- F1 Off
- F2 Off
- F3 Off
- F4 Off
- F5 Off
- F6
- F7 Off
- F8 Off
- F9 Off
- F10 Off
- F11 Off
- F12 Off
- F13
- F14 Off
- F15 Off
- F16 Off
- F17 Off
- F18 Off
- F19 Off
- F20 Off
- F21 Off
- F22
- F23 Off
- F24 Off
- F25 Off
- F26 Off
- F27 Off
- F28 Off
- F29
- F30 Off
- F31 Off
- undefined_13-1
- undefined_13-2
- undefined_14-1
- undefined_15-1
- undefined_16-1
- undefined_17-1
- undefined_18-1
- undefined_19-1
- undefined_21-1
- undefined_20-1
- undefined_23-1
- undefined_13_1
- Single-Two Off
- Refi type Off
- refi program Off
- Estate Off
- Title held Off
- Trust Information Off
- Indian Country Land Tenure Off
- Mortgage Type Applied For Off
- Mortgage Lien Type Off
- Amortization Type Off
- G1 Off
- G2 Off
- G3 Off
- G4 Off
- G5 Off
- G6
- G7
- G8
- G9
- G10 Off
- G11 Off
- G12 Off
- G13 Off
- G14 Off
- G15 Off
- G16
- G17
- G18
- G19
- G20
- G21
- G22
- G23 Off
- G24
- G25 Off
- G26
- G27 Off
- G28 Off
- G29
- G30 Off
- G31
- G32 Off
- G33
- G34
- G35
- G36
- G37
- G38
- G39
- G40
- G41
- G42
- Property Held
- refi
- Text18-1
- Text18-2
- Text18-3
- Text18-4
- Text18-5
- Text18-6
- Text18-7
- Text18-8
- Text18-9
- Text18-10
- Text18-11
- Text18-12
- Text18-13
- Text18-14
- Text18-15
- Text18-16
- Text18-17
- Text18-18
- Text18-19
- Lender
- case no
- If you selected ldquoUnmarriedrdquo in Section 1 is there a person who is not your legal spouse but who currently has real property rights similar to those of a legal spouse Off
- Relationship and State Off
- Other-5
- Text19-1
- BName
- Additional Information
- ABN
- Additional Information1
- BSign
- BSDate
- ABSign
- ABDate
- MortageeNameAddress
- NAmeAddress
- Bname1
- DOB1
- DOB2
- SignOfBorr1
- SignOfBorr
- Date Signed
- SignOfBorr2
- SignOfBorr3
- Date Signed3
- Date Signed4
- MortgageeRepSign
- DirectSign
- DirectSign1
- Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union Off
- AppSign
- AppSign1
- AppSign2
- AppSign3
- Nopage38 Off
- Yespage38 Off
- Yes1 Off
- No1 Off
- Yes2 Off
- Yes3 Off
- Yes4 Off
- Yes5 Off
- Yes6 Off
- Yes7 Off
- Yes8 Off
- Yes9 Off
- Yes10 Off
- No2 Off
- No3 Off
- No4 Off
- No5 Off
- No6 Off
- No7 Off
- No8 Off
- No9 Off
- No10 Off
- BorrowerNo Off
- BorrowerYes Off
- AppSignature
- AppSignature1
- CurrentSign
- CurrentSign1
- InterviewSign
- Yes_1 Off
- No_1 Off
- Yes_2 Off
- No_2 Off
- Mail Off
- Phone Off
Section 5 DeclarationsThis section asks youspecific questions about the property your funding and yourpastfinancial history
5aAboutthis Property and Your Moneyfor this Loan
A Will you occupy the property as your primary residence
If YES have you had an ownershipinterest 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 investmentproperty(IP)
(2) How did you holdtitle to the property by yourself (S) jointly with your spouse(SP) or jointly with another person (O)
YESYES
B If this is a Purchase Transaction Do you have a family relationship or businessaffiliation with the seller of the property NO YES
C Are you borrowing any moneyforthis real estate transaction (eg money foryour closing costs or down payment) orobtaining any moneyfrom anotherparty such astheseller or realtor that you have notdisclosed on this loan application NO YES
If YES what is the amountof this money $
D 1 Have you orwill you be applying for a mortgage loan on anotherproperty (not the property securing this loan) on or
before closing this transaction that is not disclosed on this loan application
NO YES
2 Have you orwill you be applying for any newcredit (eg installment loan credit card etc) on or before closing this loan that
is not disclosed on this application
No YES
E Will this property be subject to a lien that could take priority over the first mortgagelien such as a clean energylien paid
through yourproperty taxes(eg the PropertyAssessed Clean Energy Program)NO YES
5b About YourFinances
F Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application NO YES
G Are there any outstanding judgments against you No YES
H Areyou currently delinquentor in default on a Federal debt No YES
I Areyou a party to a lawsuit in which you potentially have any personalfinancialliability NO YES
J Have you conveyedtitle to any property in lieu of foreclosure in the past 7 years NO YES
K Within the past 7 years have you completed a pre-foreclosure sale or short sale whereby the property wassold to a
third party and the Lenderagreed to acceptless than the outstanding mortgage balance due
NO YES
L Have you hadproperty foreclosed uponin thelast 7 years NO YES
M Have you declared bankruptcy within the past 7 years ONO YESIf YES identify the type(s) of bankruptcy Chapter7 Chapter11 Chapter12 Chapter 13
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 6 Acknowledgments and AgreementsThis section tells you about yourlegal obligations whenyousign this application
Acknowledgments and Agreements
Definitions- Lenderincludes the Lenderrsquos agents service providers and any oftheir successors andassigns
Other Loan Participantsrdquo includes(i) any actual or potential owners of
a loan resulting from this application (the ldquoLoanrsquo)(ii) acquirers ofany beneficial or other interest in the Loan(iii) any mortgageinsurer(iv) any guarantor (v) any servicer of the Loan and (vi) any of theseparties service providers successors or assigns
I agree to acknowledgeand representthe following
(1) The Complete Informationfor this Application- The information | have providedin this application is true accurate
and completeas of the date | signed this application
laquo If the information | submitted changesor | have new information
before closing of the Loan | must change and supplementthis
application including providing any updatedsupplementedrealestate sales contract
- For purchase transactions The terms and conditionsof anyrealestate sales contract signed by mein connection with this application
are true accurate and complete to the best of my knowledge andbelief | have not entered into any other agreement written ororal inconnection withthis real estate transaction
- The Lender and OtherLoan Participants mayrely on the informationcontainedin the application before and after closing of the Loan
- Any intentional or negligent misrepresentation of information may
result in the impositionof(a) civil liability on me including monetary damagesif a
person suffers any loss because the person relied on anymisrepresentation that | have made onthis application andor
(b) criminal penalties on me including but not limited to fine orimprisonment or both underthe provisions of Federal law(18 USC sectsect 1001 et seq)
(2) The Propertyrsquos SecurityThe Loan | have applied for in this application will be secured by
a mortgage or deedoftrust which provides the Lendera security
interest in the property described in this application
(3) The Propertys Appraisal Value and Condition- Any appraisal or value of the property obtained by the Lenderis
for use by the Lender and OtherLoanParticipantslaquoThe Lender and OtherLoan Participants have not made anyrepresentation or warranty express or implied to me about the
propertyits conditionorits value
(4) Electronic Records and Signatures- The Lender and OtherLoan Participants may keep any paper record
andorelectronic record of this application whether or not the Loan
is approved
BorrowerSignature
- If this application is created as (or converted into) an ldquoelectronicapplicationrdquo | consent to the use of ldquoelectronic recordsrdquo and
ldquoelectronic signaturesrdquo as the termsare defined in and governed byapplicable Federal andorstate electronic transactions laws
| intend to sign and have signedthis application either using my(a) electronic signature or(b) a written signature and agreethatif a paper version ofthis
application is converted into an electronic application theapplication will be an electronic record and the representationof my written signature on this application will be my binding
electronic signature- | agree that the applicationif delivered or transmitted to the Lenderor Other Loan Participants as an electronic record with myelectronicsignaturewill be as effective and enforceable as a paperapplicationsigned by mein writing
(5) Delinquencylaquo The Lender and OtherLoan Participants may report information about
my accountto credit bureaus Late payments missed paymentsorother defaults on my account maybereflected in my credit report andwill likely affect my credit score
- If | have trouble making my payments | understand that | may contacta HUD-approved housing counseling organization for advice about
actions I can take to meet my mortgageobligations
(6) Authorization for Use and Sharing of InformationBy signing belowin addition to the representations and agreementsmade above| expressly authorize the Lender and Other LoanParticipants to obtain use and share with each other(i) the loan
application and related loan information and documentation(ii) aconsumercredit report on me and(iii) my tax return information asnecessary to perform theactionslisted belowfor so long as they havean interest in my loanorits servicing
(a) process and underwrite myloan(b) verify any data contained in my consumercredit 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 analysisandreviews
(e) perform analysis and modeling for risk assessments(f) monitor the accountfor this loan for potential delinquencies and
determineanyassistance that may beavailable to me and
(g) other actions permissible under applicable law
Date (mmddyyyy)
Additional Borrower Signature Date (mmddyyyy)
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 7 Military ServiceThis section asks questions about your(or your deceased spouses) military service
Military Service of Borrower
Military Service mdash Did you (or your deceased spouse) everserve or are you currently serving in the United States Armed Forces NO YES
If YES check allthat apply Currently serving on active duty with projected expiration date of servicetour (mmddyyyy)
Currently retired discharged or separated from service
Only period of service was as a non-activated memberof the Reserve or National GuardSurviving spouse
Section 8 Demographic InformationThis section asks about your ethnicity sex and race
Demographic Information of Borrower
The purposeofcollecting this informationis to help ensure thatall applicants are treated fairly and that the housing needs of communities
and neighborhoodsare beingfulfilled 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 mayselect one or more designationsfor
Ethnicity and one or more designationsfor Race The law provides that we maynotdiscriminate on the basis of this information or onwhetheryou chooseto provideit However if you choose not to provide the information and you have madethis application in person Federal
regulations require us to note your ethnicity sex and race on thebasis of visual observation or surname Thelaw also provides that we may notdiscriminate on the basis of age or marital status information you providein this application If you do not wish to provide someorall of this
information please check below
Ethnicity Check one or more Race Check one or moreHispanic or Latino AmericanIndian or Alaska Native - Print nameofenrolled
or principaltribe Mexican PuertoRican CubanOther Hispanic or Latino - Print origin Asian
Asian Indian Chinese Filipino
Japanese Korean Vietnamese
OtherAsian mdash Print race
For example Hmong Laotian Thai Pakistani Cambodian and so on
Black or African American
Native Hawaiian or OtherPacific Islander
Native Hawaiian GuamanianorChamorro Samoan
For exampleArgentinean Colombian Dominican Nicaraguan
Salvadoran Spaniard andso on
Not Hispanic or Latino
| do not wish to providethis information
5Female OtherPacific Islander mdash Print race
Male For example Fijian Tongan and so on| do not wish to providethis information white
| do not wish to providethis information
Wasthe ethnicity of the Borrowercollected on the basis of visual observation or surname )NO YESWasthe sex of the Borrowercollected on the basis of visual observation or surname NO YESWastherace of the Borrowercollected on the basis of visual observation or surname NO YES
Face-to-Face Interview (includes Electronic Media w Video Component) TelephoneInterview Faxor Mail Email or Internet
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
ReelTemCrCL
Loan Originator Organization Name
Address
Loan Originator Organization NMLSR ID State License ID
Loan Originator Name
Loan Originator NMLSR ID State License ID
Date (mmddyyyy)
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Uniform Residential Loan Application mdash Additional BorrowerVerify and complete the information onthis application as directed by your Lender
Section 1 Borrower Informationthis section asks about yourpersonal information and your income fromemploymentandother sources such as retirement that you want considered to qualify for this loan
1a Personal Information
Name(First Middle Last Suffix)
Alternate Names - List any namesby which you are known or any namesunder which credit was previously received (First Middle Last Suffix)
Social Security Number - -(or Individual TaxpayerIdentification Number)
Dateof Birth Citizenship(mmddyyyy)
USCitizenPermanentResidentAlienNon-Permanent ResidentAlien
Type ofCredit| am applying for individualcredit
lam applying forjoint credit Total Number of Borrowers
Each Borrowerintendsto applyfor joint credit Your initials
List Name(s) of Other Borrower(s) Applying for this Loan
(First Middle Last Suffix) - Use a separator between names
Marital Status Dependents(notlisted by another Borrower)
Contact Information
Married Number _ Home Phone ( ) -
( ) _
( ) -mdash_ mdash_
Separated Ages CellPhone
Unmarried ens Work Phone Ext(Single Divorced WidowedCivil Union Domestic Partnership Registered
Reciprocal Beneficiary Relationship)lsquol
Emal
Current Address
Street Unit
City State ZIP Country
How Long at Current Address=Years mdashMonths Housing Noprimary housing expense Own Rent($ month)
If at Current Address for LESS than 2 yearslist Former Address Does not apply
Street Unit
City State ZIP Country
How Long at Former Address Years mdashMonths Housing Noprimary housing expense Own month)
Mailing Address- ifdifferent from CurrentAddress Does not apply
Street Unit
City State ZIP Country
eeeeCeeteiChuraleCme Doesnot apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base S$month
City State ZIP Country Overtime =$_____monthBonus $ month
Position orTitle Checkif this statementapplies Commission sect month| am employedby a family memberpropertyseller real estate agent or otherparty to the transaction
TTStart Date ____ (mmddyy) Military
Entitlements$_How longin this line of work Years =Months mdash monthSS
Other $ monthCheckif you are the BusinessOwnerorSelf-Employed
| have an ownershipshare ofless than 25 Monthly Income(or Loss) mdashmdash| have an ownership share of 25 or more $ TOTAL $ 000month
Uniform Residential Loan Application mdash Additional Borrower
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
CoeeeMCMCmeticlm tu)Comiteteilteeilelie mieit
Does not apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base
OvertimeBonus
Commission
MilitaryEntitlements
Other
$ month
$ month$ month
$ month
$ month
$ month
City State ZIP Country
Position orTitle ose if this statement applieslam employed by a family memberpropertyseller real estate agent or otherparty to the transaction
Start Date (mmddyy)How long in this line of work Years =Months
Checkif you are the Business
Owneror Self-Employed| have an ownershipshare of less than 25 Monthly Income(or Loss)
Ihave an ownership share of 25 or more $ TOTAL$ 000month
CPONMeeeMummaTestetiersdeere lire miret Does not apply
Provideat least 2 years of current and previous employment and income
Employeror Business Name Previous Gross MonthlyStreet Unit Income s month
City State ZIP Country
Position or Title
Start Date
End Date
Checkif you were the BusinessOwneror Self-Employed
(mmddyyyy)
(mmddyyyy) 1e Income from Other Sources Does not apply
Include incomefrom other sources below Under Income Source choose from the sourceslisted herelaquo Alimonylaquo Automobile Allowanceraquo Boarder Incomelaquo Capital Gains
Child Support+ Disability+ Foster Care Housing or Parsonage
+ Interest and DividendslaquoMortgage Credit Certificate Mortgage DifferentialPayments
laquo Notes Receivable+ Public Assistancelaquo Retirement(eg Pension IRA)
+raquo Royalty Payments Separate Maintenance
+ Social Security
raquo Trust
+ UnemploymentBenefits
laquo VA Compensation
laquo Other
NOTE Revealalimony child support separate maintenance or other income ONLYIFyou wantit considered in determining yourqualification
for this loan
Income Source - uselist above Monthly Income
$
$
$
$ 000Provide TOTAL AmountHere|
Section 2 Financial Information mdash Assets andLiabilities
Myinformation for Section 2 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 3 Financial Information mdash Real Estate
Myinformation for Section 3 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 4 Loan and Property Information
Myinformation for Section 4 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 5 DeclarationsThis section asks you specific questions about the property your funding and your past
financial history
5aAboutthis Property and Your Moneyforthis Loan
A Will you occupy the property as your primary residence NO YES
If YES have you had an ownershipinterest in another property in the last three years NO YES
If YES complete (1) and (2) below
(1)What type of property did you ownprimary residence (PR) FHA secondary residence (SR) second home(SH)
or investmentproperty (IP)
(2) How did you holdtitle to the property by yourself (S) jointly with your spouse(SP) or jointly with another person (O)
B If this is a Purchase Transaction Do you have a family relationship or businessaffiliation with the seller of the property NO YES Cc Are you borrowing any moneyforthis real estate transaction (eg money foryour closing costs or down payment) or
obtaining any moneyfrom anotherparty suchastheselleror realtor that you have not disclosed on this loan application NO YES
If YES whatis the amountof this money $
D 1 Have youorwill you be applying for a mortgage loan on anotherproperty (not the property securing this loan) on orbefore closing this transaction that is not disclosed on this loan application
NO YES
2 Have you orwill you be applying for any newcredit (eg installment loan credit card etc) on or before closing this loan that wsis not disclosed on this application
NO YES
E Will this property be subject to a lien that could take priority over thefirst mortgagelien such as a clean energylien paid
through yourproperty taxes(eg the PropertyAssessed Clean Energy Program)No YES
EK) Veli ellim ait
F Areyou a co-signer or guarantor on any debtor loan thatis not disclosed on this application NO ES
G Are there any outstanding judgments against you NO YES
H Are you currently delinquentor in default on a Federal debt NO YES
I Are you a party to a lawsuit in which you potentially have any personalfinancialliability NO YES
J Have you conveyedtitle to any property in lieu of foreclosure in the past 7 years NO YES
K Within the past 7 years have you completed a pre-foreclosure sale or short sale whereby the property wassold to a
third party and the Lender agreed to acceptless than the outstanding mortgage balance due
No YES
L Have you had property foreclosed uponin thelast 7 years NO YES
M Have you declared bankruptcy within the past 7 years no vESIf YES identify the type(s) of bankruptcy Chapter 7 Chapter11 Chapter12 Chapter 13
Section 6 Acknowledgements and AgreementsMy signature for Section 6 is on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 7 Military Service This section asks questions about your(or your deceased spouses) military service
Military Service of Borrower
Military Service mdash Did you (or your deceased spouse)everserve or are you currently serving in the United States Armed Forces NO YES
IfYES check allthat apply Currently serving on active duty with projected expiration date of servicetour (mmddyyyy)
Currently retired discharged or separated from service nnOnly period of service was as a non-activated memberofthe Reserve or National GuardSurviving spouse
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 8 Demographic InformationThis section asks about your ethnicity sex and race
Demographic Information of Borrower
The purposeofcollecting this information is to help ensure thatall applicants are treated fairly and that the housing needs of communities
and neighborhoodsare beingfulfilled 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 providethis information but are encouraged to do so You mayselect one or more designationsfor
Ethnicity and one or more designationsfor Race The law provides that we maynotdiscriminate onthe basis of this information or onwhetheryou chooseto provideit However if you choose notto provide the information and you have madethis application in person Federal
regulations require us to note yourethnicity sex and race on the basis of visual observation or surname The law also provides that we may notdiscriminate on the basis of age or marital status information you providein this application If you do not wish to provide someorall of this
information please check below
Ethnicity Check one or more Race Check one or moreHispanic or Latino AmericanIndian or Alaska Native - Print nameofenrolled
or principaltribeMexican PuertoRican Cuban
OtherHispanic or Latino - Printorigin siansian Indian Chinese Filipino
For exampleArgentinean Colombian Dominican NicaraguanSalvadoran Spaniard andso on
Japanese Korean VietnameseOtherAsian - Print race Forexample Hmong Laotian Thai Pakistani Cambodian andso on
Black or African American
Native Hawaiian or OtherPacific Islander
Native Hawaiian GuamanianorChamorro Samoan
OtherPacific Islander mdash Print race
Not Hispanic or Latino
| do not wish to providethis information
Sex
Female
Male
| do not wish to providethis informationFor example Fijian Tongan and so on
White
| do not wish to providethis information
Wasthe ethnicity of the Borrowercollected on thebasis of visual observation or surnameWasthesex of the Borrowercollected on the basis of visual observation or surnameWastherace of the Borrowercollected on the basis of visual observation or surname
)NO YESNO YESNO YES
Face-to-Face Interview (includes Electronic Media w Video Component) Telephone Interview Faxor Mail Email or Internet
Loan Originator Organization Name
Address
Loan Originator Organization NMLSR ID State License ID
Loan Originator Name
Loan Originator NMLSR ID State License ID
Email Phone (
Signature Date (mmddyyyy)
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Pe)aae-emeet)
Community Property State
At least one borrowerlives in a community propertystateThe property is in a community property state
Transaction DetailConversion of Contract for Deed or Land ContractRenovationConstruction-ConversionConstruction-to-Permanent
Single-Closing Two-ClosingConstructionImprovementCosts $
LotAcquired Date
Original Cost of Lot $(mmddyyyy)
Refinance Program
Full DocumentationInterest Rate ReductionStreamlined without Appraisal
Other
Refinance Type
NoCash OutLimited Cash OutCash Out
Energy Improvement
Mortgageloanwill finance energy-related improvements
Propertyis currently subject to a lien that could take priority ovethe first mortgagelien such as a clean energylien paid for througproperty taxes(eg the PropertyAssessed Clean Energyprogram)
Project Type Condominium Cooperative Planned Unit Development (PUD) Propertyis notlocatedin a project
Peiwlivcestetece)a)
Title to the Property Will be Held in What Name(s)
For RefinanceTitle to the Property is Currently Held in What Name(s
Trust Information
tle Will be Held byan Inter Vivos (Living) Trust
Title Will be Held by a Land TrustLeasehold Expiration Date
Mannerin WhichTitle Will be Held Indian Country Land Tenure
Sole OwnershipLife EstateTenancy in Common
Joint Tenancywith Right of Survivorship]Tenancybythe EntiretyOther
Fee Simple Ona ReservationIndividualTrust Land (AllottedRestricted)Tribal Trust Land On a ReservationTribal Trust Land Off ReservationAlaska Native Corporation Land
Estate Will be Held in
Fee Simple(mmddyyyy)
3 Mortgage LoanInformation
Termsof Loan
Note Rate
Loan Term (months)
MortgageLien Type
First LienSubordinate Lien
Mortgage Type Applied For
Conventional USDA-RDFHA VA Other
Amortization Type
Fixed RateAdjustable Rate
If Adjustable Rate
Initial Period Prior to First Adjustment
Subsequent AdjustmentPeriod
Proposed Monthly Paymentfor Property
First Mortgage (P amp I) $
Subordinate Lien(s) (P amp |) $
Other(explain)
Homeowners Insurance $(months)
(months)
Loan Features Property Taxes $
Balloon Balloon Term (months)
Interest Only Interest OnlyTermNegative AmortizationPrepaymentPenalty Prepayment Penalty Term (months) Other
Temporary Interest Rate BuydownInitial Buydown Rate TOTALOther(explain)
Mortgage Insurance $
AssociationProject Dues (Condo Co-Op PUD) $
Supplemental Property Insurance $
(months)
Borrower Name(s)Uniform Residential Loan Application mdash LenderLoan Information
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
L4 Qualifying the Borrower - Minimum Required Funds or Cash Back
DUEFROM BORROWER(S)
A Sales Contract Price
B Improvements Renovations and Repairs
C Land(ifacquired separately)
D For Refinance Balance of Mortgage Loanson the Propertyto be paid off in the Transaction
(See Table 3a Property You Own)
E Credit Cards and Other Debts Paid Off
(See Table 2c Liabilities mdash Credit Cards Other Debts and Leases that You Owe)
F BorrowerClosing Costs (including Prepaid andInitial Escrow Payments)
G Discount Points
HTOTAL DUE FROM BORROWER(s)(Total of A thru G)
TOTALMORTGAGE LOANS
Loan Amount
Loan AmountExcluding Financed Mortgage Insurance (or Mortgage Insurance Equivalent) $
Financed Mortgage Insurance (or Mortgage Insurance Equivalent) Amount $
Other New Mortgage Loanson the Property the Borrower(s) is Buying or Refinancing(See Table 4b Other New MortgageLoanson the Property You are Buying or Refinancing)
KTOTAL MORTGAGELOANS(Totalof| and J)
TOTALCREDITS
L Seller Credits (Enter the amountofBorrower(s) costs paid by the property seller)
MOtherCredits (Enter the sum ofall other credits mdash BorrowerPaid Fees Earnest Money EmployerAssistedHousing Lease Purchase Fund Lot Equity Relocation Funds Sweat Equity Trade Equity Other)
NTOTAL CREDITS(Total of L and M)
CALCULATION
TOTAL DUE FROM BORROWER(s)(Line H)
LESSTOTAL MORTGAGELOANS(Line K) AND TOTAL CREDITS(Line N)
Cash FromTothe Borrower(Line H minusLine K and Line N)NOTE This amountdoesnotinclude reservesor other funds that may be required by the Lenderto be verified
Borrower Name(s)Uniform Residential Loan Application mdash LenderLoan Information
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
Uniform Residential Loan Application mdash Unmarried Addendum
eeCeceetatimC elitleeComeLy
Lenders Instructions for Using the Unmarried Addendum
The Lender may use the Unmarried Addendum only when a Borrowerselected ldquoUnmarriedrdquoin Section 1 and the information collected is
necessary to determine howState property lawsdirectly or indirectly affecting creditworthiness apply including ensuring clear title
For example the Lender may use the Unmarried Addendum whentheBorrowerresides in a State that recognizescivil unions domestic
partnerships or registered reciprocal beneficiary relationships or when the property is located in such a State ldquoStaterdquo meansanystate the
District of Columbia the Commonwealth of Puerto Rico or anyterritory or possession of the United States
Ifyou selected ldquoUnmarriedrdquoin Section 1 is there a person whois not your legal spouse but whocurrently has real property rights similar to
those of a legal spouse +=) NOQ YES
If YES indicate the type of relationship and the State in which the relationship was formed For example indicate if you are in a
civil union domestic partnership registered reciprocal beneficiary relationship or other relationship recognized by the State in which you
currently reside or where the property is located
O Civil Union copy Domestic Partnership copy Registered Reciprocal Beneficiary Relationship copy) Other(explain)
Statea]
Borrower NameUniform Residential Loan Application mdash Unmarried Addendum
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Uniform Residential Loan Application mdash Continuation Sheet
Use this continuation sheet if you need more space to complete the Uniform Residential Loan Application
Borrower Name(First Middle Last Suffix )
Additional Information
Additional Borrower Name(First Middle Last Suffix )
Additional Information
IWefully understand thatit is a federal crime punishable by fine or imprisonment or both to knowingly make anyfalse statements concerningany of the abovefacts as applicable underthe provisions of federal law (18 USC sectsect 1001 et seq)
BorrowerSignature Date (mmddyyyy)
Additional Borrower Signature Date (mmddyyyy)
Uniform Residential Loan Application mdash Continuation SheetFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
INSTRUCTIONS FOR COMPLETING THE UNIFORM RESIDENTIAL LOAN APPLICATION
Use the instructions below to complete the enclosed Uniform Residential Loan Application (Freddie Mac Form 65Fannie Mae Form 1003) To avoid any delays in your application review please provide all of the requested information
If you need to make a correction on the application draw a line through the incorrect text and mark your initials beside the change Donrsquot use correction tape or fluid The application must be completed signed and dated in ink
The Uniform Residential Loan Application (URLA)
The URLA contains the following sections Section 1 Borrower Information Please provide your personal information income and employment
Section 2 Financial Information ndash Assets and Liabilities Please provide information about your financial assets personal financial obligations and debts you owe
Section 3 Financial Information ndash Real Estate Please provide information about property you own and the debts and expenses related to the property
Section 4 Loan and Property Information Please provide information about the loan purpose and the property you are buying or refinancing
Section 5 Declarations Please answer questions about the property how the property will be financed and your past financial history
Section 6 Acknowledgments and Agreements Informs you of your legal obligations related to the mortgage application and asks that you acknowledge certain information will be obtained used and shared
Section 7 Military Service Please provide information about your (or your deceased spousersquos) military service
Section 8 Demographic Information Requests information the Lender is required by law to ask you
Section 9 Loan Originator Information Will be completed by Chase
Uniform Residential Loan Application ndash Additional Borrower
The URLA ndash Additional Borrower contains the following sections Section 1 Borrower Information This is the same as the Borrower Information section of the URLA
Section 2 Financial Information ndash Assets and Liabilities Contains only the following statement for the additional Borrower to complete ldquoMy information for Section 2 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo The name of the other borrower is entered here
Complete a separate URLA for each BorrowermiddotThree or more Borrowers ndash Use any combination of URLA and URLA-Additional Borrower forms in accordance with the above examples
Section 3 Financial Information ndash Real Estate Contains only the following statement for the additional borrower to complete ldquoMy information for Section 3 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 4 Loan and Property Information Contains only the following statement for the additional borrower to complete ldquoMy information for Section 4 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 5 Declarations This is the same as the Declarations section of the URLA
Section 6 Acknowledgments and Agreements Contains only the following statement for the additional borrower to complete ldquoMy signature for Section 6 is on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 7 Military Service This is the same as the Military Service section of the URLA
Section 8 Demographic Information This is the same as the Demographic Information section on the URLA
Section 9 Loan Originator Information This is the same as the Loan Originator Information section of the URLA
Using the URLA and URLA ndash Additional Borrower Together The URLA and the URLA ndash Additional Borrower are used together to collect information for two Borrowers who have joint assets liabilities andor real estate information The URLA and URLA ndash Additional Borrower can also be used for Borrowers who do not have joint information but wish to combine their information on the URLA for ease of use Here are examples of how to use the URLA and URLA ndash Additional Borrower
For one borrower Complete the URLA
For two borrowers with joint financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you dont need to duplicate them on more than one URLA or o In cases where Borrowers are not collaborating when completing the loan application
joint assets liabilities and real estate may be duplicated on each URLA bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you do not need to duplicate them on more than one URLA or
o In cases where Borrowers are not collaborating when completing the loan application joint assets liabilities and real estate may be duplicated on each URLA
For two borrowers with separate financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower Report the assets liabilities and
real estate for the additional Borrower on the URLA or bull Complete a separate URLA for each Borrower
For three or more borrowers use any combination of URLA and URLA ndash Additional Borrower forms described for two borrowers
Uniform Residential Loan Application ndash Unmarried Addendum If any borrower listed on the URLA or URLA ndash Additional Borrower form selects Unmarried in Section 1 (Personal Information) the lender will complete this optional form
The information must be collected to determine how to apply state property laws that directly or indirectly affect creditworthiness including ensuring clear title
Uniform Residential Loan Application ndash Continuation Sheet Use the URLA ndash Continuation Sheet if you need more space to complete either the URLA or URLA ndash Additional Borrower forms
99177-URLAI-0215
HUD Addendum to Uniform Residential Loan Application OMB Approval No HUD 2502-0059 (exp )
Part I - Identifying Information HUDFHA Application for Insurance under the National Housing Act and Borrower Certification
FHA Case No (include any suffix) Mortgagee Case No
Mortgagee ID Sponsor ID Agent ID
Mortgagee Name Address (include ZIP Code) and Telephone Number
Type or print all entries clearly
Name and Address of Sponsor Name and Address of Agent
Borrowers Name amp Present Address (include ZIP Code) Property Address (include name of subdivision lot amp block no amp ZIP Code)
Sponsored Originations
Name of Third-Party Originator NMLS ID of Third-Party Originator
Part II - Borrower Consent for Social Security Administration to Verify Social Security Number I authorize the Social Security Administration (SSA) to verify my Social Security Number (SSN) to the Mortgagee and HUDFHA I authorize SSA to provide explanatory
information to HUDFHA in the event of a discrepancy This consent is valid for 180 days from the date signed unless indicated otherwise by the individual(s) named in this
loan application
Signature(s) of Borrower(s) - Read consent carefully Review accuracy of Social Security Number(s) provided on this application
Borrowerrsquos NameDate of BirthSocial Security Number
Co-Borrowerrsquos Name Date of BirthSocial Security Number
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
Part III - Borrower Notices Information and Acknowledgment Public Reporting Burden
Public reporting burden for this collection of information is estimated to average 10 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 conduct or sponsor and a person is not
required to respond to a collection of information unless that collection displays a valid OMB control number which can be located on the OMB Internet page at
httpwwwreginfogovpublicdoPRAMain
Privacy Act Information
The information requested on the Uniform Residential Loan Application and this Addendum is authorized by the National Housing Act of 1934 12 USC sect 1701 et seq The Debt
Collection Act of 1982 Pub L 97-365 and HUDrsquos Housing and Community Development Act of 1987 42 USC sect 3543 require persons applying for a federally insured loan to
furnish their SSN You must provide all the requested information including your SSN HUD may conduct a computer match to verify the information you provide HUD may
disclose certain information to Federal State and local agencies when relevant to civil criminal or regulatory investigations and prosecutions It will not otherwise be disclosed or
released outside of HUD except as required and permitted by law The information will be used to determine whether you qualify as a mortgagor Failure to provide any of the
requested information including SSN may result in disapproval of your loan application This is notice to you as required by the Right to Financial Privacy Act of 1978 that
HUDFHA has a right of access to financial records held by financial institutions in connection with the consideration or administration of assistance to you Financial records
involving your transaction will be available to HUDFHA without further notice or authorization but will not be disclosed or released by the institution to another Government Agency
or Department without your consent except as required or permitted by law
WARNING This warning applies to all certifications made in this document Anyone who knowingly submits a false claim or makes false statements is subject to criminal and civil penalties including confinement for up to 5 years fines and civil penalties 18 USC sectsect 287 1001 and 31 USC sect 3729
orm HUD-92900-A ( ) Page 1
Borrower Name ____________________________ FHA Case No __________________
Caution Delinquencies Defaults Foreclosures and Abuses Delinquencies defaults foreclosures and abuses of mortgage loans involving programs of the Federal Government can be costly and detrimental to your credit now and in the future The Mortgagee in this transaction its agents and assigns as well as the Federal Government its agencies agents and assigns are authorized to take any and all of the following actions in the event loan payments become delinquent on the mortgage loan described in the attached application (1) Report your name and account information to a credit bureau (2) Assess additional interest and penalty charges for the period of time that payment is not made (3) Assess charges to cover additional administrative costs incurred by the Federal Government to service your account (4) Offset amounts owed to you
under other Federal programs (5) Refer your account to a private attorney collection agency or mortgage servicing agency to collect the amount due foreclose
the mortgage sell the property and seek judgment against you for any deficiency (6) Refer your account to the Department of Justice (DOJ) for litigation in the
courts (7) If you are a current or retired Federal employee take action to offset your salary or civil service retirement benefits (8) Refer your debt to the Internal
Revenue Service for offset against any amount owed to you as an income tax refund and (9) Report any resulting written off debt of yours to the Internal Revenue Service as your taxable income All of these actions may be used to recover any debts owed when it is determined to be in the interest of the Mortgagee or Federal Government or both
As a mortgage loan borrower you will be legally obligated to make the mortgage payments called for by your mortgage loan contract The fact that you dispose of your property after the loan has been made will not relieve you of liability for making these payments Payment of the loan in full is ordinarily the way liability on a mortgage note is ended Some home buyers have the mistaken impression that if they sell their homes when they move to another locality or dispose of it for any other reasons they are no longer liable for the mortgage payments and that liability for these payments is solely that of the new owners Even though the new owners may agree in writing to assume liability for your mortgage payments this assumption agreement will not relieve you from liability to the holder of the note which you signed when you obtained the loan to buy the property Unless you are able to sell the property to a buyer who is acceptable to HUDFHA who will assume the payment of your obligation to the lender you will not be relieved from liability to repay any claim which HUDFHA may be required to pay your lender on account of default in your loan payments The amount of any such claim payment may be a debt owed by you to the Federal Government and subject to established collection procedures
Fair Housing Act I and anyone acting on my behalf are and will remain in compliance with the Fair Housing Act 42 USC sect 3604 et seq with respect to the dwelling or property covered by the loan and in the provision of services or facilities in connection therewith I recognize that any restrictive covenant on this property related to race color religion sex disability familial status or national origin is unlawful under the Fair Housing Act and unenforceable I further recognize that in addition to administrative action by HUD a civil action may be brought by the DOJ in any appropriate US court against any person responsible for a violation of the
applicable law
Certification and Acknowledgment All information in this application is given for the purpose of obtaining a loan to be insured under the National Housing Act and the information in the Uniform Residential Loan Application and this Addendum is true and complete to the best of my knowledge and belief Verification may be obtained from any source named herein I have read and understand the foregoing concerning my liability on the loan and Part III Borrower Notices Information and Acknowledgment
Signature(s) of Borrower(s) - Do not sign unless this application is fully completed Read the certification carefully and review accuracy of this application
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
orm HUD-92900-A ( Page 2
___________________________________
______________________________________________________
______________________________________________________________
- - - - - - - - - - - - - - - - - - - - - - -
Borrower Name ____________________________ FHA Case No __________________
Part IV - Direct Endorsement Approval for a HUD FHA-Insured Mortgage A Underwriting the Borrower
Date Mortgage Approved ______________________________ Date Approval Expires ______________________
For mortgages rated as an ldquoacceptrdquo or ldquoapproverdquo by FHAs TOTAL Mortgage Scorecard
The information submitted to TOTAL was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA4e Final Underwriting Decision (TOTAL) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee Representative Signature
Printed Name
Title
OR
For mortgages rated as a ldquoreferrdquo by FHAs TOTAL Mortgage Scorecard or manually underwritten by a Direct Endorsement underwriter I have personally reviewed and underwritten the borrowerrsquos credit application The information used to underwrite the borrower was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA5d Final Underwriting Decision (Manual) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
B Underwriting the Property
For all mortgages where FHA requires an appraisal I have personally reviewed and underwritten the appraisal according to FHA requirements I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
orm HUD-92900-A ( ) Page 3
Borrower Name ____________________________ FHA Case No __________________
Part V Mortgagees Certification
I have personally reviewed the mortgage documents and the application for insurance endorsement and This mortgage complies with SF Handbook 40001 Section IIA7 Post-Closing and Endorsement to the extent that no defect exists that would have changed the decision to endorse or submit the mortgage for insurance
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee
Name of Mortgageersquos Representative
Title of Mortgageersquos Representative
Signature of the Mortgageersquos Representative Date
orm HUD-92900-A ( ) Page 4
GENERAL AUTHORIZATION FOR A MORTGAGE LOAN ASSUMPTION
Applicant name(s)
Loan number
NOTICES AND DISCLOSURES
Non-discriminatory underwriting guidelines Anyone who inquires about the availability of credit from us has the right to receive a copy of our non-discriminatory underwriting guidelines To request a copy of these guidelines contact your Loan Processor
Attorney note Itrsquos the responsibility of our attorneys to protect our interest You may at your expense request an attorney to represent your interest
Notice to HUDFHA applicants As required by the Right to Financial Privacy Act of 1978 this notice is to inform you that the US Department of Housing and Urban Development (HUD)Federal Housing Administration (FHA) has a right of access to financial records held by financial institutions related to a request for assistance Financial records involving your assumption will be available to HUDFHA without further notice or authorization but wonrsquot be disclosed or released by us to another government agency or department without your consent except as required or permitted by law
Borrower consent to the use of tax return information I understand acknowledge and agree that the Lender and Other Loan Participants can obtain use and share tax return information for purposes of (i) providing an offer (ii) originating maintaining managing monitoring servicing selling insuring and securitizing a loan (iii) marketing or (iv) as otherwise permitted by applicable laws including state and federal privacy and data security laws The Lender includes the Lenderrsquos affiliates agents service providers and any of aforementioned partiesrsquo successors and assigns The Other Loan Participants includes any actual or potential owners of a loan resulting from your loan application or acquirers of any beneficial or other interest in the loan and mortgage insurer guarantor any servicers or service providers for these parties and any of aforementioned partiesrsquo successors and assigns
CERTIFICATION AND AUTHORIZATION
Environmental certification By signing below I represent and warrant that Irsquom not aware of any substances materials or products that may be an environmental hazard such as but not limited to asbestos formaldehyde radon gas lead-based paint fuel or chemical storage tanks (above or below ground) and contaminated soil or water on the property I acknowledge that Chase is relying on this representation and warranty as a material part of its loan application process I also am not aware of any landfill on any portion of the property
Exceptions to the above I further acknowledge (1) receipt of applicable disclosures from the seller in purchase transactions (2) that lead-based paint may exist in housing constructed prior to 1978 (3) that Chase performs no environmental investigation on my behalf and isnrsquot responsible for identifying lead-based paint or any other environmental conditions that might impact the property or its residents and (4) that it is my sole obligation to investigate for potential impact to the property from environmental conditions
Certifications I certify by signing below that (1) all of the loan application information provided is true and complete (2) I understand any intentional or negligent misrepresentation(s) of the information provided in conjunction with my application may result in civil liability andor 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 Chase its agents successors and assigns insurers and any other person who may suffer any loss due to reliance upon any misrepresentation that I have made on the application and (3) any significant change from the information provided at the time of application until the final loan application is signed may have a bearing on the approval of my application for a home loan
Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union
This question is asked because of state laws that extend the same or similar rights benefits and protections of spouses in a marriage to persons who are members of a partnership or union recognized under state law You should consult with your own legal advisor for advice regarding the rights protections benefits responsibilities obligations and duties of those who are registered domestic partners civil union partners or members of other unions recognized under applicable law
CREDIT AUTHORIZATION RELEASE
By signing below I authorize Chase andor my mortgage insurer (if any) to verify my past and present employment earnings records (including information contained in income tax returns that have been filed with the IRS) bank accounts stock holdings and any other information that it finds necessary to process my mortgage loan application or to review it for quality-control purposes I understand that a credit report will be ordered from a credit reporting agency for verification prior to loan closing as part of the application process and may be ordered after closing as part of the Lenderrsquos quality-control program A credit report may also be completed as part of the Lenderrsquos servicing or collection of the loan or in consideration of any other product or service that the Lender may consider offering me in the future and at any time throughout the life of the loan I understand that use of a photocopy of this form may be necessary to verify one or more of my credit references I understand that a photocopy or fax copy of this form will also serve as authorization
By signing below each applicant acknowledges (1) making the above certifications and authorizations and (2) that each applicant has received and understands the above notices and disclosures
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
You do not have to give us this information but if you donrsquot your application for approval as a borrower may be delayed or rejected The information requested in this form is authorized by Title 38 USC Chapter 37 (if VA) by 12 USC Section 1701 et seq (if HUDFHA) by 42 USC Section 1452b (if HUDCPD) and Title 42 USC 1471 et seq or 7 USC 1921 et seq (if USDA FHA)
Updated December 2021 99177-GA-0215
1b
2b
Form 4506-C (September 2020)
Department of the Treasury - Internal Revenue Service
IVES Request for Transcript of Tax Return OMB Number
1545-1872
Do not sign this form unless all applicable lines have been completed Request may be rejected if the form is incomplete or illegible
For more information about Form 4506-C visit wwwirsgov and search IVES
1a Name shown on tax return (if a joint return enter the name shown first)
First social security number on tax return individual taxpayer identification number or employer identification number (see instructions)
2a If a joint return enter spousersquos name shown on tax return Second social security number or individual taxpayer identification number if joint tax return
3 Current name address (including apt room or suite no) city state and ZIP code (see instructions)
4 Previous address shown on the last return filed if different from line 3 (see instructions)
5a IVES participant name address and SOR mailbox ID
DataVerify 875 Greentree Rd 8 Parkway Center Pittsburgh PA 15220
5b Customer file number (if applicable) (see instructions)
Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing (see instructions)
6 Transcript requested Enter the tax form number here (1040 1065 1120 etc) and check the appropriate box below Enter only one tax form number per request 1040
a Return Transcript which includes most of the line items of a tax return as filed with the IRS A tax return transcript does not reflect changes made to the account after the return is processed Transcripts are only available for the following returns Form 1040 series Form 1065 Form 1120 Form 1120-A Form 1120-H Form 1120-L and Form 1120S Return transcripts are available for the current year and returns processed during the prior 3 processing years
b Account Transcript which contains information on the financial status of the account such as payments made on the account penalty assessments and adjustments made by you or the IRS after the return was filed Return information is limited to items such as tax liability and estimated tax payments Account transcripts are available for most returns
c Record of Account which provides the most detailed information as it is a combination of the Return Transcript and the Account Transcript Available for current year and 3 prior tax years
7 Form W-2 Form 1099 series Form 1098 series or Form 5498 series transcript The IRS can provide a transcript that includes data from these information returns State or local information is not included with the Form W-2 information The IRS may be able to provide this transcript information for up to 10 years Information for the current year is generally not available until the year after it is filed with the IRS For example W-2 information for 2016 filed in 2017 will likely not be available from the IRS until 2018 If you need W-2 information for retirement purposes you should contact the Social Security Administration at 1-800-772-1213
Caution If you need a copy of Form W-2 or Form 1099 you should first contact the payer To get a copy of the Form W-2 or Form 1099 filed with your return you must use Form 4506 and request a copy of your return which includes all attachments
8 Year or period requested Enter the ending date of the tax year or period using the mmddyyyy format (see instructions)
12 31 2020 12 31 2019 12 31 2018 Caution Do not sign this form unless all applicable lines have been completed
Signature of taxpayer(s) I declare that I am either the taxpayer whose name is shown on line 1a or 2a or a person authorized to obtain the tax information requested If the request applies to a joint return at least one spouse must sign If signed by a corporate officer 1 percent or more shareholder partner managing member guardian tax matters partner executor receiver administrator trustee or party other than the taxpayer I certify that I have the authority to execute Form 4506-C on behalf of the taxpayer Note This form must be received by IRS within 120 days of the signature date
Signatory attests that heshe has read the attestation clause and upon so reading declares that heshe has the authority to sign the Form 4506-C See instructions
Sign Here
Signature (see instructions) Date Phone number of taxpayer on line 1a or 2a
PrintType name
Title (if line 1a above is a corporation partnership estate or trust)
Spousersquos signature Date
PrintType name
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020) For Privacy Act and Paperwork Reduction Act Notice see page 2
Instructions for Form 4506-C IVES Request for Transcript of Tax Return
Section references are to the Internal Revenue Code unless otherwise noted
Future Developments
For the latest information about Form 4506-C and its instructions go to wwwirsgov and search IVES Information about any recent developments affecting Form 4506-C (such as legislation enacted after we released it) will be posted on that page
Whats New Form 4506-C was created to be utilized by authorized IVES participants to order tax transcripts with the consent of the taxpayer
General Instructions
Caution Do not sign this form unless all applicable lines have been completed
Designated Recipient Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information received pursuant to the taxpayerrsquos consent and holds the recipient subject to penalties for any unauthorized access other use or redisclosure without the taxpayerrsquos express permission or request
Taxpayer Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information provided pursuant to your consent and holds the recipient subject to penalties brought by private right of action for any unauthorized access other use or redisclosure without your express permission or request
Purpose of form Use Form 4506-C to request tax return information through an authorized IVES participant You will designate an IVES participant to receive the information on line 5a
Note If you are unsure of which type of transcript you need check with the party requesting your tax information
Where to file The IVES participant will fax Form 4506-C with the approved IVES cover sheet to their assigned Service Center
Chart for ordering transcripts
If your assigned Service Center is
Fax the requests with the approved coversheet to
Austin Submission Processing Center
Austin IVES Team
844-249-6238
Fresno Submission Processing Center
Fresno IVES Team
844-249-6239
Kansas City Submission Processing Center
Kansas City IVES Team
844-249-8128
Ogden Submission Processing Center
Ogden IVES Team
844-249-8129
Specific Instructions
Line 1b Enter the social security number (SSN) or individual taxpayer identification number (ITIN) for the individual listed on line 1a or enter the employer identification number (EIN) for the business listed on line 1a
Line 3 Enter your current address If you use a PO box include it on this line
Line 4 Enter the address shown on the last return filed if different from the address entered on line 3
Note If the addresses on lines 3 and 4 are different and you have not changed your address with the IRS file Form 8822 Change of Address or Form 8822-BChange of Address or Responsible Party mdash Business with Form 4506-C
Line 5b Enter up to 10 numeric characters to create a unique customer file number that will appear on the transcript The customer file number cannot contain an SSN ITIN or EIN Completion of this line is not required
Note If you use an SSN name or combination of both we will not input the information and the customer file number will reflect a generic entry of 9999999999 on the transcript
Line 8 Enter the end date of the tax year or period requested in mmddyyyy format This may be a calendar year fiscal year or quarter Enter each quarter requested for quarterly returns Example Enter 12312018 for a calendar year 2018 Form 1040 transcript
Signature and date Form 4506-C must be signed and dated by the taxpayer listed on line 1a or 2a The IRS must receive Form 4506-C within 120 days of the date signed by the taxpayer or it will be rejected Ensure that all applicable lines including lines 5a through 8 are completed before signing
You must check the box in the signature area to acknowledge you have the authority to sign and request the information The form will not be processed if unchecked
Individuals Transcripts listed on on line 6 may be furnished to either spouse if jointly filed Only one signature is required Sign Form 4506-C exactly as your name appeared on the original return If you changed your name also sign your current name
Corporations Generally Form 4506-C can be signed by
(1) an officer having legal authority to bind the corporation (2) any person designated by the board of directors or other governing body or (3) any officer or employee on written request by any principal officer and attested to by the secretary or other officer A bona fide shareholder of record owning 1 percent or more of the outstanding stock of the corporation may submit a Form 4506-C but must provide documentation to support the requesters right to receive the information
Partnerships Generally Form 4506-C can be signed by any person who was a member of the partnership during any part of the tax period requested on line 8
All others See section 6103(e) if the taxpayer has died is insolvent is a dissolved corporation or if a trustee guardian executor receiver or administrator is acting for the taxpayer
Note If you are Heir at law Next of kin or Beneficiary you must be able to establish a material interest in the estate or trust
Documentation For entities other than individuals you must attach the authorization document For example this could be the letter from the principal officer authorizing an employee of the corporation or the letters testamentary authorizing an individual to act for an estate
Signature by a representative A representative can sign Form 4506-C for a taxpayer only if the taxpayer has specifically delegated this authority to the representative on Form 2848 line 5 The representative must attach Form 2848 showing the delegation to sign Form 4506-C
Privacy Act and Paperwork Reduction Act Notice We ask for the information on this form to establish your right to gain access to the requested tax information under the Internal Revenue Code We need this information to properly identify the tax information and respond to your request You are not required to request any transcript if you do request a transcript sections 6103 and 6109 and their regulations require you to provide this information including your SSN or EIN If you do not provide this information we may not be able to process your request Providing false or fraudulent information may subject you to penalties
Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and cities states the District of Columbia and US commonwealths and possessions for use in administering their tax laws We may also disclose this information to other countries under a tax treaty to federal and state agencies to enforce federal nontax criminal laws or to federal law enforcement and intelligence agencies to combat terrorism
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law Generally tax returns and return information are confidential as required by section 6103
The time needed to complete and file Form 4506-C will vary depending on individual circumstances The estimated average time is
Learning about the law or the form 10 min Preparing the form 12 min Copying assembling and sending the form to the IRS 20 min
If you have comments concerning the accuracy of these time estimates or suggestions for making Form 4506-C simpler we would be happy to hear from you You can write to
Internal Revenue Service Tax Forms and Publications Division 1111 Constitution Ave NW IR-6526 Washington DC 20224
Do not send the form to this address Instead see Where to file on this page
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020)
Rev April 2021 CHASEO Facts What does Chase do with your personal information
Why Financial companies choose how they share your personal information Federal law gives consumers the right to limit some but not all sharing Federal law also requires us to tell you how we collect share and protect your personal information Please read this notice carefully to understand what we do
What The types of personal information we collect and share depend on the product or service you have with us This information can include bull Social Security number and income bull account balances and transaction history bull credit history and payment history
How All financial companies need to share customers personal information to run their everyday business In the section below we list the reasons financial companies can share their customers personal information the reasons Chase chooses to share and whether you can limit this sharing
Reasons we can share your personal information Does Chase share
Can you limit this sharing
For our everyday business purposes - such as to process your transactions maintain your account(s) respond to court orders and legal investigations or report to credit bureaus
Yes No
For our marketing purposes - to offer our products and services to you
Yes No
For joint marketing with other financial companies Yes No
For our affiliates everyday business purposes - information about your transactions and experiences
Yes No
For our affiliates everyday business purposes - information about your creditworthiness
Yes Yes
For our affiliates to market to you Yes Yes
For nonaffiliates to market to you Yes Yes
a
0
To limit our sharing
bull Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
bull Visit us online chasecomprivacypreferences
Please note If you are a new customer we can begin sharing your information 30 days from the date we sent this notice When you are no longer our customer we continue to share your information as described in this notice However you can contact us at any time to limit our sharing
Questions
Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
PAGE 2
Who we are
Who is providing this notice The US consumer financial companies within the JPMorgan Chase amp Co family including JPMorgan Chase Bank NA Chase Insurance Agency Inc and JP Morgan Securities LLC
What we do
How does Chase protect my To protect your personal information from unauthorized access and use we personal information use security measures that comply with federal law These measures include
computer safeguards and secured files and buildings We authorize our employees to get your information only when they need it to do their work and we require companies that work for us to protect your information
How does Chase collect my We collect your personal information for example when you personal information bull open an account or make deposits or withdrawals from your account
bull pay your bills or apply for a loan bull use your credit or debit card We also collect your personal information from others such as credit bureaus affiliates or other companies
Why cant I limit all sharing Federal law gives you the right to limit only bull sharing for affiliates everyday business purposes - information about your
creditworthiness bull affiliates from using your information to market to you bull sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing See below for more on your rights under state law
What happens when I limit sharing for an account I hold jointly with someone else
Your choices will apply to everyone on your account
Definitions
Affiliates Companies related by common ownership or control They can be financial and non financial companies bull Our affiliates include companies with a Chase or JP Morgan name and financial companies such asjP Morgan Securities LLC
Nonaffiliates Companies not related by common ownership or control They can be financial and non financial companies bull Nonaffiliates we share with can include companies such as retailers auto dealers auto makers and membership clubs
Joint marketing A formal agreement between nonaffiliated financial companies that together market financial products or services to you bull Our joint marketing partners include categories of companies such as insurance companies
Other important information
VT Accounts with a Vermont mailing address are automatically treated as if they have limited the sharing as described on page 1 For joint marketing we will only disclose your name contact information and information about your transactions
NV We are providing you this notice pursuant to Nevada law If you prefer not to receive marketing calls from us you may be placed on our Internal Do Not Call List by calling 1-800-945-9470 or by writing to us at PO Box 734007 Dallas TX 75373-4007
For more information contact us at the address above or email PrivacylnfoJPMChasecom with Nevada Annual Notice in the subject line You may also contact the Nevada Attorney Generals office Bureau of Consumer Protection Office of the Nevada Attorney General 555 E Washington St Suite 3900 Las Vegas NV 89101 telephone number 1-702-486-3132 email BCPINFOagstatenvus
CA Accounts with a California mailing address are automatically treated as if they have limited the sharing with nonaffiliates as described on page 1 CA residents are provided a CA notice for additional choices
CHASE O
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
The following disclosure is required by the USA PATRIOT Act
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 opens an account
What this means to you When you 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 drivers
license or other identifying documents
99177-PAT-0215
VETERAN STATEMENT When this loan was opened the US Department of Veterans Affairs (VA) used the veteran borrowerrsquos entitlement which is a set amount the VA promises to repay a lender if the borrower defaults on the mortgage An assumption will modify who is obligated to pay the existing mortgage loan but all loan termsmdashincluding the entitlementmdashwill remain the same If the veteran borrower is being removed from the loan the entitlement would remain with whoever is assuming the loan because the loan will continue to be serviced by the VA If the applicant is also a veteran and can substitute his or her entitlement for the current entitlement then the current borrowerrsquos entitlement can be released
Please review the following questions and answer as appropriate This form requires completion by both the applicant(s) and current borrower(s)
1 Applicant to Complete
Are you (the applicant) currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the reverse side)
Yes (If yes please provide the information requested below answer the question in section 3 and sign and date this form at the bottom of the reverse side)
Name of applicant(s) who answered ldquoyesrdquo to the above question
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Are you receiving VA disability benefts
Applicant
Yes
No
Co-Applicant
Yes
No
Are you entitled to receive VA disability benefts Yes No Yes No
Have you received VA disability benefts in the past Yes No Yes No
Are you a surviving spouse of a veteran who died on active duty or as the result of a service-related disability
Yes No Yes No
Do you have any VA loans Yes No Yes No
2 Current Borrower to Complete
Is the current borrowerco-borrower currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the page)
Yes (If yes please answer the question in section 3 and sign and date this form at the bottom of the page)
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
________________________________________________________________________________________________
3 Applicant and Current Borrower to Complete
If the answer to the questions in section 1 and 2 are both yes please answer the following question After yoursquove reviewed and completed this entire form please sign and date at the bottom
Applicant Current Borrower
Do you want to apply for a substitution of entitlement Yes Yes No No
In order to complete a substitution of entitlement the veteran applicant must have suffcient entitlement to substitute for that of the current borrower Contact the VA Offce of Jurisdiction for your area for more information Also before the veteran applicant can substitute entitlement on a VA loan heshe must certify that the property securing the loan will be occupied as hisher primary residence Both the applicantrsquos and current borrowerrsquos original certifcate of eligibility will be required If your sales contract is contingent upon the restoration of entitlement please contact your VA Offce of Jurisdiction for complete procedures Otherwise the substitution will be completed after the loan has been approved and closed
Date Applicant printed name Applicant signature
Date Applicant printed name Applicant signature
Date Current Borrower printed name Current Borrower signature
Date Current Borrower printed name Current Borrower signature
Forms completed by Mail Phone
For Chase use only
Interviewer signature Date
99177-VS-0215
- Assumption Application Package_41521-noscannedpages-update-4pdf
-
- 1 FM203 Cover Pagepdf
- 2 FM202 Mortgage Assumption Application Package pagepdf
- 3 The Documents Youll need to Send Uspdf
- 4 FM201 FAQpdf
- 5 FM142 CIWpdf
- 6 FM126 URLApdf
- 7 FM130 URLA Instpdf
-
- Blank Page
-
- 8 92900a Addednum to Loan Applicationpdf
- 9 FM462 Gen Authpdf
- 10 FM220 4506-Cpdf
- 11 FM153 Chase Federal Privacy Noticepdf
- 12 FM144 Info on Opening a New Accountpdf
- 13 FM152 Veteran Statementpdf
-
- Date
- Loan number
- Applicant name
- Phone1
- Loan number 1
- Loan number 2
- Other
- Other_2
- 1
- 2
- undefined_7
- Available hours
- Available hours_2
- undefined_8
- Available hours_3
- undefined_9
- Current address 1
- Neither
- Available hours_4
- Available hours_5
- undefined_10
- Available hours_6
- 1_2
- 2_2
- undefined_11
- Available hours_7
- Available hours_8
- undefined_12
- Available hours_9
- FHA Case No include any suffix
- Mortgagee Case No
- Mortgagee ID
- Sponsor ID
- Agent ID
- Name and Address of Sponsor Name and Address of Agent
- Borrowers Name Present Address include ZIP Code Property Address
- include name of subdivision lot block no ZIP Code
- Name of ThirdParty Originator
- NMLS ID of ThirdParty Originator
- s application
- ty Number
- ty Number_2
- Date Signed_2
- Date Mortgage Approved
- Date Approval Expires
- Printed Name
- Title 1
- DEs ID Number
- DEs ID Number_2
- Mortgagee
- Name of Mortgagees Representative
- Title of Mortgagees Representative
- Signature of the Mortgagees Representative
- Date_2
- Applicant names 1
- Applicant names 2
- Applicant names 3
- Loan number_2
- Date_3
- Applicant printed name
- Social Security number
- Date_4
- Applicant printed name_2
- Social Security number_2
- Date_5
- Applicant printed name_3
- Social Security number_3
- Date_6
- Applicant printed name_4
- Social Security number_4
- 1a Name shown on tax return if a joint return enter the name shown first
- 1b First social security number on tax return individual taxpayer identification number or employer identification number see instructions
- 2a If a joint return enter spouses name shown on tax return
- 2b Second social security number or individual taxpayer identification number if joint tax return
- 4 Previous address shown on the last return filed if different from line 3 see instructions
- 5a IVES participant name address and SOR mailbox ID
- Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing see instructions
- Signature see instructions
- Date_7
- Phone number of taxpayer on line 1a or 2a
- PrintType name
- Here
- Spouses signature
- Date_8
- PrintType name_2
- Name
- Date of birth
- Service number
- Name_2
- Date of birth_2
- Service number_2
- Date_9
- Applicant printed name_5
- Date_10
- Applicant printed name_6
- Date_11
- Current Borrower printed name
- Date_12
- Current Borrower printed name_2
- Date_13
- Text3
- Text10
- undefined_13
- Text15
- undefined_14
- undefined_15
- undefined_16
- undefined_17
- undefined_18
- undefined_19
- undefined_20
- undefined_21
- undefined_23
- Reason for assumption Off
- Requestors relationship to owners Off
- Check one Off
- Check one1 Off
- Day1
- Evening
- Cell phone
- Check one2 Off
- Check one3 Off
- Check one4 Off
- Check one5 Off
- Text2-1
- Text2-2
- Text2-3
- Text2-4
- Text2-5
- Text2-6
- Text3-1
- Text3-2
- Text3-3
- Text3-4
- Text3-6
- Text3-7
- Text3-8
- Text3-9
- Text3-10
- Text3-11
- Text3-12
- Text3-13
- Text3-14
- Text3-15
- Text3-16
- Text3-17
- Text3-18
- Text3-19
- Text3-20
- Text3-21
- Text3-22
- Text3-23
- Text3-24
- Text3-25
- Text3-26
- Text3-27
- Text3-28
- Text3-29
- Text3-30
- Text3-31
- Text3-32
- Text3-33
- Text3-34
- Text3-35
- Text3-36
- Text3-37
- Text3-38
- Text3-39
- Text3-40
- Text3-41
- Text3-42
- Text3-43
- Text3-44
- Text3-45
- Text3-46
- Text3-47
- Text3-48
- Text3-49
- Text3-50
- Text3-51
- Text3-52
- Text3-53
- Text3-5
- Text3-54
- Text3-55
- Text3-56
- Citizenship Off
- Type of credit Off
- Marital Status Off
- Housing Off
- Housing1 Off
- ownership Off
- DNA1 Off
- DNA2 Off
- DNA3 Off
- family Off
- BO Off
- Total
- Text31
- Text32
- Text33
- Text34
- Text35
- Text36
- Text37
- Text38
- Text39
- Text310
- Text311
- Text312
- Text313
- Text314
- Text315
- Text316
- Text317
- Text318
- Text319
- ownership1 Off
- Total1
- Total1-2
- Check Box4-1 Off
- Text320
- Text321
- Text322
- Text323
- Text324
- Text325
- Text326
- Text327
- Text328
- Text329
- Check Box4-2 Off
- Check Box4-3 Off
- Check Box4-4 Off
- Check Box4-8 Off
- Check Box4-9 Off
- Text330
- Text331
- Text332
- Text333
- Text334
- Text335
- Text1-1
- Text1-2
- Text1-3
- Text1-4
- Text1-5
- Text1-6
- Text1-7
- Text1-8
- Text1-9
- Text1-10
- Text1-11
- Text1-12
- Text1-13
- Text1-14
- Text1-15
- Text1-16
- Text1-17
- Text1-18
- Text1-19
- Text1-20
- Text1-21
- Text1-22
- Text1-23
- Text1-24
- Text1-25
- Text1-26
- Text1-27
- Text1-28
- Text1-29
- Text1-30
- Text1-31
- Text1-32
- Text1-33
- Text1-34
- Text1-35
- Check Box3-2 Off
- Check Box2-1 Off
- Check Box2-2 Off
- Check Box2-3 Off
- Check Box2-4 Off
- Check Box2-5 Off
- Text1-36
- Text1-37
- Text1-38
- Text1-39
- Text1-40
- Text1-41
- Text1-42
- Text1-43
- Text1-44
- Text1-45
- Text1-46
- Text1-47
- Text1-48
- Text1-49
- Text1-50
- Text1-51
- Text1-52
- Text1-53
- Text1-54
- Text1-55
- Text1-56
- Text1-57
- Text1-58
- Text1-59
- Text1-60
- Text1-61
- Check Box3-11 Off
- A1
- A2
- A3
- A4
- A5
- A6
- A7
- A8
- A9
- A10
- A11
- A12
- Check Box3-1 Off
- Check Box30-1 Off
- Check Box30-2 Off
- Check Box30-4 Off
- Check Box30-5 Off
- Check Box30-7 Off
- Check Box30-8 Off
- Check Box30-9 Off
- Check Box30-10 Off
- Check Box30-11 Off
- Check Box30-12 Off
- A13
- A14
- A15
- A16
- A17 Off
- A18
- A19
- A20
- A21
- A22
- A23
- A24
- A25
- A26
- A27
- A28
- A29
- A30
- A31
- A32
- A33
- A34
- A35
- A36
- A37
- A38 Off
- A39
- A40
- A41
- A42
- A43
- A44
- A45
- A46
- A47
- A48
- A49
- A50
- A51
- A52
- A53
- A54
- A55
- A56
- A57
- A58
- A59
- A60
- A61
- A62
- A63
- A64
- A65
- A66
- A67
- A68
- A69
- A70
- A71
- A72
- A73
- A74
- Loan Purpose Off
- occupancy1 Off
- lien type Off
- lientype Off
- mixed use Off
- manufactured home Off
- deposit1 Off
- deposit2 Off
- B1
- B2
- B3
- B4
- B5
- B6
- B7
- B8
- B9
- B10
- fha Off
- Check Box51 Off
- B11
- B12
- B13
- B14
- B15
- B16
- B17
- B18
- B19 Off
- B20
- B21
- B22 Off
- B23
- B24
- B25
- B26
- B27
- B28
- A
-
- Will you occupy the property as your primary residence Off
- Will you occupy the property as your primary residence1 Off
-
- If yes have you had an ownership interest in another property in the last three years Off
- Text9-2
- B
-
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property Off
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property1 Off
-
- 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 Off
- 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 application1 Off
-
- 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 Off
- 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 application1 Off
-
- new credit Off
- 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) Off
- the Property Assessed Clean Energy Program)1 Off
-
- F
-
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application Off
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application1 Off
-
- G
-
- Are there any outstanding judgments against you Off
- Are there any outstanding judgments against you1 Off
-
- H
-
- Are you currently delinquent or in default on a Federal debt Off
- Are you currently delinquent or in default on a Federal debt1 Off
-
- I
-
- Are you a party to a lawsuit in which you potentially have any personal financial liability Off
- Are you a party to a lawsuit in which you potentially have any personal financial liability1 Off
-
- J
-
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years Off
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years1 Off
-
- 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 Off
- 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 due1 Off
-
- L
-
- Have you had property foreclosed upon in the last 7 years Off
- Have you had property foreclosed upon in the last 7 years1 Off
-
- M
-
- Have you declared bankruptcy within the past 7 years Off
- Have you declared bankruptcy within the past 7 years1 Off
-
- Check Box8-2 Off
- Check Box8-3 Off
- Check Box8-4 Off
- Text9-3
- Text9-5
- Text9-6
- Text97
- military Off
- ethnicity Off
- sex Off
- race Off
- demo Off
- Text12-1
- Check Box11-1 Off
- Check Box11-2 Off
- Check Box11-3 Off
- Check Box11-4 Off
- Check Box11-5 Off
- Check Box11-6 Off
- Check Box11-7 Off
- Check Box11-8 Off
- Check Box11-9 Off
- Text12-2
- Check Box11-10 Off
- Check Box11-11 Off
- Check Box11-12 Off
- Check Box11-13 Off
- Check Box11-14 Off
- Check Box11-15 Off
- Text12-3
- Check Box11-16 Off
- Check Box11-17 Off
- Check Box11-18 Off
- Check Box11-19 Off
- Check Box11-20 Off
- Check Box11-21 Off
- Check Box11-22 Off
- Check Box11-23 Off
- Text12-4
- Check Box11-24 Off
- Check Box11-25 Off
- Check Box11-26 Off
- Check Box11-27 Off
- Check Box11-28 Off
- Check Box11-29 Off
- Text12-5
- Check Box11-30 Off
- Check Box11-31 Off
- citizen Off
- credit Off
- marital status1 Off
- housing-1 Off
- housing-2 Off
- own Off
- C1
- C2
- C3
- C6
- C7
- C8
- C9
- C10
- C11
- C12
- C13
- C14
- C15
- C16
- C17
- C18
- C19
- C20
- C21
- C22
- C23
- C24
- C25
- C26
- C27
- C28
- C29
- C30
- C31
- C32
- C33
- C34
- C35
- Check Box-2 Off
- C36
- C37
- C38
- C39
- C4
- C40
- C41
- C42
- C43
- C44
- C45
- C46
- C47
- Check Box-3 Off
- Check Box-4 Off
- C48
- C49
- C5
- C50
- C51
- C52
- C53
- C54
- C55
- Check Box-1-1 Off
- own1 Off
- Check Box-1 Off
- D1 Off
- D2
- D3
- D4
- D5
- D6
- D7
- D8
- D9
- D10
- D11
- D12
- D13
- D14 Off
- D15 Off
- D16
- D17
- D18
- D19
- D20
- D21
- D22
- D23
- D24 Off
- D25
- D26
- D27
- D28
- D29
- D30
- D31
- D32
- D33
- D34
- D35 Off
- D36
- D37 Off
- D38
- D39
- D40
- D41
- D42
- D43
- D44
- D45
- D46
- D47
- If yes have you had an ownership interest in another property in the last three years1 Off
- new credit1 Off
- Check Box8-1 Off
- Check Box8-1-2 Off
- Check Box8-1-1 Off
- Check Box8-1-3 Off
- Check Box8-1-4 Off
- Military Service mdash Did you (or your deceased spouse) ever serve or are you currently serving in the United States Armed Forces 1 Off
- Check1 Off
- Text9-1-1
- Check2 Off
- Check3 Off
- Check4 Off
- Text9-1
- E1
- E2
- E3
- Was the ethnicity of the Borrower collected on the basis of visual observation or surname1 Off
- Was the sex of the Borrower collected on the basis of visual observation or surname1 Off
- Was the race of the Borrower collected on the basis of visual observation or surname1 Off
- The Demographic Information was provided through1 Off
- F1 Off
- F2 Off
- F3 Off
- F4 Off
- F5 Off
- F6
- F7 Off
- F8 Off
- F9 Off
- F10 Off
- F11 Off
- F12 Off
- F13
- F14 Off
- F15 Off
- F16 Off
- F17 Off
- F18 Off
- F19 Off
- F20 Off
- F21 Off
- F22
- F23 Off
- F24 Off
- F25 Off
- F26 Off
- F27 Off
- F28 Off
- F29
- F30 Off
- F31 Off
- undefined_13-1
- undefined_13-2
- undefined_14-1
- undefined_15-1
- undefined_16-1
- undefined_17-1
- undefined_18-1
- undefined_19-1
- undefined_21-1
- undefined_20-1
- undefined_23-1
- undefined_13_1
- Single-Two Off
- Refi type Off
- refi program Off
- Estate Off
- Title held Off
- Trust Information Off
- Indian Country Land Tenure Off
- Mortgage Type Applied For Off
- Mortgage Lien Type Off
- Amortization Type Off
- G1 Off
- G2 Off
- G3 Off
- G4 Off
- G5 Off
- G6
- G7
- G8
- G9
- G10 Off
- G11 Off
- G12 Off
- G13 Off
- G14 Off
- G15 Off
- G16
- G17
- G18
- G19
- G20
- G21
- G22
- G23 Off
- G24
- G25 Off
- G26
- G27 Off
- G28 Off
- G29
- G30 Off
- G31
- G32 Off
- G33
- G34
- G35
- G36
- G37
- G38
- G39
- G40
- G41
- G42
- Property Held
- refi
- Text18-1
- Text18-2
- Text18-3
- Text18-4
- Text18-5
- Text18-6
- Text18-7
- Text18-8
- Text18-9
- Text18-10
- Text18-11
- Text18-12
- Text18-13
- Text18-14
- Text18-15
- Text18-16
- Text18-17
- Text18-18
- Text18-19
- Lender
- case no
- If you selected ldquoUnmarriedrdquo in Section 1 is there a person who is not your legal spouse but who currently has real property rights similar to those of a legal spouse Off
- Relationship and State Off
- Other-5
- Text19-1
- BName
- Additional Information
- ABN
- Additional Information1
- BSign
- BSDate
- ABSign
- ABDate
- MortageeNameAddress
- NAmeAddress
- Bname1
- DOB1
- DOB2
- SignOfBorr1
- SignOfBorr
- Date Signed
- SignOfBorr2
- SignOfBorr3
- Date Signed3
- Date Signed4
- MortgageeRepSign
- DirectSign
- DirectSign1
- Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union Off
- AppSign
- AppSign1
- AppSign2
- AppSign3
- Nopage38 Off
- Yespage38 Off
- Yes1 Off
- No1 Off
- Yes2 Off
- Yes3 Off
- Yes4 Off
- Yes5 Off
- Yes6 Off
- Yes7 Off
- Yes8 Off
- Yes9 Off
- Yes10 Off
- No2 Off
- No3 Off
- No4 Off
- No5 Off
- No6 Off
- No7 Off
- No8 Off
- No9 Off
- No10 Off
- BorrowerNo Off
- BorrowerYes Off
- AppSignature
- AppSignature1
- CurrentSign
- CurrentSign1
- InterviewSign
- Yes_1 Off
- No_1 Off
- Yes_2 Off
- No_2 Off
- Mail Off
- Phone Off
Section 6 Acknowledgments and AgreementsThis section tells you about yourlegal obligations whenyousign this application
Acknowledgments and Agreements
Definitions- Lenderincludes the Lenderrsquos agents service providers and any oftheir successors andassigns
Other Loan Participantsrdquo includes(i) any actual or potential owners of
a loan resulting from this application (the ldquoLoanrsquo)(ii) acquirers ofany beneficial or other interest in the Loan(iii) any mortgageinsurer(iv) any guarantor (v) any servicer of the Loan and (vi) any of theseparties service providers successors or assigns
I agree to acknowledgeand representthe following
(1) The Complete Informationfor this Application- The information | have providedin this application is true accurate
and completeas of the date | signed this application
laquo If the information | submitted changesor | have new information
before closing of the Loan | must change and supplementthis
application including providing any updatedsupplementedrealestate sales contract
- For purchase transactions The terms and conditionsof anyrealestate sales contract signed by mein connection with this application
are true accurate and complete to the best of my knowledge andbelief | have not entered into any other agreement written ororal inconnection withthis real estate transaction
- The Lender and OtherLoan Participants mayrely on the informationcontainedin the application before and after closing of the Loan
- Any intentional or negligent misrepresentation of information may
result in the impositionof(a) civil liability on me including monetary damagesif a
person suffers any loss because the person relied on anymisrepresentation that | have made onthis application andor
(b) criminal penalties on me including but not limited to fine orimprisonment or both underthe provisions of Federal law(18 USC sectsect 1001 et seq)
(2) The Propertyrsquos SecurityThe Loan | have applied for in this application will be secured by
a mortgage or deedoftrust which provides the Lendera security
interest in the property described in this application
(3) The Propertys Appraisal Value and Condition- Any appraisal or value of the property obtained by the Lenderis
for use by the Lender and OtherLoanParticipantslaquoThe Lender and OtherLoan Participants have not made anyrepresentation or warranty express or implied to me about the
propertyits conditionorits value
(4) Electronic Records and Signatures- The Lender and OtherLoan Participants may keep any paper record
andorelectronic record of this application whether or not the Loan
is approved
BorrowerSignature
- If this application is created as (or converted into) an ldquoelectronicapplicationrdquo | consent to the use of ldquoelectronic recordsrdquo and
ldquoelectronic signaturesrdquo as the termsare defined in and governed byapplicable Federal andorstate electronic transactions laws
| intend to sign and have signedthis application either using my(a) electronic signature or(b) a written signature and agreethatif a paper version ofthis
application is converted into an electronic application theapplication will be an electronic record and the representationof my written signature on this application will be my binding
electronic signature- | agree that the applicationif delivered or transmitted to the Lenderor Other Loan Participants as an electronic record with myelectronicsignaturewill be as effective and enforceable as a paperapplicationsigned by mein writing
(5) Delinquencylaquo The Lender and OtherLoan Participants may report information about
my accountto credit bureaus Late payments missed paymentsorother defaults on my account maybereflected in my credit report andwill likely affect my credit score
- If | have trouble making my payments | understand that | may contacta HUD-approved housing counseling organization for advice about
actions I can take to meet my mortgageobligations
(6) Authorization for Use and Sharing of InformationBy signing belowin addition to the representations and agreementsmade above| expressly authorize the Lender and Other LoanParticipants to obtain use and share with each other(i) the loan
application and related loan information and documentation(ii) aconsumercredit report on me and(iii) my tax return information asnecessary to perform theactionslisted belowfor so long as they havean interest in my loanorits servicing
(a) process and underwrite myloan(b) verify any data contained in my consumercredit 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 analysisandreviews
(e) perform analysis and modeling for risk assessments(f) monitor the accountfor this loan for potential delinquencies and
determineanyassistance that may beavailable to me and
(g) other actions permissible under applicable law
Date (mmddyyyy)
Additional Borrower Signature Date (mmddyyyy)
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 7 Military ServiceThis section asks questions about your(or your deceased spouses) military service
Military Service of Borrower
Military Service mdash Did you (or your deceased spouse) everserve or are you currently serving in the United States Armed Forces NO YES
If YES check allthat apply Currently serving on active duty with projected expiration date of servicetour (mmddyyyy)
Currently retired discharged or separated from service
Only period of service was as a non-activated memberof the Reserve or National GuardSurviving spouse
Section 8 Demographic InformationThis section asks about your ethnicity sex and race
Demographic Information of Borrower
The purposeofcollecting this informationis to help ensure thatall applicants are treated fairly and that the housing needs of communities
and neighborhoodsare beingfulfilled 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 mayselect one or more designationsfor
Ethnicity and one or more designationsfor Race The law provides that we maynotdiscriminate on the basis of this information or onwhetheryou chooseto provideit However if you choose not to provide the information and you have madethis application in person Federal
regulations require us to note your ethnicity sex and race on thebasis of visual observation or surname Thelaw also provides that we may notdiscriminate on the basis of age or marital status information you providein this application If you do not wish to provide someorall of this
information please check below
Ethnicity Check one or more Race Check one or moreHispanic or Latino AmericanIndian or Alaska Native - Print nameofenrolled
or principaltribe Mexican PuertoRican CubanOther Hispanic or Latino - Print origin Asian
Asian Indian Chinese Filipino
Japanese Korean Vietnamese
OtherAsian mdash Print race
For example Hmong Laotian Thai Pakistani Cambodian and so on
Black or African American
Native Hawaiian or OtherPacific Islander
Native Hawaiian GuamanianorChamorro Samoan
For exampleArgentinean Colombian Dominican Nicaraguan
Salvadoran Spaniard andso on
Not Hispanic or Latino
| do not wish to providethis information
5Female OtherPacific Islander mdash Print race
Male For example Fijian Tongan and so on| do not wish to providethis information white
| do not wish to providethis information
Wasthe ethnicity of the Borrowercollected on the basis of visual observation or surname )NO YESWasthe sex of the Borrowercollected on the basis of visual observation or surname NO YESWastherace of the Borrowercollected on the basis of visual observation or surname NO YES
Face-to-Face Interview (includes Electronic Media w Video Component) TelephoneInterview Faxor Mail Email or Internet
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
ReelTemCrCL
Loan Originator Organization Name
Address
Loan Originator Organization NMLSR ID State License ID
Loan Originator Name
Loan Originator NMLSR ID State License ID
Date (mmddyyyy)
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Uniform Residential Loan Application mdash Additional BorrowerVerify and complete the information onthis application as directed by your Lender
Section 1 Borrower Informationthis section asks about yourpersonal information and your income fromemploymentandother sources such as retirement that you want considered to qualify for this loan
1a Personal Information
Name(First Middle Last Suffix)
Alternate Names - List any namesby which you are known or any namesunder which credit was previously received (First Middle Last Suffix)
Social Security Number - -(or Individual TaxpayerIdentification Number)
Dateof Birth Citizenship(mmddyyyy)
USCitizenPermanentResidentAlienNon-Permanent ResidentAlien
Type ofCredit| am applying for individualcredit
lam applying forjoint credit Total Number of Borrowers
Each Borrowerintendsto applyfor joint credit Your initials
List Name(s) of Other Borrower(s) Applying for this Loan
(First Middle Last Suffix) - Use a separator between names
Marital Status Dependents(notlisted by another Borrower)
Contact Information
Married Number _ Home Phone ( ) -
( ) _
( ) -mdash_ mdash_
Separated Ages CellPhone
Unmarried ens Work Phone Ext(Single Divorced WidowedCivil Union Domestic Partnership Registered
Reciprocal Beneficiary Relationship)lsquol
Emal
Current Address
Street Unit
City State ZIP Country
How Long at Current Address=Years mdashMonths Housing Noprimary housing expense Own Rent($ month)
If at Current Address for LESS than 2 yearslist Former Address Does not apply
Street Unit
City State ZIP Country
How Long at Former Address Years mdashMonths Housing Noprimary housing expense Own month)
Mailing Address- ifdifferent from CurrentAddress Does not apply
Street Unit
City State ZIP Country
eeeeCeeteiChuraleCme Doesnot apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base S$month
City State ZIP Country Overtime =$_____monthBonus $ month
Position orTitle Checkif this statementapplies Commission sect month| am employedby a family memberpropertyseller real estate agent or otherparty to the transaction
TTStart Date ____ (mmddyy) Military
Entitlements$_How longin this line of work Years =Months mdash monthSS
Other $ monthCheckif you are the BusinessOwnerorSelf-Employed
| have an ownershipshare ofless than 25 Monthly Income(or Loss) mdashmdash| have an ownership share of 25 or more $ TOTAL $ 000month
Uniform Residential Loan Application mdash Additional Borrower
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
CoeeeMCMCmeticlm tu)Comiteteilteeilelie mieit
Does not apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base
OvertimeBonus
Commission
MilitaryEntitlements
Other
$ month
$ month$ month
$ month
$ month
$ month
City State ZIP Country
Position orTitle ose if this statement applieslam employed by a family memberpropertyseller real estate agent or otherparty to the transaction
Start Date (mmddyy)How long in this line of work Years =Months
Checkif you are the Business
Owneror Self-Employed| have an ownershipshare of less than 25 Monthly Income(or Loss)
Ihave an ownership share of 25 or more $ TOTAL$ 000month
CPONMeeeMummaTestetiersdeere lire miret Does not apply
Provideat least 2 years of current and previous employment and income
Employeror Business Name Previous Gross MonthlyStreet Unit Income s month
City State ZIP Country
Position or Title
Start Date
End Date
Checkif you were the BusinessOwneror Self-Employed
(mmddyyyy)
(mmddyyyy) 1e Income from Other Sources Does not apply
Include incomefrom other sources below Under Income Source choose from the sourceslisted herelaquo Alimonylaquo Automobile Allowanceraquo Boarder Incomelaquo Capital Gains
Child Support+ Disability+ Foster Care Housing or Parsonage
+ Interest and DividendslaquoMortgage Credit Certificate Mortgage DifferentialPayments
laquo Notes Receivable+ Public Assistancelaquo Retirement(eg Pension IRA)
+raquo Royalty Payments Separate Maintenance
+ Social Security
raquo Trust
+ UnemploymentBenefits
laquo VA Compensation
laquo Other
NOTE Revealalimony child support separate maintenance or other income ONLYIFyou wantit considered in determining yourqualification
for this loan
Income Source - uselist above Monthly Income
$
$
$
$ 000Provide TOTAL AmountHere|
Section 2 Financial Information mdash Assets andLiabilities
Myinformation for Section 2 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 3 Financial Information mdash Real Estate
Myinformation for Section 3 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 4 Loan and Property Information
Myinformation for Section 4 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 5 DeclarationsThis section asks you specific questions about the property your funding and your past
financial history
5aAboutthis Property and Your Moneyforthis Loan
A Will you occupy the property as your primary residence NO YES
If YES have you had an ownershipinterest in another property in the last three years NO YES
If YES complete (1) and (2) below
(1)What type of property did you ownprimary residence (PR) FHA secondary residence (SR) second home(SH)
or investmentproperty (IP)
(2) How did you holdtitle to the property by yourself (S) jointly with your spouse(SP) or jointly with another person (O)
B If this is a Purchase Transaction Do you have a family relationship or businessaffiliation with the seller of the property NO YES Cc Are you borrowing any moneyforthis real estate transaction (eg money foryour closing costs or down payment) or
obtaining any moneyfrom anotherparty suchastheselleror realtor that you have not disclosed on this loan application NO YES
If YES whatis the amountof this money $
D 1 Have youorwill you be applying for a mortgage loan on anotherproperty (not the property securing this loan) on orbefore closing this transaction that is not disclosed on this loan application
NO YES
2 Have you orwill you be applying for any newcredit (eg installment loan credit card etc) on or before closing this loan that wsis not disclosed on this application
NO YES
E Will this property be subject to a lien that could take priority over thefirst mortgagelien such as a clean energylien paid
through yourproperty taxes(eg the PropertyAssessed Clean Energy Program)No YES
EK) Veli ellim ait
F Areyou a co-signer or guarantor on any debtor loan thatis not disclosed on this application NO ES
G Are there any outstanding judgments against you NO YES
H Are you currently delinquentor in default on a Federal debt NO YES
I Are you a party to a lawsuit in which you potentially have any personalfinancialliability NO YES
J Have you conveyedtitle to any property in lieu of foreclosure in the past 7 years NO YES
K Within the past 7 years have you completed a pre-foreclosure sale or short sale whereby the property wassold to a
third party and the Lender agreed to acceptless than the outstanding mortgage balance due
No YES
L Have you had property foreclosed uponin thelast 7 years NO YES
M Have you declared bankruptcy within the past 7 years no vESIf YES identify the type(s) of bankruptcy Chapter 7 Chapter11 Chapter12 Chapter 13
Section 6 Acknowledgements and AgreementsMy signature for Section 6 is on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 7 Military Service This section asks questions about your(or your deceased spouses) military service
Military Service of Borrower
Military Service mdash Did you (or your deceased spouse)everserve or are you currently serving in the United States Armed Forces NO YES
IfYES check allthat apply Currently serving on active duty with projected expiration date of servicetour (mmddyyyy)
Currently retired discharged or separated from service nnOnly period of service was as a non-activated memberofthe Reserve or National GuardSurviving spouse
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 8 Demographic InformationThis section asks about your ethnicity sex and race
Demographic Information of Borrower
The purposeofcollecting this information is to help ensure thatall applicants are treated fairly and that the housing needs of communities
and neighborhoodsare beingfulfilled 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 providethis information but are encouraged to do so You mayselect one or more designationsfor
Ethnicity and one or more designationsfor Race The law provides that we maynotdiscriminate onthe basis of this information or onwhetheryou chooseto provideit However if you choose notto provide the information and you have madethis application in person Federal
regulations require us to note yourethnicity sex and race on the basis of visual observation or surname The law also provides that we may notdiscriminate on the basis of age or marital status information you providein this application If you do not wish to provide someorall of this
information please check below
Ethnicity Check one or more Race Check one or moreHispanic or Latino AmericanIndian or Alaska Native - Print nameofenrolled
or principaltribeMexican PuertoRican Cuban
OtherHispanic or Latino - Printorigin siansian Indian Chinese Filipino
For exampleArgentinean Colombian Dominican NicaraguanSalvadoran Spaniard andso on
Japanese Korean VietnameseOtherAsian - Print race Forexample Hmong Laotian Thai Pakistani Cambodian andso on
Black or African American
Native Hawaiian or OtherPacific Islander
Native Hawaiian GuamanianorChamorro Samoan
OtherPacific Islander mdash Print race
Not Hispanic or Latino
| do not wish to providethis information
Sex
Female
Male
| do not wish to providethis informationFor example Fijian Tongan and so on
White
| do not wish to providethis information
Wasthe ethnicity of the Borrowercollected on thebasis of visual observation or surnameWasthesex of the Borrowercollected on the basis of visual observation or surnameWastherace of the Borrowercollected on the basis of visual observation or surname
)NO YESNO YESNO YES
Face-to-Face Interview (includes Electronic Media w Video Component) Telephone Interview Faxor Mail Email or Internet
Loan Originator Organization Name
Address
Loan Originator Organization NMLSR ID State License ID
Loan Originator Name
Loan Originator NMLSR ID State License ID
Email Phone (
Signature Date (mmddyyyy)
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Pe)aae-emeet)
Community Property State
At least one borrowerlives in a community propertystateThe property is in a community property state
Transaction DetailConversion of Contract for Deed or Land ContractRenovationConstruction-ConversionConstruction-to-Permanent
Single-Closing Two-ClosingConstructionImprovementCosts $
LotAcquired Date
Original Cost of Lot $(mmddyyyy)
Refinance Program
Full DocumentationInterest Rate ReductionStreamlined without Appraisal
Other
Refinance Type
NoCash OutLimited Cash OutCash Out
Energy Improvement
Mortgageloanwill finance energy-related improvements
Propertyis currently subject to a lien that could take priority ovethe first mortgagelien such as a clean energylien paid for througproperty taxes(eg the PropertyAssessed Clean Energyprogram)
Project Type Condominium Cooperative Planned Unit Development (PUD) Propertyis notlocatedin a project
Peiwlivcestetece)a)
Title to the Property Will be Held in What Name(s)
For RefinanceTitle to the Property is Currently Held in What Name(s
Trust Information
tle Will be Held byan Inter Vivos (Living) Trust
Title Will be Held by a Land TrustLeasehold Expiration Date
Mannerin WhichTitle Will be Held Indian Country Land Tenure
Sole OwnershipLife EstateTenancy in Common
Joint Tenancywith Right of Survivorship]Tenancybythe EntiretyOther
Fee Simple Ona ReservationIndividualTrust Land (AllottedRestricted)Tribal Trust Land On a ReservationTribal Trust Land Off ReservationAlaska Native Corporation Land
Estate Will be Held in
Fee Simple(mmddyyyy)
3 Mortgage LoanInformation
Termsof Loan
Note Rate
Loan Term (months)
MortgageLien Type
First LienSubordinate Lien
Mortgage Type Applied For
Conventional USDA-RDFHA VA Other
Amortization Type
Fixed RateAdjustable Rate
If Adjustable Rate
Initial Period Prior to First Adjustment
Subsequent AdjustmentPeriod
Proposed Monthly Paymentfor Property
First Mortgage (P amp I) $
Subordinate Lien(s) (P amp |) $
Other(explain)
Homeowners Insurance $(months)
(months)
Loan Features Property Taxes $
Balloon Balloon Term (months)
Interest Only Interest OnlyTermNegative AmortizationPrepaymentPenalty Prepayment Penalty Term (months) Other
Temporary Interest Rate BuydownInitial Buydown Rate TOTALOther(explain)
Mortgage Insurance $
AssociationProject Dues (Condo Co-Op PUD) $
Supplemental Property Insurance $
(months)
Borrower Name(s)Uniform Residential Loan Application mdash LenderLoan Information
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
L4 Qualifying the Borrower - Minimum Required Funds or Cash Back
DUEFROM BORROWER(S)
A Sales Contract Price
B Improvements Renovations and Repairs
C Land(ifacquired separately)
D For Refinance Balance of Mortgage Loanson the Propertyto be paid off in the Transaction
(See Table 3a Property You Own)
E Credit Cards and Other Debts Paid Off
(See Table 2c Liabilities mdash Credit Cards Other Debts and Leases that You Owe)
F BorrowerClosing Costs (including Prepaid andInitial Escrow Payments)
G Discount Points
HTOTAL DUE FROM BORROWER(s)(Total of A thru G)
TOTALMORTGAGE LOANS
Loan Amount
Loan AmountExcluding Financed Mortgage Insurance (or Mortgage Insurance Equivalent) $
Financed Mortgage Insurance (or Mortgage Insurance Equivalent) Amount $
Other New Mortgage Loanson the Property the Borrower(s) is Buying or Refinancing(See Table 4b Other New MortgageLoanson the Property You are Buying or Refinancing)
KTOTAL MORTGAGELOANS(Totalof| and J)
TOTALCREDITS
L Seller Credits (Enter the amountofBorrower(s) costs paid by the property seller)
MOtherCredits (Enter the sum ofall other credits mdash BorrowerPaid Fees Earnest Money EmployerAssistedHousing Lease Purchase Fund Lot Equity Relocation Funds Sweat Equity Trade Equity Other)
NTOTAL CREDITS(Total of L and M)
CALCULATION
TOTAL DUE FROM BORROWER(s)(Line H)
LESSTOTAL MORTGAGELOANS(Line K) AND TOTAL CREDITS(Line N)
Cash FromTothe Borrower(Line H minusLine K and Line N)NOTE This amountdoesnotinclude reservesor other funds that may be required by the Lenderto be verified
Borrower Name(s)Uniform Residential Loan Application mdash LenderLoan Information
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
Uniform Residential Loan Application mdash Unmarried Addendum
eeCeceetatimC elitleeComeLy
Lenders Instructions for Using the Unmarried Addendum
The Lender may use the Unmarried Addendum only when a Borrowerselected ldquoUnmarriedrdquoin Section 1 and the information collected is
necessary to determine howState property lawsdirectly or indirectly affecting creditworthiness apply including ensuring clear title
For example the Lender may use the Unmarried Addendum whentheBorrowerresides in a State that recognizescivil unions domestic
partnerships or registered reciprocal beneficiary relationships or when the property is located in such a State ldquoStaterdquo meansanystate the
District of Columbia the Commonwealth of Puerto Rico or anyterritory or possession of the United States
Ifyou selected ldquoUnmarriedrdquoin Section 1 is there a person whois not your legal spouse but whocurrently has real property rights similar to
those of a legal spouse +=) NOQ YES
If YES indicate the type of relationship and the State in which the relationship was formed For example indicate if you are in a
civil union domestic partnership registered reciprocal beneficiary relationship or other relationship recognized by the State in which you
currently reside or where the property is located
O Civil Union copy Domestic Partnership copy Registered Reciprocal Beneficiary Relationship copy) Other(explain)
Statea]
Borrower NameUniform Residential Loan Application mdash Unmarried Addendum
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Uniform Residential Loan Application mdash Continuation Sheet
Use this continuation sheet if you need more space to complete the Uniform Residential Loan Application
Borrower Name(First Middle Last Suffix )
Additional Information
Additional Borrower Name(First Middle Last Suffix )
Additional Information
IWefully understand thatit is a federal crime punishable by fine or imprisonment or both to knowingly make anyfalse statements concerningany of the abovefacts as applicable underthe provisions of federal law (18 USC sectsect 1001 et seq)
BorrowerSignature Date (mmddyyyy)
Additional Borrower Signature Date (mmddyyyy)
Uniform Residential Loan Application mdash Continuation SheetFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
INSTRUCTIONS FOR COMPLETING THE UNIFORM RESIDENTIAL LOAN APPLICATION
Use the instructions below to complete the enclosed Uniform Residential Loan Application (Freddie Mac Form 65Fannie Mae Form 1003) To avoid any delays in your application review please provide all of the requested information
If you need to make a correction on the application draw a line through the incorrect text and mark your initials beside the change Donrsquot use correction tape or fluid The application must be completed signed and dated in ink
The Uniform Residential Loan Application (URLA)
The URLA contains the following sections Section 1 Borrower Information Please provide your personal information income and employment
Section 2 Financial Information ndash Assets and Liabilities Please provide information about your financial assets personal financial obligations and debts you owe
Section 3 Financial Information ndash Real Estate Please provide information about property you own and the debts and expenses related to the property
Section 4 Loan and Property Information Please provide information about the loan purpose and the property you are buying or refinancing
Section 5 Declarations Please answer questions about the property how the property will be financed and your past financial history
Section 6 Acknowledgments and Agreements Informs you of your legal obligations related to the mortgage application and asks that you acknowledge certain information will be obtained used and shared
Section 7 Military Service Please provide information about your (or your deceased spousersquos) military service
Section 8 Demographic Information Requests information the Lender is required by law to ask you
Section 9 Loan Originator Information Will be completed by Chase
Uniform Residential Loan Application ndash Additional Borrower
The URLA ndash Additional Borrower contains the following sections Section 1 Borrower Information This is the same as the Borrower Information section of the URLA
Section 2 Financial Information ndash Assets and Liabilities Contains only the following statement for the additional Borrower to complete ldquoMy information for Section 2 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo The name of the other borrower is entered here
Complete a separate URLA for each BorrowermiddotThree or more Borrowers ndash Use any combination of URLA and URLA-Additional Borrower forms in accordance with the above examples
Section 3 Financial Information ndash Real Estate Contains only the following statement for the additional borrower to complete ldquoMy information for Section 3 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 4 Loan and Property Information Contains only the following statement for the additional borrower to complete ldquoMy information for Section 4 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 5 Declarations This is the same as the Declarations section of the URLA
Section 6 Acknowledgments and Agreements Contains only the following statement for the additional borrower to complete ldquoMy signature for Section 6 is on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 7 Military Service This is the same as the Military Service section of the URLA
Section 8 Demographic Information This is the same as the Demographic Information section on the URLA
Section 9 Loan Originator Information This is the same as the Loan Originator Information section of the URLA
Using the URLA and URLA ndash Additional Borrower Together The URLA and the URLA ndash Additional Borrower are used together to collect information for two Borrowers who have joint assets liabilities andor real estate information The URLA and URLA ndash Additional Borrower can also be used for Borrowers who do not have joint information but wish to combine their information on the URLA for ease of use Here are examples of how to use the URLA and URLA ndash Additional Borrower
For one borrower Complete the URLA
For two borrowers with joint financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you dont need to duplicate them on more than one URLA or o In cases where Borrowers are not collaborating when completing the loan application
joint assets liabilities and real estate may be duplicated on each URLA bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you do not need to duplicate them on more than one URLA or
o In cases where Borrowers are not collaborating when completing the loan application joint assets liabilities and real estate may be duplicated on each URLA
For two borrowers with separate financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower Report the assets liabilities and
real estate for the additional Borrower on the URLA or bull Complete a separate URLA for each Borrower
For three or more borrowers use any combination of URLA and URLA ndash Additional Borrower forms described for two borrowers
Uniform Residential Loan Application ndash Unmarried Addendum If any borrower listed on the URLA or URLA ndash Additional Borrower form selects Unmarried in Section 1 (Personal Information) the lender will complete this optional form
The information must be collected to determine how to apply state property laws that directly or indirectly affect creditworthiness including ensuring clear title
Uniform Residential Loan Application ndash Continuation Sheet Use the URLA ndash Continuation Sheet if you need more space to complete either the URLA or URLA ndash Additional Borrower forms
99177-URLAI-0215
HUD Addendum to Uniform Residential Loan Application OMB Approval No HUD 2502-0059 (exp )
Part I - Identifying Information HUDFHA Application for Insurance under the National Housing Act and Borrower Certification
FHA Case No (include any suffix) Mortgagee Case No
Mortgagee ID Sponsor ID Agent ID
Mortgagee Name Address (include ZIP Code) and Telephone Number
Type or print all entries clearly
Name and Address of Sponsor Name and Address of Agent
Borrowers Name amp Present Address (include ZIP Code) Property Address (include name of subdivision lot amp block no amp ZIP Code)
Sponsored Originations
Name of Third-Party Originator NMLS ID of Third-Party Originator
Part II - Borrower Consent for Social Security Administration to Verify Social Security Number I authorize the Social Security Administration (SSA) to verify my Social Security Number (SSN) to the Mortgagee and HUDFHA I authorize SSA to provide explanatory
information to HUDFHA in the event of a discrepancy This consent is valid for 180 days from the date signed unless indicated otherwise by the individual(s) named in this
loan application
Signature(s) of Borrower(s) - Read consent carefully Review accuracy of Social Security Number(s) provided on this application
Borrowerrsquos NameDate of BirthSocial Security Number
Co-Borrowerrsquos Name Date of BirthSocial Security Number
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
Part III - Borrower Notices Information and Acknowledgment Public Reporting Burden
Public reporting burden for this collection of information is estimated to average 10 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 conduct or sponsor and a person is not
required to respond to a collection of information unless that collection displays a valid OMB control number which can be located on the OMB Internet page at
httpwwwreginfogovpublicdoPRAMain
Privacy Act Information
The information requested on the Uniform Residential Loan Application and this Addendum is authorized by the National Housing Act of 1934 12 USC sect 1701 et seq The Debt
Collection Act of 1982 Pub L 97-365 and HUDrsquos Housing and Community Development Act of 1987 42 USC sect 3543 require persons applying for a federally insured loan to
furnish their SSN You must provide all the requested information including your SSN HUD may conduct a computer match to verify the information you provide HUD may
disclose certain information to Federal State and local agencies when relevant to civil criminal or regulatory investigations and prosecutions It will not otherwise be disclosed or
released outside of HUD except as required and permitted by law The information will be used to determine whether you qualify as a mortgagor Failure to provide any of the
requested information including SSN may result in disapproval of your loan application This is notice to you as required by the Right to Financial Privacy Act of 1978 that
HUDFHA has a right of access to financial records held by financial institutions in connection with the consideration or administration of assistance to you Financial records
involving your transaction will be available to HUDFHA without further notice or authorization but will not be disclosed or released by the institution to another Government Agency
or Department without your consent except as required or permitted by law
WARNING This warning applies to all certifications made in this document Anyone who knowingly submits a false claim or makes false statements is subject to criminal and civil penalties including confinement for up to 5 years fines and civil penalties 18 USC sectsect 287 1001 and 31 USC sect 3729
orm HUD-92900-A ( ) Page 1
Borrower Name ____________________________ FHA Case No __________________
Caution Delinquencies Defaults Foreclosures and Abuses Delinquencies defaults foreclosures and abuses of mortgage loans involving programs of the Federal Government can be costly and detrimental to your credit now and in the future The Mortgagee in this transaction its agents and assigns as well as the Federal Government its agencies agents and assigns are authorized to take any and all of the following actions in the event loan payments become delinquent on the mortgage loan described in the attached application (1) Report your name and account information to a credit bureau (2) Assess additional interest and penalty charges for the period of time that payment is not made (3) Assess charges to cover additional administrative costs incurred by the Federal Government to service your account (4) Offset amounts owed to you
under other Federal programs (5) Refer your account to a private attorney collection agency or mortgage servicing agency to collect the amount due foreclose
the mortgage sell the property and seek judgment against you for any deficiency (6) Refer your account to the Department of Justice (DOJ) for litigation in the
courts (7) If you are a current or retired Federal employee take action to offset your salary or civil service retirement benefits (8) Refer your debt to the Internal
Revenue Service for offset against any amount owed to you as an income tax refund and (9) Report any resulting written off debt of yours to the Internal Revenue Service as your taxable income All of these actions may be used to recover any debts owed when it is determined to be in the interest of the Mortgagee or Federal Government or both
As a mortgage loan borrower you will be legally obligated to make the mortgage payments called for by your mortgage loan contract The fact that you dispose of your property after the loan has been made will not relieve you of liability for making these payments Payment of the loan in full is ordinarily the way liability on a mortgage note is ended Some home buyers have the mistaken impression that if they sell their homes when they move to another locality or dispose of it for any other reasons they are no longer liable for the mortgage payments and that liability for these payments is solely that of the new owners Even though the new owners may agree in writing to assume liability for your mortgage payments this assumption agreement will not relieve you from liability to the holder of the note which you signed when you obtained the loan to buy the property Unless you are able to sell the property to a buyer who is acceptable to HUDFHA who will assume the payment of your obligation to the lender you will not be relieved from liability to repay any claim which HUDFHA may be required to pay your lender on account of default in your loan payments The amount of any such claim payment may be a debt owed by you to the Federal Government and subject to established collection procedures
Fair Housing Act I and anyone acting on my behalf are and will remain in compliance with the Fair Housing Act 42 USC sect 3604 et seq with respect to the dwelling or property covered by the loan and in the provision of services or facilities in connection therewith I recognize that any restrictive covenant on this property related to race color religion sex disability familial status or national origin is unlawful under the Fair Housing Act and unenforceable I further recognize that in addition to administrative action by HUD a civil action may be brought by the DOJ in any appropriate US court against any person responsible for a violation of the
applicable law
Certification and Acknowledgment All information in this application is given for the purpose of obtaining a loan to be insured under the National Housing Act and the information in the Uniform Residential Loan Application and this Addendum is true and complete to the best of my knowledge and belief Verification may be obtained from any source named herein I have read and understand the foregoing concerning my liability on the loan and Part III Borrower Notices Information and Acknowledgment
Signature(s) of Borrower(s) - Do not sign unless this application is fully completed Read the certification carefully and review accuracy of this application
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
orm HUD-92900-A ( Page 2
___________________________________
______________________________________________________
______________________________________________________________
- - - - - - - - - - - - - - - - - - - - - - -
Borrower Name ____________________________ FHA Case No __________________
Part IV - Direct Endorsement Approval for a HUD FHA-Insured Mortgage A Underwriting the Borrower
Date Mortgage Approved ______________________________ Date Approval Expires ______________________
For mortgages rated as an ldquoacceptrdquo or ldquoapproverdquo by FHAs TOTAL Mortgage Scorecard
The information submitted to TOTAL was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA4e Final Underwriting Decision (TOTAL) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee Representative Signature
Printed Name
Title
OR
For mortgages rated as a ldquoreferrdquo by FHAs TOTAL Mortgage Scorecard or manually underwritten by a Direct Endorsement underwriter I have personally reviewed and underwritten the borrowerrsquos credit application The information used to underwrite the borrower was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA5d Final Underwriting Decision (Manual) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
B Underwriting the Property
For all mortgages where FHA requires an appraisal I have personally reviewed and underwritten the appraisal according to FHA requirements I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
orm HUD-92900-A ( ) Page 3
Borrower Name ____________________________ FHA Case No __________________
Part V Mortgagees Certification
I have personally reviewed the mortgage documents and the application for insurance endorsement and This mortgage complies with SF Handbook 40001 Section IIA7 Post-Closing and Endorsement to the extent that no defect exists that would have changed the decision to endorse or submit the mortgage for insurance
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee
Name of Mortgageersquos Representative
Title of Mortgageersquos Representative
Signature of the Mortgageersquos Representative Date
orm HUD-92900-A ( ) Page 4
GENERAL AUTHORIZATION FOR A MORTGAGE LOAN ASSUMPTION
Applicant name(s)
Loan number
NOTICES AND DISCLOSURES
Non-discriminatory underwriting guidelines Anyone who inquires about the availability of credit from us has the right to receive a copy of our non-discriminatory underwriting guidelines To request a copy of these guidelines contact your Loan Processor
Attorney note Itrsquos the responsibility of our attorneys to protect our interest You may at your expense request an attorney to represent your interest
Notice to HUDFHA applicants As required by the Right to Financial Privacy Act of 1978 this notice is to inform you that the US Department of Housing and Urban Development (HUD)Federal Housing Administration (FHA) has a right of access to financial records held by financial institutions related to a request for assistance Financial records involving your assumption will be available to HUDFHA without further notice or authorization but wonrsquot be disclosed or released by us to another government agency or department without your consent except as required or permitted by law
Borrower consent to the use of tax return information I understand acknowledge and agree that the Lender and Other Loan Participants can obtain use and share tax return information for purposes of (i) providing an offer (ii) originating maintaining managing monitoring servicing selling insuring and securitizing a loan (iii) marketing or (iv) as otherwise permitted by applicable laws including state and federal privacy and data security laws The Lender includes the Lenderrsquos affiliates agents service providers and any of aforementioned partiesrsquo successors and assigns The Other Loan Participants includes any actual or potential owners of a loan resulting from your loan application or acquirers of any beneficial or other interest in the loan and mortgage insurer guarantor any servicers or service providers for these parties and any of aforementioned partiesrsquo successors and assigns
CERTIFICATION AND AUTHORIZATION
Environmental certification By signing below I represent and warrant that Irsquom not aware of any substances materials or products that may be an environmental hazard such as but not limited to asbestos formaldehyde radon gas lead-based paint fuel or chemical storage tanks (above or below ground) and contaminated soil or water on the property I acknowledge that Chase is relying on this representation and warranty as a material part of its loan application process I also am not aware of any landfill on any portion of the property
Exceptions to the above I further acknowledge (1) receipt of applicable disclosures from the seller in purchase transactions (2) that lead-based paint may exist in housing constructed prior to 1978 (3) that Chase performs no environmental investigation on my behalf and isnrsquot responsible for identifying lead-based paint or any other environmental conditions that might impact the property or its residents and (4) that it is my sole obligation to investigate for potential impact to the property from environmental conditions
Certifications I certify by signing below that (1) all of the loan application information provided is true and complete (2) I understand any intentional or negligent misrepresentation(s) of the information provided in conjunction with my application may result in civil liability andor 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 Chase its agents successors and assigns insurers and any other person who may suffer any loss due to reliance upon any misrepresentation that I have made on the application and (3) any significant change from the information provided at the time of application until the final loan application is signed may have a bearing on the approval of my application for a home loan
Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union
This question is asked because of state laws that extend the same or similar rights benefits and protections of spouses in a marriage to persons who are members of a partnership or union recognized under state law You should consult with your own legal advisor for advice regarding the rights protections benefits responsibilities obligations and duties of those who are registered domestic partners civil union partners or members of other unions recognized under applicable law
CREDIT AUTHORIZATION RELEASE
By signing below I authorize Chase andor my mortgage insurer (if any) to verify my past and present employment earnings records (including information contained in income tax returns that have been filed with the IRS) bank accounts stock holdings and any other information that it finds necessary to process my mortgage loan application or to review it for quality-control purposes I understand that a credit report will be ordered from a credit reporting agency for verification prior to loan closing as part of the application process and may be ordered after closing as part of the Lenderrsquos quality-control program A credit report may also be completed as part of the Lenderrsquos servicing or collection of the loan or in consideration of any other product or service that the Lender may consider offering me in the future and at any time throughout the life of the loan I understand that use of a photocopy of this form may be necessary to verify one or more of my credit references I understand that a photocopy or fax copy of this form will also serve as authorization
By signing below each applicant acknowledges (1) making the above certifications and authorizations and (2) that each applicant has received and understands the above notices and disclosures
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
You do not have to give us this information but if you donrsquot your application for approval as a borrower may be delayed or rejected The information requested in this form is authorized by Title 38 USC Chapter 37 (if VA) by 12 USC Section 1701 et seq (if HUDFHA) by 42 USC Section 1452b (if HUDCPD) and Title 42 USC 1471 et seq or 7 USC 1921 et seq (if USDA FHA)
Updated December 2021 99177-GA-0215
1b
2b
Form 4506-C (September 2020)
Department of the Treasury - Internal Revenue Service
IVES Request for Transcript of Tax Return OMB Number
1545-1872
Do not sign this form unless all applicable lines have been completed Request may be rejected if the form is incomplete or illegible
For more information about Form 4506-C visit wwwirsgov and search IVES
1a Name shown on tax return (if a joint return enter the name shown first)
First social security number on tax return individual taxpayer identification number or employer identification number (see instructions)
2a If a joint return enter spousersquos name shown on tax return Second social security number or individual taxpayer identification number if joint tax return
3 Current name address (including apt room or suite no) city state and ZIP code (see instructions)
4 Previous address shown on the last return filed if different from line 3 (see instructions)
5a IVES participant name address and SOR mailbox ID
DataVerify 875 Greentree Rd 8 Parkway Center Pittsburgh PA 15220
5b Customer file number (if applicable) (see instructions)
Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing (see instructions)
6 Transcript requested Enter the tax form number here (1040 1065 1120 etc) and check the appropriate box below Enter only one tax form number per request 1040
a Return Transcript which includes most of the line items of a tax return as filed with the IRS A tax return transcript does not reflect changes made to the account after the return is processed Transcripts are only available for the following returns Form 1040 series Form 1065 Form 1120 Form 1120-A Form 1120-H Form 1120-L and Form 1120S Return transcripts are available for the current year and returns processed during the prior 3 processing years
b Account Transcript which contains information on the financial status of the account such as payments made on the account penalty assessments and adjustments made by you or the IRS after the return was filed Return information is limited to items such as tax liability and estimated tax payments Account transcripts are available for most returns
c Record of Account which provides the most detailed information as it is a combination of the Return Transcript and the Account Transcript Available for current year and 3 prior tax years
7 Form W-2 Form 1099 series Form 1098 series or Form 5498 series transcript The IRS can provide a transcript that includes data from these information returns State or local information is not included with the Form W-2 information The IRS may be able to provide this transcript information for up to 10 years Information for the current year is generally not available until the year after it is filed with the IRS For example W-2 information for 2016 filed in 2017 will likely not be available from the IRS until 2018 If you need W-2 information for retirement purposes you should contact the Social Security Administration at 1-800-772-1213
Caution If you need a copy of Form W-2 or Form 1099 you should first contact the payer To get a copy of the Form W-2 or Form 1099 filed with your return you must use Form 4506 and request a copy of your return which includes all attachments
8 Year or period requested Enter the ending date of the tax year or period using the mmddyyyy format (see instructions)
12 31 2020 12 31 2019 12 31 2018 Caution Do not sign this form unless all applicable lines have been completed
Signature of taxpayer(s) I declare that I am either the taxpayer whose name is shown on line 1a or 2a or a person authorized to obtain the tax information requested If the request applies to a joint return at least one spouse must sign If signed by a corporate officer 1 percent or more shareholder partner managing member guardian tax matters partner executor receiver administrator trustee or party other than the taxpayer I certify that I have the authority to execute Form 4506-C on behalf of the taxpayer Note This form must be received by IRS within 120 days of the signature date
Signatory attests that heshe has read the attestation clause and upon so reading declares that heshe has the authority to sign the Form 4506-C See instructions
Sign Here
Signature (see instructions) Date Phone number of taxpayer on line 1a or 2a
PrintType name
Title (if line 1a above is a corporation partnership estate or trust)
Spousersquos signature Date
PrintType name
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020) For Privacy Act and Paperwork Reduction Act Notice see page 2
Instructions for Form 4506-C IVES Request for Transcript of Tax Return
Section references are to the Internal Revenue Code unless otherwise noted
Future Developments
For the latest information about Form 4506-C and its instructions go to wwwirsgov and search IVES Information about any recent developments affecting Form 4506-C (such as legislation enacted after we released it) will be posted on that page
Whats New Form 4506-C was created to be utilized by authorized IVES participants to order tax transcripts with the consent of the taxpayer
General Instructions
Caution Do not sign this form unless all applicable lines have been completed
Designated Recipient Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information received pursuant to the taxpayerrsquos consent and holds the recipient subject to penalties for any unauthorized access other use or redisclosure without the taxpayerrsquos express permission or request
Taxpayer Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information provided pursuant to your consent and holds the recipient subject to penalties brought by private right of action for any unauthorized access other use or redisclosure without your express permission or request
Purpose of form Use Form 4506-C to request tax return information through an authorized IVES participant You will designate an IVES participant to receive the information on line 5a
Note If you are unsure of which type of transcript you need check with the party requesting your tax information
Where to file The IVES participant will fax Form 4506-C with the approved IVES cover sheet to their assigned Service Center
Chart for ordering transcripts
If your assigned Service Center is
Fax the requests with the approved coversheet to
Austin Submission Processing Center
Austin IVES Team
844-249-6238
Fresno Submission Processing Center
Fresno IVES Team
844-249-6239
Kansas City Submission Processing Center
Kansas City IVES Team
844-249-8128
Ogden Submission Processing Center
Ogden IVES Team
844-249-8129
Specific Instructions
Line 1b Enter the social security number (SSN) or individual taxpayer identification number (ITIN) for the individual listed on line 1a or enter the employer identification number (EIN) for the business listed on line 1a
Line 3 Enter your current address If you use a PO box include it on this line
Line 4 Enter the address shown on the last return filed if different from the address entered on line 3
Note If the addresses on lines 3 and 4 are different and you have not changed your address with the IRS file Form 8822 Change of Address or Form 8822-BChange of Address or Responsible Party mdash Business with Form 4506-C
Line 5b Enter up to 10 numeric characters to create a unique customer file number that will appear on the transcript The customer file number cannot contain an SSN ITIN or EIN Completion of this line is not required
Note If you use an SSN name or combination of both we will not input the information and the customer file number will reflect a generic entry of 9999999999 on the transcript
Line 8 Enter the end date of the tax year or period requested in mmddyyyy format This may be a calendar year fiscal year or quarter Enter each quarter requested for quarterly returns Example Enter 12312018 for a calendar year 2018 Form 1040 transcript
Signature and date Form 4506-C must be signed and dated by the taxpayer listed on line 1a or 2a The IRS must receive Form 4506-C within 120 days of the date signed by the taxpayer or it will be rejected Ensure that all applicable lines including lines 5a through 8 are completed before signing
You must check the box in the signature area to acknowledge you have the authority to sign and request the information The form will not be processed if unchecked
Individuals Transcripts listed on on line 6 may be furnished to either spouse if jointly filed Only one signature is required Sign Form 4506-C exactly as your name appeared on the original return If you changed your name also sign your current name
Corporations Generally Form 4506-C can be signed by
(1) an officer having legal authority to bind the corporation (2) any person designated by the board of directors or other governing body or (3) any officer or employee on written request by any principal officer and attested to by the secretary or other officer A bona fide shareholder of record owning 1 percent or more of the outstanding stock of the corporation may submit a Form 4506-C but must provide documentation to support the requesters right to receive the information
Partnerships Generally Form 4506-C can be signed by any person who was a member of the partnership during any part of the tax period requested on line 8
All others See section 6103(e) if the taxpayer has died is insolvent is a dissolved corporation or if a trustee guardian executor receiver or administrator is acting for the taxpayer
Note If you are Heir at law Next of kin or Beneficiary you must be able to establish a material interest in the estate or trust
Documentation For entities other than individuals you must attach the authorization document For example this could be the letter from the principal officer authorizing an employee of the corporation or the letters testamentary authorizing an individual to act for an estate
Signature by a representative A representative can sign Form 4506-C for a taxpayer only if the taxpayer has specifically delegated this authority to the representative on Form 2848 line 5 The representative must attach Form 2848 showing the delegation to sign Form 4506-C
Privacy Act and Paperwork Reduction Act Notice We ask for the information on this form to establish your right to gain access to the requested tax information under the Internal Revenue Code We need this information to properly identify the tax information and respond to your request You are not required to request any transcript if you do request a transcript sections 6103 and 6109 and their regulations require you to provide this information including your SSN or EIN If you do not provide this information we may not be able to process your request Providing false or fraudulent information may subject you to penalties
Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and cities states the District of Columbia and US commonwealths and possessions for use in administering their tax laws We may also disclose this information to other countries under a tax treaty to federal and state agencies to enforce federal nontax criminal laws or to federal law enforcement and intelligence agencies to combat terrorism
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law Generally tax returns and return information are confidential as required by section 6103
The time needed to complete and file Form 4506-C will vary depending on individual circumstances The estimated average time is
Learning about the law or the form 10 min Preparing the form 12 min Copying assembling and sending the form to the IRS 20 min
If you have comments concerning the accuracy of these time estimates or suggestions for making Form 4506-C simpler we would be happy to hear from you You can write to
Internal Revenue Service Tax Forms and Publications Division 1111 Constitution Ave NW IR-6526 Washington DC 20224
Do not send the form to this address Instead see Where to file on this page
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020)
Rev April 2021 CHASEO Facts What does Chase do with your personal information
Why Financial companies choose how they share your personal information Federal law gives consumers the right to limit some but not all sharing Federal law also requires us to tell you how we collect share and protect your personal information Please read this notice carefully to understand what we do
What The types of personal information we collect and share depend on the product or service you have with us This information can include bull Social Security number and income bull account balances and transaction history bull credit history and payment history
How All financial companies need to share customers personal information to run their everyday business In the section below we list the reasons financial companies can share their customers personal information the reasons Chase chooses to share and whether you can limit this sharing
Reasons we can share your personal information Does Chase share
Can you limit this sharing
For our everyday business purposes - such as to process your transactions maintain your account(s) respond to court orders and legal investigations or report to credit bureaus
Yes No
For our marketing purposes - to offer our products and services to you
Yes No
For joint marketing with other financial companies Yes No
For our affiliates everyday business purposes - information about your transactions and experiences
Yes No
For our affiliates everyday business purposes - information about your creditworthiness
Yes Yes
For our affiliates to market to you Yes Yes
For nonaffiliates to market to you Yes Yes
a
0
To limit our sharing
bull Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
bull Visit us online chasecomprivacypreferences
Please note If you are a new customer we can begin sharing your information 30 days from the date we sent this notice When you are no longer our customer we continue to share your information as described in this notice However you can contact us at any time to limit our sharing
Questions
Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
PAGE 2
Who we are
Who is providing this notice The US consumer financial companies within the JPMorgan Chase amp Co family including JPMorgan Chase Bank NA Chase Insurance Agency Inc and JP Morgan Securities LLC
What we do
How does Chase protect my To protect your personal information from unauthorized access and use we personal information use security measures that comply with federal law These measures include
computer safeguards and secured files and buildings We authorize our employees to get your information only when they need it to do their work and we require companies that work for us to protect your information
How does Chase collect my We collect your personal information for example when you personal information bull open an account or make deposits or withdrawals from your account
bull pay your bills or apply for a loan bull use your credit or debit card We also collect your personal information from others such as credit bureaus affiliates or other companies
Why cant I limit all sharing Federal law gives you the right to limit only bull sharing for affiliates everyday business purposes - information about your
creditworthiness bull affiliates from using your information to market to you bull sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing See below for more on your rights under state law
What happens when I limit sharing for an account I hold jointly with someone else
Your choices will apply to everyone on your account
Definitions
Affiliates Companies related by common ownership or control They can be financial and non financial companies bull Our affiliates include companies with a Chase or JP Morgan name and financial companies such asjP Morgan Securities LLC
Nonaffiliates Companies not related by common ownership or control They can be financial and non financial companies bull Nonaffiliates we share with can include companies such as retailers auto dealers auto makers and membership clubs
Joint marketing A formal agreement between nonaffiliated financial companies that together market financial products or services to you bull Our joint marketing partners include categories of companies such as insurance companies
Other important information
VT Accounts with a Vermont mailing address are automatically treated as if they have limited the sharing as described on page 1 For joint marketing we will only disclose your name contact information and information about your transactions
NV We are providing you this notice pursuant to Nevada law If you prefer not to receive marketing calls from us you may be placed on our Internal Do Not Call List by calling 1-800-945-9470 or by writing to us at PO Box 734007 Dallas TX 75373-4007
For more information contact us at the address above or email PrivacylnfoJPMChasecom with Nevada Annual Notice in the subject line You may also contact the Nevada Attorney Generals office Bureau of Consumer Protection Office of the Nevada Attorney General 555 E Washington St Suite 3900 Las Vegas NV 89101 telephone number 1-702-486-3132 email BCPINFOagstatenvus
CA Accounts with a California mailing address are automatically treated as if they have limited the sharing with nonaffiliates as described on page 1 CA residents are provided a CA notice for additional choices
CHASE O
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
The following disclosure is required by the USA PATRIOT Act
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 opens an account
What this means to you When you 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 drivers
license or other identifying documents
99177-PAT-0215
VETERAN STATEMENT When this loan was opened the US Department of Veterans Affairs (VA) used the veteran borrowerrsquos entitlement which is a set amount the VA promises to repay a lender if the borrower defaults on the mortgage An assumption will modify who is obligated to pay the existing mortgage loan but all loan termsmdashincluding the entitlementmdashwill remain the same If the veteran borrower is being removed from the loan the entitlement would remain with whoever is assuming the loan because the loan will continue to be serviced by the VA If the applicant is also a veteran and can substitute his or her entitlement for the current entitlement then the current borrowerrsquos entitlement can be released
Please review the following questions and answer as appropriate This form requires completion by both the applicant(s) and current borrower(s)
1 Applicant to Complete
Are you (the applicant) currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the reverse side)
Yes (If yes please provide the information requested below answer the question in section 3 and sign and date this form at the bottom of the reverse side)
Name of applicant(s) who answered ldquoyesrdquo to the above question
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Are you receiving VA disability benefts
Applicant
Yes
No
Co-Applicant
Yes
No
Are you entitled to receive VA disability benefts Yes No Yes No
Have you received VA disability benefts in the past Yes No Yes No
Are you a surviving spouse of a veteran who died on active duty or as the result of a service-related disability
Yes No Yes No
Do you have any VA loans Yes No Yes No
2 Current Borrower to Complete
Is the current borrowerco-borrower currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the page)
Yes (If yes please answer the question in section 3 and sign and date this form at the bottom of the page)
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
________________________________________________________________________________________________
3 Applicant and Current Borrower to Complete
If the answer to the questions in section 1 and 2 are both yes please answer the following question After yoursquove reviewed and completed this entire form please sign and date at the bottom
Applicant Current Borrower
Do you want to apply for a substitution of entitlement Yes Yes No No
In order to complete a substitution of entitlement the veteran applicant must have suffcient entitlement to substitute for that of the current borrower Contact the VA Offce of Jurisdiction for your area for more information Also before the veteran applicant can substitute entitlement on a VA loan heshe must certify that the property securing the loan will be occupied as hisher primary residence Both the applicantrsquos and current borrowerrsquos original certifcate of eligibility will be required If your sales contract is contingent upon the restoration of entitlement please contact your VA Offce of Jurisdiction for complete procedures Otherwise the substitution will be completed after the loan has been approved and closed
Date Applicant printed name Applicant signature
Date Applicant printed name Applicant signature
Date Current Borrower printed name Current Borrower signature
Date Current Borrower printed name Current Borrower signature
Forms completed by Mail Phone
For Chase use only
Interviewer signature Date
99177-VS-0215
- Assumption Application Package_41521-noscannedpages-update-4pdf
-
- 1 FM203 Cover Pagepdf
- 2 FM202 Mortgage Assumption Application Package pagepdf
- 3 The Documents Youll need to Send Uspdf
- 4 FM201 FAQpdf
- 5 FM142 CIWpdf
- 6 FM126 URLApdf
- 7 FM130 URLA Instpdf
-
- Blank Page
-
- 8 92900a Addednum to Loan Applicationpdf
- 9 FM462 Gen Authpdf
- 10 FM220 4506-Cpdf
- 11 FM153 Chase Federal Privacy Noticepdf
- 12 FM144 Info on Opening a New Accountpdf
- 13 FM152 Veteran Statementpdf
-
- Date
- Loan number
- Applicant name
- Phone1
- Loan number 1
- Loan number 2
- Other
- Other_2
- 1
- 2
- undefined_7
- Available hours
- Available hours_2
- undefined_8
- Available hours_3
- undefined_9
- Current address 1
- Neither
- Available hours_4
- Available hours_5
- undefined_10
- Available hours_6
- 1_2
- 2_2
- undefined_11
- Available hours_7
- Available hours_8
- undefined_12
- Available hours_9
- FHA Case No include any suffix
- Mortgagee Case No
- Mortgagee ID
- Sponsor ID
- Agent ID
- Name and Address of Sponsor Name and Address of Agent
- Borrowers Name Present Address include ZIP Code Property Address
- include name of subdivision lot block no ZIP Code
- Name of ThirdParty Originator
- NMLS ID of ThirdParty Originator
- s application
- ty Number
- ty Number_2
- Date Signed_2
- Date Mortgage Approved
- Date Approval Expires
- Printed Name
- Title 1
- DEs ID Number
- DEs ID Number_2
- Mortgagee
- Name of Mortgagees Representative
- Title of Mortgagees Representative
- Signature of the Mortgagees Representative
- Date_2
- Applicant names 1
- Applicant names 2
- Applicant names 3
- Loan number_2
- Date_3
- Applicant printed name
- Social Security number
- Date_4
- Applicant printed name_2
- Social Security number_2
- Date_5
- Applicant printed name_3
- Social Security number_3
- Date_6
- Applicant printed name_4
- Social Security number_4
- 1a Name shown on tax return if a joint return enter the name shown first
- 1b First social security number on tax return individual taxpayer identification number or employer identification number see instructions
- 2a If a joint return enter spouses name shown on tax return
- 2b Second social security number or individual taxpayer identification number if joint tax return
- 4 Previous address shown on the last return filed if different from line 3 see instructions
- 5a IVES participant name address and SOR mailbox ID
- Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing see instructions
- Signature see instructions
- Date_7
- Phone number of taxpayer on line 1a or 2a
- PrintType name
- Here
- Spouses signature
- Date_8
- PrintType name_2
- Name
- Date of birth
- Service number
- Name_2
- Date of birth_2
- Service number_2
- Date_9
- Applicant printed name_5
- Date_10
- Applicant printed name_6
- Date_11
- Current Borrower printed name
- Date_12
- Current Borrower printed name_2
- Date_13
- Text3
- Text10
- undefined_13
- Text15
- undefined_14
- undefined_15
- undefined_16
- undefined_17
- undefined_18
- undefined_19
- undefined_20
- undefined_21
- undefined_23
- Reason for assumption Off
- Requestors relationship to owners Off
- Check one Off
- Check one1 Off
- Day1
- Evening
- Cell phone
- Check one2 Off
- Check one3 Off
- Check one4 Off
- Check one5 Off
- Text2-1
- Text2-2
- Text2-3
- Text2-4
- Text2-5
- Text2-6
- Text3-1
- Text3-2
- Text3-3
- Text3-4
- Text3-6
- Text3-7
- Text3-8
- Text3-9
- Text3-10
- Text3-11
- Text3-12
- Text3-13
- Text3-14
- Text3-15
- Text3-16
- Text3-17
- Text3-18
- Text3-19
- Text3-20
- Text3-21
- Text3-22
- Text3-23
- Text3-24
- Text3-25
- Text3-26
- Text3-27
- Text3-28
- Text3-29
- Text3-30
- Text3-31
- Text3-32
- Text3-33
- Text3-34
- Text3-35
- Text3-36
- Text3-37
- Text3-38
- Text3-39
- Text3-40
- Text3-41
- Text3-42
- Text3-43
- Text3-44
- Text3-45
- Text3-46
- Text3-47
- Text3-48
- Text3-49
- Text3-50
- Text3-51
- Text3-52
- Text3-53
- Text3-5
- Text3-54
- Text3-55
- Text3-56
- Citizenship Off
- Type of credit Off
- Marital Status Off
- Housing Off
- Housing1 Off
- ownership Off
- DNA1 Off
- DNA2 Off
- DNA3 Off
- family Off
- BO Off
- Total
- Text31
- Text32
- Text33
- Text34
- Text35
- Text36
- Text37
- Text38
- Text39
- Text310
- Text311
- Text312
- Text313
- Text314
- Text315
- Text316
- Text317
- Text318
- Text319
- ownership1 Off
- Total1
- Total1-2
- Check Box4-1 Off
- Text320
- Text321
- Text322
- Text323
- Text324
- Text325
- Text326
- Text327
- Text328
- Text329
- Check Box4-2 Off
- Check Box4-3 Off
- Check Box4-4 Off
- Check Box4-8 Off
- Check Box4-9 Off
- Text330
- Text331
- Text332
- Text333
- Text334
- Text335
- Text1-1
- Text1-2
- Text1-3
- Text1-4
- Text1-5
- Text1-6
- Text1-7
- Text1-8
- Text1-9
- Text1-10
- Text1-11
- Text1-12
- Text1-13
- Text1-14
- Text1-15
- Text1-16
- Text1-17
- Text1-18
- Text1-19
- Text1-20
- Text1-21
- Text1-22
- Text1-23
- Text1-24
- Text1-25
- Text1-26
- Text1-27
- Text1-28
- Text1-29
- Text1-30
- Text1-31
- Text1-32
- Text1-33
- Text1-34
- Text1-35
- Check Box3-2 Off
- Check Box2-1 Off
- Check Box2-2 Off
- Check Box2-3 Off
- Check Box2-4 Off
- Check Box2-5 Off
- Text1-36
- Text1-37
- Text1-38
- Text1-39
- Text1-40
- Text1-41
- Text1-42
- Text1-43
- Text1-44
- Text1-45
- Text1-46
- Text1-47
- Text1-48
- Text1-49
- Text1-50
- Text1-51
- Text1-52
- Text1-53
- Text1-54
- Text1-55
- Text1-56
- Text1-57
- Text1-58
- Text1-59
- Text1-60
- Text1-61
- Check Box3-11 Off
- A1
- A2
- A3
- A4
- A5
- A6
- A7
- A8
- A9
- A10
- A11
- A12
- Check Box3-1 Off
- Check Box30-1 Off
- Check Box30-2 Off
- Check Box30-4 Off
- Check Box30-5 Off
- Check Box30-7 Off
- Check Box30-8 Off
- Check Box30-9 Off
- Check Box30-10 Off
- Check Box30-11 Off
- Check Box30-12 Off
- A13
- A14
- A15
- A16
- A17 Off
- A18
- A19
- A20
- A21
- A22
- A23
- A24
- A25
- A26
- A27
- A28
- A29
- A30
- A31
- A32
- A33
- A34
- A35
- A36
- A37
- A38 Off
- A39
- A40
- A41
- A42
- A43
- A44
- A45
- A46
- A47
- A48
- A49
- A50
- A51
- A52
- A53
- A54
- A55
- A56
- A57
- A58
- A59
- A60
- A61
- A62
- A63
- A64
- A65
- A66
- A67
- A68
- A69
- A70
- A71
- A72
- A73
- A74
- Loan Purpose Off
- occupancy1 Off
- lien type Off
- lientype Off
- mixed use Off
- manufactured home Off
- deposit1 Off
- deposit2 Off
- B1
- B2
- B3
- B4
- B5
- B6
- B7
- B8
- B9
- B10
- fha Off
- Check Box51 Off
- B11
- B12
- B13
- B14
- B15
- B16
- B17
- B18
- B19 Off
- B20
- B21
- B22 Off
- B23
- B24
- B25
- B26
- B27
- B28
- A
-
- Will you occupy the property as your primary residence Off
- Will you occupy the property as your primary residence1 Off
-
- If yes have you had an ownership interest in another property in the last three years Off
- Text9-2
- B
-
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property Off
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property1 Off
-
- 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 Off
- 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 application1 Off
-
- 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 Off
- 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 application1 Off
-
- new credit Off
- 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) Off
- the Property Assessed Clean Energy Program)1 Off
-
- F
-
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application Off
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application1 Off
-
- G
-
- Are there any outstanding judgments against you Off
- Are there any outstanding judgments against you1 Off
-
- H
-
- Are you currently delinquent or in default on a Federal debt Off
- Are you currently delinquent or in default on a Federal debt1 Off
-
- I
-
- Are you a party to a lawsuit in which you potentially have any personal financial liability Off
- Are you a party to a lawsuit in which you potentially have any personal financial liability1 Off
-
- J
-
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years Off
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years1 Off
-
- 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 Off
- 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 due1 Off
-
- L
-
- Have you had property foreclosed upon in the last 7 years Off
- Have you had property foreclosed upon in the last 7 years1 Off
-
- M
-
- Have you declared bankruptcy within the past 7 years Off
- Have you declared bankruptcy within the past 7 years1 Off
-
- Check Box8-2 Off
- Check Box8-3 Off
- Check Box8-4 Off
- Text9-3
- Text9-5
- Text9-6
- Text97
- military Off
- ethnicity Off
- sex Off
- race Off
- demo Off
- Text12-1
- Check Box11-1 Off
- Check Box11-2 Off
- Check Box11-3 Off
- Check Box11-4 Off
- Check Box11-5 Off
- Check Box11-6 Off
- Check Box11-7 Off
- Check Box11-8 Off
- Check Box11-9 Off
- Text12-2
- Check Box11-10 Off
- Check Box11-11 Off
- Check Box11-12 Off
- Check Box11-13 Off
- Check Box11-14 Off
- Check Box11-15 Off
- Text12-3
- Check Box11-16 Off
- Check Box11-17 Off
- Check Box11-18 Off
- Check Box11-19 Off
- Check Box11-20 Off
- Check Box11-21 Off
- Check Box11-22 Off
- Check Box11-23 Off
- Text12-4
- Check Box11-24 Off
- Check Box11-25 Off
- Check Box11-26 Off
- Check Box11-27 Off
- Check Box11-28 Off
- Check Box11-29 Off
- Text12-5
- Check Box11-30 Off
- Check Box11-31 Off
- citizen Off
- credit Off
- marital status1 Off
- housing-1 Off
- housing-2 Off
- own Off
- C1
- C2
- C3
- C6
- C7
- C8
- C9
- C10
- C11
- C12
- C13
- C14
- C15
- C16
- C17
- C18
- C19
- C20
- C21
- C22
- C23
- C24
- C25
- C26
- C27
- C28
- C29
- C30
- C31
- C32
- C33
- C34
- C35
- Check Box-2 Off
- C36
- C37
- C38
- C39
- C4
- C40
- C41
- C42
- C43
- C44
- C45
- C46
- C47
- Check Box-3 Off
- Check Box-4 Off
- C48
- C49
- C5
- C50
- C51
- C52
- C53
- C54
- C55
- Check Box-1-1 Off
- own1 Off
- Check Box-1 Off
- D1 Off
- D2
- D3
- D4
- D5
- D6
- D7
- D8
- D9
- D10
- D11
- D12
- D13
- D14 Off
- D15 Off
- D16
- D17
- D18
- D19
- D20
- D21
- D22
- D23
- D24 Off
- D25
- D26
- D27
- D28
- D29
- D30
- D31
- D32
- D33
- D34
- D35 Off
- D36
- D37 Off
- D38
- D39
- D40
- D41
- D42
- D43
- D44
- D45
- D46
- D47
- If yes have you had an ownership interest in another property in the last three years1 Off
- new credit1 Off
- Check Box8-1 Off
- Check Box8-1-2 Off
- Check Box8-1-1 Off
- Check Box8-1-3 Off
- Check Box8-1-4 Off
- Military Service mdash Did you (or your deceased spouse) ever serve or are you currently serving in the United States Armed Forces 1 Off
- Check1 Off
- Text9-1-1
- Check2 Off
- Check3 Off
- Check4 Off
- Text9-1
- E1
- E2
- E3
- Was the ethnicity of the Borrower collected on the basis of visual observation or surname1 Off
- Was the sex of the Borrower collected on the basis of visual observation or surname1 Off
- Was the race of the Borrower collected on the basis of visual observation or surname1 Off
- The Demographic Information was provided through1 Off
- F1 Off
- F2 Off
- F3 Off
- F4 Off
- F5 Off
- F6
- F7 Off
- F8 Off
- F9 Off
- F10 Off
- F11 Off
- F12 Off
- F13
- F14 Off
- F15 Off
- F16 Off
- F17 Off
- F18 Off
- F19 Off
- F20 Off
- F21 Off
- F22
- F23 Off
- F24 Off
- F25 Off
- F26 Off
- F27 Off
- F28 Off
- F29
- F30 Off
- F31 Off
- undefined_13-1
- undefined_13-2
- undefined_14-1
- undefined_15-1
- undefined_16-1
- undefined_17-1
- undefined_18-1
- undefined_19-1
- undefined_21-1
- undefined_20-1
- undefined_23-1
- undefined_13_1
- Single-Two Off
- Refi type Off
- refi program Off
- Estate Off
- Title held Off
- Trust Information Off
- Indian Country Land Tenure Off
- Mortgage Type Applied For Off
- Mortgage Lien Type Off
- Amortization Type Off
- G1 Off
- G2 Off
- G3 Off
- G4 Off
- G5 Off
- G6
- G7
- G8
- G9
- G10 Off
- G11 Off
- G12 Off
- G13 Off
- G14 Off
- G15 Off
- G16
- G17
- G18
- G19
- G20
- G21
- G22
- G23 Off
- G24
- G25 Off
- G26
- G27 Off
- G28 Off
- G29
- G30 Off
- G31
- G32 Off
- G33
- G34
- G35
- G36
- G37
- G38
- G39
- G40
- G41
- G42
- Property Held
- refi
- Text18-1
- Text18-2
- Text18-3
- Text18-4
- Text18-5
- Text18-6
- Text18-7
- Text18-8
- Text18-9
- Text18-10
- Text18-11
- Text18-12
- Text18-13
- Text18-14
- Text18-15
- Text18-16
- Text18-17
- Text18-18
- Text18-19
- Lender
- case no
- If you selected ldquoUnmarriedrdquo in Section 1 is there a person who is not your legal spouse but who currently has real property rights similar to those of a legal spouse Off
- Relationship and State Off
- Other-5
- Text19-1
- BName
- Additional Information
- ABN
- Additional Information1
- BSign
- BSDate
- ABSign
- ABDate
- MortageeNameAddress
- NAmeAddress
- Bname1
- DOB1
- DOB2
- SignOfBorr1
- SignOfBorr
- Date Signed
- SignOfBorr2
- SignOfBorr3
- Date Signed3
- Date Signed4
- MortgageeRepSign
- DirectSign
- DirectSign1
- Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union Off
- AppSign
- AppSign1
- AppSign2
- AppSign3
- Nopage38 Off
- Yespage38 Off
- Yes1 Off
- No1 Off
- Yes2 Off
- Yes3 Off
- Yes4 Off
- Yes5 Off
- Yes6 Off
- Yes7 Off
- Yes8 Off
- Yes9 Off
- Yes10 Off
- No2 Off
- No3 Off
- No4 Off
- No5 Off
- No6 Off
- No7 Off
- No8 Off
- No9 Off
- No10 Off
- BorrowerNo Off
- BorrowerYes Off
- AppSignature
- AppSignature1
- CurrentSign
- CurrentSign1
- InterviewSign
- Yes_1 Off
- No_1 Off
- Yes_2 Off
- No_2 Off
- Mail Off
- Phone Off
Section 7 Military ServiceThis section asks questions about your(or your deceased spouses) military service
Military Service of Borrower
Military Service mdash Did you (or your deceased spouse) everserve or are you currently serving in the United States Armed Forces NO YES
If YES check allthat apply Currently serving on active duty with projected expiration date of servicetour (mmddyyyy)
Currently retired discharged or separated from service
Only period of service was as a non-activated memberof the Reserve or National GuardSurviving spouse
Section 8 Demographic InformationThis section asks about your ethnicity sex and race
Demographic Information of Borrower
The purposeofcollecting this informationis to help ensure thatall applicants are treated fairly and that the housing needs of communities
and neighborhoodsare beingfulfilled 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 mayselect one or more designationsfor
Ethnicity and one or more designationsfor Race The law provides that we maynotdiscriminate on the basis of this information or onwhetheryou chooseto provideit However if you choose not to provide the information and you have madethis application in person Federal
regulations require us to note your ethnicity sex and race on thebasis of visual observation or surname Thelaw also provides that we may notdiscriminate on the basis of age or marital status information you providein this application If you do not wish to provide someorall of this
information please check below
Ethnicity Check one or more Race Check one or moreHispanic or Latino AmericanIndian or Alaska Native - Print nameofenrolled
or principaltribe Mexican PuertoRican CubanOther Hispanic or Latino - Print origin Asian
Asian Indian Chinese Filipino
Japanese Korean Vietnamese
OtherAsian mdash Print race
For example Hmong Laotian Thai Pakistani Cambodian and so on
Black or African American
Native Hawaiian or OtherPacific Islander
Native Hawaiian GuamanianorChamorro Samoan
For exampleArgentinean Colombian Dominican Nicaraguan
Salvadoran Spaniard andso on
Not Hispanic or Latino
| do not wish to providethis information
5Female OtherPacific Islander mdash Print race
Male For example Fijian Tongan and so on| do not wish to providethis information white
| do not wish to providethis information
Wasthe ethnicity of the Borrowercollected on the basis of visual observation or surname )NO YESWasthe sex of the Borrowercollected on the basis of visual observation or surname NO YESWastherace of the Borrowercollected on the basis of visual observation or surname NO YES
Face-to-Face Interview (includes Electronic Media w Video Component) TelephoneInterview Faxor Mail Email or Internet
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
ReelTemCrCL
Loan Originator Organization Name
Address
Loan Originator Organization NMLSR ID State License ID
Loan Originator Name
Loan Originator NMLSR ID State License ID
Date (mmddyyyy)
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Uniform Residential Loan Application mdash Additional BorrowerVerify and complete the information onthis application as directed by your Lender
Section 1 Borrower Informationthis section asks about yourpersonal information and your income fromemploymentandother sources such as retirement that you want considered to qualify for this loan
1a Personal Information
Name(First Middle Last Suffix)
Alternate Names - List any namesby which you are known or any namesunder which credit was previously received (First Middle Last Suffix)
Social Security Number - -(or Individual TaxpayerIdentification Number)
Dateof Birth Citizenship(mmddyyyy)
USCitizenPermanentResidentAlienNon-Permanent ResidentAlien
Type ofCredit| am applying for individualcredit
lam applying forjoint credit Total Number of Borrowers
Each Borrowerintendsto applyfor joint credit Your initials
List Name(s) of Other Borrower(s) Applying for this Loan
(First Middle Last Suffix) - Use a separator between names
Marital Status Dependents(notlisted by another Borrower)
Contact Information
Married Number _ Home Phone ( ) -
( ) _
( ) -mdash_ mdash_
Separated Ages CellPhone
Unmarried ens Work Phone Ext(Single Divorced WidowedCivil Union Domestic Partnership Registered
Reciprocal Beneficiary Relationship)lsquol
Emal
Current Address
Street Unit
City State ZIP Country
How Long at Current Address=Years mdashMonths Housing Noprimary housing expense Own Rent($ month)
If at Current Address for LESS than 2 yearslist Former Address Does not apply
Street Unit
City State ZIP Country
How Long at Former Address Years mdashMonths Housing Noprimary housing expense Own month)
Mailing Address- ifdifferent from CurrentAddress Does not apply
Street Unit
City State ZIP Country
eeeeCeeteiChuraleCme Doesnot apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base S$month
City State ZIP Country Overtime =$_____monthBonus $ month
Position orTitle Checkif this statementapplies Commission sect month| am employedby a family memberpropertyseller real estate agent or otherparty to the transaction
TTStart Date ____ (mmddyy) Military
Entitlements$_How longin this line of work Years =Months mdash monthSS
Other $ monthCheckif you are the BusinessOwnerorSelf-Employed
| have an ownershipshare ofless than 25 Monthly Income(or Loss) mdashmdash| have an ownership share of 25 or more $ TOTAL $ 000month
Uniform Residential Loan Application mdash Additional Borrower
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
CoeeeMCMCmeticlm tu)Comiteteilteeilelie mieit
Does not apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base
OvertimeBonus
Commission
MilitaryEntitlements
Other
$ month
$ month$ month
$ month
$ month
$ month
City State ZIP Country
Position orTitle ose if this statement applieslam employed by a family memberpropertyseller real estate agent or otherparty to the transaction
Start Date (mmddyy)How long in this line of work Years =Months
Checkif you are the Business
Owneror Self-Employed| have an ownershipshare of less than 25 Monthly Income(or Loss)
Ihave an ownership share of 25 or more $ TOTAL$ 000month
CPONMeeeMummaTestetiersdeere lire miret Does not apply
Provideat least 2 years of current and previous employment and income
Employeror Business Name Previous Gross MonthlyStreet Unit Income s month
City State ZIP Country
Position or Title
Start Date
End Date
Checkif you were the BusinessOwneror Self-Employed
(mmddyyyy)
(mmddyyyy) 1e Income from Other Sources Does not apply
Include incomefrom other sources below Under Income Source choose from the sourceslisted herelaquo Alimonylaquo Automobile Allowanceraquo Boarder Incomelaquo Capital Gains
Child Support+ Disability+ Foster Care Housing or Parsonage
+ Interest and DividendslaquoMortgage Credit Certificate Mortgage DifferentialPayments
laquo Notes Receivable+ Public Assistancelaquo Retirement(eg Pension IRA)
+raquo Royalty Payments Separate Maintenance
+ Social Security
raquo Trust
+ UnemploymentBenefits
laquo VA Compensation
laquo Other
NOTE Revealalimony child support separate maintenance or other income ONLYIFyou wantit considered in determining yourqualification
for this loan
Income Source - uselist above Monthly Income
$
$
$
$ 000Provide TOTAL AmountHere|
Section 2 Financial Information mdash Assets andLiabilities
Myinformation for Section 2 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 3 Financial Information mdash Real Estate
Myinformation for Section 3 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 4 Loan and Property Information
Myinformation for Section 4 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 5 DeclarationsThis section asks you specific questions about the property your funding and your past
financial history
5aAboutthis Property and Your Moneyforthis Loan
A Will you occupy the property as your primary residence NO YES
If YES have you had an ownershipinterest in another property in the last three years NO YES
If YES complete (1) and (2) below
(1)What type of property did you ownprimary residence (PR) FHA secondary residence (SR) second home(SH)
or investmentproperty (IP)
(2) How did you holdtitle to the property by yourself (S) jointly with your spouse(SP) or jointly with another person (O)
B If this is a Purchase Transaction Do you have a family relationship or businessaffiliation with the seller of the property NO YES Cc Are you borrowing any moneyforthis real estate transaction (eg money foryour closing costs or down payment) or
obtaining any moneyfrom anotherparty suchastheselleror realtor that you have not disclosed on this loan application NO YES
If YES whatis the amountof this money $
D 1 Have youorwill you be applying for a mortgage loan on anotherproperty (not the property securing this loan) on orbefore closing this transaction that is not disclosed on this loan application
NO YES
2 Have you orwill you be applying for any newcredit (eg installment loan credit card etc) on or before closing this loan that wsis not disclosed on this application
NO YES
E Will this property be subject to a lien that could take priority over thefirst mortgagelien such as a clean energylien paid
through yourproperty taxes(eg the PropertyAssessed Clean Energy Program)No YES
EK) Veli ellim ait
F Areyou a co-signer or guarantor on any debtor loan thatis not disclosed on this application NO ES
G Are there any outstanding judgments against you NO YES
H Are you currently delinquentor in default on a Federal debt NO YES
I Are you a party to a lawsuit in which you potentially have any personalfinancialliability NO YES
J Have you conveyedtitle to any property in lieu of foreclosure in the past 7 years NO YES
K Within the past 7 years have you completed a pre-foreclosure sale or short sale whereby the property wassold to a
third party and the Lender agreed to acceptless than the outstanding mortgage balance due
No YES
L Have you had property foreclosed uponin thelast 7 years NO YES
M Have you declared bankruptcy within the past 7 years no vESIf YES identify the type(s) of bankruptcy Chapter 7 Chapter11 Chapter12 Chapter 13
Section 6 Acknowledgements and AgreementsMy signature for Section 6 is on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 7 Military Service This section asks questions about your(or your deceased spouses) military service
Military Service of Borrower
Military Service mdash Did you (or your deceased spouse)everserve or are you currently serving in the United States Armed Forces NO YES
IfYES check allthat apply Currently serving on active duty with projected expiration date of servicetour (mmddyyyy)
Currently retired discharged or separated from service nnOnly period of service was as a non-activated memberofthe Reserve or National GuardSurviving spouse
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 8 Demographic InformationThis section asks about your ethnicity sex and race
Demographic Information of Borrower
The purposeofcollecting this information is to help ensure thatall applicants are treated fairly and that the housing needs of communities
and neighborhoodsare beingfulfilled 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 providethis information but are encouraged to do so You mayselect one or more designationsfor
Ethnicity and one or more designationsfor Race The law provides that we maynotdiscriminate onthe basis of this information or onwhetheryou chooseto provideit However if you choose notto provide the information and you have madethis application in person Federal
regulations require us to note yourethnicity sex and race on the basis of visual observation or surname The law also provides that we may notdiscriminate on the basis of age or marital status information you providein this application If you do not wish to provide someorall of this
information please check below
Ethnicity Check one or more Race Check one or moreHispanic or Latino AmericanIndian or Alaska Native - Print nameofenrolled
or principaltribeMexican PuertoRican Cuban
OtherHispanic or Latino - Printorigin siansian Indian Chinese Filipino
For exampleArgentinean Colombian Dominican NicaraguanSalvadoran Spaniard andso on
Japanese Korean VietnameseOtherAsian - Print race Forexample Hmong Laotian Thai Pakistani Cambodian andso on
Black or African American
Native Hawaiian or OtherPacific Islander
Native Hawaiian GuamanianorChamorro Samoan
OtherPacific Islander mdash Print race
Not Hispanic or Latino
| do not wish to providethis information
Sex
Female
Male
| do not wish to providethis informationFor example Fijian Tongan and so on
White
| do not wish to providethis information
Wasthe ethnicity of the Borrowercollected on thebasis of visual observation or surnameWasthesex of the Borrowercollected on the basis of visual observation or surnameWastherace of the Borrowercollected on the basis of visual observation or surname
)NO YESNO YESNO YES
Face-to-Face Interview (includes Electronic Media w Video Component) Telephone Interview Faxor Mail Email or Internet
Loan Originator Organization Name
Address
Loan Originator Organization NMLSR ID State License ID
Loan Originator Name
Loan Originator NMLSR ID State License ID
Email Phone (
Signature Date (mmddyyyy)
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Pe)aae-emeet)
Community Property State
At least one borrowerlives in a community propertystateThe property is in a community property state
Transaction DetailConversion of Contract for Deed or Land ContractRenovationConstruction-ConversionConstruction-to-Permanent
Single-Closing Two-ClosingConstructionImprovementCosts $
LotAcquired Date
Original Cost of Lot $(mmddyyyy)
Refinance Program
Full DocumentationInterest Rate ReductionStreamlined without Appraisal
Other
Refinance Type
NoCash OutLimited Cash OutCash Out
Energy Improvement
Mortgageloanwill finance energy-related improvements
Propertyis currently subject to a lien that could take priority ovethe first mortgagelien such as a clean energylien paid for througproperty taxes(eg the PropertyAssessed Clean Energyprogram)
Project Type Condominium Cooperative Planned Unit Development (PUD) Propertyis notlocatedin a project
Peiwlivcestetece)a)
Title to the Property Will be Held in What Name(s)
For RefinanceTitle to the Property is Currently Held in What Name(s
Trust Information
tle Will be Held byan Inter Vivos (Living) Trust
Title Will be Held by a Land TrustLeasehold Expiration Date
Mannerin WhichTitle Will be Held Indian Country Land Tenure
Sole OwnershipLife EstateTenancy in Common
Joint Tenancywith Right of Survivorship]Tenancybythe EntiretyOther
Fee Simple Ona ReservationIndividualTrust Land (AllottedRestricted)Tribal Trust Land On a ReservationTribal Trust Land Off ReservationAlaska Native Corporation Land
Estate Will be Held in
Fee Simple(mmddyyyy)
3 Mortgage LoanInformation
Termsof Loan
Note Rate
Loan Term (months)
MortgageLien Type
First LienSubordinate Lien
Mortgage Type Applied For
Conventional USDA-RDFHA VA Other
Amortization Type
Fixed RateAdjustable Rate
If Adjustable Rate
Initial Period Prior to First Adjustment
Subsequent AdjustmentPeriod
Proposed Monthly Paymentfor Property
First Mortgage (P amp I) $
Subordinate Lien(s) (P amp |) $
Other(explain)
Homeowners Insurance $(months)
(months)
Loan Features Property Taxes $
Balloon Balloon Term (months)
Interest Only Interest OnlyTermNegative AmortizationPrepaymentPenalty Prepayment Penalty Term (months) Other
Temporary Interest Rate BuydownInitial Buydown Rate TOTALOther(explain)
Mortgage Insurance $
AssociationProject Dues (Condo Co-Op PUD) $
Supplemental Property Insurance $
(months)
Borrower Name(s)Uniform Residential Loan Application mdash LenderLoan Information
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
L4 Qualifying the Borrower - Minimum Required Funds or Cash Back
DUEFROM BORROWER(S)
A Sales Contract Price
B Improvements Renovations and Repairs
C Land(ifacquired separately)
D For Refinance Balance of Mortgage Loanson the Propertyto be paid off in the Transaction
(See Table 3a Property You Own)
E Credit Cards and Other Debts Paid Off
(See Table 2c Liabilities mdash Credit Cards Other Debts and Leases that You Owe)
F BorrowerClosing Costs (including Prepaid andInitial Escrow Payments)
G Discount Points
HTOTAL DUE FROM BORROWER(s)(Total of A thru G)
TOTALMORTGAGE LOANS
Loan Amount
Loan AmountExcluding Financed Mortgage Insurance (or Mortgage Insurance Equivalent) $
Financed Mortgage Insurance (or Mortgage Insurance Equivalent) Amount $
Other New Mortgage Loanson the Property the Borrower(s) is Buying or Refinancing(See Table 4b Other New MortgageLoanson the Property You are Buying or Refinancing)
KTOTAL MORTGAGELOANS(Totalof| and J)
TOTALCREDITS
L Seller Credits (Enter the amountofBorrower(s) costs paid by the property seller)
MOtherCredits (Enter the sum ofall other credits mdash BorrowerPaid Fees Earnest Money EmployerAssistedHousing Lease Purchase Fund Lot Equity Relocation Funds Sweat Equity Trade Equity Other)
NTOTAL CREDITS(Total of L and M)
CALCULATION
TOTAL DUE FROM BORROWER(s)(Line H)
LESSTOTAL MORTGAGELOANS(Line K) AND TOTAL CREDITS(Line N)
Cash FromTothe Borrower(Line H minusLine K and Line N)NOTE This amountdoesnotinclude reservesor other funds that may be required by the Lenderto be verified
Borrower Name(s)Uniform Residential Loan Application mdash LenderLoan Information
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
Uniform Residential Loan Application mdash Unmarried Addendum
eeCeceetatimC elitleeComeLy
Lenders Instructions for Using the Unmarried Addendum
The Lender may use the Unmarried Addendum only when a Borrowerselected ldquoUnmarriedrdquoin Section 1 and the information collected is
necessary to determine howState property lawsdirectly or indirectly affecting creditworthiness apply including ensuring clear title
For example the Lender may use the Unmarried Addendum whentheBorrowerresides in a State that recognizescivil unions domestic
partnerships or registered reciprocal beneficiary relationships or when the property is located in such a State ldquoStaterdquo meansanystate the
District of Columbia the Commonwealth of Puerto Rico or anyterritory or possession of the United States
Ifyou selected ldquoUnmarriedrdquoin Section 1 is there a person whois not your legal spouse but whocurrently has real property rights similar to
those of a legal spouse +=) NOQ YES
If YES indicate the type of relationship and the State in which the relationship was formed For example indicate if you are in a
civil union domestic partnership registered reciprocal beneficiary relationship or other relationship recognized by the State in which you
currently reside or where the property is located
O Civil Union copy Domestic Partnership copy Registered Reciprocal Beneficiary Relationship copy) Other(explain)
Statea]
Borrower NameUniform Residential Loan Application mdash Unmarried Addendum
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Uniform Residential Loan Application mdash Continuation Sheet
Use this continuation sheet if you need more space to complete the Uniform Residential Loan Application
Borrower Name(First Middle Last Suffix )
Additional Information
Additional Borrower Name(First Middle Last Suffix )
Additional Information
IWefully understand thatit is a federal crime punishable by fine or imprisonment or both to knowingly make anyfalse statements concerningany of the abovefacts as applicable underthe provisions of federal law (18 USC sectsect 1001 et seq)
BorrowerSignature Date (mmddyyyy)
Additional Borrower Signature Date (mmddyyyy)
Uniform Residential Loan Application mdash Continuation SheetFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
INSTRUCTIONS FOR COMPLETING THE UNIFORM RESIDENTIAL LOAN APPLICATION
Use the instructions below to complete the enclosed Uniform Residential Loan Application (Freddie Mac Form 65Fannie Mae Form 1003) To avoid any delays in your application review please provide all of the requested information
If you need to make a correction on the application draw a line through the incorrect text and mark your initials beside the change Donrsquot use correction tape or fluid The application must be completed signed and dated in ink
The Uniform Residential Loan Application (URLA)
The URLA contains the following sections Section 1 Borrower Information Please provide your personal information income and employment
Section 2 Financial Information ndash Assets and Liabilities Please provide information about your financial assets personal financial obligations and debts you owe
Section 3 Financial Information ndash Real Estate Please provide information about property you own and the debts and expenses related to the property
Section 4 Loan and Property Information Please provide information about the loan purpose and the property you are buying or refinancing
Section 5 Declarations Please answer questions about the property how the property will be financed and your past financial history
Section 6 Acknowledgments and Agreements Informs you of your legal obligations related to the mortgage application and asks that you acknowledge certain information will be obtained used and shared
Section 7 Military Service Please provide information about your (or your deceased spousersquos) military service
Section 8 Demographic Information Requests information the Lender is required by law to ask you
Section 9 Loan Originator Information Will be completed by Chase
Uniform Residential Loan Application ndash Additional Borrower
The URLA ndash Additional Borrower contains the following sections Section 1 Borrower Information This is the same as the Borrower Information section of the URLA
Section 2 Financial Information ndash Assets and Liabilities Contains only the following statement for the additional Borrower to complete ldquoMy information for Section 2 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo The name of the other borrower is entered here
Complete a separate URLA for each BorrowermiddotThree or more Borrowers ndash Use any combination of URLA and URLA-Additional Borrower forms in accordance with the above examples
Section 3 Financial Information ndash Real Estate Contains only the following statement for the additional borrower to complete ldquoMy information for Section 3 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 4 Loan and Property Information Contains only the following statement for the additional borrower to complete ldquoMy information for Section 4 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 5 Declarations This is the same as the Declarations section of the URLA
Section 6 Acknowledgments and Agreements Contains only the following statement for the additional borrower to complete ldquoMy signature for Section 6 is on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 7 Military Service This is the same as the Military Service section of the URLA
Section 8 Demographic Information This is the same as the Demographic Information section on the URLA
Section 9 Loan Originator Information This is the same as the Loan Originator Information section of the URLA
Using the URLA and URLA ndash Additional Borrower Together The URLA and the URLA ndash Additional Borrower are used together to collect information for two Borrowers who have joint assets liabilities andor real estate information The URLA and URLA ndash Additional Borrower can also be used for Borrowers who do not have joint information but wish to combine their information on the URLA for ease of use Here are examples of how to use the URLA and URLA ndash Additional Borrower
For one borrower Complete the URLA
For two borrowers with joint financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you dont need to duplicate them on more than one URLA or o In cases where Borrowers are not collaborating when completing the loan application
joint assets liabilities and real estate may be duplicated on each URLA bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you do not need to duplicate them on more than one URLA or
o In cases where Borrowers are not collaborating when completing the loan application joint assets liabilities and real estate may be duplicated on each URLA
For two borrowers with separate financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower Report the assets liabilities and
real estate for the additional Borrower on the URLA or bull Complete a separate URLA for each Borrower
For three or more borrowers use any combination of URLA and URLA ndash Additional Borrower forms described for two borrowers
Uniform Residential Loan Application ndash Unmarried Addendum If any borrower listed on the URLA or URLA ndash Additional Borrower form selects Unmarried in Section 1 (Personal Information) the lender will complete this optional form
The information must be collected to determine how to apply state property laws that directly or indirectly affect creditworthiness including ensuring clear title
Uniform Residential Loan Application ndash Continuation Sheet Use the URLA ndash Continuation Sheet if you need more space to complete either the URLA or URLA ndash Additional Borrower forms
99177-URLAI-0215
HUD Addendum to Uniform Residential Loan Application OMB Approval No HUD 2502-0059 (exp )
Part I - Identifying Information HUDFHA Application for Insurance under the National Housing Act and Borrower Certification
FHA Case No (include any suffix) Mortgagee Case No
Mortgagee ID Sponsor ID Agent ID
Mortgagee Name Address (include ZIP Code) and Telephone Number
Type or print all entries clearly
Name and Address of Sponsor Name and Address of Agent
Borrowers Name amp Present Address (include ZIP Code) Property Address (include name of subdivision lot amp block no amp ZIP Code)
Sponsored Originations
Name of Third-Party Originator NMLS ID of Third-Party Originator
Part II - Borrower Consent for Social Security Administration to Verify Social Security Number I authorize the Social Security Administration (SSA) to verify my Social Security Number (SSN) to the Mortgagee and HUDFHA I authorize SSA to provide explanatory
information to HUDFHA in the event of a discrepancy This consent is valid for 180 days from the date signed unless indicated otherwise by the individual(s) named in this
loan application
Signature(s) of Borrower(s) - Read consent carefully Review accuracy of Social Security Number(s) provided on this application
Borrowerrsquos NameDate of BirthSocial Security Number
Co-Borrowerrsquos Name Date of BirthSocial Security Number
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
Part III - Borrower Notices Information and Acknowledgment Public Reporting Burden
Public reporting burden for this collection of information is estimated to average 10 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 conduct or sponsor and a person is not
required to respond to a collection of information unless that collection displays a valid OMB control number which can be located on the OMB Internet page at
httpwwwreginfogovpublicdoPRAMain
Privacy Act Information
The information requested on the Uniform Residential Loan Application and this Addendum is authorized by the National Housing Act of 1934 12 USC sect 1701 et seq The Debt
Collection Act of 1982 Pub L 97-365 and HUDrsquos Housing and Community Development Act of 1987 42 USC sect 3543 require persons applying for a federally insured loan to
furnish their SSN You must provide all the requested information including your SSN HUD may conduct a computer match to verify the information you provide HUD may
disclose certain information to Federal State and local agencies when relevant to civil criminal or regulatory investigations and prosecutions It will not otherwise be disclosed or
released outside of HUD except as required and permitted by law The information will be used to determine whether you qualify as a mortgagor Failure to provide any of the
requested information including SSN may result in disapproval of your loan application This is notice to you as required by the Right to Financial Privacy Act of 1978 that
HUDFHA has a right of access to financial records held by financial institutions in connection with the consideration or administration of assistance to you Financial records
involving your transaction will be available to HUDFHA without further notice or authorization but will not be disclosed or released by the institution to another Government Agency
or Department without your consent except as required or permitted by law
WARNING This warning applies to all certifications made in this document Anyone who knowingly submits a false claim or makes false statements is subject to criminal and civil penalties including confinement for up to 5 years fines and civil penalties 18 USC sectsect 287 1001 and 31 USC sect 3729
orm HUD-92900-A ( ) Page 1
Borrower Name ____________________________ FHA Case No __________________
Caution Delinquencies Defaults Foreclosures and Abuses Delinquencies defaults foreclosures and abuses of mortgage loans involving programs of the Federal Government can be costly and detrimental to your credit now and in the future The Mortgagee in this transaction its agents and assigns as well as the Federal Government its agencies agents and assigns are authorized to take any and all of the following actions in the event loan payments become delinquent on the mortgage loan described in the attached application (1) Report your name and account information to a credit bureau (2) Assess additional interest and penalty charges for the period of time that payment is not made (3) Assess charges to cover additional administrative costs incurred by the Federal Government to service your account (4) Offset amounts owed to you
under other Federal programs (5) Refer your account to a private attorney collection agency or mortgage servicing agency to collect the amount due foreclose
the mortgage sell the property and seek judgment against you for any deficiency (6) Refer your account to the Department of Justice (DOJ) for litigation in the
courts (7) If you are a current or retired Federal employee take action to offset your salary or civil service retirement benefits (8) Refer your debt to the Internal
Revenue Service for offset against any amount owed to you as an income tax refund and (9) Report any resulting written off debt of yours to the Internal Revenue Service as your taxable income All of these actions may be used to recover any debts owed when it is determined to be in the interest of the Mortgagee or Federal Government or both
As a mortgage loan borrower you will be legally obligated to make the mortgage payments called for by your mortgage loan contract The fact that you dispose of your property after the loan has been made will not relieve you of liability for making these payments Payment of the loan in full is ordinarily the way liability on a mortgage note is ended Some home buyers have the mistaken impression that if they sell their homes when they move to another locality or dispose of it for any other reasons they are no longer liable for the mortgage payments and that liability for these payments is solely that of the new owners Even though the new owners may agree in writing to assume liability for your mortgage payments this assumption agreement will not relieve you from liability to the holder of the note which you signed when you obtained the loan to buy the property Unless you are able to sell the property to a buyer who is acceptable to HUDFHA who will assume the payment of your obligation to the lender you will not be relieved from liability to repay any claim which HUDFHA may be required to pay your lender on account of default in your loan payments The amount of any such claim payment may be a debt owed by you to the Federal Government and subject to established collection procedures
Fair Housing Act I and anyone acting on my behalf are and will remain in compliance with the Fair Housing Act 42 USC sect 3604 et seq with respect to the dwelling or property covered by the loan and in the provision of services or facilities in connection therewith I recognize that any restrictive covenant on this property related to race color religion sex disability familial status or national origin is unlawful under the Fair Housing Act and unenforceable I further recognize that in addition to administrative action by HUD a civil action may be brought by the DOJ in any appropriate US court against any person responsible for a violation of the
applicable law
Certification and Acknowledgment All information in this application is given for the purpose of obtaining a loan to be insured under the National Housing Act and the information in the Uniform Residential Loan Application and this Addendum is true and complete to the best of my knowledge and belief Verification may be obtained from any source named herein I have read and understand the foregoing concerning my liability on the loan and Part III Borrower Notices Information and Acknowledgment
Signature(s) of Borrower(s) - Do not sign unless this application is fully completed Read the certification carefully and review accuracy of this application
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
orm HUD-92900-A ( Page 2
___________________________________
______________________________________________________
______________________________________________________________
- - - - - - - - - - - - - - - - - - - - - - -
Borrower Name ____________________________ FHA Case No __________________
Part IV - Direct Endorsement Approval for a HUD FHA-Insured Mortgage A Underwriting the Borrower
Date Mortgage Approved ______________________________ Date Approval Expires ______________________
For mortgages rated as an ldquoacceptrdquo or ldquoapproverdquo by FHAs TOTAL Mortgage Scorecard
The information submitted to TOTAL was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA4e Final Underwriting Decision (TOTAL) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee Representative Signature
Printed Name
Title
OR
For mortgages rated as a ldquoreferrdquo by FHAs TOTAL Mortgage Scorecard or manually underwritten by a Direct Endorsement underwriter I have personally reviewed and underwritten the borrowerrsquos credit application The information used to underwrite the borrower was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA5d Final Underwriting Decision (Manual) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
B Underwriting the Property
For all mortgages where FHA requires an appraisal I have personally reviewed and underwritten the appraisal according to FHA requirements I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
orm HUD-92900-A ( ) Page 3
Borrower Name ____________________________ FHA Case No __________________
Part V Mortgagees Certification
I have personally reviewed the mortgage documents and the application for insurance endorsement and This mortgage complies with SF Handbook 40001 Section IIA7 Post-Closing and Endorsement to the extent that no defect exists that would have changed the decision to endorse or submit the mortgage for insurance
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee
Name of Mortgageersquos Representative
Title of Mortgageersquos Representative
Signature of the Mortgageersquos Representative Date
orm HUD-92900-A ( ) Page 4
GENERAL AUTHORIZATION FOR A MORTGAGE LOAN ASSUMPTION
Applicant name(s)
Loan number
NOTICES AND DISCLOSURES
Non-discriminatory underwriting guidelines Anyone who inquires about the availability of credit from us has the right to receive a copy of our non-discriminatory underwriting guidelines To request a copy of these guidelines contact your Loan Processor
Attorney note Itrsquos the responsibility of our attorneys to protect our interest You may at your expense request an attorney to represent your interest
Notice to HUDFHA applicants As required by the Right to Financial Privacy Act of 1978 this notice is to inform you that the US Department of Housing and Urban Development (HUD)Federal Housing Administration (FHA) has a right of access to financial records held by financial institutions related to a request for assistance Financial records involving your assumption will be available to HUDFHA without further notice or authorization but wonrsquot be disclosed or released by us to another government agency or department without your consent except as required or permitted by law
Borrower consent to the use of tax return information I understand acknowledge and agree that the Lender and Other Loan Participants can obtain use and share tax return information for purposes of (i) providing an offer (ii) originating maintaining managing monitoring servicing selling insuring and securitizing a loan (iii) marketing or (iv) as otherwise permitted by applicable laws including state and federal privacy and data security laws The Lender includes the Lenderrsquos affiliates agents service providers and any of aforementioned partiesrsquo successors and assigns The Other Loan Participants includes any actual or potential owners of a loan resulting from your loan application or acquirers of any beneficial or other interest in the loan and mortgage insurer guarantor any servicers or service providers for these parties and any of aforementioned partiesrsquo successors and assigns
CERTIFICATION AND AUTHORIZATION
Environmental certification By signing below I represent and warrant that Irsquom not aware of any substances materials or products that may be an environmental hazard such as but not limited to asbestos formaldehyde radon gas lead-based paint fuel or chemical storage tanks (above or below ground) and contaminated soil or water on the property I acknowledge that Chase is relying on this representation and warranty as a material part of its loan application process I also am not aware of any landfill on any portion of the property
Exceptions to the above I further acknowledge (1) receipt of applicable disclosures from the seller in purchase transactions (2) that lead-based paint may exist in housing constructed prior to 1978 (3) that Chase performs no environmental investigation on my behalf and isnrsquot responsible for identifying lead-based paint or any other environmental conditions that might impact the property or its residents and (4) that it is my sole obligation to investigate for potential impact to the property from environmental conditions
Certifications I certify by signing below that (1) all of the loan application information provided is true and complete (2) I understand any intentional or negligent misrepresentation(s) of the information provided in conjunction with my application may result in civil liability andor 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 Chase its agents successors and assigns insurers and any other person who may suffer any loss due to reliance upon any misrepresentation that I have made on the application and (3) any significant change from the information provided at the time of application until the final loan application is signed may have a bearing on the approval of my application for a home loan
Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union
This question is asked because of state laws that extend the same or similar rights benefits and protections of spouses in a marriage to persons who are members of a partnership or union recognized under state law You should consult with your own legal advisor for advice regarding the rights protections benefits responsibilities obligations and duties of those who are registered domestic partners civil union partners or members of other unions recognized under applicable law
CREDIT AUTHORIZATION RELEASE
By signing below I authorize Chase andor my mortgage insurer (if any) to verify my past and present employment earnings records (including information contained in income tax returns that have been filed with the IRS) bank accounts stock holdings and any other information that it finds necessary to process my mortgage loan application or to review it for quality-control purposes I understand that a credit report will be ordered from a credit reporting agency for verification prior to loan closing as part of the application process and may be ordered after closing as part of the Lenderrsquos quality-control program A credit report may also be completed as part of the Lenderrsquos servicing or collection of the loan or in consideration of any other product or service that the Lender may consider offering me in the future and at any time throughout the life of the loan I understand that use of a photocopy of this form may be necessary to verify one or more of my credit references I understand that a photocopy or fax copy of this form will also serve as authorization
By signing below each applicant acknowledges (1) making the above certifications and authorizations and (2) that each applicant has received and understands the above notices and disclosures
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
You do not have to give us this information but if you donrsquot your application for approval as a borrower may be delayed or rejected The information requested in this form is authorized by Title 38 USC Chapter 37 (if VA) by 12 USC Section 1701 et seq (if HUDFHA) by 42 USC Section 1452b (if HUDCPD) and Title 42 USC 1471 et seq or 7 USC 1921 et seq (if USDA FHA)
Updated December 2021 99177-GA-0215
1b
2b
Form 4506-C (September 2020)
Department of the Treasury - Internal Revenue Service
IVES Request for Transcript of Tax Return OMB Number
1545-1872
Do not sign this form unless all applicable lines have been completed Request may be rejected if the form is incomplete or illegible
For more information about Form 4506-C visit wwwirsgov and search IVES
1a Name shown on tax return (if a joint return enter the name shown first)
First social security number on tax return individual taxpayer identification number or employer identification number (see instructions)
2a If a joint return enter spousersquos name shown on tax return Second social security number or individual taxpayer identification number if joint tax return
3 Current name address (including apt room or suite no) city state and ZIP code (see instructions)
4 Previous address shown on the last return filed if different from line 3 (see instructions)
5a IVES participant name address and SOR mailbox ID
DataVerify 875 Greentree Rd 8 Parkway Center Pittsburgh PA 15220
5b Customer file number (if applicable) (see instructions)
Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing (see instructions)
6 Transcript requested Enter the tax form number here (1040 1065 1120 etc) and check the appropriate box below Enter only one tax form number per request 1040
a Return Transcript which includes most of the line items of a tax return as filed with the IRS A tax return transcript does not reflect changes made to the account after the return is processed Transcripts are only available for the following returns Form 1040 series Form 1065 Form 1120 Form 1120-A Form 1120-H Form 1120-L and Form 1120S Return transcripts are available for the current year and returns processed during the prior 3 processing years
b Account Transcript which contains information on the financial status of the account such as payments made on the account penalty assessments and adjustments made by you or the IRS after the return was filed Return information is limited to items such as tax liability and estimated tax payments Account transcripts are available for most returns
c Record of Account which provides the most detailed information as it is a combination of the Return Transcript and the Account Transcript Available for current year and 3 prior tax years
7 Form W-2 Form 1099 series Form 1098 series or Form 5498 series transcript The IRS can provide a transcript that includes data from these information returns State or local information is not included with the Form W-2 information The IRS may be able to provide this transcript information for up to 10 years Information for the current year is generally not available until the year after it is filed with the IRS For example W-2 information for 2016 filed in 2017 will likely not be available from the IRS until 2018 If you need W-2 information for retirement purposes you should contact the Social Security Administration at 1-800-772-1213
Caution If you need a copy of Form W-2 or Form 1099 you should first contact the payer To get a copy of the Form W-2 or Form 1099 filed with your return you must use Form 4506 and request a copy of your return which includes all attachments
8 Year or period requested Enter the ending date of the tax year or period using the mmddyyyy format (see instructions)
12 31 2020 12 31 2019 12 31 2018 Caution Do not sign this form unless all applicable lines have been completed
Signature of taxpayer(s) I declare that I am either the taxpayer whose name is shown on line 1a or 2a or a person authorized to obtain the tax information requested If the request applies to a joint return at least one spouse must sign If signed by a corporate officer 1 percent or more shareholder partner managing member guardian tax matters partner executor receiver administrator trustee or party other than the taxpayer I certify that I have the authority to execute Form 4506-C on behalf of the taxpayer Note This form must be received by IRS within 120 days of the signature date
Signatory attests that heshe has read the attestation clause and upon so reading declares that heshe has the authority to sign the Form 4506-C See instructions
Sign Here
Signature (see instructions) Date Phone number of taxpayer on line 1a or 2a
PrintType name
Title (if line 1a above is a corporation partnership estate or trust)
Spousersquos signature Date
PrintType name
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020) For Privacy Act and Paperwork Reduction Act Notice see page 2
Instructions for Form 4506-C IVES Request for Transcript of Tax Return
Section references are to the Internal Revenue Code unless otherwise noted
Future Developments
For the latest information about Form 4506-C and its instructions go to wwwirsgov and search IVES Information about any recent developments affecting Form 4506-C (such as legislation enacted after we released it) will be posted on that page
Whats New Form 4506-C was created to be utilized by authorized IVES participants to order tax transcripts with the consent of the taxpayer
General Instructions
Caution Do not sign this form unless all applicable lines have been completed
Designated Recipient Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information received pursuant to the taxpayerrsquos consent and holds the recipient subject to penalties for any unauthorized access other use or redisclosure without the taxpayerrsquos express permission or request
Taxpayer Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information provided pursuant to your consent and holds the recipient subject to penalties brought by private right of action for any unauthorized access other use or redisclosure without your express permission or request
Purpose of form Use Form 4506-C to request tax return information through an authorized IVES participant You will designate an IVES participant to receive the information on line 5a
Note If you are unsure of which type of transcript you need check with the party requesting your tax information
Where to file The IVES participant will fax Form 4506-C with the approved IVES cover sheet to their assigned Service Center
Chart for ordering transcripts
If your assigned Service Center is
Fax the requests with the approved coversheet to
Austin Submission Processing Center
Austin IVES Team
844-249-6238
Fresno Submission Processing Center
Fresno IVES Team
844-249-6239
Kansas City Submission Processing Center
Kansas City IVES Team
844-249-8128
Ogden Submission Processing Center
Ogden IVES Team
844-249-8129
Specific Instructions
Line 1b Enter the social security number (SSN) or individual taxpayer identification number (ITIN) for the individual listed on line 1a or enter the employer identification number (EIN) for the business listed on line 1a
Line 3 Enter your current address If you use a PO box include it on this line
Line 4 Enter the address shown on the last return filed if different from the address entered on line 3
Note If the addresses on lines 3 and 4 are different and you have not changed your address with the IRS file Form 8822 Change of Address or Form 8822-BChange of Address or Responsible Party mdash Business with Form 4506-C
Line 5b Enter up to 10 numeric characters to create a unique customer file number that will appear on the transcript The customer file number cannot contain an SSN ITIN or EIN Completion of this line is not required
Note If you use an SSN name or combination of both we will not input the information and the customer file number will reflect a generic entry of 9999999999 on the transcript
Line 8 Enter the end date of the tax year or period requested in mmddyyyy format This may be a calendar year fiscal year or quarter Enter each quarter requested for quarterly returns Example Enter 12312018 for a calendar year 2018 Form 1040 transcript
Signature and date Form 4506-C must be signed and dated by the taxpayer listed on line 1a or 2a The IRS must receive Form 4506-C within 120 days of the date signed by the taxpayer or it will be rejected Ensure that all applicable lines including lines 5a through 8 are completed before signing
You must check the box in the signature area to acknowledge you have the authority to sign and request the information The form will not be processed if unchecked
Individuals Transcripts listed on on line 6 may be furnished to either spouse if jointly filed Only one signature is required Sign Form 4506-C exactly as your name appeared on the original return If you changed your name also sign your current name
Corporations Generally Form 4506-C can be signed by
(1) an officer having legal authority to bind the corporation (2) any person designated by the board of directors or other governing body or (3) any officer or employee on written request by any principal officer and attested to by the secretary or other officer A bona fide shareholder of record owning 1 percent or more of the outstanding stock of the corporation may submit a Form 4506-C but must provide documentation to support the requesters right to receive the information
Partnerships Generally Form 4506-C can be signed by any person who was a member of the partnership during any part of the tax period requested on line 8
All others See section 6103(e) if the taxpayer has died is insolvent is a dissolved corporation or if a trustee guardian executor receiver or administrator is acting for the taxpayer
Note If you are Heir at law Next of kin or Beneficiary you must be able to establish a material interest in the estate or trust
Documentation For entities other than individuals you must attach the authorization document For example this could be the letter from the principal officer authorizing an employee of the corporation or the letters testamentary authorizing an individual to act for an estate
Signature by a representative A representative can sign Form 4506-C for a taxpayer only if the taxpayer has specifically delegated this authority to the representative on Form 2848 line 5 The representative must attach Form 2848 showing the delegation to sign Form 4506-C
Privacy Act and Paperwork Reduction Act Notice We ask for the information on this form to establish your right to gain access to the requested tax information under the Internal Revenue Code We need this information to properly identify the tax information and respond to your request You are not required to request any transcript if you do request a transcript sections 6103 and 6109 and their regulations require you to provide this information including your SSN or EIN If you do not provide this information we may not be able to process your request Providing false or fraudulent information may subject you to penalties
Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and cities states the District of Columbia and US commonwealths and possessions for use in administering their tax laws We may also disclose this information to other countries under a tax treaty to federal and state agencies to enforce federal nontax criminal laws or to federal law enforcement and intelligence agencies to combat terrorism
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law Generally tax returns and return information are confidential as required by section 6103
The time needed to complete and file Form 4506-C will vary depending on individual circumstances The estimated average time is
Learning about the law or the form 10 min Preparing the form 12 min Copying assembling and sending the form to the IRS 20 min
If you have comments concerning the accuracy of these time estimates or suggestions for making Form 4506-C simpler we would be happy to hear from you You can write to
Internal Revenue Service Tax Forms and Publications Division 1111 Constitution Ave NW IR-6526 Washington DC 20224
Do not send the form to this address Instead see Where to file on this page
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020)
Rev April 2021 CHASEO Facts What does Chase do with your personal information
Why Financial companies choose how they share your personal information Federal law gives consumers the right to limit some but not all sharing Federal law also requires us to tell you how we collect share and protect your personal information Please read this notice carefully to understand what we do
What The types of personal information we collect and share depend on the product or service you have with us This information can include bull Social Security number and income bull account balances and transaction history bull credit history and payment history
How All financial companies need to share customers personal information to run their everyday business In the section below we list the reasons financial companies can share their customers personal information the reasons Chase chooses to share and whether you can limit this sharing
Reasons we can share your personal information Does Chase share
Can you limit this sharing
For our everyday business purposes - such as to process your transactions maintain your account(s) respond to court orders and legal investigations or report to credit bureaus
Yes No
For our marketing purposes - to offer our products and services to you
Yes No
For joint marketing with other financial companies Yes No
For our affiliates everyday business purposes - information about your transactions and experiences
Yes No
For our affiliates everyday business purposes - information about your creditworthiness
Yes Yes
For our affiliates to market to you Yes Yes
For nonaffiliates to market to you Yes Yes
a
0
To limit our sharing
bull Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
bull Visit us online chasecomprivacypreferences
Please note If you are a new customer we can begin sharing your information 30 days from the date we sent this notice When you are no longer our customer we continue to share your information as described in this notice However you can contact us at any time to limit our sharing
Questions
Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
PAGE 2
Who we are
Who is providing this notice The US consumer financial companies within the JPMorgan Chase amp Co family including JPMorgan Chase Bank NA Chase Insurance Agency Inc and JP Morgan Securities LLC
What we do
How does Chase protect my To protect your personal information from unauthorized access and use we personal information use security measures that comply with federal law These measures include
computer safeguards and secured files and buildings We authorize our employees to get your information only when they need it to do their work and we require companies that work for us to protect your information
How does Chase collect my We collect your personal information for example when you personal information bull open an account or make deposits or withdrawals from your account
bull pay your bills or apply for a loan bull use your credit or debit card We also collect your personal information from others such as credit bureaus affiliates or other companies
Why cant I limit all sharing Federal law gives you the right to limit only bull sharing for affiliates everyday business purposes - information about your
creditworthiness bull affiliates from using your information to market to you bull sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing See below for more on your rights under state law
What happens when I limit sharing for an account I hold jointly with someone else
Your choices will apply to everyone on your account
Definitions
Affiliates Companies related by common ownership or control They can be financial and non financial companies bull Our affiliates include companies with a Chase or JP Morgan name and financial companies such asjP Morgan Securities LLC
Nonaffiliates Companies not related by common ownership or control They can be financial and non financial companies bull Nonaffiliates we share with can include companies such as retailers auto dealers auto makers and membership clubs
Joint marketing A formal agreement between nonaffiliated financial companies that together market financial products or services to you bull Our joint marketing partners include categories of companies such as insurance companies
Other important information
VT Accounts with a Vermont mailing address are automatically treated as if they have limited the sharing as described on page 1 For joint marketing we will only disclose your name contact information and information about your transactions
NV We are providing you this notice pursuant to Nevada law If you prefer not to receive marketing calls from us you may be placed on our Internal Do Not Call List by calling 1-800-945-9470 or by writing to us at PO Box 734007 Dallas TX 75373-4007
For more information contact us at the address above or email PrivacylnfoJPMChasecom with Nevada Annual Notice in the subject line You may also contact the Nevada Attorney Generals office Bureau of Consumer Protection Office of the Nevada Attorney General 555 E Washington St Suite 3900 Las Vegas NV 89101 telephone number 1-702-486-3132 email BCPINFOagstatenvus
CA Accounts with a California mailing address are automatically treated as if they have limited the sharing with nonaffiliates as described on page 1 CA residents are provided a CA notice for additional choices
CHASE O
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
The following disclosure is required by the USA PATRIOT Act
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 opens an account
What this means to you When you 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 drivers
license or other identifying documents
99177-PAT-0215
VETERAN STATEMENT When this loan was opened the US Department of Veterans Affairs (VA) used the veteran borrowerrsquos entitlement which is a set amount the VA promises to repay a lender if the borrower defaults on the mortgage An assumption will modify who is obligated to pay the existing mortgage loan but all loan termsmdashincluding the entitlementmdashwill remain the same If the veteran borrower is being removed from the loan the entitlement would remain with whoever is assuming the loan because the loan will continue to be serviced by the VA If the applicant is also a veteran and can substitute his or her entitlement for the current entitlement then the current borrowerrsquos entitlement can be released
Please review the following questions and answer as appropriate This form requires completion by both the applicant(s) and current borrower(s)
1 Applicant to Complete
Are you (the applicant) currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the reverse side)
Yes (If yes please provide the information requested below answer the question in section 3 and sign and date this form at the bottom of the reverse side)
Name of applicant(s) who answered ldquoyesrdquo to the above question
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Are you receiving VA disability benefts
Applicant
Yes
No
Co-Applicant
Yes
No
Are you entitled to receive VA disability benefts Yes No Yes No
Have you received VA disability benefts in the past Yes No Yes No
Are you a surviving spouse of a veteran who died on active duty or as the result of a service-related disability
Yes No Yes No
Do you have any VA loans Yes No Yes No
2 Current Borrower to Complete
Is the current borrowerco-borrower currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the page)
Yes (If yes please answer the question in section 3 and sign and date this form at the bottom of the page)
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
________________________________________________________________________________________________
3 Applicant and Current Borrower to Complete
If the answer to the questions in section 1 and 2 are both yes please answer the following question After yoursquove reviewed and completed this entire form please sign and date at the bottom
Applicant Current Borrower
Do you want to apply for a substitution of entitlement Yes Yes No No
In order to complete a substitution of entitlement the veteran applicant must have suffcient entitlement to substitute for that of the current borrower Contact the VA Offce of Jurisdiction for your area for more information Also before the veteran applicant can substitute entitlement on a VA loan heshe must certify that the property securing the loan will be occupied as hisher primary residence Both the applicantrsquos and current borrowerrsquos original certifcate of eligibility will be required If your sales contract is contingent upon the restoration of entitlement please contact your VA Offce of Jurisdiction for complete procedures Otherwise the substitution will be completed after the loan has been approved and closed
Date Applicant printed name Applicant signature
Date Applicant printed name Applicant signature
Date Current Borrower printed name Current Borrower signature
Date Current Borrower printed name Current Borrower signature
Forms completed by Mail Phone
For Chase use only
Interviewer signature Date
99177-VS-0215
- Assumption Application Package_41521-noscannedpages-update-4pdf
-
- 1 FM203 Cover Pagepdf
- 2 FM202 Mortgage Assumption Application Package pagepdf
- 3 The Documents Youll need to Send Uspdf
- 4 FM201 FAQpdf
- 5 FM142 CIWpdf
- 6 FM126 URLApdf
- 7 FM130 URLA Instpdf
-
- Blank Page
-
- 8 92900a Addednum to Loan Applicationpdf
- 9 FM462 Gen Authpdf
- 10 FM220 4506-Cpdf
- 11 FM153 Chase Federal Privacy Noticepdf
- 12 FM144 Info on Opening a New Accountpdf
- 13 FM152 Veteran Statementpdf
-
- Date
- Loan number
- Applicant name
- Phone1
- Loan number 1
- Loan number 2
- Other
- Other_2
- 1
- 2
- undefined_7
- Available hours
- Available hours_2
- undefined_8
- Available hours_3
- undefined_9
- Current address 1
- Neither
- Available hours_4
- Available hours_5
- undefined_10
- Available hours_6
- 1_2
- 2_2
- undefined_11
- Available hours_7
- Available hours_8
- undefined_12
- Available hours_9
- FHA Case No include any suffix
- Mortgagee Case No
- Mortgagee ID
- Sponsor ID
- Agent ID
- Name and Address of Sponsor Name and Address of Agent
- Borrowers Name Present Address include ZIP Code Property Address
- include name of subdivision lot block no ZIP Code
- Name of ThirdParty Originator
- NMLS ID of ThirdParty Originator
- s application
- ty Number
- ty Number_2
- Date Signed_2
- Date Mortgage Approved
- Date Approval Expires
- Printed Name
- Title 1
- DEs ID Number
- DEs ID Number_2
- Mortgagee
- Name of Mortgagees Representative
- Title of Mortgagees Representative
- Signature of the Mortgagees Representative
- Date_2
- Applicant names 1
- Applicant names 2
- Applicant names 3
- Loan number_2
- Date_3
- Applicant printed name
- Social Security number
- Date_4
- Applicant printed name_2
- Social Security number_2
- Date_5
- Applicant printed name_3
- Social Security number_3
- Date_6
- Applicant printed name_4
- Social Security number_4
- 1a Name shown on tax return if a joint return enter the name shown first
- 1b First social security number on tax return individual taxpayer identification number or employer identification number see instructions
- 2a If a joint return enter spouses name shown on tax return
- 2b Second social security number or individual taxpayer identification number if joint tax return
- 4 Previous address shown on the last return filed if different from line 3 see instructions
- 5a IVES participant name address and SOR mailbox ID
- Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing see instructions
- Signature see instructions
- Date_7
- Phone number of taxpayer on line 1a or 2a
- PrintType name
- Here
- Spouses signature
- Date_8
- PrintType name_2
- Name
- Date of birth
- Service number
- Name_2
- Date of birth_2
- Service number_2
- Date_9
- Applicant printed name_5
- Date_10
- Applicant printed name_6
- Date_11
- Current Borrower printed name
- Date_12
- Current Borrower printed name_2
- Date_13
- Text3
- Text10
- undefined_13
- Text15
- undefined_14
- undefined_15
- undefined_16
- undefined_17
- undefined_18
- undefined_19
- undefined_20
- undefined_21
- undefined_23
- Reason for assumption Off
- Requestors relationship to owners Off
- Check one Off
- Check one1 Off
- Day1
- Evening
- Cell phone
- Check one2 Off
- Check one3 Off
- Check one4 Off
- Check one5 Off
- Text2-1
- Text2-2
- Text2-3
- Text2-4
- Text2-5
- Text2-6
- Text3-1
- Text3-2
- Text3-3
- Text3-4
- Text3-6
- Text3-7
- Text3-8
- Text3-9
- Text3-10
- Text3-11
- Text3-12
- Text3-13
- Text3-14
- Text3-15
- Text3-16
- Text3-17
- Text3-18
- Text3-19
- Text3-20
- Text3-21
- Text3-22
- Text3-23
- Text3-24
- Text3-25
- Text3-26
- Text3-27
- Text3-28
- Text3-29
- Text3-30
- Text3-31
- Text3-32
- Text3-33
- Text3-34
- Text3-35
- Text3-36
- Text3-37
- Text3-38
- Text3-39
- Text3-40
- Text3-41
- Text3-42
- Text3-43
- Text3-44
- Text3-45
- Text3-46
- Text3-47
- Text3-48
- Text3-49
- Text3-50
- Text3-51
- Text3-52
- Text3-53
- Text3-5
- Text3-54
- Text3-55
- Text3-56
- Citizenship Off
- Type of credit Off
- Marital Status Off
- Housing Off
- Housing1 Off
- ownership Off
- DNA1 Off
- DNA2 Off
- DNA3 Off
- family Off
- BO Off
- Total
- Text31
- Text32
- Text33
- Text34
- Text35
- Text36
- Text37
- Text38
- Text39
- Text310
- Text311
- Text312
- Text313
- Text314
- Text315
- Text316
- Text317
- Text318
- Text319
- ownership1 Off
- Total1
- Total1-2
- Check Box4-1 Off
- Text320
- Text321
- Text322
- Text323
- Text324
- Text325
- Text326
- Text327
- Text328
- Text329
- Check Box4-2 Off
- Check Box4-3 Off
- Check Box4-4 Off
- Check Box4-8 Off
- Check Box4-9 Off
- Text330
- Text331
- Text332
- Text333
- Text334
- Text335
- Text1-1
- Text1-2
- Text1-3
- Text1-4
- Text1-5
- Text1-6
- Text1-7
- Text1-8
- Text1-9
- Text1-10
- Text1-11
- Text1-12
- Text1-13
- Text1-14
- Text1-15
- Text1-16
- Text1-17
- Text1-18
- Text1-19
- Text1-20
- Text1-21
- Text1-22
- Text1-23
- Text1-24
- Text1-25
- Text1-26
- Text1-27
- Text1-28
- Text1-29
- Text1-30
- Text1-31
- Text1-32
- Text1-33
- Text1-34
- Text1-35
- Check Box3-2 Off
- Check Box2-1 Off
- Check Box2-2 Off
- Check Box2-3 Off
- Check Box2-4 Off
- Check Box2-5 Off
- Text1-36
- Text1-37
- Text1-38
- Text1-39
- Text1-40
- Text1-41
- Text1-42
- Text1-43
- Text1-44
- Text1-45
- Text1-46
- Text1-47
- Text1-48
- Text1-49
- Text1-50
- Text1-51
- Text1-52
- Text1-53
- Text1-54
- Text1-55
- Text1-56
- Text1-57
- Text1-58
- Text1-59
- Text1-60
- Text1-61
- Check Box3-11 Off
- A1
- A2
- A3
- A4
- A5
- A6
- A7
- A8
- A9
- A10
- A11
- A12
- Check Box3-1 Off
- Check Box30-1 Off
- Check Box30-2 Off
- Check Box30-4 Off
- Check Box30-5 Off
- Check Box30-7 Off
- Check Box30-8 Off
- Check Box30-9 Off
- Check Box30-10 Off
- Check Box30-11 Off
- Check Box30-12 Off
- A13
- A14
- A15
- A16
- A17 Off
- A18
- A19
- A20
- A21
- A22
- A23
- A24
- A25
- A26
- A27
- A28
- A29
- A30
- A31
- A32
- A33
- A34
- A35
- A36
- A37
- A38 Off
- A39
- A40
- A41
- A42
- A43
- A44
- A45
- A46
- A47
- A48
- A49
- A50
- A51
- A52
- A53
- A54
- A55
- A56
- A57
- A58
- A59
- A60
- A61
- A62
- A63
- A64
- A65
- A66
- A67
- A68
- A69
- A70
- A71
- A72
- A73
- A74
- Loan Purpose Off
- occupancy1 Off
- lien type Off
- lientype Off
- mixed use Off
- manufactured home Off
- deposit1 Off
- deposit2 Off
- B1
- B2
- B3
- B4
- B5
- B6
- B7
- B8
- B9
- B10
- fha Off
- Check Box51 Off
- B11
- B12
- B13
- B14
- B15
- B16
- B17
- B18
- B19 Off
- B20
- B21
- B22 Off
- B23
- B24
- B25
- B26
- B27
- B28
- A
-
- Will you occupy the property as your primary residence Off
- Will you occupy the property as your primary residence1 Off
-
- If yes have you had an ownership interest in another property in the last three years Off
- Text9-2
- B
-
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property Off
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property1 Off
-
- 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 Off
- 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 application1 Off
-
- 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 Off
- 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 application1 Off
-
- new credit Off
- 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) Off
- the Property Assessed Clean Energy Program)1 Off
-
- F
-
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application Off
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application1 Off
-
- G
-
- Are there any outstanding judgments against you Off
- Are there any outstanding judgments against you1 Off
-
- H
-
- Are you currently delinquent or in default on a Federal debt Off
- Are you currently delinquent or in default on a Federal debt1 Off
-
- I
-
- Are you a party to a lawsuit in which you potentially have any personal financial liability Off
- Are you a party to a lawsuit in which you potentially have any personal financial liability1 Off
-
- J
-
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years Off
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years1 Off
-
- 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 Off
- 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 due1 Off
-
- L
-
- Have you had property foreclosed upon in the last 7 years Off
- Have you had property foreclosed upon in the last 7 years1 Off
-
- M
-
- Have you declared bankruptcy within the past 7 years Off
- Have you declared bankruptcy within the past 7 years1 Off
-
- Check Box8-2 Off
- Check Box8-3 Off
- Check Box8-4 Off
- Text9-3
- Text9-5
- Text9-6
- Text97
- military Off
- ethnicity Off
- sex Off
- race Off
- demo Off
- Text12-1
- Check Box11-1 Off
- Check Box11-2 Off
- Check Box11-3 Off
- Check Box11-4 Off
- Check Box11-5 Off
- Check Box11-6 Off
- Check Box11-7 Off
- Check Box11-8 Off
- Check Box11-9 Off
- Text12-2
- Check Box11-10 Off
- Check Box11-11 Off
- Check Box11-12 Off
- Check Box11-13 Off
- Check Box11-14 Off
- Check Box11-15 Off
- Text12-3
- Check Box11-16 Off
- Check Box11-17 Off
- Check Box11-18 Off
- Check Box11-19 Off
- Check Box11-20 Off
- Check Box11-21 Off
- Check Box11-22 Off
- Check Box11-23 Off
- Text12-4
- Check Box11-24 Off
- Check Box11-25 Off
- Check Box11-26 Off
- Check Box11-27 Off
- Check Box11-28 Off
- Check Box11-29 Off
- Text12-5
- Check Box11-30 Off
- Check Box11-31 Off
- citizen Off
- credit Off
- marital status1 Off
- housing-1 Off
- housing-2 Off
- own Off
- C1
- C2
- C3
- C6
- C7
- C8
- C9
- C10
- C11
- C12
- C13
- C14
- C15
- C16
- C17
- C18
- C19
- C20
- C21
- C22
- C23
- C24
- C25
- C26
- C27
- C28
- C29
- C30
- C31
- C32
- C33
- C34
- C35
- Check Box-2 Off
- C36
- C37
- C38
- C39
- C4
- C40
- C41
- C42
- C43
- C44
- C45
- C46
- C47
- Check Box-3 Off
- Check Box-4 Off
- C48
- C49
- C5
- C50
- C51
- C52
- C53
- C54
- C55
- Check Box-1-1 Off
- own1 Off
- Check Box-1 Off
- D1 Off
- D2
- D3
- D4
- D5
- D6
- D7
- D8
- D9
- D10
- D11
- D12
- D13
- D14 Off
- D15 Off
- D16
- D17
- D18
- D19
- D20
- D21
- D22
- D23
- D24 Off
- D25
- D26
- D27
- D28
- D29
- D30
- D31
- D32
- D33
- D34
- D35 Off
- D36
- D37 Off
- D38
- D39
- D40
- D41
- D42
- D43
- D44
- D45
- D46
- D47
- If yes have you had an ownership interest in another property in the last three years1 Off
- new credit1 Off
- Check Box8-1 Off
- Check Box8-1-2 Off
- Check Box8-1-1 Off
- Check Box8-1-3 Off
- Check Box8-1-4 Off
- Military Service mdash Did you (or your deceased spouse) ever serve or are you currently serving in the United States Armed Forces 1 Off
- Check1 Off
- Text9-1-1
- Check2 Off
- Check3 Off
- Check4 Off
- Text9-1
- E1
- E2
- E3
- Was the ethnicity of the Borrower collected on the basis of visual observation or surname1 Off
- Was the sex of the Borrower collected on the basis of visual observation or surname1 Off
- Was the race of the Borrower collected on the basis of visual observation or surname1 Off
- The Demographic Information was provided through1 Off
- F1 Off
- F2 Off
- F3 Off
- F4 Off
- F5 Off
- F6
- F7 Off
- F8 Off
- F9 Off
- F10 Off
- F11 Off
- F12 Off
- F13
- F14 Off
- F15 Off
- F16 Off
- F17 Off
- F18 Off
- F19 Off
- F20 Off
- F21 Off
- F22
- F23 Off
- F24 Off
- F25 Off
- F26 Off
- F27 Off
- F28 Off
- F29
- F30 Off
- F31 Off
- undefined_13-1
- undefined_13-2
- undefined_14-1
- undefined_15-1
- undefined_16-1
- undefined_17-1
- undefined_18-1
- undefined_19-1
- undefined_21-1
- undefined_20-1
- undefined_23-1
- undefined_13_1
- Single-Two Off
- Refi type Off
- refi program Off
- Estate Off
- Title held Off
- Trust Information Off
- Indian Country Land Tenure Off
- Mortgage Type Applied For Off
- Mortgage Lien Type Off
- Amortization Type Off
- G1 Off
- G2 Off
- G3 Off
- G4 Off
- G5 Off
- G6
- G7
- G8
- G9
- G10 Off
- G11 Off
- G12 Off
- G13 Off
- G14 Off
- G15 Off
- G16
- G17
- G18
- G19
- G20
- G21
- G22
- G23 Off
- G24
- G25 Off
- G26
- G27 Off
- G28 Off
- G29
- G30 Off
- G31
- G32 Off
- G33
- G34
- G35
- G36
- G37
- G38
- G39
- G40
- G41
- G42
- Property Held
- refi
- Text18-1
- Text18-2
- Text18-3
- Text18-4
- Text18-5
- Text18-6
- Text18-7
- Text18-8
- Text18-9
- Text18-10
- Text18-11
- Text18-12
- Text18-13
- Text18-14
- Text18-15
- Text18-16
- Text18-17
- Text18-18
- Text18-19
- Lender
- case no
- If you selected ldquoUnmarriedrdquo in Section 1 is there a person who is not your legal spouse but who currently has real property rights similar to those of a legal spouse Off
- Relationship and State Off
- Other-5
- Text19-1
- BName
- Additional Information
- ABN
- Additional Information1
- BSign
- BSDate
- ABSign
- ABDate
- MortageeNameAddress
- NAmeAddress
- Bname1
- DOB1
- DOB2
- SignOfBorr1
- SignOfBorr
- Date Signed
- SignOfBorr2
- SignOfBorr3
- Date Signed3
- Date Signed4
- MortgageeRepSign
- DirectSign
- DirectSign1
- Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union Off
- AppSign
- AppSign1
- AppSign2
- AppSign3
- Nopage38 Off
- Yespage38 Off
- Yes1 Off
- No1 Off
- Yes2 Off
- Yes3 Off
- Yes4 Off
- Yes5 Off
- Yes6 Off
- Yes7 Off
- Yes8 Off
- Yes9 Off
- Yes10 Off
- No2 Off
- No3 Off
- No4 Off
- No5 Off
- No6 Off
- No7 Off
- No8 Off
- No9 Off
- No10 Off
- BorrowerNo Off
- BorrowerYes Off
- AppSignature
- AppSignature1
- CurrentSign
- CurrentSign1
- InterviewSign
- Yes_1 Off
- No_1 Off
- Yes_2 Off
- No_2 Off
- Mail Off
- Phone Off
ReelTemCrCL
Loan Originator Organization Name
Address
Loan Originator Organization NMLSR ID State License ID
Loan Originator Name
Loan Originator NMLSR ID State License ID
Date (mmddyyyy)
Borrower NameUniform Residential Loan Application
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Uniform Residential Loan Application mdash Additional BorrowerVerify and complete the information onthis application as directed by your Lender
Section 1 Borrower Informationthis section asks about yourpersonal information and your income fromemploymentandother sources such as retirement that you want considered to qualify for this loan
1a Personal Information
Name(First Middle Last Suffix)
Alternate Names - List any namesby which you are known or any namesunder which credit was previously received (First Middle Last Suffix)
Social Security Number - -(or Individual TaxpayerIdentification Number)
Dateof Birth Citizenship(mmddyyyy)
USCitizenPermanentResidentAlienNon-Permanent ResidentAlien
Type ofCredit| am applying for individualcredit
lam applying forjoint credit Total Number of Borrowers
Each Borrowerintendsto applyfor joint credit Your initials
List Name(s) of Other Borrower(s) Applying for this Loan
(First Middle Last Suffix) - Use a separator between names
Marital Status Dependents(notlisted by another Borrower)
Contact Information
Married Number _ Home Phone ( ) -
( ) _
( ) -mdash_ mdash_
Separated Ages CellPhone
Unmarried ens Work Phone Ext(Single Divorced WidowedCivil Union Domestic Partnership Registered
Reciprocal Beneficiary Relationship)lsquol
Emal
Current Address
Street Unit
City State ZIP Country
How Long at Current Address=Years mdashMonths Housing Noprimary housing expense Own Rent($ month)
If at Current Address for LESS than 2 yearslist Former Address Does not apply
Street Unit
City State ZIP Country
How Long at Former Address Years mdashMonths Housing Noprimary housing expense Own month)
Mailing Address- ifdifferent from CurrentAddress Does not apply
Street Unit
City State ZIP Country
eeeeCeeteiChuraleCme Doesnot apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base S$month
City State ZIP Country Overtime =$_____monthBonus $ month
Position orTitle Checkif this statementapplies Commission sect month| am employedby a family memberpropertyseller real estate agent or otherparty to the transaction
TTStart Date ____ (mmddyy) Military
Entitlements$_How longin this line of work Years =Months mdash monthSS
Other $ monthCheckif you are the BusinessOwnerorSelf-Employed
| have an ownershipshare ofless than 25 Monthly Income(or Loss) mdashmdash| have an ownership share of 25 or more $ TOTAL $ 000month
Uniform Residential Loan Application mdash Additional Borrower
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
CoeeeMCMCmeticlm tu)Comiteteilteeilelie mieit
Does not apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base
OvertimeBonus
Commission
MilitaryEntitlements
Other
$ month
$ month$ month
$ month
$ month
$ month
City State ZIP Country
Position orTitle ose if this statement applieslam employed by a family memberpropertyseller real estate agent or otherparty to the transaction
Start Date (mmddyy)How long in this line of work Years =Months
Checkif you are the Business
Owneror Self-Employed| have an ownershipshare of less than 25 Monthly Income(or Loss)
Ihave an ownership share of 25 or more $ TOTAL$ 000month
CPONMeeeMummaTestetiersdeere lire miret Does not apply
Provideat least 2 years of current and previous employment and income
Employeror Business Name Previous Gross MonthlyStreet Unit Income s month
City State ZIP Country
Position or Title
Start Date
End Date
Checkif you were the BusinessOwneror Self-Employed
(mmddyyyy)
(mmddyyyy) 1e Income from Other Sources Does not apply
Include incomefrom other sources below Under Income Source choose from the sourceslisted herelaquo Alimonylaquo Automobile Allowanceraquo Boarder Incomelaquo Capital Gains
Child Support+ Disability+ Foster Care Housing or Parsonage
+ Interest and DividendslaquoMortgage Credit Certificate Mortgage DifferentialPayments
laquo Notes Receivable+ Public Assistancelaquo Retirement(eg Pension IRA)
+raquo Royalty Payments Separate Maintenance
+ Social Security
raquo Trust
+ UnemploymentBenefits
laquo VA Compensation
laquo Other
NOTE Revealalimony child support separate maintenance or other income ONLYIFyou wantit considered in determining yourqualification
for this loan
Income Source - uselist above Monthly Income
$
$
$
$ 000Provide TOTAL AmountHere|
Section 2 Financial Information mdash Assets andLiabilities
Myinformation for Section 2 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 3 Financial Information mdash Real Estate
Myinformation for Section 3 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 4 Loan and Property Information
Myinformation for Section 4 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 5 DeclarationsThis section asks you specific questions about the property your funding and your past
financial history
5aAboutthis Property and Your Moneyforthis Loan
A Will you occupy the property as your primary residence NO YES
If YES have you had an ownershipinterest in another property in the last three years NO YES
If YES complete (1) and (2) below
(1)What type of property did you ownprimary residence (PR) FHA secondary residence (SR) second home(SH)
or investmentproperty (IP)
(2) How did you holdtitle to the property by yourself (S) jointly with your spouse(SP) or jointly with another person (O)
B If this is a Purchase Transaction Do you have a family relationship or businessaffiliation with the seller of the property NO YES Cc Are you borrowing any moneyforthis real estate transaction (eg money foryour closing costs or down payment) or
obtaining any moneyfrom anotherparty suchastheselleror realtor that you have not disclosed on this loan application NO YES
If YES whatis the amountof this money $
D 1 Have youorwill you be applying for a mortgage loan on anotherproperty (not the property securing this loan) on orbefore closing this transaction that is not disclosed on this loan application
NO YES
2 Have you orwill you be applying for any newcredit (eg installment loan credit card etc) on or before closing this loan that wsis not disclosed on this application
NO YES
E Will this property be subject to a lien that could take priority over thefirst mortgagelien such as a clean energylien paid
through yourproperty taxes(eg the PropertyAssessed Clean Energy Program)No YES
EK) Veli ellim ait
F Areyou a co-signer or guarantor on any debtor loan thatis not disclosed on this application NO ES
G Are there any outstanding judgments against you NO YES
H Are you currently delinquentor in default on a Federal debt NO YES
I Are you a party to a lawsuit in which you potentially have any personalfinancialliability NO YES
J Have you conveyedtitle to any property in lieu of foreclosure in the past 7 years NO YES
K Within the past 7 years have you completed a pre-foreclosure sale or short sale whereby the property wassold to a
third party and the Lender agreed to acceptless than the outstanding mortgage balance due
No YES
L Have you had property foreclosed uponin thelast 7 years NO YES
M Have you declared bankruptcy within the past 7 years no vESIf YES identify the type(s) of bankruptcy Chapter 7 Chapter11 Chapter12 Chapter 13
Section 6 Acknowledgements and AgreementsMy signature for Section 6 is on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 7 Military Service This section asks questions about your(or your deceased spouses) military service
Military Service of Borrower
Military Service mdash Did you (or your deceased spouse)everserve or are you currently serving in the United States Armed Forces NO YES
IfYES check allthat apply Currently serving on active duty with projected expiration date of servicetour (mmddyyyy)
Currently retired discharged or separated from service nnOnly period of service was as a non-activated memberofthe Reserve or National GuardSurviving spouse
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 8 Demographic InformationThis section asks about your ethnicity sex and race
Demographic Information of Borrower
The purposeofcollecting this information is to help ensure thatall applicants are treated fairly and that the housing needs of communities
and neighborhoodsare beingfulfilled 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 providethis information but are encouraged to do so You mayselect one or more designationsfor
Ethnicity and one or more designationsfor Race The law provides that we maynotdiscriminate onthe basis of this information or onwhetheryou chooseto provideit However if you choose notto provide the information and you have madethis application in person Federal
regulations require us to note yourethnicity sex and race on the basis of visual observation or surname The law also provides that we may notdiscriminate on the basis of age or marital status information you providein this application If you do not wish to provide someorall of this
information please check below
Ethnicity Check one or more Race Check one or moreHispanic or Latino AmericanIndian or Alaska Native - Print nameofenrolled
or principaltribeMexican PuertoRican Cuban
OtherHispanic or Latino - Printorigin siansian Indian Chinese Filipino
For exampleArgentinean Colombian Dominican NicaraguanSalvadoran Spaniard andso on
Japanese Korean VietnameseOtherAsian - Print race Forexample Hmong Laotian Thai Pakistani Cambodian andso on
Black or African American
Native Hawaiian or OtherPacific Islander
Native Hawaiian GuamanianorChamorro Samoan
OtherPacific Islander mdash Print race
Not Hispanic or Latino
| do not wish to providethis information
Sex
Female
Male
| do not wish to providethis informationFor example Fijian Tongan and so on
White
| do not wish to providethis information
Wasthe ethnicity of the Borrowercollected on thebasis of visual observation or surnameWasthesex of the Borrowercollected on the basis of visual observation or surnameWastherace of the Borrowercollected on the basis of visual observation or surname
)NO YESNO YESNO YES
Face-to-Face Interview (includes Electronic Media w Video Component) Telephone Interview Faxor Mail Email or Internet
Loan Originator Organization Name
Address
Loan Originator Organization NMLSR ID State License ID
Loan Originator Name
Loan Originator NMLSR ID State License ID
Email Phone (
Signature Date (mmddyyyy)
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Pe)aae-emeet)
Community Property State
At least one borrowerlives in a community propertystateThe property is in a community property state
Transaction DetailConversion of Contract for Deed or Land ContractRenovationConstruction-ConversionConstruction-to-Permanent
Single-Closing Two-ClosingConstructionImprovementCosts $
LotAcquired Date
Original Cost of Lot $(mmddyyyy)
Refinance Program
Full DocumentationInterest Rate ReductionStreamlined without Appraisal
Other
Refinance Type
NoCash OutLimited Cash OutCash Out
Energy Improvement
Mortgageloanwill finance energy-related improvements
Propertyis currently subject to a lien that could take priority ovethe first mortgagelien such as a clean energylien paid for througproperty taxes(eg the PropertyAssessed Clean Energyprogram)
Project Type Condominium Cooperative Planned Unit Development (PUD) Propertyis notlocatedin a project
Peiwlivcestetece)a)
Title to the Property Will be Held in What Name(s)
For RefinanceTitle to the Property is Currently Held in What Name(s
Trust Information
tle Will be Held byan Inter Vivos (Living) Trust
Title Will be Held by a Land TrustLeasehold Expiration Date
Mannerin WhichTitle Will be Held Indian Country Land Tenure
Sole OwnershipLife EstateTenancy in Common
Joint Tenancywith Right of Survivorship]Tenancybythe EntiretyOther
Fee Simple Ona ReservationIndividualTrust Land (AllottedRestricted)Tribal Trust Land On a ReservationTribal Trust Land Off ReservationAlaska Native Corporation Land
Estate Will be Held in
Fee Simple(mmddyyyy)
3 Mortgage LoanInformation
Termsof Loan
Note Rate
Loan Term (months)
MortgageLien Type
First LienSubordinate Lien
Mortgage Type Applied For
Conventional USDA-RDFHA VA Other
Amortization Type
Fixed RateAdjustable Rate
If Adjustable Rate
Initial Period Prior to First Adjustment
Subsequent AdjustmentPeriod
Proposed Monthly Paymentfor Property
First Mortgage (P amp I) $
Subordinate Lien(s) (P amp |) $
Other(explain)
Homeowners Insurance $(months)
(months)
Loan Features Property Taxes $
Balloon Balloon Term (months)
Interest Only Interest OnlyTermNegative AmortizationPrepaymentPenalty Prepayment Penalty Term (months) Other
Temporary Interest Rate BuydownInitial Buydown Rate TOTALOther(explain)
Mortgage Insurance $
AssociationProject Dues (Condo Co-Op PUD) $
Supplemental Property Insurance $
(months)
Borrower Name(s)Uniform Residential Loan Application mdash LenderLoan Information
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
L4 Qualifying the Borrower - Minimum Required Funds or Cash Back
DUEFROM BORROWER(S)
A Sales Contract Price
B Improvements Renovations and Repairs
C Land(ifacquired separately)
D For Refinance Balance of Mortgage Loanson the Propertyto be paid off in the Transaction
(See Table 3a Property You Own)
E Credit Cards and Other Debts Paid Off
(See Table 2c Liabilities mdash Credit Cards Other Debts and Leases that You Owe)
F BorrowerClosing Costs (including Prepaid andInitial Escrow Payments)
G Discount Points
HTOTAL DUE FROM BORROWER(s)(Total of A thru G)
TOTALMORTGAGE LOANS
Loan Amount
Loan AmountExcluding Financed Mortgage Insurance (or Mortgage Insurance Equivalent) $
Financed Mortgage Insurance (or Mortgage Insurance Equivalent) Amount $
Other New Mortgage Loanson the Property the Borrower(s) is Buying or Refinancing(See Table 4b Other New MortgageLoanson the Property You are Buying or Refinancing)
KTOTAL MORTGAGELOANS(Totalof| and J)
TOTALCREDITS
L Seller Credits (Enter the amountofBorrower(s) costs paid by the property seller)
MOtherCredits (Enter the sum ofall other credits mdash BorrowerPaid Fees Earnest Money EmployerAssistedHousing Lease Purchase Fund Lot Equity Relocation Funds Sweat Equity Trade Equity Other)
NTOTAL CREDITS(Total of L and M)
CALCULATION
TOTAL DUE FROM BORROWER(s)(Line H)
LESSTOTAL MORTGAGELOANS(Line K) AND TOTAL CREDITS(Line N)
Cash FromTothe Borrower(Line H minusLine K and Line N)NOTE This amountdoesnotinclude reservesor other funds that may be required by the Lenderto be verified
Borrower Name(s)Uniform Residential Loan Application mdash LenderLoan Information
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
Uniform Residential Loan Application mdash Unmarried Addendum
eeCeceetatimC elitleeComeLy
Lenders Instructions for Using the Unmarried Addendum
The Lender may use the Unmarried Addendum only when a Borrowerselected ldquoUnmarriedrdquoin Section 1 and the information collected is
necessary to determine howState property lawsdirectly or indirectly affecting creditworthiness apply including ensuring clear title
For example the Lender may use the Unmarried Addendum whentheBorrowerresides in a State that recognizescivil unions domestic
partnerships or registered reciprocal beneficiary relationships or when the property is located in such a State ldquoStaterdquo meansanystate the
District of Columbia the Commonwealth of Puerto Rico or anyterritory or possession of the United States
Ifyou selected ldquoUnmarriedrdquoin Section 1 is there a person whois not your legal spouse but whocurrently has real property rights similar to
those of a legal spouse +=) NOQ YES
If YES indicate the type of relationship and the State in which the relationship was formed For example indicate if you are in a
civil union domestic partnership registered reciprocal beneficiary relationship or other relationship recognized by the State in which you
currently reside or where the property is located
O Civil Union copy Domestic Partnership copy Registered Reciprocal Beneficiary Relationship copy) Other(explain)
Statea]
Borrower NameUniform Residential Loan Application mdash Unmarried Addendum
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Uniform Residential Loan Application mdash Continuation Sheet
Use this continuation sheet if you need more space to complete the Uniform Residential Loan Application
Borrower Name(First Middle Last Suffix )
Additional Information
Additional Borrower Name(First Middle Last Suffix )
Additional Information
IWefully understand thatit is a federal crime punishable by fine or imprisonment or both to knowingly make anyfalse statements concerningany of the abovefacts as applicable underthe provisions of federal law (18 USC sectsect 1001 et seq)
BorrowerSignature Date (mmddyyyy)
Additional Borrower Signature Date (mmddyyyy)
Uniform Residential Loan Application mdash Continuation SheetFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
INSTRUCTIONS FOR COMPLETING THE UNIFORM RESIDENTIAL LOAN APPLICATION
Use the instructions below to complete the enclosed Uniform Residential Loan Application (Freddie Mac Form 65Fannie Mae Form 1003) To avoid any delays in your application review please provide all of the requested information
If you need to make a correction on the application draw a line through the incorrect text and mark your initials beside the change Donrsquot use correction tape or fluid The application must be completed signed and dated in ink
The Uniform Residential Loan Application (URLA)
The URLA contains the following sections Section 1 Borrower Information Please provide your personal information income and employment
Section 2 Financial Information ndash Assets and Liabilities Please provide information about your financial assets personal financial obligations and debts you owe
Section 3 Financial Information ndash Real Estate Please provide information about property you own and the debts and expenses related to the property
Section 4 Loan and Property Information Please provide information about the loan purpose and the property you are buying or refinancing
Section 5 Declarations Please answer questions about the property how the property will be financed and your past financial history
Section 6 Acknowledgments and Agreements Informs you of your legal obligations related to the mortgage application and asks that you acknowledge certain information will be obtained used and shared
Section 7 Military Service Please provide information about your (or your deceased spousersquos) military service
Section 8 Demographic Information Requests information the Lender is required by law to ask you
Section 9 Loan Originator Information Will be completed by Chase
Uniform Residential Loan Application ndash Additional Borrower
The URLA ndash Additional Borrower contains the following sections Section 1 Borrower Information This is the same as the Borrower Information section of the URLA
Section 2 Financial Information ndash Assets and Liabilities Contains only the following statement for the additional Borrower to complete ldquoMy information for Section 2 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo The name of the other borrower is entered here
Complete a separate URLA for each BorrowermiddotThree or more Borrowers ndash Use any combination of URLA and URLA-Additional Borrower forms in accordance with the above examples
Section 3 Financial Information ndash Real Estate Contains only the following statement for the additional borrower to complete ldquoMy information for Section 3 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 4 Loan and Property Information Contains only the following statement for the additional borrower to complete ldquoMy information for Section 4 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 5 Declarations This is the same as the Declarations section of the URLA
Section 6 Acknowledgments and Agreements Contains only the following statement for the additional borrower to complete ldquoMy signature for Section 6 is on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 7 Military Service This is the same as the Military Service section of the URLA
Section 8 Demographic Information This is the same as the Demographic Information section on the URLA
Section 9 Loan Originator Information This is the same as the Loan Originator Information section of the URLA
Using the URLA and URLA ndash Additional Borrower Together The URLA and the URLA ndash Additional Borrower are used together to collect information for two Borrowers who have joint assets liabilities andor real estate information The URLA and URLA ndash Additional Borrower can also be used for Borrowers who do not have joint information but wish to combine their information on the URLA for ease of use Here are examples of how to use the URLA and URLA ndash Additional Borrower
For one borrower Complete the URLA
For two borrowers with joint financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you dont need to duplicate them on more than one URLA or o In cases where Borrowers are not collaborating when completing the loan application
joint assets liabilities and real estate may be duplicated on each URLA bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you do not need to duplicate them on more than one URLA or
o In cases where Borrowers are not collaborating when completing the loan application joint assets liabilities and real estate may be duplicated on each URLA
For two borrowers with separate financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower Report the assets liabilities and
real estate for the additional Borrower on the URLA or bull Complete a separate URLA for each Borrower
For three or more borrowers use any combination of URLA and URLA ndash Additional Borrower forms described for two borrowers
Uniform Residential Loan Application ndash Unmarried Addendum If any borrower listed on the URLA or URLA ndash Additional Borrower form selects Unmarried in Section 1 (Personal Information) the lender will complete this optional form
The information must be collected to determine how to apply state property laws that directly or indirectly affect creditworthiness including ensuring clear title
Uniform Residential Loan Application ndash Continuation Sheet Use the URLA ndash Continuation Sheet if you need more space to complete either the URLA or URLA ndash Additional Borrower forms
99177-URLAI-0215
HUD Addendum to Uniform Residential Loan Application OMB Approval No HUD 2502-0059 (exp )
Part I - Identifying Information HUDFHA Application for Insurance under the National Housing Act and Borrower Certification
FHA Case No (include any suffix) Mortgagee Case No
Mortgagee ID Sponsor ID Agent ID
Mortgagee Name Address (include ZIP Code) and Telephone Number
Type or print all entries clearly
Name and Address of Sponsor Name and Address of Agent
Borrowers Name amp Present Address (include ZIP Code) Property Address (include name of subdivision lot amp block no amp ZIP Code)
Sponsored Originations
Name of Third-Party Originator NMLS ID of Third-Party Originator
Part II - Borrower Consent for Social Security Administration to Verify Social Security Number I authorize the Social Security Administration (SSA) to verify my Social Security Number (SSN) to the Mortgagee and HUDFHA I authorize SSA to provide explanatory
information to HUDFHA in the event of a discrepancy This consent is valid for 180 days from the date signed unless indicated otherwise by the individual(s) named in this
loan application
Signature(s) of Borrower(s) - Read consent carefully Review accuracy of Social Security Number(s) provided on this application
Borrowerrsquos NameDate of BirthSocial Security Number
Co-Borrowerrsquos Name Date of BirthSocial Security Number
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
Part III - Borrower Notices Information and Acknowledgment Public Reporting Burden
Public reporting burden for this collection of information is estimated to average 10 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 conduct or sponsor and a person is not
required to respond to a collection of information unless that collection displays a valid OMB control number which can be located on the OMB Internet page at
httpwwwreginfogovpublicdoPRAMain
Privacy Act Information
The information requested on the Uniform Residential Loan Application and this Addendum is authorized by the National Housing Act of 1934 12 USC sect 1701 et seq The Debt
Collection Act of 1982 Pub L 97-365 and HUDrsquos Housing and Community Development Act of 1987 42 USC sect 3543 require persons applying for a federally insured loan to
furnish their SSN You must provide all the requested information including your SSN HUD may conduct a computer match to verify the information you provide HUD may
disclose certain information to Federal State and local agencies when relevant to civil criminal or regulatory investigations and prosecutions It will not otherwise be disclosed or
released outside of HUD except as required and permitted by law The information will be used to determine whether you qualify as a mortgagor Failure to provide any of the
requested information including SSN may result in disapproval of your loan application This is notice to you as required by the Right to Financial Privacy Act of 1978 that
HUDFHA has a right of access to financial records held by financial institutions in connection with the consideration or administration of assistance to you Financial records
involving your transaction will be available to HUDFHA without further notice or authorization but will not be disclosed or released by the institution to another Government Agency
or Department without your consent except as required or permitted by law
WARNING This warning applies to all certifications made in this document Anyone who knowingly submits a false claim or makes false statements is subject to criminal and civil penalties including confinement for up to 5 years fines and civil penalties 18 USC sectsect 287 1001 and 31 USC sect 3729
orm HUD-92900-A ( ) Page 1
Borrower Name ____________________________ FHA Case No __________________
Caution Delinquencies Defaults Foreclosures and Abuses Delinquencies defaults foreclosures and abuses of mortgage loans involving programs of the Federal Government can be costly and detrimental to your credit now and in the future The Mortgagee in this transaction its agents and assigns as well as the Federal Government its agencies agents and assigns are authorized to take any and all of the following actions in the event loan payments become delinquent on the mortgage loan described in the attached application (1) Report your name and account information to a credit bureau (2) Assess additional interest and penalty charges for the period of time that payment is not made (3) Assess charges to cover additional administrative costs incurred by the Federal Government to service your account (4) Offset amounts owed to you
under other Federal programs (5) Refer your account to a private attorney collection agency or mortgage servicing agency to collect the amount due foreclose
the mortgage sell the property and seek judgment against you for any deficiency (6) Refer your account to the Department of Justice (DOJ) for litigation in the
courts (7) If you are a current or retired Federal employee take action to offset your salary or civil service retirement benefits (8) Refer your debt to the Internal
Revenue Service for offset against any amount owed to you as an income tax refund and (9) Report any resulting written off debt of yours to the Internal Revenue Service as your taxable income All of these actions may be used to recover any debts owed when it is determined to be in the interest of the Mortgagee or Federal Government or both
As a mortgage loan borrower you will be legally obligated to make the mortgage payments called for by your mortgage loan contract The fact that you dispose of your property after the loan has been made will not relieve you of liability for making these payments Payment of the loan in full is ordinarily the way liability on a mortgage note is ended Some home buyers have the mistaken impression that if they sell their homes when they move to another locality or dispose of it for any other reasons they are no longer liable for the mortgage payments and that liability for these payments is solely that of the new owners Even though the new owners may agree in writing to assume liability for your mortgage payments this assumption agreement will not relieve you from liability to the holder of the note which you signed when you obtained the loan to buy the property Unless you are able to sell the property to a buyer who is acceptable to HUDFHA who will assume the payment of your obligation to the lender you will not be relieved from liability to repay any claim which HUDFHA may be required to pay your lender on account of default in your loan payments The amount of any such claim payment may be a debt owed by you to the Federal Government and subject to established collection procedures
Fair Housing Act I and anyone acting on my behalf are and will remain in compliance with the Fair Housing Act 42 USC sect 3604 et seq with respect to the dwelling or property covered by the loan and in the provision of services or facilities in connection therewith I recognize that any restrictive covenant on this property related to race color religion sex disability familial status or national origin is unlawful under the Fair Housing Act and unenforceable I further recognize that in addition to administrative action by HUD a civil action may be brought by the DOJ in any appropriate US court against any person responsible for a violation of the
applicable law
Certification and Acknowledgment All information in this application is given for the purpose of obtaining a loan to be insured under the National Housing Act and the information in the Uniform Residential Loan Application and this Addendum is true and complete to the best of my knowledge and belief Verification may be obtained from any source named herein I have read and understand the foregoing concerning my liability on the loan and Part III Borrower Notices Information and Acknowledgment
Signature(s) of Borrower(s) - Do not sign unless this application is fully completed Read the certification carefully and review accuracy of this application
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
orm HUD-92900-A ( Page 2
___________________________________
______________________________________________________
______________________________________________________________
- - - - - - - - - - - - - - - - - - - - - - -
Borrower Name ____________________________ FHA Case No __________________
Part IV - Direct Endorsement Approval for a HUD FHA-Insured Mortgage A Underwriting the Borrower
Date Mortgage Approved ______________________________ Date Approval Expires ______________________
For mortgages rated as an ldquoacceptrdquo or ldquoapproverdquo by FHAs TOTAL Mortgage Scorecard
The information submitted to TOTAL was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA4e Final Underwriting Decision (TOTAL) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee Representative Signature
Printed Name
Title
OR
For mortgages rated as a ldquoreferrdquo by FHAs TOTAL Mortgage Scorecard or manually underwritten by a Direct Endorsement underwriter I have personally reviewed and underwritten the borrowerrsquos credit application The information used to underwrite the borrower was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA5d Final Underwriting Decision (Manual) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
B Underwriting the Property
For all mortgages where FHA requires an appraisal I have personally reviewed and underwritten the appraisal according to FHA requirements I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
orm HUD-92900-A ( ) Page 3
Borrower Name ____________________________ FHA Case No __________________
Part V Mortgagees Certification
I have personally reviewed the mortgage documents and the application for insurance endorsement and This mortgage complies with SF Handbook 40001 Section IIA7 Post-Closing and Endorsement to the extent that no defect exists that would have changed the decision to endorse or submit the mortgage for insurance
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee
Name of Mortgageersquos Representative
Title of Mortgageersquos Representative
Signature of the Mortgageersquos Representative Date
orm HUD-92900-A ( ) Page 4
GENERAL AUTHORIZATION FOR A MORTGAGE LOAN ASSUMPTION
Applicant name(s)
Loan number
NOTICES AND DISCLOSURES
Non-discriminatory underwriting guidelines Anyone who inquires about the availability of credit from us has the right to receive a copy of our non-discriminatory underwriting guidelines To request a copy of these guidelines contact your Loan Processor
Attorney note Itrsquos the responsibility of our attorneys to protect our interest You may at your expense request an attorney to represent your interest
Notice to HUDFHA applicants As required by the Right to Financial Privacy Act of 1978 this notice is to inform you that the US Department of Housing and Urban Development (HUD)Federal Housing Administration (FHA) has a right of access to financial records held by financial institutions related to a request for assistance Financial records involving your assumption will be available to HUDFHA without further notice or authorization but wonrsquot be disclosed or released by us to another government agency or department without your consent except as required or permitted by law
Borrower consent to the use of tax return information I understand acknowledge and agree that the Lender and Other Loan Participants can obtain use and share tax return information for purposes of (i) providing an offer (ii) originating maintaining managing monitoring servicing selling insuring and securitizing a loan (iii) marketing or (iv) as otherwise permitted by applicable laws including state and federal privacy and data security laws The Lender includes the Lenderrsquos affiliates agents service providers and any of aforementioned partiesrsquo successors and assigns The Other Loan Participants includes any actual or potential owners of a loan resulting from your loan application or acquirers of any beneficial or other interest in the loan and mortgage insurer guarantor any servicers or service providers for these parties and any of aforementioned partiesrsquo successors and assigns
CERTIFICATION AND AUTHORIZATION
Environmental certification By signing below I represent and warrant that Irsquom not aware of any substances materials or products that may be an environmental hazard such as but not limited to asbestos formaldehyde radon gas lead-based paint fuel or chemical storage tanks (above or below ground) and contaminated soil or water on the property I acknowledge that Chase is relying on this representation and warranty as a material part of its loan application process I also am not aware of any landfill on any portion of the property
Exceptions to the above I further acknowledge (1) receipt of applicable disclosures from the seller in purchase transactions (2) that lead-based paint may exist in housing constructed prior to 1978 (3) that Chase performs no environmental investigation on my behalf and isnrsquot responsible for identifying lead-based paint or any other environmental conditions that might impact the property or its residents and (4) that it is my sole obligation to investigate for potential impact to the property from environmental conditions
Certifications I certify by signing below that (1) all of the loan application information provided is true and complete (2) I understand any intentional or negligent misrepresentation(s) of the information provided in conjunction with my application may result in civil liability andor 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 Chase its agents successors and assigns insurers and any other person who may suffer any loss due to reliance upon any misrepresentation that I have made on the application and (3) any significant change from the information provided at the time of application until the final loan application is signed may have a bearing on the approval of my application for a home loan
Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union
This question is asked because of state laws that extend the same or similar rights benefits and protections of spouses in a marriage to persons who are members of a partnership or union recognized under state law You should consult with your own legal advisor for advice regarding the rights protections benefits responsibilities obligations and duties of those who are registered domestic partners civil union partners or members of other unions recognized under applicable law
CREDIT AUTHORIZATION RELEASE
By signing below I authorize Chase andor my mortgage insurer (if any) to verify my past and present employment earnings records (including information contained in income tax returns that have been filed with the IRS) bank accounts stock holdings and any other information that it finds necessary to process my mortgage loan application or to review it for quality-control purposes I understand that a credit report will be ordered from a credit reporting agency for verification prior to loan closing as part of the application process and may be ordered after closing as part of the Lenderrsquos quality-control program A credit report may also be completed as part of the Lenderrsquos servicing or collection of the loan or in consideration of any other product or service that the Lender may consider offering me in the future and at any time throughout the life of the loan I understand that use of a photocopy of this form may be necessary to verify one or more of my credit references I understand that a photocopy or fax copy of this form will also serve as authorization
By signing below each applicant acknowledges (1) making the above certifications and authorizations and (2) that each applicant has received and understands the above notices and disclosures
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
You do not have to give us this information but if you donrsquot your application for approval as a borrower may be delayed or rejected The information requested in this form is authorized by Title 38 USC Chapter 37 (if VA) by 12 USC Section 1701 et seq (if HUDFHA) by 42 USC Section 1452b (if HUDCPD) and Title 42 USC 1471 et seq or 7 USC 1921 et seq (if USDA FHA)
Updated December 2021 99177-GA-0215
1b
2b
Form 4506-C (September 2020)
Department of the Treasury - Internal Revenue Service
IVES Request for Transcript of Tax Return OMB Number
1545-1872
Do not sign this form unless all applicable lines have been completed Request may be rejected if the form is incomplete or illegible
For more information about Form 4506-C visit wwwirsgov and search IVES
1a Name shown on tax return (if a joint return enter the name shown first)
First social security number on tax return individual taxpayer identification number or employer identification number (see instructions)
2a If a joint return enter spousersquos name shown on tax return Second social security number or individual taxpayer identification number if joint tax return
3 Current name address (including apt room or suite no) city state and ZIP code (see instructions)
4 Previous address shown on the last return filed if different from line 3 (see instructions)
5a IVES participant name address and SOR mailbox ID
DataVerify 875 Greentree Rd 8 Parkway Center Pittsburgh PA 15220
5b Customer file number (if applicable) (see instructions)
Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing (see instructions)
6 Transcript requested Enter the tax form number here (1040 1065 1120 etc) and check the appropriate box below Enter only one tax form number per request 1040
a Return Transcript which includes most of the line items of a tax return as filed with the IRS A tax return transcript does not reflect changes made to the account after the return is processed Transcripts are only available for the following returns Form 1040 series Form 1065 Form 1120 Form 1120-A Form 1120-H Form 1120-L and Form 1120S Return transcripts are available for the current year and returns processed during the prior 3 processing years
b Account Transcript which contains information on the financial status of the account such as payments made on the account penalty assessments and adjustments made by you or the IRS after the return was filed Return information is limited to items such as tax liability and estimated tax payments Account transcripts are available for most returns
c Record of Account which provides the most detailed information as it is a combination of the Return Transcript and the Account Transcript Available for current year and 3 prior tax years
7 Form W-2 Form 1099 series Form 1098 series or Form 5498 series transcript The IRS can provide a transcript that includes data from these information returns State or local information is not included with the Form W-2 information The IRS may be able to provide this transcript information for up to 10 years Information for the current year is generally not available until the year after it is filed with the IRS For example W-2 information for 2016 filed in 2017 will likely not be available from the IRS until 2018 If you need W-2 information for retirement purposes you should contact the Social Security Administration at 1-800-772-1213
Caution If you need a copy of Form W-2 or Form 1099 you should first contact the payer To get a copy of the Form W-2 or Form 1099 filed with your return you must use Form 4506 and request a copy of your return which includes all attachments
8 Year or period requested Enter the ending date of the tax year or period using the mmddyyyy format (see instructions)
12 31 2020 12 31 2019 12 31 2018 Caution Do not sign this form unless all applicable lines have been completed
Signature of taxpayer(s) I declare that I am either the taxpayer whose name is shown on line 1a or 2a or a person authorized to obtain the tax information requested If the request applies to a joint return at least one spouse must sign If signed by a corporate officer 1 percent or more shareholder partner managing member guardian tax matters partner executor receiver administrator trustee or party other than the taxpayer I certify that I have the authority to execute Form 4506-C on behalf of the taxpayer Note This form must be received by IRS within 120 days of the signature date
Signatory attests that heshe has read the attestation clause and upon so reading declares that heshe has the authority to sign the Form 4506-C See instructions
Sign Here
Signature (see instructions) Date Phone number of taxpayer on line 1a or 2a
PrintType name
Title (if line 1a above is a corporation partnership estate or trust)
Spousersquos signature Date
PrintType name
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020) For Privacy Act and Paperwork Reduction Act Notice see page 2
Instructions for Form 4506-C IVES Request for Transcript of Tax Return
Section references are to the Internal Revenue Code unless otherwise noted
Future Developments
For the latest information about Form 4506-C and its instructions go to wwwirsgov and search IVES Information about any recent developments affecting Form 4506-C (such as legislation enacted after we released it) will be posted on that page
Whats New Form 4506-C was created to be utilized by authorized IVES participants to order tax transcripts with the consent of the taxpayer
General Instructions
Caution Do not sign this form unless all applicable lines have been completed
Designated Recipient Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information received pursuant to the taxpayerrsquos consent and holds the recipient subject to penalties for any unauthorized access other use or redisclosure without the taxpayerrsquos express permission or request
Taxpayer Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information provided pursuant to your consent and holds the recipient subject to penalties brought by private right of action for any unauthorized access other use or redisclosure without your express permission or request
Purpose of form Use Form 4506-C to request tax return information through an authorized IVES participant You will designate an IVES participant to receive the information on line 5a
Note If you are unsure of which type of transcript you need check with the party requesting your tax information
Where to file The IVES participant will fax Form 4506-C with the approved IVES cover sheet to their assigned Service Center
Chart for ordering transcripts
If your assigned Service Center is
Fax the requests with the approved coversheet to
Austin Submission Processing Center
Austin IVES Team
844-249-6238
Fresno Submission Processing Center
Fresno IVES Team
844-249-6239
Kansas City Submission Processing Center
Kansas City IVES Team
844-249-8128
Ogden Submission Processing Center
Ogden IVES Team
844-249-8129
Specific Instructions
Line 1b Enter the social security number (SSN) or individual taxpayer identification number (ITIN) for the individual listed on line 1a or enter the employer identification number (EIN) for the business listed on line 1a
Line 3 Enter your current address If you use a PO box include it on this line
Line 4 Enter the address shown on the last return filed if different from the address entered on line 3
Note If the addresses on lines 3 and 4 are different and you have not changed your address with the IRS file Form 8822 Change of Address or Form 8822-BChange of Address or Responsible Party mdash Business with Form 4506-C
Line 5b Enter up to 10 numeric characters to create a unique customer file number that will appear on the transcript The customer file number cannot contain an SSN ITIN or EIN Completion of this line is not required
Note If you use an SSN name or combination of both we will not input the information and the customer file number will reflect a generic entry of 9999999999 on the transcript
Line 8 Enter the end date of the tax year or period requested in mmddyyyy format This may be a calendar year fiscal year or quarter Enter each quarter requested for quarterly returns Example Enter 12312018 for a calendar year 2018 Form 1040 transcript
Signature and date Form 4506-C must be signed and dated by the taxpayer listed on line 1a or 2a The IRS must receive Form 4506-C within 120 days of the date signed by the taxpayer or it will be rejected Ensure that all applicable lines including lines 5a through 8 are completed before signing
You must check the box in the signature area to acknowledge you have the authority to sign and request the information The form will not be processed if unchecked
Individuals Transcripts listed on on line 6 may be furnished to either spouse if jointly filed Only one signature is required Sign Form 4506-C exactly as your name appeared on the original return If you changed your name also sign your current name
Corporations Generally Form 4506-C can be signed by
(1) an officer having legal authority to bind the corporation (2) any person designated by the board of directors or other governing body or (3) any officer or employee on written request by any principal officer and attested to by the secretary or other officer A bona fide shareholder of record owning 1 percent or more of the outstanding stock of the corporation may submit a Form 4506-C but must provide documentation to support the requesters right to receive the information
Partnerships Generally Form 4506-C can be signed by any person who was a member of the partnership during any part of the tax period requested on line 8
All others See section 6103(e) if the taxpayer has died is insolvent is a dissolved corporation or if a trustee guardian executor receiver or administrator is acting for the taxpayer
Note If you are Heir at law Next of kin or Beneficiary you must be able to establish a material interest in the estate or trust
Documentation For entities other than individuals you must attach the authorization document For example this could be the letter from the principal officer authorizing an employee of the corporation or the letters testamentary authorizing an individual to act for an estate
Signature by a representative A representative can sign Form 4506-C for a taxpayer only if the taxpayer has specifically delegated this authority to the representative on Form 2848 line 5 The representative must attach Form 2848 showing the delegation to sign Form 4506-C
Privacy Act and Paperwork Reduction Act Notice We ask for the information on this form to establish your right to gain access to the requested tax information under the Internal Revenue Code We need this information to properly identify the tax information and respond to your request You are not required to request any transcript if you do request a transcript sections 6103 and 6109 and their regulations require you to provide this information including your SSN or EIN If you do not provide this information we may not be able to process your request Providing false or fraudulent information may subject you to penalties
Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and cities states the District of Columbia and US commonwealths and possessions for use in administering their tax laws We may also disclose this information to other countries under a tax treaty to federal and state agencies to enforce federal nontax criminal laws or to federal law enforcement and intelligence agencies to combat terrorism
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law Generally tax returns and return information are confidential as required by section 6103
The time needed to complete and file Form 4506-C will vary depending on individual circumstances The estimated average time is
Learning about the law or the form 10 min Preparing the form 12 min Copying assembling and sending the form to the IRS 20 min
If you have comments concerning the accuracy of these time estimates or suggestions for making Form 4506-C simpler we would be happy to hear from you You can write to
Internal Revenue Service Tax Forms and Publications Division 1111 Constitution Ave NW IR-6526 Washington DC 20224
Do not send the form to this address Instead see Where to file on this page
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020)
Rev April 2021 CHASEO Facts What does Chase do with your personal information
Why Financial companies choose how they share your personal information Federal law gives consumers the right to limit some but not all sharing Federal law also requires us to tell you how we collect share and protect your personal information Please read this notice carefully to understand what we do
What The types of personal information we collect and share depend on the product or service you have with us This information can include bull Social Security number and income bull account balances and transaction history bull credit history and payment history
How All financial companies need to share customers personal information to run their everyday business In the section below we list the reasons financial companies can share their customers personal information the reasons Chase chooses to share and whether you can limit this sharing
Reasons we can share your personal information Does Chase share
Can you limit this sharing
For our everyday business purposes - such as to process your transactions maintain your account(s) respond to court orders and legal investigations or report to credit bureaus
Yes No
For our marketing purposes - to offer our products and services to you
Yes No
For joint marketing with other financial companies Yes No
For our affiliates everyday business purposes - information about your transactions and experiences
Yes No
For our affiliates everyday business purposes - information about your creditworthiness
Yes Yes
For our affiliates to market to you Yes Yes
For nonaffiliates to market to you Yes Yes
a
0
To limit our sharing
bull Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
bull Visit us online chasecomprivacypreferences
Please note If you are a new customer we can begin sharing your information 30 days from the date we sent this notice When you are no longer our customer we continue to share your information as described in this notice However you can contact us at any time to limit our sharing
Questions
Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
PAGE 2
Who we are
Who is providing this notice The US consumer financial companies within the JPMorgan Chase amp Co family including JPMorgan Chase Bank NA Chase Insurance Agency Inc and JP Morgan Securities LLC
What we do
How does Chase protect my To protect your personal information from unauthorized access and use we personal information use security measures that comply with federal law These measures include
computer safeguards and secured files and buildings We authorize our employees to get your information only when they need it to do their work and we require companies that work for us to protect your information
How does Chase collect my We collect your personal information for example when you personal information bull open an account or make deposits or withdrawals from your account
bull pay your bills or apply for a loan bull use your credit or debit card We also collect your personal information from others such as credit bureaus affiliates or other companies
Why cant I limit all sharing Federal law gives you the right to limit only bull sharing for affiliates everyday business purposes - information about your
creditworthiness bull affiliates from using your information to market to you bull sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing See below for more on your rights under state law
What happens when I limit sharing for an account I hold jointly with someone else
Your choices will apply to everyone on your account
Definitions
Affiliates Companies related by common ownership or control They can be financial and non financial companies bull Our affiliates include companies with a Chase or JP Morgan name and financial companies such asjP Morgan Securities LLC
Nonaffiliates Companies not related by common ownership or control They can be financial and non financial companies bull Nonaffiliates we share with can include companies such as retailers auto dealers auto makers and membership clubs
Joint marketing A formal agreement between nonaffiliated financial companies that together market financial products or services to you bull Our joint marketing partners include categories of companies such as insurance companies
Other important information
VT Accounts with a Vermont mailing address are automatically treated as if they have limited the sharing as described on page 1 For joint marketing we will only disclose your name contact information and information about your transactions
NV We are providing you this notice pursuant to Nevada law If you prefer not to receive marketing calls from us you may be placed on our Internal Do Not Call List by calling 1-800-945-9470 or by writing to us at PO Box 734007 Dallas TX 75373-4007
For more information contact us at the address above or email PrivacylnfoJPMChasecom with Nevada Annual Notice in the subject line You may also contact the Nevada Attorney Generals office Bureau of Consumer Protection Office of the Nevada Attorney General 555 E Washington St Suite 3900 Las Vegas NV 89101 telephone number 1-702-486-3132 email BCPINFOagstatenvus
CA Accounts with a California mailing address are automatically treated as if they have limited the sharing with nonaffiliates as described on page 1 CA residents are provided a CA notice for additional choices
CHASE O
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
The following disclosure is required by the USA PATRIOT Act
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 opens an account
What this means to you When you 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 drivers
license or other identifying documents
99177-PAT-0215
VETERAN STATEMENT When this loan was opened the US Department of Veterans Affairs (VA) used the veteran borrowerrsquos entitlement which is a set amount the VA promises to repay a lender if the borrower defaults on the mortgage An assumption will modify who is obligated to pay the existing mortgage loan but all loan termsmdashincluding the entitlementmdashwill remain the same If the veteran borrower is being removed from the loan the entitlement would remain with whoever is assuming the loan because the loan will continue to be serviced by the VA If the applicant is also a veteran and can substitute his or her entitlement for the current entitlement then the current borrowerrsquos entitlement can be released
Please review the following questions and answer as appropriate This form requires completion by both the applicant(s) and current borrower(s)
1 Applicant to Complete
Are you (the applicant) currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the reverse side)
Yes (If yes please provide the information requested below answer the question in section 3 and sign and date this form at the bottom of the reverse side)
Name of applicant(s) who answered ldquoyesrdquo to the above question
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Are you receiving VA disability benefts
Applicant
Yes
No
Co-Applicant
Yes
No
Are you entitled to receive VA disability benefts Yes No Yes No
Have you received VA disability benefts in the past Yes No Yes No
Are you a surviving spouse of a veteran who died on active duty or as the result of a service-related disability
Yes No Yes No
Do you have any VA loans Yes No Yes No
2 Current Borrower to Complete
Is the current borrowerco-borrower currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the page)
Yes (If yes please answer the question in section 3 and sign and date this form at the bottom of the page)
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
________________________________________________________________________________________________
3 Applicant and Current Borrower to Complete
If the answer to the questions in section 1 and 2 are both yes please answer the following question After yoursquove reviewed and completed this entire form please sign and date at the bottom
Applicant Current Borrower
Do you want to apply for a substitution of entitlement Yes Yes No No
In order to complete a substitution of entitlement the veteran applicant must have suffcient entitlement to substitute for that of the current borrower Contact the VA Offce of Jurisdiction for your area for more information Also before the veteran applicant can substitute entitlement on a VA loan heshe must certify that the property securing the loan will be occupied as hisher primary residence Both the applicantrsquos and current borrowerrsquos original certifcate of eligibility will be required If your sales contract is contingent upon the restoration of entitlement please contact your VA Offce of Jurisdiction for complete procedures Otherwise the substitution will be completed after the loan has been approved and closed
Date Applicant printed name Applicant signature
Date Applicant printed name Applicant signature
Date Current Borrower printed name Current Borrower signature
Date Current Borrower printed name Current Borrower signature
Forms completed by Mail Phone
For Chase use only
Interviewer signature Date
99177-VS-0215
- Assumption Application Package_41521-noscannedpages-update-4pdf
-
- 1 FM203 Cover Pagepdf
- 2 FM202 Mortgage Assumption Application Package pagepdf
- 3 The Documents Youll need to Send Uspdf
- 4 FM201 FAQpdf
- 5 FM142 CIWpdf
- 6 FM126 URLApdf
- 7 FM130 URLA Instpdf
-
- Blank Page
-
- 8 92900a Addednum to Loan Applicationpdf
- 9 FM462 Gen Authpdf
- 10 FM220 4506-Cpdf
- 11 FM153 Chase Federal Privacy Noticepdf
- 12 FM144 Info on Opening a New Accountpdf
- 13 FM152 Veteran Statementpdf
-
- Date
- Loan number
- Applicant name
- Phone1
- Loan number 1
- Loan number 2
- Other
- Other_2
- 1
- 2
- undefined_7
- Available hours
- Available hours_2
- undefined_8
- Available hours_3
- undefined_9
- Current address 1
- Neither
- Available hours_4
- Available hours_5
- undefined_10
- Available hours_6
- 1_2
- 2_2
- undefined_11
- Available hours_7
- Available hours_8
- undefined_12
- Available hours_9
- FHA Case No include any suffix
- Mortgagee Case No
- Mortgagee ID
- Sponsor ID
- Agent ID
- Name and Address of Sponsor Name and Address of Agent
- Borrowers Name Present Address include ZIP Code Property Address
- include name of subdivision lot block no ZIP Code
- Name of ThirdParty Originator
- NMLS ID of ThirdParty Originator
- s application
- ty Number
- ty Number_2
- Date Signed_2
- Date Mortgage Approved
- Date Approval Expires
- Printed Name
- Title 1
- DEs ID Number
- DEs ID Number_2
- Mortgagee
- Name of Mortgagees Representative
- Title of Mortgagees Representative
- Signature of the Mortgagees Representative
- Date_2
- Applicant names 1
- Applicant names 2
- Applicant names 3
- Loan number_2
- Date_3
- Applicant printed name
- Social Security number
- Date_4
- Applicant printed name_2
- Social Security number_2
- Date_5
- Applicant printed name_3
- Social Security number_3
- Date_6
- Applicant printed name_4
- Social Security number_4
- 1a Name shown on tax return if a joint return enter the name shown first
- 1b First social security number on tax return individual taxpayer identification number or employer identification number see instructions
- 2a If a joint return enter spouses name shown on tax return
- 2b Second social security number or individual taxpayer identification number if joint tax return
- 4 Previous address shown on the last return filed if different from line 3 see instructions
- 5a IVES participant name address and SOR mailbox ID
- Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing see instructions
- Signature see instructions
- Date_7
- Phone number of taxpayer on line 1a or 2a
- PrintType name
- Here
- Spouses signature
- Date_8
- PrintType name_2
- Name
- Date of birth
- Service number
- Name_2
- Date of birth_2
- Service number_2
- Date_9
- Applicant printed name_5
- Date_10
- Applicant printed name_6
- Date_11
- Current Borrower printed name
- Date_12
- Current Borrower printed name_2
- Date_13
- Text3
- Text10
- undefined_13
- Text15
- undefined_14
- undefined_15
- undefined_16
- undefined_17
- undefined_18
- undefined_19
- undefined_20
- undefined_21
- undefined_23
- Reason for assumption Off
- Requestors relationship to owners Off
- Check one Off
- Check one1 Off
- Day1
- Evening
- Cell phone
- Check one2 Off
- Check one3 Off
- Check one4 Off
- Check one5 Off
- Text2-1
- Text2-2
- Text2-3
- Text2-4
- Text2-5
- Text2-6
- Text3-1
- Text3-2
- Text3-3
- Text3-4
- Text3-6
- Text3-7
- Text3-8
- Text3-9
- Text3-10
- Text3-11
- Text3-12
- Text3-13
- Text3-14
- Text3-15
- Text3-16
- Text3-17
- Text3-18
- Text3-19
- Text3-20
- Text3-21
- Text3-22
- Text3-23
- Text3-24
- Text3-25
- Text3-26
- Text3-27
- Text3-28
- Text3-29
- Text3-30
- Text3-31
- Text3-32
- Text3-33
- Text3-34
- Text3-35
- Text3-36
- Text3-37
- Text3-38
- Text3-39
- Text3-40
- Text3-41
- Text3-42
- Text3-43
- Text3-44
- Text3-45
- Text3-46
- Text3-47
- Text3-48
- Text3-49
- Text3-50
- Text3-51
- Text3-52
- Text3-53
- Text3-5
- Text3-54
- Text3-55
- Text3-56
- Citizenship Off
- Type of credit Off
- Marital Status Off
- Housing Off
- Housing1 Off
- ownership Off
- DNA1 Off
- DNA2 Off
- DNA3 Off
- family Off
- BO Off
- Total
- Text31
- Text32
- Text33
- Text34
- Text35
- Text36
- Text37
- Text38
- Text39
- Text310
- Text311
- Text312
- Text313
- Text314
- Text315
- Text316
- Text317
- Text318
- Text319
- ownership1 Off
- Total1
- Total1-2
- Check Box4-1 Off
- Text320
- Text321
- Text322
- Text323
- Text324
- Text325
- Text326
- Text327
- Text328
- Text329
- Check Box4-2 Off
- Check Box4-3 Off
- Check Box4-4 Off
- Check Box4-8 Off
- Check Box4-9 Off
- Text330
- Text331
- Text332
- Text333
- Text334
- Text335
- Text1-1
- Text1-2
- Text1-3
- Text1-4
- Text1-5
- Text1-6
- Text1-7
- Text1-8
- Text1-9
- Text1-10
- Text1-11
- Text1-12
- Text1-13
- Text1-14
- Text1-15
- Text1-16
- Text1-17
- Text1-18
- Text1-19
- Text1-20
- Text1-21
- Text1-22
- Text1-23
- Text1-24
- Text1-25
- Text1-26
- Text1-27
- Text1-28
- Text1-29
- Text1-30
- Text1-31
- Text1-32
- Text1-33
- Text1-34
- Text1-35
- Check Box3-2 Off
- Check Box2-1 Off
- Check Box2-2 Off
- Check Box2-3 Off
- Check Box2-4 Off
- Check Box2-5 Off
- Text1-36
- Text1-37
- Text1-38
- Text1-39
- Text1-40
- Text1-41
- Text1-42
- Text1-43
- Text1-44
- Text1-45
- Text1-46
- Text1-47
- Text1-48
- Text1-49
- Text1-50
- Text1-51
- Text1-52
- Text1-53
- Text1-54
- Text1-55
- Text1-56
- Text1-57
- Text1-58
- Text1-59
- Text1-60
- Text1-61
- Check Box3-11 Off
- A1
- A2
- A3
- A4
- A5
- A6
- A7
- A8
- A9
- A10
- A11
- A12
- Check Box3-1 Off
- Check Box30-1 Off
- Check Box30-2 Off
- Check Box30-4 Off
- Check Box30-5 Off
- Check Box30-7 Off
- Check Box30-8 Off
- Check Box30-9 Off
- Check Box30-10 Off
- Check Box30-11 Off
- Check Box30-12 Off
- A13
- A14
- A15
- A16
- A17 Off
- A18
- A19
- A20
- A21
- A22
- A23
- A24
- A25
- A26
- A27
- A28
- A29
- A30
- A31
- A32
- A33
- A34
- A35
- A36
- A37
- A38 Off
- A39
- A40
- A41
- A42
- A43
- A44
- A45
- A46
- A47
- A48
- A49
- A50
- A51
- A52
- A53
- A54
- A55
- A56
- A57
- A58
- A59
- A60
- A61
- A62
- A63
- A64
- A65
- A66
- A67
- A68
- A69
- A70
- A71
- A72
- A73
- A74
- Loan Purpose Off
- occupancy1 Off
- lien type Off
- lientype Off
- mixed use Off
- manufactured home Off
- deposit1 Off
- deposit2 Off
- B1
- B2
- B3
- B4
- B5
- B6
- B7
- B8
- B9
- B10
- fha Off
- Check Box51 Off
- B11
- B12
- B13
- B14
- B15
- B16
- B17
- B18
- B19 Off
- B20
- B21
- B22 Off
- B23
- B24
- B25
- B26
- B27
- B28
- A
-
- Will you occupy the property as your primary residence Off
- Will you occupy the property as your primary residence1 Off
-
- If yes have you had an ownership interest in another property in the last three years Off
- Text9-2
- B
-
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property Off
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property1 Off
-
- 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 Off
- 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 application1 Off
-
- 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 Off
- 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 application1 Off
-
- new credit Off
- 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) Off
- the Property Assessed Clean Energy Program)1 Off
-
- F
-
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application Off
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application1 Off
-
- G
-
- Are there any outstanding judgments against you Off
- Are there any outstanding judgments against you1 Off
-
- H
-
- Are you currently delinquent or in default on a Federal debt Off
- Are you currently delinquent or in default on a Federal debt1 Off
-
- I
-
- Are you a party to a lawsuit in which you potentially have any personal financial liability Off
- Are you a party to a lawsuit in which you potentially have any personal financial liability1 Off
-
- J
-
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years Off
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years1 Off
-
- 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 Off
- 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 due1 Off
-
- L
-
- Have you had property foreclosed upon in the last 7 years Off
- Have you had property foreclosed upon in the last 7 years1 Off
-
- M
-
- Have you declared bankruptcy within the past 7 years Off
- Have you declared bankruptcy within the past 7 years1 Off
-
- Check Box8-2 Off
- Check Box8-3 Off
- Check Box8-4 Off
- Text9-3
- Text9-5
- Text9-6
- Text97
- military Off
- ethnicity Off
- sex Off
- race Off
- demo Off
- Text12-1
- Check Box11-1 Off
- Check Box11-2 Off
- Check Box11-3 Off
- Check Box11-4 Off
- Check Box11-5 Off
- Check Box11-6 Off
- Check Box11-7 Off
- Check Box11-8 Off
- Check Box11-9 Off
- Text12-2
- Check Box11-10 Off
- Check Box11-11 Off
- Check Box11-12 Off
- Check Box11-13 Off
- Check Box11-14 Off
- Check Box11-15 Off
- Text12-3
- Check Box11-16 Off
- Check Box11-17 Off
- Check Box11-18 Off
- Check Box11-19 Off
- Check Box11-20 Off
- Check Box11-21 Off
- Check Box11-22 Off
- Check Box11-23 Off
- Text12-4
- Check Box11-24 Off
- Check Box11-25 Off
- Check Box11-26 Off
- Check Box11-27 Off
- Check Box11-28 Off
- Check Box11-29 Off
- Text12-5
- Check Box11-30 Off
- Check Box11-31 Off
- citizen Off
- credit Off
- marital status1 Off
- housing-1 Off
- housing-2 Off
- own Off
- C1
- C2
- C3
- C6
- C7
- C8
- C9
- C10
- C11
- C12
- C13
- C14
- C15
- C16
- C17
- C18
- C19
- C20
- C21
- C22
- C23
- C24
- C25
- C26
- C27
- C28
- C29
- C30
- C31
- C32
- C33
- C34
- C35
- Check Box-2 Off
- C36
- C37
- C38
- C39
- C4
- C40
- C41
- C42
- C43
- C44
- C45
- C46
- C47
- Check Box-3 Off
- Check Box-4 Off
- C48
- C49
- C5
- C50
- C51
- C52
- C53
- C54
- C55
- Check Box-1-1 Off
- own1 Off
- Check Box-1 Off
- D1 Off
- D2
- D3
- D4
- D5
- D6
- D7
- D8
- D9
- D10
- D11
- D12
- D13
- D14 Off
- D15 Off
- D16
- D17
- D18
- D19
- D20
- D21
- D22
- D23
- D24 Off
- D25
- D26
- D27
- D28
- D29
- D30
- D31
- D32
- D33
- D34
- D35 Off
- D36
- D37 Off
- D38
- D39
- D40
- D41
- D42
- D43
- D44
- D45
- D46
- D47
- If yes have you had an ownership interest in another property in the last three years1 Off
- new credit1 Off
- Check Box8-1 Off
- Check Box8-1-2 Off
- Check Box8-1-1 Off
- Check Box8-1-3 Off
- Check Box8-1-4 Off
- Military Service mdash Did you (or your deceased spouse) ever serve or are you currently serving in the United States Armed Forces 1 Off
- Check1 Off
- Text9-1-1
- Check2 Off
- Check3 Off
- Check4 Off
- Text9-1
- E1
- E2
- E3
- Was the ethnicity of the Borrower collected on the basis of visual observation or surname1 Off
- Was the sex of the Borrower collected on the basis of visual observation or surname1 Off
- Was the race of the Borrower collected on the basis of visual observation or surname1 Off
- The Demographic Information was provided through1 Off
- F1 Off
- F2 Off
- F3 Off
- F4 Off
- F5 Off
- F6
- F7 Off
- F8 Off
- F9 Off
- F10 Off
- F11 Off
- F12 Off
- F13
- F14 Off
- F15 Off
- F16 Off
- F17 Off
- F18 Off
- F19 Off
- F20 Off
- F21 Off
- F22
- F23 Off
- F24 Off
- F25 Off
- F26 Off
- F27 Off
- F28 Off
- F29
- F30 Off
- F31 Off
- undefined_13-1
- undefined_13-2
- undefined_14-1
- undefined_15-1
- undefined_16-1
- undefined_17-1
- undefined_18-1
- undefined_19-1
- undefined_21-1
- undefined_20-1
- undefined_23-1
- undefined_13_1
- Single-Two Off
- Refi type Off
- refi program Off
- Estate Off
- Title held Off
- Trust Information Off
- Indian Country Land Tenure Off
- Mortgage Type Applied For Off
- Mortgage Lien Type Off
- Amortization Type Off
- G1 Off
- G2 Off
- G3 Off
- G4 Off
- G5 Off
- G6
- G7
- G8
- G9
- G10 Off
- G11 Off
- G12 Off
- G13 Off
- G14 Off
- G15 Off
- G16
- G17
- G18
- G19
- G20
- G21
- G22
- G23 Off
- G24
- G25 Off
- G26
- G27 Off
- G28 Off
- G29
- G30 Off
- G31
- G32 Off
- G33
- G34
- G35
- G36
- G37
- G38
- G39
- G40
- G41
- G42
- Property Held
- refi
- Text18-1
- Text18-2
- Text18-3
- Text18-4
- Text18-5
- Text18-6
- Text18-7
- Text18-8
- Text18-9
- Text18-10
- Text18-11
- Text18-12
- Text18-13
- Text18-14
- Text18-15
- Text18-16
- Text18-17
- Text18-18
- Text18-19
- Lender
- case no
- If you selected ldquoUnmarriedrdquo in Section 1 is there a person who is not your legal spouse but who currently has real property rights similar to those of a legal spouse Off
- Relationship and State Off
- Other-5
- Text19-1
- BName
- Additional Information
- ABN
- Additional Information1
- BSign
- BSDate
- ABSign
- ABDate
- MortageeNameAddress
- NAmeAddress
- Bname1
- DOB1
- DOB2
- SignOfBorr1
- SignOfBorr
- Date Signed
- SignOfBorr2
- SignOfBorr3
- Date Signed3
- Date Signed4
- MortgageeRepSign
- DirectSign
- DirectSign1
- Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union Off
- AppSign
- AppSign1
- AppSign2
- AppSign3
- Nopage38 Off
- Yespage38 Off
- Yes1 Off
- No1 Off
- Yes2 Off
- Yes3 Off
- Yes4 Off
- Yes5 Off
- Yes6 Off
- Yes7 Off
- Yes8 Off
- Yes9 Off
- Yes10 Off
- No2 Off
- No3 Off
- No4 Off
- No5 Off
- No6 Off
- No7 Off
- No8 Off
- No9 Off
- No10 Off
- BorrowerNo Off
- BorrowerYes Off
- AppSignature
- AppSignature1
- CurrentSign
- CurrentSign1
- InterviewSign
- Yes_1 Off
- No_1 Off
- Yes_2 Off
- No_2 Off
- Mail Off
- Phone Off
Uniform Residential Loan Application mdash Additional BorrowerVerify and complete the information onthis application as directed by your Lender
Section 1 Borrower Informationthis section asks about yourpersonal information and your income fromemploymentandother sources such as retirement that you want considered to qualify for this loan
1a Personal Information
Name(First Middle Last Suffix)
Alternate Names - List any namesby which you are known or any namesunder which credit was previously received (First Middle Last Suffix)
Social Security Number - -(or Individual TaxpayerIdentification Number)
Dateof Birth Citizenship(mmddyyyy)
USCitizenPermanentResidentAlienNon-Permanent ResidentAlien
Type ofCredit| am applying for individualcredit
lam applying forjoint credit Total Number of Borrowers
Each Borrowerintendsto applyfor joint credit Your initials
List Name(s) of Other Borrower(s) Applying for this Loan
(First Middle Last Suffix) - Use a separator between names
Marital Status Dependents(notlisted by another Borrower)
Contact Information
Married Number _ Home Phone ( ) -
( ) _
( ) -mdash_ mdash_
Separated Ages CellPhone
Unmarried ens Work Phone Ext(Single Divorced WidowedCivil Union Domestic Partnership Registered
Reciprocal Beneficiary Relationship)lsquol
Emal
Current Address
Street Unit
City State ZIP Country
How Long at Current Address=Years mdashMonths Housing Noprimary housing expense Own Rent($ month)
If at Current Address for LESS than 2 yearslist Former Address Does not apply
Street Unit
City State ZIP Country
How Long at Former Address Years mdashMonths Housing Noprimary housing expense Own month)
Mailing Address- ifdifferent from CurrentAddress Does not apply
Street Unit
City State ZIP Country
eeeeCeeteiChuraleCme Doesnot apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base S$month
City State ZIP Country Overtime =$_____monthBonus $ month
Position orTitle Checkif this statementapplies Commission sect month| am employedby a family memberpropertyseller real estate agent or otherparty to the transaction
TTStart Date ____ (mmddyy) Military
Entitlements$_How longin this line of work Years =Months mdash monthSS
Other $ monthCheckif you are the BusinessOwnerorSelf-Employed
| have an ownershipshare ofless than 25 Monthly Income(or Loss) mdashmdash| have an ownership share of 25 or more $ TOTAL $ 000month
Uniform Residential Loan Application mdash Additional Borrower
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
CoeeeMCMCmeticlm tu)Comiteteilteeilelie mieit
Does not apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base
OvertimeBonus
Commission
MilitaryEntitlements
Other
$ month
$ month$ month
$ month
$ month
$ month
City State ZIP Country
Position orTitle ose if this statement applieslam employed by a family memberpropertyseller real estate agent or otherparty to the transaction
Start Date (mmddyy)How long in this line of work Years =Months
Checkif you are the Business
Owneror Self-Employed| have an ownershipshare of less than 25 Monthly Income(or Loss)
Ihave an ownership share of 25 or more $ TOTAL$ 000month
CPONMeeeMummaTestetiersdeere lire miret Does not apply
Provideat least 2 years of current and previous employment and income
Employeror Business Name Previous Gross MonthlyStreet Unit Income s month
City State ZIP Country
Position or Title
Start Date
End Date
Checkif you were the BusinessOwneror Self-Employed
(mmddyyyy)
(mmddyyyy) 1e Income from Other Sources Does not apply
Include incomefrom other sources below Under Income Source choose from the sourceslisted herelaquo Alimonylaquo Automobile Allowanceraquo Boarder Incomelaquo Capital Gains
Child Support+ Disability+ Foster Care Housing or Parsonage
+ Interest and DividendslaquoMortgage Credit Certificate Mortgage DifferentialPayments
laquo Notes Receivable+ Public Assistancelaquo Retirement(eg Pension IRA)
+raquo Royalty Payments Separate Maintenance
+ Social Security
raquo Trust
+ UnemploymentBenefits
laquo VA Compensation
laquo Other
NOTE Revealalimony child support separate maintenance or other income ONLYIFyou wantit considered in determining yourqualification
for this loan
Income Source - uselist above Monthly Income
$
$
$
$ 000Provide TOTAL AmountHere|
Section 2 Financial Information mdash Assets andLiabilities
Myinformation for Section 2 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 3 Financial Information mdash Real Estate
Myinformation for Section 3 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 4 Loan and Property Information
Myinformation for Section 4 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 5 DeclarationsThis section asks you specific questions about the property your funding and your past
financial history
5aAboutthis Property and Your Moneyforthis Loan
A Will you occupy the property as your primary residence NO YES
If YES have you had an ownershipinterest in another property in the last three years NO YES
If YES complete (1) and (2) below
(1)What type of property did you ownprimary residence (PR) FHA secondary residence (SR) second home(SH)
or investmentproperty (IP)
(2) How did you holdtitle to the property by yourself (S) jointly with your spouse(SP) or jointly with another person (O)
B If this is a Purchase Transaction Do you have a family relationship or businessaffiliation with the seller of the property NO YES Cc Are you borrowing any moneyforthis real estate transaction (eg money foryour closing costs or down payment) or
obtaining any moneyfrom anotherparty suchastheselleror realtor that you have not disclosed on this loan application NO YES
If YES whatis the amountof this money $
D 1 Have youorwill you be applying for a mortgage loan on anotherproperty (not the property securing this loan) on orbefore closing this transaction that is not disclosed on this loan application
NO YES
2 Have you orwill you be applying for any newcredit (eg installment loan credit card etc) on or before closing this loan that wsis not disclosed on this application
NO YES
E Will this property be subject to a lien that could take priority over thefirst mortgagelien such as a clean energylien paid
through yourproperty taxes(eg the PropertyAssessed Clean Energy Program)No YES
EK) Veli ellim ait
F Areyou a co-signer or guarantor on any debtor loan thatis not disclosed on this application NO ES
G Are there any outstanding judgments against you NO YES
H Are you currently delinquentor in default on a Federal debt NO YES
I Are you a party to a lawsuit in which you potentially have any personalfinancialliability NO YES
J Have you conveyedtitle to any property in lieu of foreclosure in the past 7 years NO YES
K Within the past 7 years have you completed a pre-foreclosure sale or short sale whereby the property wassold to a
third party and the Lender agreed to acceptless than the outstanding mortgage balance due
No YES
L Have you had property foreclosed uponin thelast 7 years NO YES
M Have you declared bankruptcy within the past 7 years no vESIf YES identify the type(s) of bankruptcy Chapter 7 Chapter11 Chapter12 Chapter 13
Section 6 Acknowledgements and AgreementsMy signature for Section 6 is on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 7 Military Service This section asks questions about your(or your deceased spouses) military service
Military Service of Borrower
Military Service mdash Did you (or your deceased spouse)everserve or are you currently serving in the United States Armed Forces NO YES
IfYES check allthat apply Currently serving on active duty with projected expiration date of servicetour (mmddyyyy)
Currently retired discharged or separated from service nnOnly period of service was as a non-activated memberofthe Reserve or National GuardSurviving spouse
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 8 Demographic InformationThis section asks about your ethnicity sex and race
Demographic Information of Borrower
The purposeofcollecting this information is to help ensure thatall applicants are treated fairly and that the housing needs of communities
and neighborhoodsare beingfulfilled 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 providethis information but are encouraged to do so You mayselect one or more designationsfor
Ethnicity and one or more designationsfor Race The law provides that we maynotdiscriminate onthe basis of this information or onwhetheryou chooseto provideit However if you choose notto provide the information and you have madethis application in person Federal
regulations require us to note yourethnicity sex and race on the basis of visual observation or surname The law also provides that we may notdiscriminate on the basis of age or marital status information you providein this application If you do not wish to provide someorall of this
information please check below
Ethnicity Check one or more Race Check one or moreHispanic or Latino AmericanIndian or Alaska Native - Print nameofenrolled
or principaltribeMexican PuertoRican Cuban
OtherHispanic or Latino - Printorigin siansian Indian Chinese Filipino
For exampleArgentinean Colombian Dominican NicaraguanSalvadoran Spaniard andso on
Japanese Korean VietnameseOtherAsian - Print race Forexample Hmong Laotian Thai Pakistani Cambodian andso on
Black or African American
Native Hawaiian or OtherPacific Islander
Native Hawaiian GuamanianorChamorro Samoan
OtherPacific Islander mdash Print race
Not Hispanic or Latino
| do not wish to providethis information
Sex
Female
Male
| do not wish to providethis informationFor example Fijian Tongan and so on
White
| do not wish to providethis information
Wasthe ethnicity of the Borrowercollected on thebasis of visual observation or surnameWasthesex of the Borrowercollected on the basis of visual observation or surnameWastherace of the Borrowercollected on the basis of visual observation or surname
)NO YESNO YESNO YES
Face-to-Face Interview (includes Electronic Media w Video Component) Telephone Interview Faxor Mail Email or Internet
Loan Originator Organization Name
Address
Loan Originator Organization NMLSR ID State License ID
Loan Originator Name
Loan Originator NMLSR ID State License ID
Email Phone (
Signature Date (mmddyyyy)
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Pe)aae-emeet)
Community Property State
At least one borrowerlives in a community propertystateThe property is in a community property state
Transaction DetailConversion of Contract for Deed or Land ContractRenovationConstruction-ConversionConstruction-to-Permanent
Single-Closing Two-ClosingConstructionImprovementCosts $
LotAcquired Date
Original Cost of Lot $(mmddyyyy)
Refinance Program
Full DocumentationInterest Rate ReductionStreamlined without Appraisal
Other
Refinance Type
NoCash OutLimited Cash OutCash Out
Energy Improvement
Mortgageloanwill finance energy-related improvements
Propertyis currently subject to a lien that could take priority ovethe first mortgagelien such as a clean energylien paid for througproperty taxes(eg the PropertyAssessed Clean Energyprogram)
Project Type Condominium Cooperative Planned Unit Development (PUD) Propertyis notlocatedin a project
Peiwlivcestetece)a)
Title to the Property Will be Held in What Name(s)
For RefinanceTitle to the Property is Currently Held in What Name(s
Trust Information
tle Will be Held byan Inter Vivos (Living) Trust
Title Will be Held by a Land TrustLeasehold Expiration Date
Mannerin WhichTitle Will be Held Indian Country Land Tenure
Sole OwnershipLife EstateTenancy in Common
Joint Tenancywith Right of Survivorship]Tenancybythe EntiretyOther
Fee Simple Ona ReservationIndividualTrust Land (AllottedRestricted)Tribal Trust Land On a ReservationTribal Trust Land Off ReservationAlaska Native Corporation Land
Estate Will be Held in
Fee Simple(mmddyyyy)
3 Mortgage LoanInformation
Termsof Loan
Note Rate
Loan Term (months)
MortgageLien Type
First LienSubordinate Lien
Mortgage Type Applied For
Conventional USDA-RDFHA VA Other
Amortization Type
Fixed RateAdjustable Rate
If Adjustable Rate
Initial Period Prior to First Adjustment
Subsequent AdjustmentPeriod
Proposed Monthly Paymentfor Property
First Mortgage (P amp I) $
Subordinate Lien(s) (P amp |) $
Other(explain)
Homeowners Insurance $(months)
(months)
Loan Features Property Taxes $
Balloon Balloon Term (months)
Interest Only Interest OnlyTermNegative AmortizationPrepaymentPenalty Prepayment Penalty Term (months) Other
Temporary Interest Rate BuydownInitial Buydown Rate TOTALOther(explain)
Mortgage Insurance $
AssociationProject Dues (Condo Co-Op PUD) $
Supplemental Property Insurance $
(months)
Borrower Name(s)Uniform Residential Loan Application mdash LenderLoan Information
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
L4 Qualifying the Borrower - Minimum Required Funds or Cash Back
DUEFROM BORROWER(S)
A Sales Contract Price
B Improvements Renovations and Repairs
C Land(ifacquired separately)
D For Refinance Balance of Mortgage Loanson the Propertyto be paid off in the Transaction
(See Table 3a Property You Own)
E Credit Cards and Other Debts Paid Off
(See Table 2c Liabilities mdash Credit Cards Other Debts and Leases that You Owe)
F BorrowerClosing Costs (including Prepaid andInitial Escrow Payments)
G Discount Points
HTOTAL DUE FROM BORROWER(s)(Total of A thru G)
TOTALMORTGAGE LOANS
Loan Amount
Loan AmountExcluding Financed Mortgage Insurance (or Mortgage Insurance Equivalent) $
Financed Mortgage Insurance (or Mortgage Insurance Equivalent) Amount $
Other New Mortgage Loanson the Property the Borrower(s) is Buying or Refinancing(See Table 4b Other New MortgageLoanson the Property You are Buying or Refinancing)
KTOTAL MORTGAGELOANS(Totalof| and J)
TOTALCREDITS
L Seller Credits (Enter the amountofBorrower(s) costs paid by the property seller)
MOtherCredits (Enter the sum ofall other credits mdash BorrowerPaid Fees Earnest Money EmployerAssistedHousing Lease Purchase Fund Lot Equity Relocation Funds Sweat Equity Trade Equity Other)
NTOTAL CREDITS(Total of L and M)
CALCULATION
TOTAL DUE FROM BORROWER(s)(Line H)
LESSTOTAL MORTGAGELOANS(Line K) AND TOTAL CREDITS(Line N)
Cash FromTothe Borrower(Line H minusLine K and Line N)NOTE This amountdoesnotinclude reservesor other funds that may be required by the Lenderto be verified
Borrower Name(s)Uniform Residential Loan Application mdash LenderLoan Information
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
Uniform Residential Loan Application mdash Unmarried Addendum
eeCeceetatimC elitleeComeLy
Lenders Instructions for Using the Unmarried Addendum
The Lender may use the Unmarried Addendum only when a Borrowerselected ldquoUnmarriedrdquoin Section 1 and the information collected is
necessary to determine howState property lawsdirectly or indirectly affecting creditworthiness apply including ensuring clear title
For example the Lender may use the Unmarried Addendum whentheBorrowerresides in a State that recognizescivil unions domestic
partnerships or registered reciprocal beneficiary relationships or when the property is located in such a State ldquoStaterdquo meansanystate the
District of Columbia the Commonwealth of Puerto Rico or anyterritory or possession of the United States
Ifyou selected ldquoUnmarriedrdquoin Section 1 is there a person whois not your legal spouse but whocurrently has real property rights similar to
those of a legal spouse +=) NOQ YES
If YES indicate the type of relationship and the State in which the relationship was formed For example indicate if you are in a
civil union domestic partnership registered reciprocal beneficiary relationship or other relationship recognized by the State in which you
currently reside or where the property is located
O Civil Union copy Domestic Partnership copy Registered Reciprocal Beneficiary Relationship copy) Other(explain)
Statea]
Borrower NameUniform Residential Loan Application mdash Unmarried Addendum
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Uniform Residential Loan Application mdash Continuation Sheet
Use this continuation sheet if you need more space to complete the Uniform Residential Loan Application
Borrower Name(First Middle Last Suffix )
Additional Information
Additional Borrower Name(First Middle Last Suffix )
Additional Information
IWefully understand thatit is a federal crime punishable by fine or imprisonment or both to knowingly make anyfalse statements concerningany of the abovefacts as applicable underthe provisions of federal law (18 USC sectsect 1001 et seq)
BorrowerSignature Date (mmddyyyy)
Additional Borrower Signature Date (mmddyyyy)
Uniform Residential Loan Application mdash Continuation SheetFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
INSTRUCTIONS FOR COMPLETING THE UNIFORM RESIDENTIAL LOAN APPLICATION
Use the instructions below to complete the enclosed Uniform Residential Loan Application (Freddie Mac Form 65Fannie Mae Form 1003) To avoid any delays in your application review please provide all of the requested information
If you need to make a correction on the application draw a line through the incorrect text and mark your initials beside the change Donrsquot use correction tape or fluid The application must be completed signed and dated in ink
The Uniform Residential Loan Application (URLA)
The URLA contains the following sections Section 1 Borrower Information Please provide your personal information income and employment
Section 2 Financial Information ndash Assets and Liabilities Please provide information about your financial assets personal financial obligations and debts you owe
Section 3 Financial Information ndash Real Estate Please provide information about property you own and the debts and expenses related to the property
Section 4 Loan and Property Information Please provide information about the loan purpose and the property you are buying or refinancing
Section 5 Declarations Please answer questions about the property how the property will be financed and your past financial history
Section 6 Acknowledgments and Agreements Informs you of your legal obligations related to the mortgage application and asks that you acknowledge certain information will be obtained used and shared
Section 7 Military Service Please provide information about your (or your deceased spousersquos) military service
Section 8 Demographic Information Requests information the Lender is required by law to ask you
Section 9 Loan Originator Information Will be completed by Chase
Uniform Residential Loan Application ndash Additional Borrower
The URLA ndash Additional Borrower contains the following sections Section 1 Borrower Information This is the same as the Borrower Information section of the URLA
Section 2 Financial Information ndash Assets and Liabilities Contains only the following statement for the additional Borrower to complete ldquoMy information for Section 2 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo The name of the other borrower is entered here
Complete a separate URLA for each BorrowermiddotThree or more Borrowers ndash Use any combination of URLA and URLA-Additional Borrower forms in accordance with the above examples
Section 3 Financial Information ndash Real Estate Contains only the following statement for the additional borrower to complete ldquoMy information for Section 3 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 4 Loan and Property Information Contains only the following statement for the additional borrower to complete ldquoMy information for Section 4 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 5 Declarations This is the same as the Declarations section of the URLA
Section 6 Acknowledgments and Agreements Contains only the following statement for the additional borrower to complete ldquoMy signature for Section 6 is on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 7 Military Service This is the same as the Military Service section of the URLA
Section 8 Demographic Information This is the same as the Demographic Information section on the URLA
Section 9 Loan Originator Information This is the same as the Loan Originator Information section of the URLA
Using the URLA and URLA ndash Additional Borrower Together The URLA and the URLA ndash Additional Borrower are used together to collect information for two Borrowers who have joint assets liabilities andor real estate information The URLA and URLA ndash Additional Borrower can also be used for Borrowers who do not have joint information but wish to combine their information on the URLA for ease of use Here are examples of how to use the URLA and URLA ndash Additional Borrower
For one borrower Complete the URLA
For two borrowers with joint financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you dont need to duplicate them on more than one URLA or o In cases where Borrowers are not collaborating when completing the loan application
joint assets liabilities and real estate may be duplicated on each URLA bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you do not need to duplicate them on more than one URLA or
o In cases where Borrowers are not collaborating when completing the loan application joint assets liabilities and real estate may be duplicated on each URLA
For two borrowers with separate financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower Report the assets liabilities and
real estate for the additional Borrower on the URLA or bull Complete a separate URLA for each Borrower
For three or more borrowers use any combination of URLA and URLA ndash Additional Borrower forms described for two borrowers
Uniform Residential Loan Application ndash Unmarried Addendum If any borrower listed on the URLA or URLA ndash Additional Borrower form selects Unmarried in Section 1 (Personal Information) the lender will complete this optional form
The information must be collected to determine how to apply state property laws that directly or indirectly affect creditworthiness including ensuring clear title
Uniform Residential Loan Application ndash Continuation Sheet Use the URLA ndash Continuation Sheet if you need more space to complete either the URLA or URLA ndash Additional Borrower forms
99177-URLAI-0215
HUD Addendum to Uniform Residential Loan Application OMB Approval No HUD 2502-0059 (exp )
Part I - Identifying Information HUDFHA Application for Insurance under the National Housing Act and Borrower Certification
FHA Case No (include any suffix) Mortgagee Case No
Mortgagee ID Sponsor ID Agent ID
Mortgagee Name Address (include ZIP Code) and Telephone Number
Type or print all entries clearly
Name and Address of Sponsor Name and Address of Agent
Borrowers Name amp Present Address (include ZIP Code) Property Address (include name of subdivision lot amp block no amp ZIP Code)
Sponsored Originations
Name of Third-Party Originator NMLS ID of Third-Party Originator
Part II - Borrower Consent for Social Security Administration to Verify Social Security Number I authorize the Social Security Administration (SSA) to verify my Social Security Number (SSN) to the Mortgagee and HUDFHA I authorize SSA to provide explanatory
information to HUDFHA in the event of a discrepancy This consent is valid for 180 days from the date signed unless indicated otherwise by the individual(s) named in this
loan application
Signature(s) of Borrower(s) - Read consent carefully Review accuracy of Social Security Number(s) provided on this application
Borrowerrsquos NameDate of BirthSocial Security Number
Co-Borrowerrsquos Name Date of BirthSocial Security Number
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
Part III - Borrower Notices Information and Acknowledgment Public Reporting Burden
Public reporting burden for this collection of information is estimated to average 10 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 conduct or sponsor and a person is not
required to respond to a collection of information unless that collection displays a valid OMB control number which can be located on the OMB Internet page at
httpwwwreginfogovpublicdoPRAMain
Privacy Act Information
The information requested on the Uniform Residential Loan Application and this Addendum is authorized by the National Housing Act of 1934 12 USC sect 1701 et seq The Debt
Collection Act of 1982 Pub L 97-365 and HUDrsquos Housing and Community Development Act of 1987 42 USC sect 3543 require persons applying for a federally insured loan to
furnish their SSN You must provide all the requested information including your SSN HUD may conduct a computer match to verify the information you provide HUD may
disclose certain information to Federal State and local agencies when relevant to civil criminal or regulatory investigations and prosecutions It will not otherwise be disclosed or
released outside of HUD except as required and permitted by law The information will be used to determine whether you qualify as a mortgagor Failure to provide any of the
requested information including SSN may result in disapproval of your loan application This is notice to you as required by the Right to Financial Privacy Act of 1978 that
HUDFHA has a right of access to financial records held by financial institutions in connection with the consideration or administration of assistance to you Financial records
involving your transaction will be available to HUDFHA without further notice or authorization but will not be disclosed or released by the institution to another Government Agency
or Department without your consent except as required or permitted by law
WARNING This warning applies to all certifications made in this document Anyone who knowingly submits a false claim or makes false statements is subject to criminal and civil penalties including confinement for up to 5 years fines and civil penalties 18 USC sectsect 287 1001 and 31 USC sect 3729
orm HUD-92900-A ( ) Page 1
Borrower Name ____________________________ FHA Case No __________________
Caution Delinquencies Defaults Foreclosures and Abuses Delinquencies defaults foreclosures and abuses of mortgage loans involving programs of the Federal Government can be costly and detrimental to your credit now and in the future The Mortgagee in this transaction its agents and assigns as well as the Federal Government its agencies agents and assigns are authorized to take any and all of the following actions in the event loan payments become delinquent on the mortgage loan described in the attached application (1) Report your name and account information to a credit bureau (2) Assess additional interest and penalty charges for the period of time that payment is not made (3) Assess charges to cover additional administrative costs incurred by the Federal Government to service your account (4) Offset amounts owed to you
under other Federal programs (5) Refer your account to a private attorney collection agency or mortgage servicing agency to collect the amount due foreclose
the mortgage sell the property and seek judgment against you for any deficiency (6) Refer your account to the Department of Justice (DOJ) for litigation in the
courts (7) If you are a current or retired Federal employee take action to offset your salary or civil service retirement benefits (8) Refer your debt to the Internal
Revenue Service for offset against any amount owed to you as an income tax refund and (9) Report any resulting written off debt of yours to the Internal Revenue Service as your taxable income All of these actions may be used to recover any debts owed when it is determined to be in the interest of the Mortgagee or Federal Government or both
As a mortgage loan borrower you will be legally obligated to make the mortgage payments called for by your mortgage loan contract The fact that you dispose of your property after the loan has been made will not relieve you of liability for making these payments Payment of the loan in full is ordinarily the way liability on a mortgage note is ended Some home buyers have the mistaken impression that if they sell their homes when they move to another locality or dispose of it for any other reasons they are no longer liable for the mortgage payments and that liability for these payments is solely that of the new owners Even though the new owners may agree in writing to assume liability for your mortgage payments this assumption agreement will not relieve you from liability to the holder of the note which you signed when you obtained the loan to buy the property Unless you are able to sell the property to a buyer who is acceptable to HUDFHA who will assume the payment of your obligation to the lender you will not be relieved from liability to repay any claim which HUDFHA may be required to pay your lender on account of default in your loan payments The amount of any such claim payment may be a debt owed by you to the Federal Government and subject to established collection procedures
Fair Housing Act I and anyone acting on my behalf are and will remain in compliance with the Fair Housing Act 42 USC sect 3604 et seq with respect to the dwelling or property covered by the loan and in the provision of services or facilities in connection therewith I recognize that any restrictive covenant on this property related to race color religion sex disability familial status or national origin is unlawful under the Fair Housing Act and unenforceable I further recognize that in addition to administrative action by HUD a civil action may be brought by the DOJ in any appropriate US court against any person responsible for a violation of the
applicable law
Certification and Acknowledgment All information in this application is given for the purpose of obtaining a loan to be insured under the National Housing Act and the information in the Uniform Residential Loan Application and this Addendum is true and complete to the best of my knowledge and belief Verification may be obtained from any source named herein I have read and understand the foregoing concerning my liability on the loan and Part III Borrower Notices Information and Acknowledgment
Signature(s) of Borrower(s) - Do not sign unless this application is fully completed Read the certification carefully and review accuracy of this application
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
orm HUD-92900-A ( Page 2
___________________________________
______________________________________________________
______________________________________________________________
- - - - - - - - - - - - - - - - - - - - - - -
Borrower Name ____________________________ FHA Case No __________________
Part IV - Direct Endorsement Approval for a HUD FHA-Insured Mortgage A Underwriting the Borrower
Date Mortgage Approved ______________________________ Date Approval Expires ______________________
For mortgages rated as an ldquoacceptrdquo or ldquoapproverdquo by FHAs TOTAL Mortgage Scorecard
The information submitted to TOTAL was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA4e Final Underwriting Decision (TOTAL) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee Representative Signature
Printed Name
Title
OR
For mortgages rated as a ldquoreferrdquo by FHAs TOTAL Mortgage Scorecard or manually underwritten by a Direct Endorsement underwriter I have personally reviewed and underwritten the borrowerrsquos credit application The information used to underwrite the borrower was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA5d Final Underwriting Decision (Manual) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
B Underwriting the Property
For all mortgages where FHA requires an appraisal I have personally reviewed and underwritten the appraisal according to FHA requirements I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
orm HUD-92900-A ( ) Page 3
Borrower Name ____________________________ FHA Case No __________________
Part V Mortgagees Certification
I have personally reviewed the mortgage documents and the application for insurance endorsement and This mortgage complies with SF Handbook 40001 Section IIA7 Post-Closing and Endorsement to the extent that no defect exists that would have changed the decision to endorse or submit the mortgage for insurance
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee
Name of Mortgageersquos Representative
Title of Mortgageersquos Representative
Signature of the Mortgageersquos Representative Date
orm HUD-92900-A ( ) Page 4
GENERAL AUTHORIZATION FOR A MORTGAGE LOAN ASSUMPTION
Applicant name(s)
Loan number
NOTICES AND DISCLOSURES
Non-discriminatory underwriting guidelines Anyone who inquires about the availability of credit from us has the right to receive a copy of our non-discriminatory underwriting guidelines To request a copy of these guidelines contact your Loan Processor
Attorney note Itrsquos the responsibility of our attorneys to protect our interest You may at your expense request an attorney to represent your interest
Notice to HUDFHA applicants As required by the Right to Financial Privacy Act of 1978 this notice is to inform you that the US Department of Housing and Urban Development (HUD)Federal Housing Administration (FHA) has a right of access to financial records held by financial institutions related to a request for assistance Financial records involving your assumption will be available to HUDFHA without further notice or authorization but wonrsquot be disclosed or released by us to another government agency or department without your consent except as required or permitted by law
Borrower consent to the use of tax return information I understand acknowledge and agree that the Lender and Other Loan Participants can obtain use and share tax return information for purposes of (i) providing an offer (ii) originating maintaining managing monitoring servicing selling insuring and securitizing a loan (iii) marketing or (iv) as otherwise permitted by applicable laws including state and federal privacy and data security laws The Lender includes the Lenderrsquos affiliates agents service providers and any of aforementioned partiesrsquo successors and assigns The Other Loan Participants includes any actual or potential owners of a loan resulting from your loan application or acquirers of any beneficial or other interest in the loan and mortgage insurer guarantor any servicers or service providers for these parties and any of aforementioned partiesrsquo successors and assigns
CERTIFICATION AND AUTHORIZATION
Environmental certification By signing below I represent and warrant that Irsquom not aware of any substances materials or products that may be an environmental hazard such as but not limited to asbestos formaldehyde radon gas lead-based paint fuel or chemical storage tanks (above or below ground) and contaminated soil or water on the property I acknowledge that Chase is relying on this representation and warranty as a material part of its loan application process I also am not aware of any landfill on any portion of the property
Exceptions to the above I further acknowledge (1) receipt of applicable disclosures from the seller in purchase transactions (2) that lead-based paint may exist in housing constructed prior to 1978 (3) that Chase performs no environmental investigation on my behalf and isnrsquot responsible for identifying lead-based paint or any other environmental conditions that might impact the property or its residents and (4) that it is my sole obligation to investigate for potential impact to the property from environmental conditions
Certifications I certify by signing below that (1) all of the loan application information provided is true and complete (2) I understand any intentional or negligent misrepresentation(s) of the information provided in conjunction with my application may result in civil liability andor 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 Chase its agents successors and assigns insurers and any other person who may suffer any loss due to reliance upon any misrepresentation that I have made on the application and (3) any significant change from the information provided at the time of application until the final loan application is signed may have a bearing on the approval of my application for a home loan
Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union
This question is asked because of state laws that extend the same or similar rights benefits and protections of spouses in a marriage to persons who are members of a partnership or union recognized under state law You should consult with your own legal advisor for advice regarding the rights protections benefits responsibilities obligations and duties of those who are registered domestic partners civil union partners or members of other unions recognized under applicable law
CREDIT AUTHORIZATION RELEASE
By signing below I authorize Chase andor my mortgage insurer (if any) to verify my past and present employment earnings records (including information contained in income tax returns that have been filed with the IRS) bank accounts stock holdings and any other information that it finds necessary to process my mortgage loan application or to review it for quality-control purposes I understand that a credit report will be ordered from a credit reporting agency for verification prior to loan closing as part of the application process and may be ordered after closing as part of the Lenderrsquos quality-control program A credit report may also be completed as part of the Lenderrsquos servicing or collection of the loan or in consideration of any other product or service that the Lender may consider offering me in the future and at any time throughout the life of the loan I understand that use of a photocopy of this form may be necessary to verify one or more of my credit references I understand that a photocopy or fax copy of this form will also serve as authorization
By signing below each applicant acknowledges (1) making the above certifications and authorizations and (2) that each applicant has received and understands the above notices and disclosures
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
You do not have to give us this information but if you donrsquot your application for approval as a borrower may be delayed or rejected The information requested in this form is authorized by Title 38 USC Chapter 37 (if VA) by 12 USC Section 1701 et seq (if HUDFHA) by 42 USC Section 1452b (if HUDCPD) and Title 42 USC 1471 et seq or 7 USC 1921 et seq (if USDA FHA)
Updated December 2021 99177-GA-0215
1b
2b
Form 4506-C (September 2020)
Department of the Treasury - Internal Revenue Service
IVES Request for Transcript of Tax Return OMB Number
1545-1872
Do not sign this form unless all applicable lines have been completed Request may be rejected if the form is incomplete or illegible
For more information about Form 4506-C visit wwwirsgov and search IVES
1a Name shown on tax return (if a joint return enter the name shown first)
First social security number on tax return individual taxpayer identification number or employer identification number (see instructions)
2a If a joint return enter spousersquos name shown on tax return Second social security number or individual taxpayer identification number if joint tax return
3 Current name address (including apt room or suite no) city state and ZIP code (see instructions)
4 Previous address shown on the last return filed if different from line 3 (see instructions)
5a IVES participant name address and SOR mailbox ID
DataVerify 875 Greentree Rd 8 Parkway Center Pittsburgh PA 15220
5b Customer file number (if applicable) (see instructions)
Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing (see instructions)
6 Transcript requested Enter the tax form number here (1040 1065 1120 etc) and check the appropriate box below Enter only one tax form number per request 1040
a Return Transcript which includes most of the line items of a tax return as filed with the IRS A tax return transcript does not reflect changes made to the account after the return is processed Transcripts are only available for the following returns Form 1040 series Form 1065 Form 1120 Form 1120-A Form 1120-H Form 1120-L and Form 1120S Return transcripts are available for the current year and returns processed during the prior 3 processing years
b Account Transcript which contains information on the financial status of the account such as payments made on the account penalty assessments and adjustments made by you or the IRS after the return was filed Return information is limited to items such as tax liability and estimated tax payments Account transcripts are available for most returns
c Record of Account which provides the most detailed information as it is a combination of the Return Transcript and the Account Transcript Available for current year and 3 prior tax years
7 Form W-2 Form 1099 series Form 1098 series or Form 5498 series transcript The IRS can provide a transcript that includes data from these information returns State or local information is not included with the Form W-2 information The IRS may be able to provide this transcript information for up to 10 years Information for the current year is generally not available until the year after it is filed with the IRS For example W-2 information for 2016 filed in 2017 will likely not be available from the IRS until 2018 If you need W-2 information for retirement purposes you should contact the Social Security Administration at 1-800-772-1213
Caution If you need a copy of Form W-2 or Form 1099 you should first contact the payer To get a copy of the Form W-2 or Form 1099 filed with your return you must use Form 4506 and request a copy of your return which includes all attachments
8 Year or period requested Enter the ending date of the tax year or period using the mmddyyyy format (see instructions)
12 31 2020 12 31 2019 12 31 2018 Caution Do not sign this form unless all applicable lines have been completed
Signature of taxpayer(s) I declare that I am either the taxpayer whose name is shown on line 1a or 2a or a person authorized to obtain the tax information requested If the request applies to a joint return at least one spouse must sign If signed by a corporate officer 1 percent or more shareholder partner managing member guardian tax matters partner executor receiver administrator trustee or party other than the taxpayer I certify that I have the authority to execute Form 4506-C on behalf of the taxpayer Note This form must be received by IRS within 120 days of the signature date
Signatory attests that heshe has read the attestation clause and upon so reading declares that heshe has the authority to sign the Form 4506-C See instructions
Sign Here
Signature (see instructions) Date Phone number of taxpayer on line 1a or 2a
PrintType name
Title (if line 1a above is a corporation partnership estate or trust)
Spousersquos signature Date
PrintType name
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020) For Privacy Act and Paperwork Reduction Act Notice see page 2
Instructions for Form 4506-C IVES Request for Transcript of Tax Return
Section references are to the Internal Revenue Code unless otherwise noted
Future Developments
For the latest information about Form 4506-C and its instructions go to wwwirsgov and search IVES Information about any recent developments affecting Form 4506-C (such as legislation enacted after we released it) will be posted on that page
Whats New Form 4506-C was created to be utilized by authorized IVES participants to order tax transcripts with the consent of the taxpayer
General Instructions
Caution Do not sign this form unless all applicable lines have been completed
Designated Recipient Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information received pursuant to the taxpayerrsquos consent and holds the recipient subject to penalties for any unauthorized access other use or redisclosure without the taxpayerrsquos express permission or request
Taxpayer Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information provided pursuant to your consent and holds the recipient subject to penalties brought by private right of action for any unauthorized access other use or redisclosure without your express permission or request
Purpose of form Use Form 4506-C to request tax return information through an authorized IVES participant You will designate an IVES participant to receive the information on line 5a
Note If you are unsure of which type of transcript you need check with the party requesting your tax information
Where to file The IVES participant will fax Form 4506-C with the approved IVES cover sheet to their assigned Service Center
Chart for ordering transcripts
If your assigned Service Center is
Fax the requests with the approved coversheet to
Austin Submission Processing Center
Austin IVES Team
844-249-6238
Fresno Submission Processing Center
Fresno IVES Team
844-249-6239
Kansas City Submission Processing Center
Kansas City IVES Team
844-249-8128
Ogden Submission Processing Center
Ogden IVES Team
844-249-8129
Specific Instructions
Line 1b Enter the social security number (SSN) or individual taxpayer identification number (ITIN) for the individual listed on line 1a or enter the employer identification number (EIN) for the business listed on line 1a
Line 3 Enter your current address If you use a PO box include it on this line
Line 4 Enter the address shown on the last return filed if different from the address entered on line 3
Note If the addresses on lines 3 and 4 are different and you have not changed your address with the IRS file Form 8822 Change of Address or Form 8822-BChange of Address or Responsible Party mdash Business with Form 4506-C
Line 5b Enter up to 10 numeric characters to create a unique customer file number that will appear on the transcript The customer file number cannot contain an SSN ITIN or EIN Completion of this line is not required
Note If you use an SSN name or combination of both we will not input the information and the customer file number will reflect a generic entry of 9999999999 on the transcript
Line 8 Enter the end date of the tax year or period requested in mmddyyyy format This may be a calendar year fiscal year or quarter Enter each quarter requested for quarterly returns Example Enter 12312018 for a calendar year 2018 Form 1040 transcript
Signature and date Form 4506-C must be signed and dated by the taxpayer listed on line 1a or 2a The IRS must receive Form 4506-C within 120 days of the date signed by the taxpayer or it will be rejected Ensure that all applicable lines including lines 5a through 8 are completed before signing
You must check the box in the signature area to acknowledge you have the authority to sign and request the information The form will not be processed if unchecked
Individuals Transcripts listed on on line 6 may be furnished to either spouse if jointly filed Only one signature is required Sign Form 4506-C exactly as your name appeared on the original return If you changed your name also sign your current name
Corporations Generally Form 4506-C can be signed by
(1) an officer having legal authority to bind the corporation (2) any person designated by the board of directors or other governing body or (3) any officer or employee on written request by any principal officer and attested to by the secretary or other officer A bona fide shareholder of record owning 1 percent or more of the outstanding stock of the corporation may submit a Form 4506-C but must provide documentation to support the requesters right to receive the information
Partnerships Generally Form 4506-C can be signed by any person who was a member of the partnership during any part of the tax period requested on line 8
All others See section 6103(e) if the taxpayer has died is insolvent is a dissolved corporation or if a trustee guardian executor receiver or administrator is acting for the taxpayer
Note If you are Heir at law Next of kin or Beneficiary you must be able to establish a material interest in the estate or trust
Documentation For entities other than individuals you must attach the authorization document For example this could be the letter from the principal officer authorizing an employee of the corporation or the letters testamentary authorizing an individual to act for an estate
Signature by a representative A representative can sign Form 4506-C for a taxpayer only if the taxpayer has specifically delegated this authority to the representative on Form 2848 line 5 The representative must attach Form 2848 showing the delegation to sign Form 4506-C
Privacy Act and Paperwork Reduction Act Notice We ask for the information on this form to establish your right to gain access to the requested tax information under the Internal Revenue Code We need this information to properly identify the tax information and respond to your request You are not required to request any transcript if you do request a transcript sections 6103 and 6109 and their regulations require you to provide this information including your SSN or EIN If you do not provide this information we may not be able to process your request Providing false or fraudulent information may subject you to penalties
Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and cities states the District of Columbia and US commonwealths and possessions for use in administering their tax laws We may also disclose this information to other countries under a tax treaty to federal and state agencies to enforce federal nontax criminal laws or to federal law enforcement and intelligence agencies to combat terrorism
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law Generally tax returns and return information are confidential as required by section 6103
The time needed to complete and file Form 4506-C will vary depending on individual circumstances The estimated average time is
Learning about the law or the form 10 min Preparing the form 12 min Copying assembling and sending the form to the IRS 20 min
If you have comments concerning the accuracy of these time estimates or suggestions for making Form 4506-C simpler we would be happy to hear from you You can write to
Internal Revenue Service Tax Forms and Publications Division 1111 Constitution Ave NW IR-6526 Washington DC 20224
Do not send the form to this address Instead see Where to file on this page
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020)
Rev April 2021 CHASEO Facts What does Chase do with your personal information
Why Financial companies choose how they share your personal information Federal law gives consumers the right to limit some but not all sharing Federal law also requires us to tell you how we collect share and protect your personal information Please read this notice carefully to understand what we do
What The types of personal information we collect and share depend on the product or service you have with us This information can include bull Social Security number and income bull account balances and transaction history bull credit history and payment history
How All financial companies need to share customers personal information to run their everyday business In the section below we list the reasons financial companies can share their customers personal information the reasons Chase chooses to share and whether you can limit this sharing
Reasons we can share your personal information Does Chase share
Can you limit this sharing
For our everyday business purposes - such as to process your transactions maintain your account(s) respond to court orders and legal investigations or report to credit bureaus
Yes No
For our marketing purposes - to offer our products and services to you
Yes No
For joint marketing with other financial companies Yes No
For our affiliates everyday business purposes - information about your transactions and experiences
Yes No
For our affiliates everyday business purposes - information about your creditworthiness
Yes Yes
For our affiliates to market to you Yes Yes
For nonaffiliates to market to you Yes Yes
a
0
To limit our sharing
bull Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
bull Visit us online chasecomprivacypreferences
Please note If you are a new customer we can begin sharing your information 30 days from the date we sent this notice When you are no longer our customer we continue to share your information as described in this notice However you can contact us at any time to limit our sharing
Questions
Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
PAGE 2
Who we are
Who is providing this notice The US consumer financial companies within the JPMorgan Chase amp Co family including JPMorgan Chase Bank NA Chase Insurance Agency Inc and JP Morgan Securities LLC
What we do
How does Chase protect my To protect your personal information from unauthorized access and use we personal information use security measures that comply with federal law These measures include
computer safeguards and secured files and buildings We authorize our employees to get your information only when they need it to do their work and we require companies that work for us to protect your information
How does Chase collect my We collect your personal information for example when you personal information bull open an account or make deposits or withdrawals from your account
bull pay your bills or apply for a loan bull use your credit or debit card We also collect your personal information from others such as credit bureaus affiliates or other companies
Why cant I limit all sharing Federal law gives you the right to limit only bull sharing for affiliates everyday business purposes - information about your
creditworthiness bull affiliates from using your information to market to you bull sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing See below for more on your rights under state law
What happens when I limit sharing for an account I hold jointly with someone else
Your choices will apply to everyone on your account
Definitions
Affiliates Companies related by common ownership or control They can be financial and non financial companies bull Our affiliates include companies with a Chase or JP Morgan name and financial companies such asjP Morgan Securities LLC
Nonaffiliates Companies not related by common ownership or control They can be financial and non financial companies bull Nonaffiliates we share with can include companies such as retailers auto dealers auto makers and membership clubs
Joint marketing A formal agreement between nonaffiliated financial companies that together market financial products or services to you bull Our joint marketing partners include categories of companies such as insurance companies
Other important information
VT Accounts with a Vermont mailing address are automatically treated as if they have limited the sharing as described on page 1 For joint marketing we will only disclose your name contact information and information about your transactions
NV We are providing you this notice pursuant to Nevada law If you prefer not to receive marketing calls from us you may be placed on our Internal Do Not Call List by calling 1-800-945-9470 or by writing to us at PO Box 734007 Dallas TX 75373-4007
For more information contact us at the address above or email PrivacylnfoJPMChasecom with Nevada Annual Notice in the subject line You may also contact the Nevada Attorney Generals office Bureau of Consumer Protection Office of the Nevada Attorney General 555 E Washington St Suite 3900 Las Vegas NV 89101 telephone number 1-702-486-3132 email BCPINFOagstatenvus
CA Accounts with a California mailing address are automatically treated as if they have limited the sharing with nonaffiliates as described on page 1 CA residents are provided a CA notice for additional choices
CHASE O
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
The following disclosure is required by the USA PATRIOT Act
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 opens an account
What this means to you When you 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 drivers
license or other identifying documents
99177-PAT-0215
VETERAN STATEMENT When this loan was opened the US Department of Veterans Affairs (VA) used the veteran borrowerrsquos entitlement which is a set amount the VA promises to repay a lender if the borrower defaults on the mortgage An assumption will modify who is obligated to pay the existing mortgage loan but all loan termsmdashincluding the entitlementmdashwill remain the same If the veteran borrower is being removed from the loan the entitlement would remain with whoever is assuming the loan because the loan will continue to be serviced by the VA If the applicant is also a veteran and can substitute his or her entitlement for the current entitlement then the current borrowerrsquos entitlement can be released
Please review the following questions and answer as appropriate This form requires completion by both the applicant(s) and current borrower(s)
1 Applicant to Complete
Are you (the applicant) currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the reverse side)
Yes (If yes please provide the information requested below answer the question in section 3 and sign and date this form at the bottom of the reverse side)
Name of applicant(s) who answered ldquoyesrdquo to the above question
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Are you receiving VA disability benefts
Applicant
Yes
No
Co-Applicant
Yes
No
Are you entitled to receive VA disability benefts Yes No Yes No
Have you received VA disability benefts in the past Yes No Yes No
Are you a surviving spouse of a veteran who died on active duty or as the result of a service-related disability
Yes No Yes No
Do you have any VA loans Yes No Yes No
2 Current Borrower to Complete
Is the current borrowerco-borrower currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the page)
Yes (If yes please answer the question in section 3 and sign and date this form at the bottom of the page)
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
________________________________________________________________________________________________
3 Applicant and Current Borrower to Complete
If the answer to the questions in section 1 and 2 are both yes please answer the following question After yoursquove reviewed and completed this entire form please sign and date at the bottom
Applicant Current Borrower
Do you want to apply for a substitution of entitlement Yes Yes No No
In order to complete a substitution of entitlement the veteran applicant must have suffcient entitlement to substitute for that of the current borrower Contact the VA Offce of Jurisdiction for your area for more information Also before the veteran applicant can substitute entitlement on a VA loan heshe must certify that the property securing the loan will be occupied as hisher primary residence Both the applicantrsquos and current borrowerrsquos original certifcate of eligibility will be required If your sales contract is contingent upon the restoration of entitlement please contact your VA Offce of Jurisdiction for complete procedures Otherwise the substitution will be completed after the loan has been approved and closed
Date Applicant printed name Applicant signature
Date Applicant printed name Applicant signature
Date Current Borrower printed name Current Borrower signature
Date Current Borrower printed name Current Borrower signature
Forms completed by Mail Phone
For Chase use only
Interviewer signature Date
99177-VS-0215
- Assumption Application Package_41521-noscannedpages-update-4pdf
-
- 1 FM203 Cover Pagepdf
- 2 FM202 Mortgage Assumption Application Package pagepdf
- 3 The Documents Youll need to Send Uspdf
- 4 FM201 FAQpdf
- 5 FM142 CIWpdf
- 6 FM126 URLApdf
- 7 FM130 URLA Instpdf
-
- Blank Page
-
- 8 92900a Addednum to Loan Applicationpdf
- 9 FM462 Gen Authpdf
- 10 FM220 4506-Cpdf
- 11 FM153 Chase Federal Privacy Noticepdf
- 12 FM144 Info on Opening a New Accountpdf
- 13 FM152 Veteran Statementpdf
-
- Date
- Loan number
- Applicant name
- Phone1
- Loan number 1
- Loan number 2
- Other
- Other_2
- 1
- 2
- undefined_7
- Available hours
- Available hours_2
- undefined_8
- Available hours_3
- undefined_9
- Current address 1
- Neither
- Available hours_4
- Available hours_5
- undefined_10
- Available hours_6
- 1_2
- 2_2
- undefined_11
- Available hours_7
- Available hours_8
- undefined_12
- Available hours_9
- FHA Case No include any suffix
- Mortgagee Case No
- Mortgagee ID
- Sponsor ID
- Agent ID
- Name and Address of Sponsor Name and Address of Agent
- Borrowers Name Present Address include ZIP Code Property Address
- include name of subdivision lot block no ZIP Code
- Name of ThirdParty Originator
- NMLS ID of ThirdParty Originator
- s application
- ty Number
- ty Number_2
- Date Signed_2
- Date Mortgage Approved
- Date Approval Expires
- Printed Name
- Title 1
- DEs ID Number
- DEs ID Number_2
- Mortgagee
- Name of Mortgagees Representative
- Title of Mortgagees Representative
- Signature of the Mortgagees Representative
- Date_2
- Applicant names 1
- Applicant names 2
- Applicant names 3
- Loan number_2
- Date_3
- Applicant printed name
- Social Security number
- Date_4
- Applicant printed name_2
- Social Security number_2
- Date_5
- Applicant printed name_3
- Social Security number_3
- Date_6
- Applicant printed name_4
- Social Security number_4
- 1a Name shown on tax return if a joint return enter the name shown first
- 1b First social security number on tax return individual taxpayer identification number or employer identification number see instructions
- 2a If a joint return enter spouses name shown on tax return
- 2b Second social security number or individual taxpayer identification number if joint tax return
- 4 Previous address shown on the last return filed if different from line 3 see instructions
- 5a IVES participant name address and SOR mailbox ID
- Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing see instructions
- Signature see instructions
- Date_7
- Phone number of taxpayer on line 1a or 2a
- PrintType name
- Here
- Spouses signature
- Date_8
- PrintType name_2
- Name
- Date of birth
- Service number
- Name_2
- Date of birth_2
- Service number_2
- Date_9
- Applicant printed name_5
- Date_10
- Applicant printed name_6
- Date_11
- Current Borrower printed name
- Date_12
- Current Borrower printed name_2
- Date_13
- Text3
- Text10
- undefined_13
- Text15
- undefined_14
- undefined_15
- undefined_16
- undefined_17
- undefined_18
- undefined_19
- undefined_20
- undefined_21
- undefined_23
- Reason for assumption Off
- Requestors relationship to owners Off
- Check one Off
- Check one1 Off
- Day1
- Evening
- Cell phone
- Check one2 Off
- Check one3 Off
- Check one4 Off
- Check one5 Off
- Text2-1
- Text2-2
- Text2-3
- Text2-4
- Text2-5
- Text2-6
- Text3-1
- Text3-2
- Text3-3
- Text3-4
- Text3-6
- Text3-7
- Text3-8
- Text3-9
- Text3-10
- Text3-11
- Text3-12
- Text3-13
- Text3-14
- Text3-15
- Text3-16
- Text3-17
- Text3-18
- Text3-19
- Text3-20
- Text3-21
- Text3-22
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- Text3-25
- Text3-26
- Text3-27
- Text3-28
- Text3-29
- Text3-30
- Text3-31
- Text3-32
- Text3-33
- Text3-34
- Text3-35
- Text3-36
- Text3-37
- Text3-38
- Text3-39
- Text3-40
- Text3-41
- Text3-42
- Text3-43
- Text3-44
- Text3-45
- Text3-46
- Text3-47
- Text3-48
- Text3-49
- Text3-50
- Text3-51
- Text3-52
- Text3-53
- Text3-5
- Text3-54
- Text3-55
- Text3-56
- Citizenship Off
- Type of credit Off
- Marital Status Off
- Housing Off
- Housing1 Off
- ownership Off
- DNA1 Off
- DNA2 Off
- DNA3 Off
- family Off
- BO Off
- Total
- Text31
- Text32
- Text33
- Text34
- Text35
- Text36
- Text37
- Text38
- Text39
- Text310
- Text311
- Text312
- Text313
- Text314
- Text315
- Text316
- Text317
- Text318
- Text319
- ownership1 Off
- Total1
- Total1-2
- Check Box4-1 Off
- Text320
- Text321
- Text322
- Text323
- Text324
- Text325
- Text326
- Text327
- Text328
- Text329
- Check Box4-2 Off
- Check Box4-3 Off
- Check Box4-4 Off
- Check Box4-8 Off
- Check Box4-9 Off
- Text330
- Text331
- Text332
- Text333
- Text334
- Text335
- Text1-1
- Text1-2
- Text1-3
- Text1-4
- Text1-5
- Text1-6
- Text1-7
- Text1-8
- Text1-9
- Text1-10
- Text1-11
- Text1-12
- Text1-13
- Text1-14
- Text1-15
- Text1-16
- Text1-17
- Text1-18
- Text1-19
- Text1-20
- Text1-21
- Text1-22
- Text1-23
- Text1-24
- Text1-25
- Text1-26
- Text1-27
- Text1-28
- Text1-29
- Text1-30
- Text1-31
- Text1-32
- Text1-33
- Text1-34
- Text1-35
- Check Box3-2 Off
- Check Box2-1 Off
- Check Box2-2 Off
- Check Box2-3 Off
- Check Box2-4 Off
- Check Box2-5 Off
- Text1-36
- Text1-37
- Text1-38
- Text1-39
- Text1-40
- Text1-41
- Text1-42
- Text1-43
- Text1-44
- Text1-45
- Text1-46
- Text1-47
- Text1-48
- Text1-49
- Text1-50
- Text1-51
- Text1-52
- Text1-53
- Text1-54
- Text1-55
- Text1-56
- Text1-57
- Text1-58
- Text1-59
- Text1-60
- Text1-61
- Check Box3-11 Off
- A1
- A2
- A3
- A4
- A5
- A6
- A7
- A8
- A9
- A10
- A11
- A12
- Check Box3-1 Off
- Check Box30-1 Off
- Check Box30-2 Off
- Check Box30-4 Off
- Check Box30-5 Off
- Check Box30-7 Off
- Check Box30-8 Off
- Check Box30-9 Off
- Check Box30-10 Off
- Check Box30-11 Off
- Check Box30-12 Off
- A13
- A14
- A15
- A16
- A17 Off
- A18
- A19
- A20
- A21
- A22
- A23
- A24
- A25
- A26
- A27
- A28
- A29
- A30
- A31
- A32
- A33
- A34
- A35
- A36
- A37
- A38 Off
- A39
- A40
- A41
- A42
- A43
- A44
- A45
- A46
- A47
- A48
- A49
- A50
- A51
- A52
- A53
- A54
- A55
- A56
- A57
- A58
- A59
- A60
- A61
- A62
- A63
- A64
- A65
- A66
- A67
- A68
- A69
- A70
- A71
- A72
- A73
- A74
- Loan Purpose Off
- occupancy1 Off
- lien type Off
- lientype Off
- mixed use Off
- manufactured home Off
- deposit1 Off
- deposit2 Off
- B1
- B2
- B3
- B4
- B5
- B6
- B7
- B8
- B9
- B10
- fha Off
- Check Box51 Off
- B11
- B12
- B13
- B14
- B15
- B16
- B17
- B18
- B19 Off
- B20
- B21
- B22 Off
- B23
- B24
- B25
- B26
- B27
- B28
- A
-
- Will you occupy the property as your primary residence Off
- Will you occupy the property as your primary residence1 Off
-
- If yes have you had an ownership interest in another property in the last three years Off
- Text9-2
- B
-
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property Off
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property1 Off
-
- 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 Off
- 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 application1 Off
-
- 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 Off
- 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 application1 Off
-
- new credit Off
- 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) Off
- the Property Assessed Clean Energy Program)1 Off
-
- F
-
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application Off
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application1 Off
-
- G
-
- Are there any outstanding judgments against you Off
- Are there any outstanding judgments against you1 Off
-
- H
-
- Are you currently delinquent or in default on a Federal debt Off
- Are you currently delinquent or in default on a Federal debt1 Off
-
- I
-
- Are you a party to a lawsuit in which you potentially have any personal financial liability Off
- Are you a party to a lawsuit in which you potentially have any personal financial liability1 Off
-
- J
-
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years Off
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years1 Off
-
- 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 Off
- 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 due1 Off
-
- L
-
- Have you had property foreclosed upon in the last 7 years Off
- Have you had property foreclosed upon in the last 7 years1 Off
-
- M
-
- Have you declared bankruptcy within the past 7 years Off
- Have you declared bankruptcy within the past 7 years1 Off
-
- Check Box8-2 Off
- Check Box8-3 Off
- Check Box8-4 Off
- Text9-3
- Text9-5
- Text9-6
- Text97
- military Off
- ethnicity Off
- sex Off
- race Off
- demo Off
- Text12-1
- Check Box11-1 Off
- Check Box11-2 Off
- Check Box11-3 Off
- Check Box11-4 Off
- Check Box11-5 Off
- Check Box11-6 Off
- Check Box11-7 Off
- Check Box11-8 Off
- Check Box11-9 Off
- Text12-2
- Check Box11-10 Off
- Check Box11-11 Off
- Check Box11-12 Off
- Check Box11-13 Off
- Check Box11-14 Off
- Check Box11-15 Off
- Text12-3
- Check Box11-16 Off
- Check Box11-17 Off
- Check Box11-18 Off
- Check Box11-19 Off
- Check Box11-20 Off
- Check Box11-21 Off
- Check Box11-22 Off
- Check Box11-23 Off
- Text12-4
- Check Box11-24 Off
- Check Box11-25 Off
- Check Box11-26 Off
- Check Box11-27 Off
- Check Box11-28 Off
- Check Box11-29 Off
- Text12-5
- Check Box11-30 Off
- Check Box11-31 Off
- citizen Off
- credit Off
- marital status1 Off
- housing-1 Off
- housing-2 Off
- own Off
- C1
- C2
- C3
- C6
- C7
- C8
- C9
- C10
- C11
- C12
- C13
- C14
- C15
- C16
- C17
- C18
- C19
- C20
- C21
- C22
- C23
- C24
- C25
- C26
- C27
- C28
- C29
- C30
- C31
- C32
- C33
- C34
- C35
- Check Box-2 Off
- C36
- C37
- C38
- C39
- C4
- C40
- C41
- C42
- C43
- C44
- C45
- C46
- C47
- Check Box-3 Off
- Check Box-4 Off
- C48
- C49
- C5
- C50
- C51
- C52
- C53
- C54
- C55
- Check Box-1-1 Off
- own1 Off
- Check Box-1 Off
- D1 Off
- D2
- D3
- D4
- D5
- D6
- D7
- D8
- D9
- D10
- D11
- D12
- D13
- D14 Off
- D15 Off
- D16
- D17
- D18
- D19
- D20
- D21
- D22
- D23
- D24 Off
- D25
- D26
- D27
- D28
- D29
- D30
- D31
- D32
- D33
- D34
- D35 Off
- D36
- D37 Off
- D38
- D39
- D40
- D41
- D42
- D43
- D44
- D45
- D46
- D47
- If yes have you had an ownership interest in another property in the last three years1 Off
- new credit1 Off
- Check Box8-1 Off
- Check Box8-1-2 Off
- Check Box8-1-1 Off
- Check Box8-1-3 Off
- Check Box8-1-4 Off
- Military Service mdash Did you (or your deceased spouse) ever serve or are you currently serving in the United States Armed Forces 1 Off
- Check1 Off
- Text9-1-1
- Check2 Off
- Check3 Off
- Check4 Off
- Text9-1
- E1
- E2
- E3
- Was the ethnicity of the Borrower collected on the basis of visual observation or surname1 Off
- Was the sex of the Borrower collected on the basis of visual observation or surname1 Off
- Was the race of the Borrower collected on the basis of visual observation or surname1 Off
- The Demographic Information was provided through1 Off
- F1 Off
- F2 Off
- F3 Off
- F4 Off
- F5 Off
- F6
- F7 Off
- F8 Off
- F9 Off
- F10 Off
- F11 Off
- F12 Off
- F13
- F14 Off
- F15 Off
- F16 Off
- F17 Off
- F18 Off
- F19 Off
- F20 Off
- F21 Off
- F22
- F23 Off
- F24 Off
- F25 Off
- F26 Off
- F27 Off
- F28 Off
- F29
- F30 Off
- F31 Off
- undefined_13-1
- undefined_13-2
- undefined_14-1
- undefined_15-1
- undefined_16-1
- undefined_17-1
- undefined_18-1
- undefined_19-1
- undefined_21-1
- undefined_20-1
- undefined_23-1
- undefined_13_1
- Single-Two Off
- Refi type Off
- refi program Off
- Estate Off
- Title held Off
- Trust Information Off
- Indian Country Land Tenure Off
- Mortgage Type Applied For Off
- Mortgage Lien Type Off
- Amortization Type Off
- G1 Off
- G2 Off
- G3 Off
- G4 Off
- G5 Off
- G6
- G7
- G8
- G9
- G10 Off
- G11 Off
- G12 Off
- G13 Off
- G14 Off
- G15 Off
- G16
- G17
- G18
- G19
- G20
- G21
- G22
- G23 Off
- G24
- G25 Off
- G26
- G27 Off
- G28 Off
- G29
- G30 Off
- G31
- G32 Off
- G33
- G34
- G35
- G36
- G37
- G38
- G39
- G40
- G41
- G42
- Property Held
- refi
- Text18-1
- Text18-2
- Text18-3
- Text18-4
- Text18-5
- Text18-6
- Text18-7
- Text18-8
- Text18-9
- Text18-10
- Text18-11
- Text18-12
- Text18-13
- Text18-14
- Text18-15
- Text18-16
- Text18-17
- Text18-18
- Text18-19
- Lender
- case no
- If you selected ldquoUnmarriedrdquo in Section 1 is there a person who is not your legal spouse but who currently has real property rights similar to those of a legal spouse Off
- Relationship and State Off
- Other-5
- Text19-1
- BName
- Additional Information
- ABN
- Additional Information1
- BSign
- BSDate
- ABSign
- ABDate
- MortageeNameAddress
- NAmeAddress
- Bname1
- DOB1
- DOB2
- SignOfBorr1
- SignOfBorr
- Date Signed
- SignOfBorr2
- SignOfBorr3
- Date Signed3
- Date Signed4
- MortgageeRepSign
- DirectSign
- DirectSign1
- Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union Off
- AppSign
- AppSign1
- AppSign2
- AppSign3
- Nopage38 Off
- Yespage38 Off
- Yes1 Off
- No1 Off
- Yes2 Off
- Yes3 Off
- Yes4 Off
- Yes5 Off
- Yes6 Off
- Yes7 Off
- Yes8 Off
- Yes9 Off
- Yes10 Off
- No2 Off
- No3 Off
- No4 Off
- No5 Off
- No6 Off
- No7 Off
- No8 Off
- No9 Off
- No10 Off
- BorrowerNo Off
- BorrowerYes Off
- AppSignature
- AppSignature1
- CurrentSign
- CurrentSign1
- InterviewSign
- Yes_1 Off
- No_1 Off
- Yes_2 Off
- No_2 Off
- Mail Off
- Phone Off
CoeeeMCMCmeticlm tu)Comiteteilteeilelie mieit
Does not apply
Employeror Business Name Phone ( ) - Gross Monthly Income
Street Unit Base
OvertimeBonus
Commission
MilitaryEntitlements
Other
$ month
$ month$ month
$ month
$ month
$ month
City State ZIP Country
Position orTitle ose if this statement applieslam employed by a family memberpropertyseller real estate agent or otherparty to the transaction
Start Date (mmddyy)How long in this line of work Years =Months
Checkif you are the Business
Owneror Self-Employed| have an ownershipshare of less than 25 Monthly Income(or Loss)
Ihave an ownership share of 25 or more $ TOTAL$ 000month
CPONMeeeMummaTestetiersdeere lire miret Does not apply
Provideat least 2 years of current and previous employment and income
Employeror Business Name Previous Gross MonthlyStreet Unit Income s month
City State ZIP Country
Position or Title
Start Date
End Date
Checkif you were the BusinessOwneror Self-Employed
(mmddyyyy)
(mmddyyyy) 1e Income from Other Sources Does not apply
Include incomefrom other sources below Under Income Source choose from the sourceslisted herelaquo Alimonylaquo Automobile Allowanceraquo Boarder Incomelaquo Capital Gains
Child Support+ Disability+ Foster Care Housing or Parsonage
+ Interest and DividendslaquoMortgage Credit Certificate Mortgage DifferentialPayments
laquo Notes Receivable+ Public Assistancelaquo Retirement(eg Pension IRA)
+raquo Royalty Payments Separate Maintenance
+ Social Security
raquo Trust
+ UnemploymentBenefits
laquo VA Compensation
laquo Other
NOTE Revealalimony child support separate maintenance or other income ONLYIFyou wantit considered in determining yourqualification
for this loan
Income Source - uselist above Monthly Income
$
$
$
$ 000Provide TOTAL AmountHere|
Section 2 Financial Information mdash Assets andLiabilities
Myinformation for Section 2 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 3 Financial Information mdash Real Estate
Myinformation for Section 3 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 4 Loan and Property Information
Myinformation for Section 4 is listed on the Uniform Residential Loan Application with
(insert name of Borrower)
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 5 DeclarationsThis section asks you specific questions about the property your funding and your past
financial history
5aAboutthis Property and Your Moneyforthis Loan
A Will you occupy the property as your primary residence NO YES
If YES have you had an ownershipinterest in another property in the last three years NO YES
If YES complete (1) and (2) below
(1)What type of property did you ownprimary residence (PR) FHA secondary residence (SR) second home(SH)
or investmentproperty (IP)
(2) How did you holdtitle to the property by yourself (S) jointly with your spouse(SP) or jointly with another person (O)
B If this is a Purchase Transaction Do you have a family relationship or businessaffiliation with the seller of the property NO YES Cc Are you borrowing any moneyforthis real estate transaction (eg money foryour closing costs or down payment) or
obtaining any moneyfrom anotherparty suchastheselleror realtor that you have not disclosed on this loan application NO YES
If YES whatis the amountof this money $
D 1 Have youorwill you be applying for a mortgage loan on anotherproperty (not the property securing this loan) on orbefore closing this transaction that is not disclosed on this loan application
NO YES
2 Have you orwill you be applying for any newcredit (eg installment loan credit card etc) on or before closing this loan that wsis not disclosed on this application
NO YES
E Will this property be subject to a lien that could take priority over thefirst mortgagelien such as a clean energylien paid
through yourproperty taxes(eg the PropertyAssessed Clean Energy Program)No YES
EK) Veli ellim ait
F Areyou a co-signer or guarantor on any debtor loan thatis not disclosed on this application NO ES
G Are there any outstanding judgments against you NO YES
H Are you currently delinquentor in default on a Federal debt NO YES
I Are you a party to a lawsuit in which you potentially have any personalfinancialliability NO YES
J Have you conveyedtitle to any property in lieu of foreclosure in the past 7 years NO YES
K Within the past 7 years have you completed a pre-foreclosure sale or short sale whereby the property wassold to a
third party and the Lender agreed to acceptless than the outstanding mortgage balance due
No YES
L Have you had property foreclosed uponin thelast 7 years NO YES
M Have you declared bankruptcy within the past 7 years no vESIf YES identify the type(s) of bankruptcy Chapter 7 Chapter11 Chapter12 Chapter 13
Section 6 Acknowledgements and AgreementsMy signature for Section 6 is on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 7 Military Service This section asks questions about your(or your deceased spouses) military service
Military Service of Borrower
Military Service mdash Did you (or your deceased spouse)everserve or are you currently serving in the United States Armed Forces NO YES
IfYES check allthat apply Currently serving on active duty with projected expiration date of servicetour (mmddyyyy)
Currently retired discharged or separated from service nnOnly period of service was as a non-activated memberofthe Reserve or National GuardSurviving spouse
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 8 Demographic InformationThis section asks about your ethnicity sex and race
Demographic Information of Borrower
The purposeofcollecting this information is to help ensure thatall applicants are treated fairly and that the housing needs of communities
and neighborhoodsare beingfulfilled 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 providethis information but are encouraged to do so You mayselect one or more designationsfor
Ethnicity and one or more designationsfor Race The law provides that we maynotdiscriminate onthe basis of this information or onwhetheryou chooseto provideit However if you choose notto provide the information and you have madethis application in person Federal
regulations require us to note yourethnicity sex and race on the basis of visual observation or surname The law also provides that we may notdiscriminate on the basis of age or marital status information you providein this application If you do not wish to provide someorall of this
information please check below
Ethnicity Check one or more Race Check one or moreHispanic or Latino AmericanIndian or Alaska Native - Print nameofenrolled
or principaltribeMexican PuertoRican Cuban
OtherHispanic or Latino - Printorigin siansian Indian Chinese Filipino
For exampleArgentinean Colombian Dominican NicaraguanSalvadoran Spaniard andso on
Japanese Korean VietnameseOtherAsian - Print race Forexample Hmong Laotian Thai Pakistani Cambodian andso on
Black or African American
Native Hawaiian or OtherPacific Islander
Native Hawaiian GuamanianorChamorro Samoan
OtherPacific Islander mdash Print race
Not Hispanic or Latino
| do not wish to providethis information
Sex
Female
Male
| do not wish to providethis informationFor example Fijian Tongan and so on
White
| do not wish to providethis information
Wasthe ethnicity of the Borrowercollected on thebasis of visual observation or surnameWasthesex of the Borrowercollected on the basis of visual observation or surnameWastherace of the Borrowercollected on the basis of visual observation or surname
)NO YESNO YESNO YES
Face-to-Face Interview (includes Electronic Media w Video Component) Telephone Interview Faxor Mail Email or Internet
Loan Originator Organization Name
Address
Loan Originator Organization NMLSR ID State License ID
Loan Originator Name
Loan Originator NMLSR ID State License ID
Email Phone (
Signature Date (mmddyyyy)
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Pe)aae-emeet)
Community Property State
At least one borrowerlives in a community propertystateThe property is in a community property state
Transaction DetailConversion of Contract for Deed or Land ContractRenovationConstruction-ConversionConstruction-to-Permanent
Single-Closing Two-ClosingConstructionImprovementCosts $
LotAcquired Date
Original Cost of Lot $(mmddyyyy)
Refinance Program
Full DocumentationInterest Rate ReductionStreamlined without Appraisal
Other
Refinance Type
NoCash OutLimited Cash OutCash Out
Energy Improvement
Mortgageloanwill finance energy-related improvements
Propertyis currently subject to a lien that could take priority ovethe first mortgagelien such as a clean energylien paid for througproperty taxes(eg the PropertyAssessed Clean Energyprogram)
Project Type Condominium Cooperative Planned Unit Development (PUD) Propertyis notlocatedin a project
Peiwlivcestetece)a)
Title to the Property Will be Held in What Name(s)
For RefinanceTitle to the Property is Currently Held in What Name(s
Trust Information
tle Will be Held byan Inter Vivos (Living) Trust
Title Will be Held by a Land TrustLeasehold Expiration Date
Mannerin WhichTitle Will be Held Indian Country Land Tenure
Sole OwnershipLife EstateTenancy in Common
Joint Tenancywith Right of Survivorship]Tenancybythe EntiretyOther
Fee Simple Ona ReservationIndividualTrust Land (AllottedRestricted)Tribal Trust Land On a ReservationTribal Trust Land Off ReservationAlaska Native Corporation Land
Estate Will be Held in
Fee Simple(mmddyyyy)
3 Mortgage LoanInformation
Termsof Loan
Note Rate
Loan Term (months)
MortgageLien Type
First LienSubordinate Lien
Mortgage Type Applied For
Conventional USDA-RDFHA VA Other
Amortization Type
Fixed RateAdjustable Rate
If Adjustable Rate
Initial Period Prior to First Adjustment
Subsequent AdjustmentPeriod
Proposed Monthly Paymentfor Property
First Mortgage (P amp I) $
Subordinate Lien(s) (P amp |) $
Other(explain)
Homeowners Insurance $(months)
(months)
Loan Features Property Taxes $
Balloon Balloon Term (months)
Interest Only Interest OnlyTermNegative AmortizationPrepaymentPenalty Prepayment Penalty Term (months) Other
Temporary Interest Rate BuydownInitial Buydown Rate TOTALOther(explain)
Mortgage Insurance $
AssociationProject Dues (Condo Co-Op PUD) $
Supplemental Property Insurance $
(months)
Borrower Name(s)Uniform Residential Loan Application mdash LenderLoan Information
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
L4 Qualifying the Borrower - Minimum Required Funds or Cash Back
DUEFROM BORROWER(S)
A Sales Contract Price
B Improvements Renovations and Repairs
C Land(ifacquired separately)
D For Refinance Balance of Mortgage Loanson the Propertyto be paid off in the Transaction
(See Table 3a Property You Own)
E Credit Cards and Other Debts Paid Off
(See Table 2c Liabilities mdash Credit Cards Other Debts and Leases that You Owe)
F BorrowerClosing Costs (including Prepaid andInitial Escrow Payments)
G Discount Points
HTOTAL DUE FROM BORROWER(s)(Total of A thru G)
TOTALMORTGAGE LOANS
Loan Amount
Loan AmountExcluding Financed Mortgage Insurance (or Mortgage Insurance Equivalent) $
Financed Mortgage Insurance (or Mortgage Insurance Equivalent) Amount $
Other New Mortgage Loanson the Property the Borrower(s) is Buying or Refinancing(See Table 4b Other New MortgageLoanson the Property You are Buying or Refinancing)
KTOTAL MORTGAGELOANS(Totalof| and J)
TOTALCREDITS
L Seller Credits (Enter the amountofBorrower(s) costs paid by the property seller)
MOtherCredits (Enter the sum ofall other credits mdash BorrowerPaid Fees Earnest Money EmployerAssistedHousing Lease Purchase Fund Lot Equity Relocation Funds Sweat Equity Trade Equity Other)
NTOTAL CREDITS(Total of L and M)
CALCULATION
TOTAL DUE FROM BORROWER(s)(Line H)
LESSTOTAL MORTGAGELOANS(Line K) AND TOTAL CREDITS(Line N)
Cash FromTothe Borrower(Line H minusLine K and Line N)NOTE This amountdoesnotinclude reservesor other funds that may be required by the Lenderto be verified
Borrower Name(s)Uniform Residential Loan Application mdash LenderLoan Information
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
Uniform Residential Loan Application mdash Unmarried Addendum
eeCeceetatimC elitleeComeLy
Lenders Instructions for Using the Unmarried Addendum
The Lender may use the Unmarried Addendum only when a Borrowerselected ldquoUnmarriedrdquoin Section 1 and the information collected is
necessary to determine howState property lawsdirectly or indirectly affecting creditworthiness apply including ensuring clear title
For example the Lender may use the Unmarried Addendum whentheBorrowerresides in a State that recognizescivil unions domestic
partnerships or registered reciprocal beneficiary relationships or when the property is located in such a State ldquoStaterdquo meansanystate the
District of Columbia the Commonwealth of Puerto Rico or anyterritory or possession of the United States
Ifyou selected ldquoUnmarriedrdquoin Section 1 is there a person whois not your legal spouse but whocurrently has real property rights similar to
those of a legal spouse +=) NOQ YES
If YES indicate the type of relationship and the State in which the relationship was formed For example indicate if you are in a
civil union domestic partnership registered reciprocal beneficiary relationship or other relationship recognized by the State in which you
currently reside or where the property is located
O Civil Union copy Domestic Partnership copy Registered Reciprocal Beneficiary Relationship copy) Other(explain)
Statea]
Borrower NameUniform Residential Loan Application mdash Unmarried Addendum
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Uniform Residential Loan Application mdash Continuation Sheet
Use this continuation sheet if you need more space to complete the Uniform Residential Loan Application
Borrower Name(First Middle Last Suffix )
Additional Information
Additional Borrower Name(First Middle Last Suffix )
Additional Information
IWefully understand thatit is a federal crime punishable by fine or imprisonment or both to knowingly make anyfalse statements concerningany of the abovefacts as applicable underthe provisions of federal law (18 USC sectsect 1001 et seq)
BorrowerSignature Date (mmddyyyy)
Additional Borrower Signature Date (mmddyyyy)
Uniform Residential Loan Application mdash Continuation SheetFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
INSTRUCTIONS FOR COMPLETING THE UNIFORM RESIDENTIAL LOAN APPLICATION
Use the instructions below to complete the enclosed Uniform Residential Loan Application (Freddie Mac Form 65Fannie Mae Form 1003) To avoid any delays in your application review please provide all of the requested information
If you need to make a correction on the application draw a line through the incorrect text and mark your initials beside the change Donrsquot use correction tape or fluid The application must be completed signed and dated in ink
The Uniform Residential Loan Application (URLA)
The URLA contains the following sections Section 1 Borrower Information Please provide your personal information income and employment
Section 2 Financial Information ndash Assets and Liabilities Please provide information about your financial assets personal financial obligations and debts you owe
Section 3 Financial Information ndash Real Estate Please provide information about property you own and the debts and expenses related to the property
Section 4 Loan and Property Information Please provide information about the loan purpose and the property you are buying or refinancing
Section 5 Declarations Please answer questions about the property how the property will be financed and your past financial history
Section 6 Acknowledgments and Agreements Informs you of your legal obligations related to the mortgage application and asks that you acknowledge certain information will be obtained used and shared
Section 7 Military Service Please provide information about your (or your deceased spousersquos) military service
Section 8 Demographic Information Requests information the Lender is required by law to ask you
Section 9 Loan Originator Information Will be completed by Chase
Uniform Residential Loan Application ndash Additional Borrower
The URLA ndash Additional Borrower contains the following sections Section 1 Borrower Information This is the same as the Borrower Information section of the URLA
Section 2 Financial Information ndash Assets and Liabilities Contains only the following statement for the additional Borrower to complete ldquoMy information for Section 2 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo The name of the other borrower is entered here
Complete a separate URLA for each BorrowermiddotThree or more Borrowers ndash Use any combination of URLA and URLA-Additional Borrower forms in accordance with the above examples
Section 3 Financial Information ndash Real Estate Contains only the following statement for the additional borrower to complete ldquoMy information for Section 3 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 4 Loan and Property Information Contains only the following statement for the additional borrower to complete ldquoMy information for Section 4 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 5 Declarations This is the same as the Declarations section of the URLA
Section 6 Acknowledgments and Agreements Contains only the following statement for the additional borrower to complete ldquoMy signature for Section 6 is on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 7 Military Service This is the same as the Military Service section of the URLA
Section 8 Demographic Information This is the same as the Demographic Information section on the URLA
Section 9 Loan Originator Information This is the same as the Loan Originator Information section of the URLA
Using the URLA and URLA ndash Additional Borrower Together The URLA and the URLA ndash Additional Borrower are used together to collect information for two Borrowers who have joint assets liabilities andor real estate information The URLA and URLA ndash Additional Borrower can also be used for Borrowers who do not have joint information but wish to combine their information on the URLA for ease of use Here are examples of how to use the URLA and URLA ndash Additional Borrower
For one borrower Complete the URLA
For two borrowers with joint financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you dont need to duplicate them on more than one URLA or o In cases where Borrowers are not collaborating when completing the loan application
joint assets liabilities and real estate may be duplicated on each URLA bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you do not need to duplicate them on more than one URLA or
o In cases where Borrowers are not collaborating when completing the loan application joint assets liabilities and real estate may be duplicated on each URLA
For two borrowers with separate financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower Report the assets liabilities and
real estate for the additional Borrower on the URLA or bull Complete a separate URLA for each Borrower
For three or more borrowers use any combination of URLA and URLA ndash Additional Borrower forms described for two borrowers
Uniform Residential Loan Application ndash Unmarried Addendum If any borrower listed on the URLA or URLA ndash Additional Borrower form selects Unmarried in Section 1 (Personal Information) the lender will complete this optional form
The information must be collected to determine how to apply state property laws that directly or indirectly affect creditworthiness including ensuring clear title
Uniform Residential Loan Application ndash Continuation Sheet Use the URLA ndash Continuation Sheet if you need more space to complete either the URLA or URLA ndash Additional Borrower forms
99177-URLAI-0215
HUD Addendum to Uniform Residential Loan Application OMB Approval No HUD 2502-0059 (exp )
Part I - Identifying Information HUDFHA Application for Insurance under the National Housing Act and Borrower Certification
FHA Case No (include any suffix) Mortgagee Case No
Mortgagee ID Sponsor ID Agent ID
Mortgagee Name Address (include ZIP Code) and Telephone Number
Type or print all entries clearly
Name and Address of Sponsor Name and Address of Agent
Borrowers Name amp Present Address (include ZIP Code) Property Address (include name of subdivision lot amp block no amp ZIP Code)
Sponsored Originations
Name of Third-Party Originator NMLS ID of Third-Party Originator
Part II - Borrower Consent for Social Security Administration to Verify Social Security Number I authorize the Social Security Administration (SSA) to verify my Social Security Number (SSN) to the Mortgagee and HUDFHA I authorize SSA to provide explanatory
information to HUDFHA in the event of a discrepancy This consent is valid for 180 days from the date signed unless indicated otherwise by the individual(s) named in this
loan application
Signature(s) of Borrower(s) - Read consent carefully Review accuracy of Social Security Number(s) provided on this application
Borrowerrsquos NameDate of BirthSocial Security Number
Co-Borrowerrsquos Name Date of BirthSocial Security Number
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
Part III - Borrower Notices Information and Acknowledgment Public Reporting Burden
Public reporting burden for this collection of information is estimated to average 10 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 conduct or sponsor and a person is not
required to respond to a collection of information unless that collection displays a valid OMB control number which can be located on the OMB Internet page at
httpwwwreginfogovpublicdoPRAMain
Privacy Act Information
The information requested on the Uniform Residential Loan Application and this Addendum is authorized by the National Housing Act of 1934 12 USC sect 1701 et seq The Debt
Collection Act of 1982 Pub L 97-365 and HUDrsquos Housing and Community Development Act of 1987 42 USC sect 3543 require persons applying for a federally insured loan to
furnish their SSN You must provide all the requested information including your SSN HUD may conduct a computer match to verify the information you provide HUD may
disclose certain information to Federal State and local agencies when relevant to civil criminal or regulatory investigations and prosecutions It will not otherwise be disclosed or
released outside of HUD except as required and permitted by law The information will be used to determine whether you qualify as a mortgagor Failure to provide any of the
requested information including SSN may result in disapproval of your loan application This is notice to you as required by the Right to Financial Privacy Act of 1978 that
HUDFHA has a right of access to financial records held by financial institutions in connection with the consideration or administration of assistance to you Financial records
involving your transaction will be available to HUDFHA without further notice or authorization but will not be disclosed or released by the institution to another Government Agency
or Department without your consent except as required or permitted by law
WARNING This warning applies to all certifications made in this document Anyone who knowingly submits a false claim or makes false statements is subject to criminal and civil penalties including confinement for up to 5 years fines and civil penalties 18 USC sectsect 287 1001 and 31 USC sect 3729
orm HUD-92900-A ( ) Page 1
Borrower Name ____________________________ FHA Case No __________________
Caution Delinquencies Defaults Foreclosures and Abuses Delinquencies defaults foreclosures and abuses of mortgage loans involving programs of the Federal Government can be costly and detrimental to your credit now and in the future The Mortgagee in this transaction its agents and assigns as well as the Federal Government its agencies agents and assigns are authorized to take any and all of the following actions in the event loan payments become delinquent on the mortgage loan described in the attached application (1) Report your name and account information to a credit bureau (2) Assess additional interest and penalty charges for the period of time that payment is not made (3) Assess charges to cover additional administrative costs incurred by the Federal Government to service your account (4) Offset amounts owed to you
under other Federal programs (5) Refer your account to a private attorney collection agency or mortgage servicing agency to collect the amount due foreclose
the mortgage sell the property and seek judgment against you for any deficiency (6) Refer your account to the Department of Justice (DOJ) for litigation in the
courts (7) If you are a current or retired Federal employee take action to offset your salary or civil service retirement benefits (8) Refer your debt to the Internal
Revenue Service for offset against any amount owed to you as an income tax refund and (9) Report any resulting written off debt of yours to the Internal Revenue Service as your taxable income All of these actions may be used to recover any debts owed when it is determined to be in the interest of the Mortgagee or Federal Government or both
As a mortgage loan borrower you will be legally obligated to make the mortgage payments called for by your mortgage loan contract The fact that you dispose of your property after the loan has been made will not relieve you of liability for making these payments Payment of the loan in full is ordinarily the way liability on a mortgage note is ended Some home buyers have the mistaken impression that if they sell their homes when they move to another locality or dispose of it for any other reasons they are no longer liable for the mortgage payments and that liability for these payments is solely that of the new owners Even though the new owners may agree in writing to assume liability for your mortgage payments this assumption agreement will not relieve you from liability to the holder of the note which you signed when you obtained the loan to buy the property Unless you are able to sell the property to a buyer who is acceptable to HUDFHA who will assume the payment of your obligation to the lender you will not be relieved from liability to repay any claim which HUDFHA may be required to pay your lender on account of default in your loan payments The amount of any such claim payment may be a debt owed by you to the Federal Government and subject to established collection procedures
Fair Housing Act I and anyone acting on my behalf are and will remain in compliance with the Fair Housing Act 42 USC sect 3604 et seq with respect to the dwelling or property covered by the loan and in the provision of services or facilities in connection therewith I recognize that any restrictive covenant on this property related to race color religion sex disability familial status or national origin is unlawful under the Fair Housing Act and unenforceable I further recognize that in addition to administrative action by HUD a civil action may be brought by the DOJ in any appropriate US court against any person responsible for a violation of the
applicable law
Certification and Acknowledgment All information in this application is given for the purpose of obtaining a loan to be insured under the National Housing Act and the information in the Uniform Residential Loan Application and this Addendum is true and complete to the best of my knowledge and belief Verification may be obtained from any source named herein I have read and understand the foregoing concerning my liability on the loan and Part III Borrower Notices Information and Acknowledgment
Signature(s) of Borrower(s) - Do not sign unless this application is fully completed Read the certification carefully and review accuracy of this application
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
orm HUD-92900-A ( Page 2
___________________________________
______________________________________________________
______________________________________________________________
- - - - - - - - - - - - - - - - - - - - - - -
Borrower Name ____________________________ FHA Case No __________________
Part IV - Direct Endorsement Approval for a HUD FHA-Insured Mortgage A Underwriting the Borrower
Date Mortgage Approved ______________________________ Date Approval Expires ______________________
For mortgages rated as an ldquoacceptrdquo or ldquoapproverdquo by FHAs TOTAL Mortgage Scorecard
The information submitted to TOTAL was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA4e Final Underwriting Decision (TOTAL) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee Representative Signature
Printed Name
Title
OR
For mortgages rated as a ldquoreferrdquo by FHAs TOTAL Mortgage Scorecard or manually underwritten by a Direct Endorsement underwriter I have personally reviewed and underwritten the borrowerrsquos credit application The information used to underwrite the borrower was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA5d Final Underwriting Decision (Manual) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
B Underwriting the Property
For all mortgages where FHA requires an appraisal I have personally reviewed and underwritten the appraisal according to FHA requirements I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
orm HUD-92900-A ( ) Page 3
Borrower Name ____________________________ FHA Case No __________________
Part V Mortgagees Certification
I have personally reviewed the mortgage documents and the application for insurance endorsement and This mortgage complies with SF Handbook 40001 Section IIA7 Post-Closing and Endorsement to the extent that no defect exists that would have changed the decision to endorse or submit the mortgage for insurance
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee
Name of Mortgageersquos Representative
Title of Mortgageersquos Representative
Signature of the Mortgageersquos Representative Date
orm HUD-92900-A ( ) Page 4
GENERAL AUTHORIZATION FOR A MORTGAGE LOAN ASSUMPTION
Applicant name(s)
Loan number
NOTICES AND DISCLOSURES
Non-discriminatory underwriting guidelines Anyone who inquires about the availability of credit from us has the right to receive a copy of our non-discriminatory underwriting guidelines To request a copy of these guidelines contact your Loan Processor
Attorney note Itrsquos the responsibility of our attorneys to protect our interest You may at your expense request an attorney to represent your interest
Notice to HUDFHA applicants As required by the Right to Financial Privacy Act of 1978 this notice is to inform you that the US Department of Housing and Urban Development (HUD)Federal Housing Administration (FHA) has a right of access to financial records held by financial institutions related to a request for assistance Financial records involving your assumption will be available to HUDFHA without further notice or authorization but wonrsquot be disclosed or released by us to another government agency or department without your consent except as required or permitted by law
Borrower consent to the use of tax return information I understand acknowledge and agree that the Lender and Other Loan Participants can obtain use and share tax return information for purposes of (i) providing an offer (ii) originating maintaining managing monitoring servicing selling insuring and securitizing a loan (iii) marketing or (iv) as otherwise permitted by applicable laws including state and federal privacy and data security laws The Lender includes the Lenderrsquos affiliates agents service providers and any of aforementioned partiesrsquo successors and assigns The Other Loan Participants includes any actual or potential owners of a loan resulting from your loan application or acquirers of any beneficial or other interest in the loan and mortgage insurer guarantor any servicers or service providers for these parties and any of aforementioned partiesrsquo successors and assigns
CERTIFICATION AND AUTHORIZATION
Environmental certification By signing below I represent and warrant that Irsquom not aware of any substances materials or products that may be an environmental hazard such as but not limited to asbestos formaldehyde radon gas lead-based paint fuel or chemical storage tanks (above or below ground) and contaminated soil or water on the property I acknowledge that Chase is relying on this representation and warranty as a material part of its loan application process I also am not aware of any landfill on any portion of the property
Exceptions to the above I further acknowledge (1) receipt of applicable disclosures from the seller in purchase transactions (2) that lead-based paint may exist in housing constructed prior to 1978 (3) that Chase performs no environmental investigation on my behalf and isnrsquot responsible for identifying lead-based paint or any other environmental conditions that might impact the property or its residents and (4) that it is my sole obligation to investigate for potential impact to the property from environmental conditions
Certifications I certify by signing below that (1) all of the loan application information provided is true and complete (2) I understand any intentional or negligent misrepresentation(s) of the information provided in conjunction with my application may result in civil liability andor 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 Chase its agents successors and assigns insurers and any other person who may suffer any loss due to reliance upon any misrepresentation that I have made on the application and (3) any significant change from the information provided at the time of application until the final loan application is signed may have a bearing on the approval of my application for a home loan
Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union
This question is asked because of state laws that extend the same or similar rights benefits and protections of spouses in a marriage to persons who are members of a partnership or union recognized under state law You should consult with your own legal advisor for advice regarding the rights protections benefits responsibilities obligations and duties of those who are registered domestic partners civil union partners or members of other unions recognized under applicable law
CREDIT AUTHORIZATION RELEASE
By signing below I authorize Chase andor my mortgage insurer (if any) to verify my past and present employment earnings records (including information contained in income tax returns that have been filed with the IRS) bank accounts stock holdings and any other information that it finds necessary to process my mortgage loan application or to review it for quality-control purposes I understand that a credit report will be ordered from a credit reporting agency for verification prior to loan closing as part of the application process and may be ordered after closing as part of the Lenderrsquos quality-control program A credit report may also be completed as part of the Lenderrsquos servicing or collection of the loan or in consideration of any other product or service that the Lender may consider offering me in the future and at any time throughout the life of the loan I understand that use of a photocopy of this form may be necessary to verify one or more of my credit references I understand that a photocopy or fax copy of this form will also serve as authorization
By signing below each applicant acknowledges (1) making the above certifications and authorizations and (2) that each applicant has received and understands the above notices and disclosures
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
You do not have to give us this information but if you donrsquot your application for approval as a borrower may be delayed or rejected The information requested in this form is authorized by Title 38 USC Chapter 37 (if VA) by 12 USC Section 1701 et seq (if HUDFHA) by 42 USC Section 1452b (if HUDCPD) and Title 42 USC 1471 et seq or 7 USC 1921 et seq (if USDA FHA)
Updated December 2021 99177-GA-0215
1b
2b
Form 4506-C (September 2020)
Department of the Treasury - Internal Revenue Service
IVES Request for Transcript of Tax Return OMB Number
1545-1872
Do not sign this form unless all applicable lines have been completed Request may be rejected if the form is incomplete or illegible
For more information about Form 4506-C visit wwwirsgov and search IVES
1a Name shown on tax return (if a joint return enter the name shown first)
First social security number on tax return individual taxpayer identification number or employer identification number (see instructions)
2a If a joint return enter spousersquos name shown on tax return Second social security number or individual taxpayer identification number if joint tax return
3 Current name address (including apt room or suite no) city state and ZIP code (see instructions)
4 Previous address shown on the last return filed if different from line 3 (see instructions)
5a IVES participant name address and SOR mailbox ID
DataVerify 875 Greentree Rd 8 Parkway Center Pittsburgh PA 15220
5b Customer file number (if applicable) (see instructions)
Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing (see instructions)
6 Transcript requested Enter the tax form number here (1040 1065 1120 etc) and check the appropriate box below Enter only one tax form number per request 1040
a Return Transcript which includes most of the line items of a tax return as filed with the IRS A tax return transcript does not reflect changes made to the account after the return is processed Transcripts are only available for the following returns Form 1040 series Form 1065 Form 1120 Form 1120-A Form 1120-H Form 1120-L and Form 1120S Return transcripts are available for the current year and returns processed during the prior 3 processing years
b Account Transcript which contains information on the financial status of the account such as payments made on the account penalty assessments and adjustments made by you or the IRS after the return was filed Return information is limited to items such as tax liability and estimated tax payments Account transcripts are available for most returns
c Record of Account which provides the most detailed information as it is a combination of the Return Transcript and the Account Transcript Available for current year and 3 prior tax years
7 Form W-2 Form 1099 series Form 1098 series or Form 5498 series transcript The IRS can provide a transcript that includes data from these information returns State or local information is not included with the Form W-2 information The IRS may be able to provide this transcript information for up to 10 years Information for the current year is generally not available until the year after it is filed with the IRS For example W-2 information for 2016 filed in 2017 will likely not be available from the IRS until 2018 If you need W-2 information for retirement purposes you should contact the Social Security Administration at 1-800-772-1213
Caution If you need a copy of Form W-2 or Form 1099 you should first contact the payer To get a copy of the Form W-2 or Form 1099 filed with your return you must use Form 4506 and request a copy of your return which includes all attachments
8 Year or period requested Enter the ending date of the tax year or period using the mmddyyyy format (see instructions)
12 31 2020 12 31 2019 12 31 2018 Caution Do not sign this form unless all applicable lines have been completed
Signature of taxpayer(s) I declare that I am either the taxpayer whose name is shown on line 1a or 2a or a person authorized to obtain the tax information requested If the request applies to a joint return at least one spouse must sign If signed by a corporate officer 1 percent or more shareholder partner managing member guardian tax matters partner executor receiver administrator trustee or party other than the taxpayer I certify that I have the authority to execute Form 4506-C on behalf of the taxpayer Note This form must be received by IRS within 120 days of the signature date
Signatory attests that heshe has read the attestation clause and upon so reading declares that heshe has the authority to sign the Form 4506-C See instructions
Sign Here
Signature (see instructions) Date Phone number of taxpayer on line 1a or 2a
PrintType name
Title (if line 1a above is a corporation partnership estate or trust)
Spousersquos signature Date
PrintType name
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020) For Privacy Act and Paperwork Reduction Act Notice see page 2
Instructions for Form 4506-C IVES Request for Transcript of Tax Return
Section references are to the Internal Revenue Code unless otherwise noted
Future Developments
For the latest information about Form 4506-C and its instructions go to wwwirsgov and search IVES Information about any recent developments affecting Form 4506-C (such as legislation enacted after we released it) will be posted on that page
Whats New Form 4506-C was created to be utilized by authorized IVES participants to order tax transcripts with the consent of the taxpayer
General Instructions
Caution Do not sign this form unless all applicable lines have been completed
Designated Recipient Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information received pursuant to the taxpayerrsquos consent and holds the recipient subject to penalties for any unauthorized access other use or redisclosure without the taxpayerrsquos express permission or request
Taxpayer Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information provided pursuant to your consent and holds the recipient subject to penalties brought by private right of action for any unauthorized access other use or redisclosure without your express permission or request
Purpose of form Use Form 4506-C to request tax return information through an authorized IVES participant You will designate an IVES participant to receive the information on line 5a
Note If you are unsure of which type of transcript you need check with the party requesting your tax information
Where to file The IVES participant will fax Form 4506-C with the approved IVES cover sheet to their assigned Service Center
Chart for ordering transcripts
If your assigned Service Center is
Fax the requests with the approved coversheet to
Austin Submission Processing Center
Austin IVES Team
844-249-6238
Fresno Submission Processing Center
Fresno IVES Team
844-249-6239
Kansas City Submission Processing Center
Kansas City IVES Team
844-249-8128
Ogden Submission Processing Center
Ogden IVES Team
844-249-8129
Specific Instructions
Line 1b Enter the social security number (SSN) or individual taxpayer identification number (ITIN) for the individual listed on line 1a or enter the employer identification number (EIN) for the business listed on line 1a
Line 3 Enter your current address If you use a PO box include it on this line
Line 4 Enter the address shown on the last return filed if different from the address entered on line 3
Note If the addresses on lines 3 and 4 are different and you have not changed your address with the IRS file Form 8822 Change of Address or Form 8822-BChange of Address or Responsible Party mdash Business with Form 4506-C
Line 5b Enter up to 10 numeric characters to create a unique customer file number that will appear on the transcript The customer file number cannot contain an SSN ITIN or EIN Completion of this line is not required
Note If you use an SSN name or combination of both we will not input the information and the customer file number will reflect a generic entry of 9999999999 on the transcript
Line 8 Enter the end date of the tax year or period requested in mmddyyyy format This may be a calendar year fiscal year or quarter Enter each quarter requested for quarterly returns Example Enter 12312018 for a calendar year 2018 Form 1040 transcript
Signature and date Form 4506-C must be signed and dated by the taxpayer listed on line 1a or 2a The IRS must receive Form 4506-C within 120 days of the date signed by the taxpayer or it will be rejected Ensure that all applicable lines including lines 5a through 8 are completed before signing
You must check the box in the signature area to acknowledge you have the authority to sign and request the information The form will not be processed if unchecked
Individuals Transcripts listed on on line 6 may be furnished to either spouse if jointly filed Only one signature is required Sign Form 4506-C exactly as your name appeared on the original return If you changed your name also sign your current name
Corporations Generally Form 4506-C can be signed by
(1) an officer having legal authority to bind the corporation (2) any person designated by the board of directors or other governing body or (3) any officer or employee on written request by any principal officer and attested to by the secretary or other officer A bona fide shareholder of record owning 1 percent or more of the outstanding stock of the corporation may submit a Form 4506-C but must provide documentation to support the requesters right to receive the information
Partnerships Generally Form 4506-C can be signed by any person who was a member of the partnership during any part of the tax period requested on line 8
All others See section 6103(e) if the taxpayer has died is insolvent is a dissolved corporation or if a trustee guardian executor receiver or administrator is acting for the taxpayer
Note If you are Heir at law Next of kin or Beneficiary you must be able to establish a material interest in the estate or trust
Documentation For entities other than individuals you must attach the authorization document For example this could be the letter from the principal officer authorizing an employee of the corporation or the letters testamentary authorizing an individual to act for an estate
Signature by a representative A representative can sign Form 4506-C for a taxpayer only if the taxpayer has specifically delegated this authority to the representative on Form 2848 line 5 The representative must attach Form 2848 showing the delegation to sign Form 4506-C
Privacy Act and Paperwork Reduction Act Notice We ask for the information on this form to establish your right to gain access to the requested tax information under the Internal Revenue Code We need this information to properly identify the tax information and respond to your request You are not required to request any transcript if you do request a transcript sections 6103 and 6109 and their regulations require you to provide this information including your SSN or EIN If you do not provide this information we may not be able to process your request Providing false or fraudulent information may subject you to penalties
Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and cities states the District of Columbia and US commonwealths and possessions for use in administering their tax laws We may also disclose this information to other countries under a tax treaty to federal and state agencies to enforce federal nontax criminal laws or to federal law enforcement and intelligence agencies to combat terrorism
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law Generally tax returns and return information are confidential as required by section 6103
The time needed to complete and file Form 4506-C will vary depending on individual circumstances The estimated average time is
Learning about the law or the form 10 min Preparing the form 12 min Copying assembling and sending the form to the IRS 20 min
If you have comments concerning the accuracy of these time estimates or suggestions for making Form 4506-C simpler we would be happy to hear from you You can write to
Internal Revenue Service Tax Forms and Publications Division 1111 Constitution Ave NW IR-6526 Washington DC 20224
Do not send the form to this address Instead see Where to file on this page
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020)
Rev April 2021 CHASEO Facts What does Chase do with your personal information
Why Financial companies choose how they share your personal information Federal law gives consumers the right to limit some but not all sharing Federal law also requires us to tell you how we collect share and protect your personal information Please read this notice carefully to understand what we do
What The types of personal information we collect and share depend on the product or service you have with us This information can include bull Social Security number and income bull account balances and transaction history bull credit history and payment history
How All financial companies need to share customers personal information to run their everyday business In the section below we list the reasons financial companies can share their customers personal information the reasons Chase chooses to share and whether you can limit this sharing
Reasons we can share your personal information Does Chase share
Can you limit this sharing
For our everyday business purposes - such as to process your transactions maintain your account(s) respond to court orders and legal investigations or report to credit bureaus
Yes No
For our marketing purposes - to offer our products and services to you
Yes No
For joint marketing with other financial companies Yes No
For our affiliates everyday business purposes - information about your transactions and experiences
Yes No
For our affiliates everyday business purposes - information about your creditworthiness
Yes Yes
For our affiliates to market to you Yes Yes
For nonaffiliates to market to you Yes Yes
a
0
To limit our sharing
bull Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
bull Visit us online chasecomprivacypreferences
Please note If you are a new customer we can begin sharing your information 30 days from the date we sent this notice When you are no longer our customer we continue to share your information as described in this notice However you can contact us at any time to limit our sharing
Questions
Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
PAGE 2
Who we are
Who is providing this notice The US consumer financial companies within the JPMorgan Chase amp Co family including JPMorgan Chase Bank NA Chase Insurance Agency Inc and JP Morgan Securities LLC
What we do
How does Chase protect my To protect your personal information from unauthorized access and use we personal information use security measures that comply with federal law These measures include
computer safeguards and secured files and buildings We authorize our employees to get your information only when they need it to do their work and we require companies that work for us to protect your information
How does Chase collect my We collect your personal information for example when you personal information bull open an account or make deposits or withdrawals from your account
bull pay your bills or apply for a loan bull use your credit or debit card We also collect your personal information from others such as credit bureaus affiliates or other companies
Why cant I limit all sharing Federal law gives you the right to limit only bull sharing for affiliates everyday business purposes - information about your
creditworthiness bull affiliates from using your information to market to you bull sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing See below for more on your rights under state law
What happens when I limit sharing for an account I hold jointly with someone else
Your choices will apply to everyone on your account
Definitions
Affiliates Companies related by common ownership or control They can be financial and non financial companies bull Our affiliates include companies with a Chase or JP Morgan name and financial companies such asjP Morgan Securities LLC
Nonaffiliates Companies not related by common ownership or control They can be financial and non financial companies bull Nonaffiliates we share with can include companies such as retailers auto dealers auto makers and membership clubs
Joint marketing A formal agreement between nonaffiliated financial companies that together market financial products or services to you bull Our joint marketing partners include categories of companies such as insurance companies
Other important information
VT Accounts with a Vermont mailing address are automatically treated as if they have limited the sharing as described on page 1 For joint marketing we will only disclose your name contact information and information about your transactions
NV We are providing you this notice pursuant to Nevada law If you prefer not to receive marketing calls from us you may be placed on our Internal Do Not Call List by calling 1-800-945-9470 or by writing to us at PO Box 734007 Dallas TX 75373-4007
For more information contact us at the address above or email PrivacylnfoJPMChasecom with Nevada Annual Notice in the subject line You may also contact the Nevada Attorney Generals office Bureau of Consumer Protection Office of the Nevada Attorney General 555 E Washington St Suite 3900 Las Vegas NV 89101 telephone number 1-702-486-3132 email BCPINFOagstatenvus
CA Accounts with a California mailing address are automatically treated as if they have limited the sharing with nonaffiliates as described on page 1 CA residents are provided a CA notice for additional choices
CHASE O
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
The following disclosure is required by the USA PATRIOT Act
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 opens an account
What this means to you When you 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 drivers
license or other identifying documents
99177-PAT-0215
VETERAN STATEMENT When this loan was opened the US Department of Veterans Affairs (VA) used the veteran borrowerrsquos entitlement which is a set amount the VA promises to repay a lender if the borrower defaults on the mortgage An assumption will modify who is obligated to pay the existing mortgage loan but all loan termsmdashincluding the entitlementmdashwill remain the same If the veteran borrower is being removed from the loan the entitlement would remain with whoever is assuming the loan because the loan will continue to be serviced by the VA If the applicant is also a veteran and can substitute his or her entitlement for the current entitlement then the current borrowerrsquos entitlement can be released
Please review the following questions and answer as appropriate This form requires completion by both the applicant(s) and current borrower(s)
1 Applicant to Complete
Are you (the applicant) currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the reverse side)
Yes (If yes please provide the information requested below answer the question in section 3 and sign and date this form at the bottom of the reverse side)
Name of applicant(s) who answered ldquoyesrdquo to the above question
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Are you receiving VA disability benefts
Applicant
Yes
No
Co-Applicant
Yes
No
Are you entitled to receive VA disability benefts Yes No Yes No
Have you received VA disability benefts in the past Yes No Yes No
Are you a surviving spouse of a veteran who died on active duty or as the result of a service-related disability
Yes No Yes No
Do you have any VA loans Yes No Yes No
2 Current Borrower to Complete
Is the current borrowerco-borrower currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the page)
Yes (If yes please answer the question in section 3 and sign and date this form at the bottom of the page)
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
________________________________________________________________________________________________
3 Applicant and Current Borrower to Complete
If the answer to the questions in section 1 and 2 are both yes please answer the following question After yoursquove reviewed and completed this entire form please sign and date at the bottom
Applicant Current Borrower
Do you want to apply for a substitution of entitlement Yes Yes No No
In order to complete a substitution of entitlement the veteran applicant must have suffcient entitlement to substitute for that of the current borrower Contact the VA Offce of Jurisdiction for your area for more information Also before the veteran applicant can substitute entitlement on a VA loan heshe must certify that the property securing the loan will be occupied as hisher primary residence Both the applicantrsquos and current borrowerrsquos original certifcate of eligibility will be required If your sales contract is contingent upon the restoration of entitlement please contact your VA Offce of Jurisdiction for complete procedures Otherwise the substitution will be completed after the loan has been approved and closed
Date Applicant printed name Applicant signature
Date Applicant printed name Applicant signature
Date Current Borrower printed name Current Borrower signature
Date Current Borrower printed name Current Borrower signature
Forms completed by Mail Phone
For Chase use only
Interviewer signature Date
99177-VS-0215
- Assumption Application Package_41521-noscannedpages-update-4pdf
-
- 1 FM203 Cover Pagepdf
- 2 FM202 Mortgage Assumption Application Package pagepdf
- 3 The Documents Youll need to Send Uspdf
- 4 FM201 FAQpdf
- 5 FM142 CIWpdf
- 6 FM126 URLApdf
- 7 FM130 URLA Instpdf
-
- Blank Page
-
- 8 92900a Addednum to Loan Applicationpdf
- 9 FM462 Gen Authpdf
- 10 FM220 4506-Cpdf
- 11 FM153 Chase Federal Privacy Noticepdf
- 12 FM144 Info on Opening a New Accountpdf
- 13 FM152 Veteran Statementpdf
-
- Date
- Loan number
- Applicant name
- Phone1
- Loan number 1
- Loan number 2
- Other
- Other_2
- 1
- 2
- undefined_7
- Available hours
- Available hours_2
- undefined_8
- Available hours_3
- undefined_9
- Current address 1
- Neither
- Available hours_4
- Available hours_5
- undefined_10
- Available hours_6
- 1_2
- 2_2
- undefined_11
- Available hours_7
- Available hours_8
- undefined_12
- Available hours_9
- FHA Case No include any suffix
- Mortgagee Case No
- Mortgagee ID
- Sponsor ID
- Agent ID
- Name and Address of Sponsor Name and Address of Agent
- Borrowers Name Present Address include ZIP Code Property Address
- include name of subdivision lot block no ZIP Code
- Name of ThirdParty Originator
- NMLS ID of ThirdParty Originator
- s application
- ty Number
- ty Number_2
- Date Signed_2
- Date Mortgage Approved
- Date Approval Expires
- Printed Name
- Title 1
- DEs ID Number
- DEs ID Number_2
- Mortgagee
- Name of Mortgagees Representative
- Title of Mortgagees Representative
- Signature of the Mortgagees Representative
- Date_2
- Applicant names 1
- Applicant names 2
- Applicant names 3
- Loan number_2
- Date_3
- Applicant printed name
- Social Security number
- Date_4
- Applicant printed name_2
- Social Security number_2
- Date_5
- Applicant printed name_3
- Social Security number_3
- Date_6
- Applicant printed name_4
- Social Security number_4
- 1a Name shown on tax return if a joint return enter the name shown first
- 1b First social security number on tax return individual taxpayer identification number or employer identification number see instructions
- 2a If a joint return enter spouses name shown on tax return
- 2b Second social security number or individual taxpayer identification number if joint tax return
- 4 Previous address shown on the last return filed if different from line 3 see instructions
- 5a IVES participant name address and SOR mailbox ID
- Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing see instructions
- Signature see instructions
- Date_7
- Phone number of taxpayer on line 1a or 2a
- PrintType name
- Here
- Spouses signature
- Date_8
- PrintType name_2
- Name
- Date of birth
- Service number
- Name_2
- Date of birth_2
- Service number_2
- Date_9
- Applicant printed name_5
- Date_10
- Applicant printed name_6
- Date_11
- Current Borrower printed name
- Date_12
- Current Borrower printed name_2
- Date_13
- Text3
- Text10
- undefined_13
- Text15
- undefined_14
- undefined_15
- undefined_16
- undefined_17
- undefined_18
- undefined_19
- undefined_20
- undefined_21
- undefined_23
- Reason for assumption Off
- Requestors relationship to owners Off
- Check one Off
- Check one1 Off
- Day1
- Evening
- Cell phone
- Check one2 Off
- Check one3 Off
- Check one4 Off
- Check one5 Off
- Text2-1
- Text2-2
- Text2-3
- Text2-4
- Text2-5
- Text2-6
- Text3-1
- Text3-2
- Text3-3
- Text3-4
- Text3-6
- Text3-7
- Text3-8
- Text3-9
- Text3-10
- Text3-11
- Text3-12
- Text3-13
- Text3-14
- Text3-15
- Text3-16
- Text3-17
- Text3-18
- Text3-19
- Text3-20
- Text3-21
- Text3-22
- Text3-23
- Text3-24
- Text3-25
- Text3-26
- Text3-27
- Text3-28
- Text3-29
- Text3-30
- Text3-31
- Text3-32
- Text3-33
- Text3-34
- Text3-35
- Text3-36
- Text3-37
- Text3-38
- Text3-39
- Text3-40
- Text3-41
- Text3-42
- Text3-43
- Text3-44
- Text3-45
- Text3-46
- Text3-47
- Text3-48
- Text3-49
- Text3-50
- Text3-51
- Text3-52
- Text3-53
- Text3-5
- Text3-54
- Text3-55
- Text3-56
- Citizenship Off
- Type of credit Off
- Marital Status Off
- Housing Off
- Housing1 Off
- ownership Off
- DNA1 Off
- DNA2 Off
- DNA3 Off
- family Off
- BO Off
- Total
- Text31
- Text32
- Text33
- Text34
- Text35
- Text36
- Text37
- Text38
- Text39
- Text310
- Text311
- Text312
- Text313
- Text314
- Text315
- Text316
- Text317
- Text318
- Text319
- ownership1 Off
- Total1
- Total1-2
- Check Box4-1 Off
- Text320
- Text321
- Text322
- Text323
- Text324
- Text325
- Text326
- Text327
- Text328
- Text329
- Check Box4-2 Off
- Check Box4-3 Off
- Check Box4-4 Off
- Check Box4-8 Off
- Check Box4-9 Off
- Text330
- Text331
- Text332
- Text333
- Text334
- Text335
- Text1-1
- Text1-2
- Text1-3
- Text1-4
- Text1-5
- Text1-6
- Text1-7
- Text1-8
- Text1-9
- Text1-10
- Text1-11
- Text1-12
- Text1-13
- Text1-14
- Text1-15
- Text1-16
- Text1-17
- Text1-18
- Text1-19
- Text1-20
- Text1-21
- Text1-22
- Text1-23
- Text1-24
- Text1-25
- Text1-26
- Text1-27
- Text1-28
- Text1-29
- Text1-30
- Text1-31
- Text1-32
- Text1-33
- Text1-34
- Text1-35
- Check Box3-2 Off
- Check Box2-1 Off
- Check Box2-2 Off
- Check Box2-3 Off
- Check Box2-4 Off
- Check Box2-5 Off
- Text1-36
- Text1-37
- Text1-38
- Text1-39
- Text1-40
- Text1-41
- Text1-42
- Text1-43
- Text1-44
- Text1-45
- Text1-46
- Text1-47
- Text1-48
- Text1-49
- Text1-50
- Text1-51
- Text1-52
- Text1-53
- Text1-54
- Text1-55
- Text1-56
- Text1-57
- Text1-58
- Text1-59
- Text1-60
- Text1-61
- Check Box3-11 Off
- A1
- A2
- A3
- A4
- A5
- A6
- A7
- A8
- A9
- A10
- A11
- A12
- Check Box3-1 Off
- Check Box30-1 Off
- Check Box30-2 Off
- Check Box30-4 Off
- Check Box30-5 Off
- Check Box30-7 Off
- Check Box30-8 Off
- Check Box30-9 Off
- Check Box30-10 Off
- Check Box30-11 Off
- Check Box30-12 Off
- A13
- A14
- A15
- A16
- A17 Off
- A18
- A19
- A20
- A21
- A22
- A23
- A24
- A25
- A26
- A27
- A28
- A29
- A30
- A31
- A32
- A33
- A34
- A35
- A36
- A37
- A38 Off
- A39
- A40
- A41
- A42
- A43
- A44
- A45
- A46
- A47
- A48
- A49
- A50
- A51
- A52
- A53
- A54
- A55
- A56
- A57
- A58
- A59
- A60
- A61
- A62
- A63
- A64
- A65
- A66
- A67
- A68
- A69
- A70
- A71
- A72
- A73
- A74
- Loan Purpose Off
- occupancy1 Off
- lien type Off
- lientype Off
- mixed use Off
- manufactured home Off
- deposit1 Off
- deposit2 Off
- B1
- B2
- B3
- B4
- B5
- B6
- B7
- B8
- B9
- B10
- fha Off
- Check Box51 Off
- B11
- B12
- B13
- B14
- B15
- B16
- B17
- B18
- B19 Off
- B20
- B21
- B22 Off
- B23
- B24
- B25
- B26
- B27
- B28
- A
-
- Will you occupy the property as your primary residence Off
- Will you occupy the property as your primary residence1 Off
-
- If yes have you had an ownership interest in another property in the last three years Off
- Text9-2
- B
-
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property Off
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property1 Off
-
- 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 Off
- 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 application1 Off
-
- 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 Off
- 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 application1 Off
-
- new credit Off
- 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) Off
- the Property Assessed Clean Energy Program)1 Off
-
- F
-
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application Off
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application1 Off
-
- G
-
- Are there any outstanding judgments against you Off
- Are there any outstanding judgments against you1 Off
-
- H
-
- Are you currently delinquent or in default on a Federal debt Off
- Are you currently delinquent or in default on a Federal debt1 Off
-
- I
-
- Are you a party to a lawsuit in which you potentially have any personal financial liability Off
- Are you a party to a lawsuit in which you potentially have any personal financial liability1 Off
-
- J
-
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years Off
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years1 Off
-
- 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 Off
- 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 due1 Off
-
- L
-
- Have you had property foreclosed upon in the last 7 years Off
- Have you had property foreclosed upon in the last 7 years1 Off
-
- M
-
- Have you declared bankruptcy within the past 7 years Off
- Have you declared bankruptcy within the past 7 years1 Off
-
- Check Box8-2 Off
- Check Box8-3 Off
- Check Box8-4 Off
- Text9-3
- Text9-5
- Text9-6
- Text97
- military Off
- ethnicity Off
- sex Off
- race Off
- demo Off
- Text12-1
- Check Box11-1 Off
- Check Box11-2 Off
- Check Box11-3 Off
- Check Box11-4 Off
- Check Box11-5 Off
- Check Box11-6 Off
- Check Box11-7 Off
- Check Box11-8 Off
- Check Box11-9 Off
- Text12-2
- Check Box11-10 Off
- Check Box11-11 Off
- Check Box11-12 Off
- Check Box11-13 Off
- Check Box11-14 Off
- Check Box11-15 Off
- Text12-3
- Check Box11-16 Off
- Check Box11-17 Off
- Check Box11-18 Off
- Check Box11-19 Off
- Check Box11-20 Off
- Check Box11-21 Off
- Check Box11-22 Off
- Check Box11-23 Off
- Text12-4
- Check Box11-24 Off
- Check Box11-25 Off
- Check Box11-26 Off
- Check Box11-27 Off
- Check Box11-28 Off
- Check Box11-29 Off
- Text12-5
- Check Box11-30 Off
- Check Box11-31 Off
- citizen Off
- credit Off
- marital status1 Off
- housing-1 Off
- housing-2 Off
- own Off
- C1
- C2
- C3
- C6
- C7
- C8
- C9
- C10
- C11
- C12
- C13
- C14
- C15
- C16
- C17
- C18
- C19
- C20
- C21
- C22
- C23
- C24
- C25
- C26
- C27
- C28
- C29
- C30
- C31
- C32
- C33
- C34
- C35
- Check Box-2 Off
- C36
- C37
- C38
- C39
- C4
- C40
- C41
- C42
- C43
- C44
- C45
- C46
- C47
- Check Box-3 Off
- Check Box-4 Off
- C48
- C49
- C5
- C50
- C51
- C52
- C53
- C54
- C55
- Check Box-1-1 Off
- own1 Off
- Check Box-1 Off
- D1 Off
- D2
- D3
- D4
- D5
- D6
- D7
- D8
- D9
- D10
- D11
- D12
- D13
- D14 Off
- D15 Off
- D16
- D17
- D18
- D19
- D20
- D21
- D22
- D23
- D24 Off
- D25
- D26
- D27
- D28
- D29
- D30
- D31
- D32
- D33
- D34
- D35 Off
- D36
- D37 Off
- D38
- D39
- D40
- D41
- D42
- D43
- D44
- D45
- D46
- D47
- If yes have you had an ownership interest in another property in the last three years1 Off
- new credit1 Off
- Check Box8-1 Off
- Check Box8-1-2 Off
- Check Box8-1-1 Off
- Check Box8-1-3 Off
- Check Box8-1-4 Off
- Military Service mdash Did you (or your deceased spouse) ever serve or are you currently serving in the United States Armed Forces 1 Off
- Check1 Off
- Text9-1-1
- Check2 Off
- Check3 Off
- Check4 Off
- Text9-1
- E1
- E2
- E3
- Was the ethnicity of the Borrower collected on the basis of visual observation or surname1 Off
- Was the sex of the Borrower collected on the basis of visual observation or surname1 Off
- Was the race of the Borrower collected on the basis of visual observation or surname1 Off
- The Demographic Information was provided through1 Off
- F1 Off
- F2 Off
- F3 Off
- F4 Off
- F5 Off
- F6
- F7 Off
- F8 Off
- F9 Off
- F10 Off
- F11 Off
- F12 Off
- F13
- F14 Off
- F15 Off
- F16 Off
- F17 Off
- F18 Off
- F19 Off
- F20 Off
- F21 Off
- F22
- F23 Off
- F24 Off
- F25 Off
- F26 Off
- F27 Off
- F28 Off
- F29
- F30 Off
- F31 Off
- undefined_13-1
- undefined_13-2
- undefined_14-1
- undefined_15-1
- undefined_16-1
- undefined_17-1
- undefined_18-1
- undefined_19-1
- undefined_21-1
- undefined_20-1
- undefined_23-1
- undefined_13_1
- Single-Two Off
- Refi type Off
- refi program Off
- Estate Off
- Title held Off
- Trust Information Off
- Indian Country Land Tenure Off
- Mortgage Type Applied For Off
- Mortgage Lien Type Off
- Amortization Type Off
- G1 Off
- G2 Off
- G3 Off
- G4 Off
- G5 Off
- G6
- G7
- G8
- G9
- G10 Off
- G11 Off
- G12 Off
- G13 Off
- G14 Off
- G15 Off
- G16
- G17
- G18
- G19
- G20
- G21
- G22
- G23 Off
- G24
- G25 Off
- G26
- G27 Off
- G28 Off
- G29
- G30 Off
- G31
- G32 Off
- G33
- G34
- G35
- G36
- G37
- G38
- G39
- G40
- G41
- G42
- Property Held
- refi
- Text18-1
- Text18-2
- Text18-3
- Text18-4
- Text18-5
- Text18-6
- Text18-7
- Text18-8
- Text18-9
- Text18-10
- Text18-11
- Text18-12
- Text18-13
- Text18-14
- Text18-15
- Text18-16
- Text18-17
- Text18-18
- Text18-19
- Lender
- case no
- If you selected ldquoUnmarriedrdquo in Section 1 is there a person who is not your legal spouse but who currently has real property rights similar to those of a legal spouse Off
- Relationship and State Off
- Other-5
- Text19-1
- BName
- Additional Information
- ABN
- Additional Information1
- BSign
- BSDate
- ABSign
- ABDate
- MortageeNameAddress
- NAmeAddress
- Bname1
- DOB1
- DOB2
- SignOfBorr1
- SignOfBorr
- Date Signed
- SignOfBorr2
- SignOfBorr3
- Date Signed3
- Date Signed4
- MortgageeRepSign
- DirectSign
- DirectSign1
- Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union Off
- AppSign
- AppSign1
- AppSign2
- AppSign3
- Nopage38 Off
- Yespage38 Off
- Yes1 Off
- No1 Off
- Yes2 Off
- Yes3 Off
- Yes4 Off
- Yes5 Off
- Yes6 Off
- Yes7 Off
- Yes8 Off
- Yes9 Off
- Yes10 Off
- No2 Off
- No3 Off
- No4 Off
- No5 Off
- No6 Off
- No7 Off
- No8 Off
- No9 Off
- No10 Off
- BorrowerNo Off
- BorrowerYes Off
- AppSignature
- AppSignature1
- CurrentSign
- CurrentSign1
- InterviewSign
- Yes_1 Off
- No_1 Off
- Yes_2 Off
- No_2 Off
- Mail Off
- Phone Off
Section 5 DeclarationsThis section asks you specific questions about the property your funding and your past
financial history
5aAboutthis Property and Your Moneyforthis Loan
A Will you occupy the property as your primary residence NO YES
If YES have you had an ownershipinterest in another property in the last three years NO YES
If YES complete (1) and (2) below
(1)What type of property did you ownprimary residence (PR) FHA secondary residence (SR) second home(SH)
or investmentproperty (IP)
(2) How did you holdtitle to the property by yourself (S) jointly with your spouse(SP) or jointly with another person (O)
B If this is a Purchase Transaction Do you have a family relationship or businessaffiliation with the seller of the property NO YES Cc Are you borrowing any moneyforthis real estate transaction (eg money foryour closing costs or down payment) or
obtaining any moneyfrom anotherparty suchastheselleror realtor that you have not disclosed on this loan application NO YES
If YES whatis the amountof this money $
D 1 Have youorwill you be applying for a mortgage loan on anotherproperty (not the property securing this loan) on orbefore closing this transaction that is not disclosed on this loan application
NO YES
2 Have you orwill you be applying for any newcredit (eg installment loan credit card etc) on or before closing this loan that wsis not disclosed on this application
NO YES
E Will this property be subject to a lien that could take priority over thefirst mortgagelien such as a clean energylien paid
through yourproperty taxes(eg the PropertyAssessed Clean Energy Program)No YES
EK) Veli ellim ait
F Areyou a co-signer or guarantor on any debtor loan thatis not disclosed on this application NO ES
G Are there any outstanding judgments against you NO YES
H Are you currently delinquentor in default on a Federal debt NO YES
I Are you a party to a lawsuit in which you potentially have any personalfinancialliability NO YES
J Have you conveyedtitle to any property in lieu of foreclosure in the past 7 years NO YES
K Within the past 7 years have you completed a pre-foreclosure sale or short sale whereby the property wassold to a
third party and the Lender agreed to acceptless than the outstanding mortgage balance due
No YES
L Have you had property foreclosed uponin thelast 7 years NO YES
M Have you declared bankruptcy within the past 7 years no vESIf YES identify the type(s) of bankruptcy Chapter 7 Chapter11 Chapter12 Chapter 13
Section 6 Acknowledgements and AgreementsMy signature for Section 6 is on the Uniform Residential Loan Application with
(insert name of Borrower)
Section 7 Military Service This section asks questions about your(or your deceased spouses) military service
Military Service of Borrower
Military Service mdash Did you (or your deceased spouse)everserve or are you currently serving in the United States Armed Forces NO YES
IfYES check allthat apply Currently serving on active duty with projected expiration date of servicetour (mmddyyyy)
Currently retired discharged or separated from service nnOnly period of service was as a non-activated memberofthe Reserve or National GuardSurviving spouse
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Section 8 Demographic InformationThis section asks about your ethnicity sex and race
Demographic Information of Borrower
The purposeofcollecting this information is to help ensure thatall applicants are treated fairly and that the housing needs of communities
and neighborhoodsare beingfulfilled 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 providethis information but are encouraged to do so You mayselect one or more designationsfor
Ethnicity and one or more designationsfor Race The law provides that we maynotdiscriminate onthe basis of this information or onwhetheryou chooseto provideit However if you choose notto provide the information and you have madethis application in person Federal
regulations require us to note yourethnicity sex and race on the basis of visual observation or surname The law also provides that we may notdiscriminate on the basis of age or marital status information you providein this application If you do not wish to provide someorall of this
information please check below
Ethnicity Check one or more Race Check one or moreHispanic or Latino AmericanIndian or Alaska Native - Print nameofenrolled
or principaltribeMexican PuertoRican Cuban
OtherHispanic or Latino - Printorigin siansian Indian Chinese Filipino
For exampleArgentinean Colombian Dominican NicaraguanSalvadoran Spaniard andso on
Japanese Korean VietnameseOtherAsian - Print race Forexample Hmong Laotian Thai Pakistani Cambodian andso on
Black or African American
Native Hawaiian or OtherPacific Islander
Native Hawaiian GuamanianorChamorro Samoan
OtherPacific Islander mdash Print race
Not Hispanic or Latino
| do not wish to providethis information
Sex
Female
Male
| do not wish to providethis informationFor example Fijian Tongan and so on
White
| do not wish to providethis information
Wasthe ethnicity of the Borrowercollected on thebasis of visual observation or surnameWasthesex of the Borrowercollected on the basis of visual observation or surnameWastherace of the Borrowercollected on the basis of visual observation or surname
)NO YESNO YESNO YES
Face-to-Face Interview (includes Electronic Media w Video Component) Telephone Interview Faxor Mail Email or Internet
Loan Originator Organization Name
Address
Loan Originator Organization NMLSR ID State License ID
Loan Originator Name
Loan Originator NMLSR ID State License ID
Email Phone (
Signature Date (mmddyyyy)
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Pe)aae-emeet)
Community Property State
At least one borrowerlives in a community propertystateThe property is in a community property state
Transaction DetailConversion of Contract for Deed or Land ContractRenovationConstruction-ConversionConstruction-to-Permanent
Single-Closing Two-ClosingConstructionImprovementCosts $
LotAcquired Date
Original Cost of Lot $(mmddyyyy)
Refinance Program
Full DocumentationInterest Rate ReductionStreamlined without Appraisal
Other
Refinance Type
NoCash OutLimited Cash OutCash Out
Energy Improvement
Mortgageloanwill finance energy-related improvements
Propertyis currently subject to a lien that could take priority ovethe first mortgagelien such as a clean energylien paid for througproperty taxes(eg the PropertyAssessed Clean Energyprogram)
Project Type Condominium Cooperative Planned Unit Development (PUD) Propertyis notlocatedin a project
Peiwlivcestetece)a)
Title to the Property Will be Held in What Name(s)
For RefinanceTitle to the Property is Currently Held in What Name(s
Trust Information
tle Will be Held byan Inter Vivos (Living) Trust
Title Will be Held by a Land TrustLeasehold Expiration Date
Mannerin WhichTitle Will be Held Indian Country Land Tenure
Sole OwnershipLife EstateTenancy in Common
Joint Tenancywith Right of Survivorship]Tenancybythe EntiretyOther
Fee Simple Ona ReservationIndividualTrust Land (AllottedRestricted)Tribal Trust Land On a ReservationTribal Trust Land Off ReservationAlaska Native Corporation Land
Estate Will be Held in
Fee Simple(mmddyyyy)
3 Mortgage LoanInformation
Termsof Loan
Note Rate
Loan Term (months)
MortgageLien Type
First LienSubordinate Lien
Mortgage Type Applied For
Conventional USDA-RDFHA VA Other
Amortization Type
Fixed RateAdjustable Rate
If Adjustable Rate
Initial Period Prior to First Adjustment
Subsequent AdjustmentPeriod
Proposed Monthly Paymentfor Property
First Mortgage (P amp I) $
Subordinate Lien(s) (P amp |) $
Other(explain)
Homeowners Insurance $(months)
(months)
Loan Features Property Taxes $
Balloon Balloon Term (months)
Interest Only Interest OnlyTermNegative AmortizationPrepaymentPenalty Prepayment Penalty Term (months) Other
Temporary Interest Rate BuydownInitial Buydown Rate TOTALOther(explain)
Mortgage Insurance $
AssociationProject Dues (Condo Co-Op PUD) $
Supplemental Property Insurance $
(months)
Borrower Name(s)Uniform Residential Loan Application mdash LenderLoan Information
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
L4 Qualifying the Borrower - Minimum Required Funds or Cash Back
DUEFROM BORROWER(S)
A Sales Contract Price
B Improvements Renovations and Repairs
C Land(ifacquired separately)
D For Refinance Balance of Mortgage Loanson the Propertyto be paid off in the Transaction
(See Table 3a Property You Own)
E Credit Cards and Other Debts Paid Off
(See Table 2c Liabilities mdash Credit Cards Other Debts and Leases that You Owe)
F BorrowerClosing Costs (including Prepaid andInitial Escrow Payments)
G Discount Points
HTOTAL DUE FROM BORROWER(s)(Total of A thru G)
TOTALMORTGAGE LOANS
Loan Amount
Loan AmountExcluding Financed Mortgage Insurance (or Mortgage Insurance Equivalent) $
Financed Mortgage Insurance (or Mortgage Insurance Equivalent) Amount $
Other New Mortgage Loanson the Property the Borrower(s) is Buying or Refinancing(See Table 4b Other New MortgageLoanson the Property You are Buying or Refinancing)
KTOTAL MORTGAGELOANS(Totalof| and J)
TOTALCREDITS
L Seller Credits (Enter the amountofBorrower(s) costs paid by the property seller)
MOtherCredits (Enter the sum ofall other credits mdash BorrowerPaid Fees Earnest Money EmployerAssistedHousing Lease Purchase Fund Lot Equity Relocation Funds Sweat Equity Trade Equity Other)
NTOTAL CREDITS(Total of L and M)
CALCULATION
TOTAL DUE FROM BORROWER(s)(Line H)
LESSTOTAL MORTGAGELOANS(Line K) AND TOTAL CREDITS(Line N)
Cash FromTothe Borrower(Line H minusLine K and Line N)NOTE This amountdoesnotinclude reservesor other funds that may be required by the Lenderto be verified
Borrower Name(s)Uniform Residential Loan Application mdash LenderLoan Information
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
Uniform Residential Loan Application mdash Unmarried Addendum
eeCeceetatimC elitleeComeLy
Lenders Instructions for Using the Unmarried Addendum
The Lender may use the Unmarried Addendum only when a Borrowerselected ldquoUnmarriedrdquoin Section 1 and the information collected is
necessary to determine howState property lawsdirectly or indirectly affecting creditworthiness apply including ensuring clear title
For example the Lender may use the Unmarried Addendum whentheBorrowerresides in a State that recognizescivil unions domestic
partnerships or registered reciprocal beneficiary relationships or when the property is located in such a State ldquoStaterdquo meansanystate the
District of Columbia the Commonwealth of Puerto Rico or anyterritory or possession of the United States
Ifyou selected ldquoUnmarriedrdquoin Section 1 is there a person whois not your legal spouse but whocurrently has real property rights similar to
those of a legal spouse +=) NOQ YES
If YES indicate the type of relationship and the State in which the relationship was formed For example indicate if you are in a
civil union domestic partnership registered reciprocal beneficiary relationship or other relationship recognized by the State in which you
currently reside or where the property is located
O Civil Union copy Domestic Partnership copy Registered Reciprocal Beneficiary Relationship copy) Other(explain)
Statea]
Borrower NameUniform Residential Loan Application mdash Unmarried Addendum
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Uniform Residential Loan Application mdash Continuation Sheet
Use this continuation sheet if you need more space to complete the Uniform Residential Loan Application
Borrower Name(First Middle Last Suffix )
Additional Information
Additional Borrower Name(First Middle Last Suffix )
Additional Information
IWefully understand thatit is a federal crime punishable by fine or imprisonment or both to knowingly make anyfalse statements concerningany of the abovefacts as applicable underthe provisions of federal law (18 USC sectsect 1001 et seq)
BorrowerSignature Date (mmddyyyy)
Additional Borrower Signature Date (mmddyyyy)
Uniform Residential Loan Application mdash Continuation SheetFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
INSTRUCTIONS FOR COMPLETING THE UNIFORM RESIDENTIAL LOAN APPLICATION
Use the instructions below to complete the enclosed Uniform Residential Loan Application (Freddie Mac Form 65Fannie Mae Form 1003) To avoid any delays in your application review please provide all of the requested information
If you need to make a correction on the application draw a line through the incorrect text and mark your initials beside the change Donrsquot use correction tape or fluid The application must be completed signed and dated in ink
The Uniform Residential Loan Application (URLA)
The URLA contains the following sections Section 1 Borrower Information Please provide your personal information income and employment
Section 2 Financial Information ndash Assets and Liabilities Please provide information about your financial assets personal financial obligations and debts you owe
Section 3 Financial Information ndash Real Estate Please provide information about property you own and the debts and expenses related to the property
Section 4 Loan and Property Information Please provide information about the loan purpose and the property you are buying or refinancing
Section 5 Declarations Please answer questions about the property how the property will be financed and your past financial history
Section 6 Acknowledgments and Agreements Informs you of your legal obligations related to the mortgage application and asks that you acknowledge certain information will be obtained used and shared
Section 7 Military Service Please provide information about your (or your deceased spousersquos) military service
Section 8 Demographic Information Requests information the Lender is required by law to ask you
Section 9 Loan Originator Information Will be completed by Chase
Uniform Residential Loan Application ndash Additional Borrower
The URLA ndash Additional Borrower contains the following sections Section 1 Borrower Information This is the same as the Borrower Information section of the URLA
Section 2 Financial Information ndash Assets and Liabilities Contains only the following statement for the additional Borrower to complete ldquoMy information for Section 2 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo The name of the other borrower is entered here
Complete a separate URLA for each BorrowermiddotThree or more Borrowers ndash Use any combination of URLA and URLA-Additional Borrower forms in accordance with the above examples
Section 3 Financial Information ndash Real Estate Contains only the following statement for the additional borrower to complete ldquoMy information for Section 3 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 4 Loan and Property Information Contains only the following statement for the additional borrower to complete ldquoMy information for Section 4 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 5 Declarations This is the same as the Declarations section of the URLA
Section 6 Acknowledgments and Agreements Contains only the following statement for the additional borrower to complete ldquoMy signature for Section 6 is on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 7 Military Service This is the same as the Military Service section of the URLA
Section 8 Demographic Information This is the same as the Demographic Information section on the URLA
Section 9 Loan Originator Information This is the same as the Loan Originator Information section of the URLA
Using the URLA and URLA ndash Additional Borrower Together The URLA and the URLA ndash Additional Borrower are used together to collect information for two Borrowers who have joint assets liabilities andor real estate information The URLA and URLA ndash Additional Borrower can also be used for Borrowers who do not have joint information but wish to combine their information on the URLA for ease of use Here are examples of how to use the URLA and URLA ndash Additional Borrower
For one borrower Complete the URLA
For two borrowers with joint financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you dont need to duplicate them on more than one URLA or o In cases where Borrowers are not collaborating when completing the loan application
joint assets liabilities and real estate may be duplicated on each URLA bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you do not need to duplicate them on more than one URLA or
o In cases where Borrowers are not collaborating when completing the loan application joint assets liabilities and real estate may be duplicated on each URLA
For two borrowers with separate financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower Report the assets liabilities and
real estate for the additional Borrower on the URLA or bull Complete a separate URLA for each Borrower
For three or more borrowers use any combination of URLA and URLA ndash Additional Borrower forms described for two borrowers
Uniform Residential Loan Application ndash Unmarried Addendum If any borrower listed on the URLA or URLA ndash Additional Borrower form selects Unmarried in Section 1 (Personal Information) the lender will complete this optional form
The information must be collected to determine how to apply state property laws that directly or indirectly affect creditworthiness including ensuring clear title
Uniform Residential Loan Application ndash Continuation Sheet Use the URLA ndash Continuation Sheet if you need more space to complete either the URLA or URLA ndash Additional Borrower forms
99177-URLAI-0215
HUD Addendum to Uniform Residential Loan Application OMB Approval No HUD 2502-0059 (exp )
Part I - Identifying Information HUDFHA Application for Insurance under the National Housing Act and Borrower Certification
FHA Case No (include any suffix) Mortgagee Case No
Mortgagee ID Sponsor ID Agent ID
Mortgagee Name Address (include ZIP Code) and Telephone Number
Type or print all entries clearly
Name and Address of Sponsor Name and Address of Agent
Borrowers Name amp Present Address (include ZIP Code) Property Address (include name of subdivision lot amp block no amp ZIP Code)
Sponsored Originations
Name of Third-Party Originator NMLS ID of Third-Party Originator
Part II - Borrower Consent for Social Security Administration to Verify Social Security Number I authorize the Social Security Administration (SSA) to verify my Social Security Number (SSN) to the Mortgagee and HUDFHA I authorize SSA to provide explanatory
information to HUDFHA in the event of a discrepancy This consent is valid for 180 days from the date signed unless indicated otherwise by the individual(s) named in this
loan application
Signature(s) of Borrower(s) - Read consent carefully Review accuracy of Social Security Number(s) provided on this application
Borrowerrsquos NameDate of BirthSocial Security Number
Co-Borrowerrsquos Name Date of BirthSocial Security Number
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
Part III - Borrower Notices Information and Acknowledgment Public Reporting Burden
Public reporting burden for this collection of information is estimated to average 10 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 conduct or sponsor and a person is not
required to respond to a collection of information unless that collection displays a valid OMB control number which can be located on the OMB Internet page at
httpwwwreginfogovpublicdoPRAMain
Privacy Act Information
The information requested on the Uniform Residential Loan Application and this Addendum is authorized by the National Housing Act of 1934 12 USC sect 1701 et seq The Debt
Collection Act of 1982 Pub L 97-365 and HUDrsquos Housing and Community Development Act of 1987 42 USC sect 3543 require persons applying for a federally insured loan to
furnish their SSN You must provide all the requested information including your SSN HUD may conduct a computer match to verify the information you provide HUD may
disclose certain information to Federal State and local agencies when relevant to civil criminal or regulatory investigations and prosecutions It will not otherwise be disclosed or
released outside of HUD except as required and permitted by law The information will be used to determine whether you qualify as a mortgagor Failure to provide any of the
requested information including SSN may result in disapproval of your loan application This is notice to you as required by the Right to Financial Privacy Act of 1978 that
HUDFHA has a right of access to financial records held by financial institutions in connection with the consideration or administration of assistance to you Financial records
involving your transaction will be available to HUDFHA without further notice or authorization but will not be disclosed or released by the institution to another Government Agency
or Department without your consent except as required or permitted by law
WARNING This warning applies to all certifications made in this document Anyone who knowingly submits a false claim or makes false statements is subject to criminal and civil penalties including confinement for up to 5 years fines and civil penalties 18 USC sectsect 287 1001 and 31 USC sect 3729
orm HUD-92900-A ( ) Page 1
Borrower Name ____________________________ FHA Case No __________________
Caution Delinquencies Defaults Foreclosures and Abuses Delinquencies defaults foreclosures and abuses of mortgage loans involving programs of the Federal Government can be costly and detrimental to your credit now and in the future The Mortgagee in this transaction its agents and assigns as well as the Federal Government its agencies agents and assigns are authorized to take any and all of the following actions in the event loan payments become delinquent on the mortgage loan described in the attached application (1) Report your name and account information to a credit bureau (2) Assess additional interest and penalty charges for the period of time that payment is not made (3) Assess charges to cover additional administrative costs incurred by the Federal Government to service your account (4) Offset amounts owed to you
under other Federal programs (5) Refer your account to a private attorney collection agency or mortgage servicing agency to collect the amount due foreclose
the mortgage sell the property and seek judgment against you for any deficiency (6) Refer your account to the Department of Justice (DOJ) for litigation in the
courts (7) If you are a current or retired Federal employee take action to offset your salary or civil service retirement benefits (8) Refer your debt to the Internal
Revenue Service for offset against any amount owed to you as an income tax refund and (9) Report any resulting written off debt of yours to the Internal Revenue Service as your taxable income All of these actions may be used to recover any debts owed when it is determined to be in the interest of the Mortgagee or Federal Government or both
As a mortgage loan borrower you will be legally obligated to make the mortgage payments called for by your mortgage loan contract The fact that you dispose of your property after the loan has been made will not relieve you of liability for making these payments Payment of the loan in full is ordinarily the way liability on a mortgage note is ended Some home buyers have the mistaken impression that if they sell their homes when they move to another locality or dispose of it for any other reasons they are no longer liable for the mortgage payments and that liability for these payments is solely that of the new owners Even though the new owners may agree in writing to assume liability for your mortgage payments this assumption agreement will not relieve you from liability to the holder of the note which you signed when you obtained the loan to buy the property Unless you are able to sell the property to a buyer who is acceptable to HUDFHA who will assume the payment of your obligation to the lender you will not be relieved from liability to repay any claim which HUDFHA may be required to pay your lender on account of default in your loan payments The amount of any such claim payment may be a debt owed by you to the Federal Government and subject to established collection procedures
Fair Housing Act I and anyone acting on my behalf are and will remain in compliance with the Fair Housing Act 42 USC sect 3604 et seq with respect to the dwelling or property covered by the loan and in the provision of services or facilities in connection therewith I recognize that any restrictive covenant on this property related to race color religion sex disability familial status or national origin is unlawful under the Fair Housing Act and unenforceable I further recognize that in addition to administrative action by HUD a civil action may be brought by the DOJ in any appropriate US court against any person responsible for a violation of the
applicable law
Certification and Acknowledgment All information in this application is given for the purpose of obtaining a loan to be insured under the National Housing Act and the information in the Uniform Residential Loan Application and this Addendum is true and complete to the best of my knowledge and belief Verification may be obtained from any source named herein I have read and understand the foregoing concerning my liability on the loan and Part III Borrower Notices Information and Acknowledgment
Signature(s) of Borrower(s) - Do not sign unless this application is fully completed Read the certification carefully and review accuracy of this application
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
orm HUD-92900-A ( Page 2
___________________________________
______________________________________________________
______________________________________________________________
- - - - - - - - - - - - - - - - - - - - - - -
Borrower Name ____________________________ FHA Case No __________________
Part IV - Direct Endorsement Approval for a HUD FHA-Insured Mortgage A Underwriting the Borrower
Date Mortgage Approved ______________________________ Date Approval Expires ______________________
For mortgages rated as an ldquoacceptrdquo or ldquoapproverdquo by FHAs TOTAL Mortgage Scorecard
The information submitted to TOTAL was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA4e Final Underwriting Decision (TOTAL) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee Representative Signature
Printed Name
Title
OR
For mortgages rated as a ldquoreferrdquo by FHAs TOTAL Mortgage Scorecard or manually underwritten by a Direct Endorsement underwriter I have personally reviewed and underwritten the borrowerrsquos credit application The information used to underwrite the borrower was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA5d Final Underwriting Decision (Manual) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
B Underwriting the Property
For all mortgages where FHA requires an appraisal I have personally reviewed and underwritten the appraisal according to FHA requirements I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
orm HUD-92900-A ( ) Page 3
Borrower Name ____________________________ FHA Case No __________________
Part V Mortgagees Certification
I have personally reviewed the mortgage documents and the application for insurance endorsement and This mortgage complies with SF Handbook 40001 Section IIA7 Post-Closing and Endorsement to the extent that no defect exists that would have changed the decision to endorse or submit the mortgage for insurance
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee
Name of Mortgageersquos Representative
Title of Mortgageersquos Representative
Signature of the Mortgageersquos Representative Date
orm HUD-92900-A ( ) Page 4
GENERAL AUTHORIZATION FOR A MORTGAGE LOAN ASSUMPTION
Applicant name(s)
Loan number
NOTICES AND DISCLOSURES
Non-discriminatory underwriting guidelines Anyone who inquires about the availability of credit from us has the right to receive a copy of our non-discriminatory underwriting guidelines To request a copy of these guidelines contact your Loan Processor
Attorney note Itrsquos the responsibility of our attorneys to protect our interest You may at your expense request an attorney to represent your interest
Notice to HUDFHA applicants As required by the Right to Financial Privacy Act of 1978 this notice is to inform you that the US Department of Housing and Urban Development (HUD)Federal Housing Administration (FHA) has a right of access to financial records held by financial institutions related to a request for assistance Financial records involving your assumption will be available to HUDFHA without further notice or authorization but wonrsquot be disclosed or released by us to another government agency or department without your consent except as required or permitted by law
Borrower consent to the use of tax return information I understand acknowledge and agree that the Lender and Other Loan Participants can obtain use and share tax return information for purposes of (i) providing an offer (ii) originating maintaining managing monitoring servicing selling insuring and securitizing a loan (iii) marketing or (iv) as otherwise permitted by applicable laws including state and federal privacy and data security laws The Lender includes the Lenderrsquos affiliates agents service providers and any of aforementioned partiesrsquo successors and assigns The Other Loan Participants includes any actual or potential owners of a loan resulting from your loan application or acquirers of any beneficial or other interest in the loan and mortgage insurer guarantor any servicers or service providers for these parties and any of aforementioned partiesrsquo successors and assigns
CERTIFICATION AND AUTHORIZATION
Environmental certification By signing below I represent and warrant that Irsquom not aware of any substances materials or products that may be an environmental hazard such as but not limited to asbestos formaldehyde radon gas lead-based paint fuel or chemical storage tanks (above or below ground) and contaminated soil or water on the property I acknowledge that Chase is relying on this representation and warranty as a material part of its loan application process I also am not aware of any landfill on any portion of the property
Exceptions to the above I further acknowledge (1) receipt of applicable disclosures from the seller in purchase transactions (2) that lead-based paint may exist in housing constructed prior to 1978 (3) that Chase performs no environmental investigation on my behalf and isnrsquot responsible for identifying lead-based paint or any other environmental conditions that might impact the property or its residents and (4) that it is my sole obligation to investigate for potential impact to the property from environmental conditions
Certifications I certify by signing below that (1) all of the loan application information provided is true and complete (2) I understand any intentional or negligent misrepresentation(s) of the information provided in conjunction with my application may result in civil liability andor 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 Chase its agents successors and assigns insurers and any other person who may suffer any loss due to reliance upon any misrepresentation that I have made on the application and (3) any significant change from the information provided at the time of application until the final loan application is signed may have a bearing on the approval of my application for a home loan
Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union
This question is asked because of state laws that extend the same or similar rights benefits and protections of spouses in a marriage to persons who are members of a partnership or union recognized under state law You should consult with your own legal advisor for advice regarding the rights protections benefits responsibilities obligations and duties of those who are registered domestic partners civil union partners or members of other unions recognized under applicable law
CREDIT AUTHORIZATION RELEASE
By signing below I authorize Chase andor my mortgage insurer (if any) to verify my past and present employment earnings records (including information contained in income tax returns that have been filed with the IRS) bank accounts stock holdings and any other information that it finds necessary to process my mortgage loan application or to review it for quality-control purposes I understand that a credit report will be ordered from a credit reporting agency for verification prior to loan closing as part of the application process and may be ordered after closing as part of the Lenderrsquos quality-control program A credit report may also be completed as part of the Lenderrsquos servicing or collection of the loan or in consideration of any other product or service that the Lender may consider offering me in the future and at any time throughout the life of the loan I understand that use of a photocopy of this form may be necessary to verify one or more of my credit references I understand that a photocopy or fax copy of this form will also serve as authorization
By signing below each applicant acknowledges (1) making the above certifications and authorizations and (2) that each applicant has received and understands the above notices and disclosures
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
You do not have to give us this information but if you donrsquot your application for approval as a borrower may be delayed or rejected The information requested in this form is authorized by Title 38 USC Chapter 37 (if VA) by 12 USC Section 1701 et seq (if HUDFHA) by 42 USC Section 1452b (if HUDCPD) and Title 42 USC 1471 et seq or 7 USC 1921 et seq (if USDA FHA)
Updated December 2021 99177-GA-0215
1b
2b
Form 4506-C (September 2020)
Department of the Treasury - Internal Revenue Service
IVES Request for Transcript of Tax Return OMB Number
1545-1872
Do not sign this form unless all applicable lines have been completed Request may be rejected if the form is incomplete or illegible
For more information about Form 4506-C visit wwwirsgov and search IVES
1a Name shown on tax return (if a joint return enter the name shown first)
First social security number on tax return individual taxpayer identification number or employer identification number (see instructions)
2a If a joint return enter spousersquos name shown on tax return Second social security number or individual taxpayer identification number if joint tax return
3 Current name address (including apt room or suite no) city state and ZIP code (see instructions)
4 Previous address shown on the last return filed if different from line 3 (see instructions)
5a IVES participant name address and SOR mailbox ID
DataVerify 875 Greentree Rd 8 Parkway Center Pittsburgh PA 15220
5b Customer file number (if applicable) (see instructions)
Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing (see instructions)
6 Transcript requested Enter the tax form number here (1040 1065 1120 etc) and check the appropriate box below Enter only one tax form number per request 1040
a Return Transcript which includes most of the line items of a tax return as filed with the IRS A tax return transcript does not reflect changes made to the account after the return is processed Transcripts are only available for the following returns Form 1040 series Form 1065 Form 1120 Form 1120-A Form 1120-H Form 1120-L and Form 1120S Return transcripts are available for the current year and returns processed during the prior 3 processing years
b Account Transcript which contains information on the financial status of the account such as payments made on the account penalty assessments and adjustments made by you or the IRS after the return was filed Return information is limited to items such as tax liability and estimated tax payments Account transcripts are available for most returns
c Record of Account which provides the most detailed information as it is a combination of the Return Transcript and the Account Transcript Available for current year and 3 prior tax years
7 Form W-2 Form 1099 series Form 1098 series or Form 5498 series transcript The IRS can provide a transcript that includes data from these information returns State or local information is not included with the Form W-2 information The IRS may be able to provide this transcript information for up to 10 years Information for the current year is generally not available until the year after it is filed with the IRS For example W-2 information for 2016 filed in 2017 will likely not be available from the IRS until 2018 If you need W-2 information for retirement purposes you should contact the Social Security Administration at 1-800-772-1213
Caution If you need a copy of Form W-2 or Form 1099 you should first contact the payer To get a copy of the Form W-2 or Form 1099 filed with your return you must use Form 4506 and request a copy of your return which includes all attachments
8 Year or period requested Enter the ending date of the tax year or period using the mmddyyyy format (see instructions)
12 31 2020 12 31 2019 12 31 2018 Caution Do not sign this form unless all applicable lines have been completed
Signature of taxpayer(s) I declare that I am either the taxpayer whose name is shown on line 1a or 2a or a person authorized to obtain the tax information requested If the request applies to a joint return at least one spouse must sign If signed by a corporate officer 1 percent or more shareholder partner managing member guardian tax matters partner executor receiver administrator trustee or party other than the taxpayer I certify that I have the authority to execute Form 4506-C on behalf of the taxpayer Note This form must be received by IRS within 120 days of the signature date
Signatory attests that heshe has read the attestation clause and upon so reading declares that heshe has the authority to sign the Form 4506-C See instructions
Sign Here
Signature (see instructions) Date Phone number of taxpayer on line 1a or 2a
PrintType name
Title (if line 1a above is a corporation partnership estate or trust)
Spousersquos signature Date
PrintType name
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020) For Privacy Act and Paperwork Reduction Act Notice see page 2
Instructions for Form 4506-C IVES Request for Transcript of Tax Return
Section references are to the Internal Revenue Code unless otherwise noted
Future Developments
For the latest information about Form 4506-C and its instructions go to wwwirsgov and search IVES Information about any recent developments affecting Form 4506-C (such as legislation enacted after we released it) will be posted on that page
Whats New Form 4506-C was created to be utilized by authorized IVES participants to order tax transcripts with the consent of the taxpayer
General Instructions
Caution Do not sign this form unless all applicable lines have been completed
Designated Recipient Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information received pursuant to the taxpayerrsquos consent and holds the recipient subject to penalties for any unauthorized access other use or redisclosure without the taxpayerrsquos express permission or request
Taxpayer Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information provided pursuant to your consent and holds the recipient subject to penalties brought by private right of action for any unauthorized access other use or redisclosure without your express permission or request
Purpose of form Use Form 4506-C to request tax return information through an authorized IVES participant You will designate an IVES participant to receive the information on line 5a
Note If you are unsure of which type of transcript you need check with the party requesting your tax information
Where to file The IVES participant will fax Form 4506-C with the approved IVES cover sheet to their assigned Service Center
Chart for ordering transcripts
If your assigned Service Center is
Fax the requests with the approved coversheet to
Austin Submission Processing Center
Austin IVES Team
844-249-6238
Fresno Submission Processing Center
Fresno IVES Team
844-249-6239
Kansas City Submission Processing Center
Kansas City IVES Team
844-249-8128
Ogden Submission Processing Center
Ogden IVES Team
844-249-8129
Specific Instructions
Line 1b Enter the social security number (SSN) or individual taxpayer identification number (ITIN) for the individual listed on line 1a or enter the employer identification number (EIN) for the business listed on line 1a
Line 3 Enter your current address If you use a PO box include it on this line
Line 4 Enter the address shown on the last return filed if different from the address entered on line 3
Note If the addresses on lines 3 and 4 are different and you have not changed your address with the IRS file Form 8822 Change of Address or Form 8822-BChange of Address or Responsible Party mdash Business with Form 4506-C
Line 5b Enter up to 10 numeric characters to create a unique customer file number that will appear on the transcript The customer file number cannot contain an SSN ITIN or EIN Completion of this line is not required
Note If you use an SSN name or combination of both we will not input the information and the customer file number will reflect a generic entry of 9999999999 on the transcript
Line 8 Enter the end date of the tax year or period requested in mmddyyyy format This may be a calendar year fiscal year or quarter Enter each quarter requested for quarterly returns Example Enter 12312018 for a calendar year 2018 Form 1040 transcript
Signature and date Form 4506-C must be signed and dated by the taxpayer listed on line 1a or 2a The IRS must receive Form 4506-C within 120 days of the date signed by the taxpayer or it will be rejected Ensure that all applicable lines including lines 5a through 8 are completed before signing
You must check the box in the signature area to acknowledge you have the authority to sign and request the information The form will not be processed if unchecked
Individuals Transcripts listed on on line 6 may be furnished to either spouse if jointly filed Only one signature is required Sign Form 4506-C exactly as your name appeared on the original return If you changed your name also sign your current name
Corporations Generally Form 4506-C can be signed by
(1) an officer having legal authority to bind the corporation (2) any person designated by the board of directors or other governing body or (3) any officer or employee on written request by any principal officer and attested to by the secretary or other officer A bona fide shareholder of record owning 1 percent or more of the outstanding stock of the corporation may submit a Form 4506-C but must provide documentation to support the requesters right to receive the information
Partnerships Generally Form 4506-C can be signed by any person who was a member of the partnership during any part of the tax period requested on line 8
All others See section 6103(e) if the taxpayer has died is insolvent is a dissolved corporation or if a trustee guardian executor receiver or administrator is acting for the taxpayer
Note If you are Heir at law Next of kin or Beneficiary you must be able to establish a material interest in the estate or trust
Documentation For entities other than individuals you must attach the authorization document For example this could be the letter from the principal officer authorizing an employee of the corporation or the letters testamentary authorizing an individual to act for an estate
Signature by a representative A representative can sign Form 4506-C for a taxpayer only if the taxpayer has specifically delegated this authority to the representative on Form 2848 line 5 The representative must attach Form 2848 showing the delegation to sign Form 4506-C
Privacy Act and Paperwork Reduction Act Notice We ask for the information on this form to establish your right to gain access to the requested tax information under the Internal Revenue Code We need this information to properly identify the tax information and respond to your request You are not required to request any transcript if you do request a transcript sections 6103 and 6109 and their regulations require you to provide this information including your SSN or EIN If you do not provide this information we may not be able to process your request Providing false or fraudulent information may subject you to penalties
Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and cities states the District of Columbia and US commonwealths and possessions for use in administering their tax laws We may also disclose this information to other countries under a tax treaty to federal and state agencies to enforce federal nontax criminal laws or to federal law enforcement and intelligence agencies to combat terrorism
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law Generally tax returns and return information are confidential as required by section 6103
The time needed to complete and file Form 4506-C will vary depending on individual circumstances The estimated average time is
Learning about the law or the form 10 min Preparing the form 12 min Copying assembling and sending the form to the IRS 20 min
If you have comments concerning the accuracy of these time estimates or suggestions for making Form 4506-C simpler we would be happy to hear from you You can write to
Internal Revenue Service Tax Forms and Publications Division 1111 Constitution Ave NW IR-6526 Washington DC 20224
Do not send the form to this address Instead see Where to file on this page
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020)
Rev April 2021 CHASEO Facts What does Chase do with your personal information
Why Financial companies choose how they share your personal information Federal law gives consumers the right to limit some but not all sharing Federal law also requires us to tell you how we collect share and protect your personal information Please read this notice carefully to understand what we do
What The types of personal information we collect and share depend on the product or service you have with us This information can include bull Social Security number and income bull account balances and transaction history bull credit history and payment history
How All financial companies need to share customers personal information to run their everyday business In the section below we list the reasons financial companies can share their customers personal information the reasons Chase chooses to share and whether you can limit this sharing
Reasons we can share your personal information Does Chase share
Can you limit this sharing
For our everyday business purposes - such as to process your transactions maintain your account(s) respond to court orders and legal investigations or report to credit bureaus
Yes No
For our marketing purposes - to offer our products and services to you
Yes No
For joint marketing with other financial companies Yes No
For our affiliates everyday business purposes - information about your transactions and experiences
Yes No
For our affiliates everyday business purposes - information about your creditworthiness
Yes Yes
For our affiliates to market to you Yes Yes
For nonaffiliates to market to you Yes Yes
a
0
To limit our sharing
bull Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
bull Visit us online chasecomprivacypreferences
Please note If you are a new customer we can begin sharing your information 30 days from the date we sent this notice When you are no longer our customer we continue to share your information as described in this notice However you can contact us at any time to limit our sharing
Questions
Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
PAGE 2
Who we are
Who is providing this notice The US consumer financial companies within the JPMorgan Chase amp Co family including JPMorgan Chase Bank NA Chase Insurance Agency Inc and JP Morgan Securities LLC
What we do
How does Chase protect my To protect your personal information from unauthorized access and use we personal information use security measures that comply with federal law These measures include
computer safeguards and secured files and buildings We authorize our employees to get your information only when they need it to do their work and we require companies that work for us to protect your information
How does Chase collect my We collect your personal information for example when you personal information bull open an account or make deposits or withdrawals from your account
bull pay your bills or apply for a loan bull use your credit or debit card We also collect your personal information from others such as credit bureaus affiliates or other companies
Why cant I limit all sharing Federal law gives you the right to limit only bull sharing for affiliates everyday business purposes - information about your
creditworthiness bull affiliates from using your information to market to you bull sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing See below for more on your rights under state law
What happens when I limit sharing for an account I hold jointly with someone else
Your choices will apply to everyone on your account
Definitions
Affiliates Companies related by common ownership or control They can be financial and non financial companies bull Our affiliates include companies with a Chase or JP Morgan name and financial companies such asjP Morgan Securities LLC
Nonaffiliates Companies not related by common ownership or control They can be financial and non financial companies bull Nonaffiliates we share with can include companies such as retailers auto dealers auto makers and membership clubs
Joint marketing A formal agreement between nonaffiliated financial companies that together market financial products or services to you bull Our joint marketing partners include categories of companies such as insurance companies
Other important information
VT Accounts with a Vermont mailing address are automatically treated as if they have limited the sharing as described on page 1 For joint marketing we will only disclose your name contact information and information about your transactions
NV We are providing you this notice pursuant to Nevada law If you prefer not to receive marketing calls from us you may be placed on our Internal Do Not Call List by calling 1-800-945-9470 or by writing to us at PO Box 734007 Dallas TX 75373-4007
For more information contact us at the address above or email PrivacylnfoJPMChasecom with Nevada Annual Notice in the subject line You may also contact the Nevada Attorney Generals office Bureau of Consumer Protection Office of the Nevada Attorney General 555 E Washington St Suite 3900 Las Vegas NV 89101 telephone number 1-702-486-3132 email BCPINFOagstatenvus
CA Accounts with a California mailing address are automatically treated as if they have limited the sharing with nonaffiliates as described on page 1 CA residents are provided a CA notice for additional choices
CHASE O
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
The following disclosure is required by the USA PATRIOT Act
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 opens an account
What this means to you When you 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 drivers
license or other identifying documents
99177-PAT-0215
VETERAN STATEMENT When this loan was opened the US Department of Veterans Affairs (VA) used the veteran borrowerrsquos entitlement which is a set amount the VA promises to repay a lender if the borrower defaults on the mortgage An assumption will modify who is obligated to pay the existing mortgage loan but all loan termsmdashincluding the entitlementmdashwill remain the same If the veteran borrower is being removed from the loan the entitlement would remain with whoever is assuming the loan because the loan will continue to be serviced by the VA If the applicant is also a veteran and can substitute his or her entitlement for the current entitlement then the current borrowerrsquos entitlement can be released
Please review the following questions and answer as appropriate This form requires completion by both the applicant(s) and current borrower(s)
1 Applicant to Complete
Are you (the applicant) currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the reverse side)
Yes (If yes please provide the information requested below answer the question in section 3 and sign and date this form at the bottom of the reverse side)
Name of applicant(s) who answered ldquoyesrdquo to the above question
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Are you receiving VA disability benefts
Applicant
Yes
No
Co-Applicant
Yes
No
Are you entitled to receive VA disability benefts Yes No Yes No
Have you received VA disability benefts in the past Yes No Yes No
Are you a surviving spouse of a veteran who died on active duty or as the result of a service-related disability
Yes No Yes No
Do you have any VA loans Yes No Yes No
2 Current Borrower to Complete
Is the current borrowerco-borrower currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the page)
Yes (If yes please answer the question in section 3 and sign and date this form at the bottom of the page)
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
________________________________________________________________________________________________
3 Applicant and Current Borrower to Complete
If the answer to the questions in section 1 and 2 are both yes please answer the following question After yoursquove reviewed and completed this entire form please sign and date at the bottom
Applicant Current Borrower
Do you want to apply for a substitution of entitlement Yes Yes No No
In order to complete a substitution of entitlement the veteran applicant must have suffcient entitlement to substitute for that of the current borrower Contact the VA Offce of Jurisdiction for your area for more information Also before the veteran applicant can substitute entitlement on a VA loan heshe must certify that the property securing the loan will be occupied as hisher primary residence Both the applicantrsquos and current borrowerrsquos original certifcate of eligibility will be required If your sales contract is contingent upon the restoration of entitlement please contact your VA Offce of Jurisdiction for complete procedures Otherwise the substitution will be completed after the loan has been approved and closed
Date Applicant printed name Applicant signature
Date Applicant printed name Applicant signature
Date Current Borrower printed name Current Borrower signature
Date Current Borrower printed name Current Borrower signature
Forms completed by Mail Phone
For Chase use only
Interviewer signature Date
99177-VS-0215
- Assumption Application Package_41521-noscannedpages-update-4pdf
-
- 1 FM203 Cover Pagepdf
- 2 FM202 Mortgage Assumption Application Package pagepdf
- 3 The Documents Youll need to Send Uspdf
- 4 FM201 FAQpdf
- 5 FM142 CIWpdf
- 6 FM126 URLApdf
- 7 FM130 URLA Instpdf
-
- Blank Page
-
- 8 92900a Addednum to Loan Applicationpdf
- 9 FM462 Gen Authpdf
- 10 FM220 4506-Cpdf
- 11 FM153 Chase Federal Privacy Noticepdf
- 12 FM144 Info on Opening a New Accountpdf
- 13 FM152 Veteran Statementpdf
-
- Date
- Loan number
- Applicant name
- Phone1
- Loan number 1
- Loan number 2
- Other
- Other_2
- 1
- 2
- undefined_7
- Available hours
- Available hours_2
- undefined_8
- Available hours_3
- undefined_9
- Current address 1
- Neither
- Available hours_4
- Available hours_5
- undefined_10
- Available hours_6
- 1_2
- 2_2
- undefined_11
- Available hours_7
- Available hours_8
- undefined_12
- Available hours_9
- FHA Case No include any suffix
- Mortgagee Case No
- Mortgagee ID
- Sponsor ID
- Agent ID
- Name and Address of Sponsor Name and Address of Agent
- Borrowers Name Present Address include ZIP Code Property Address
- include name of subdivision lot block no ZIP Code
- Name of ThirdParty Originator
- NMLS ID of ThirdParty Originator
- s application
- ty Number
- ty Number_2
- Date Signed_2
- Date Mortgage Approved
- Date Approval Expires
- Printed Name
- Title 1
- DEs ID Number
- DEs ID Number_2
- Mortgagee
- Name of Mortgagees Representative
- Title of Mortgagees Representative
- Signature of the Mortgagees Representative
- Date_2
- Applicant names 1
- Applicant names 2
- Applicant names 3
- Loan number_2
- Date_3
- Applicant printed name
- Social Security number
- Date_4
- Applicant printed name_2
- Social Security number_2
- Date_5
- Applicant printed name_3
- Social Security number_3
- Date_6
- Applicant printed name_4
- Social Security number_4
- 1a Name shown on tax return if a joint return enter the name shown first
- 1b First social security number on tax return individual taxpayer identification number or employer identification number see instructions
- 2a If a joint return enter spouses name shown on tax return
- 2b Second social security number or individual taxpayer identification number if joint tax return
- 4 Previous address shown on the last return filed if different from line 3 see instructions
- 5a IVES participant name address and SOR mailbox ID
- Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing see instructions
- Signature see instructions
- Date_7
- Phone number of taxpayer on line 1a or 2a
- PrintType name
- Here
- Spouses signature
- Date_8
- PrintType name_2
- Name
- Date of birth
- Service number
- Name_2
- Date of birth_2
- Service number_2
- Date_9
- Applicant printed name_5
- Date_10
- Applicant printed name_6
- Date_11
- Current Borrower printed name
- Date_12
- Current Borrower printed name_2
- Date_13
- Text3
- Text10
- undefined_13
- Text15
- undefined_14
- undefined_15
- undefined_16
- undefined_17
- undefined_18
- undefined_19
- undefined_20
- undefined_21
- undefined_23
- Reason for assumption Off
- Requestors relationship to owners Off
- Check one Off
- Check one1 Off
- Day1
- Evening
- Cell phone
- Check one2 Off
- Check one3 Off
- Check one4 Off
- Check one5 Off
- Text2-1
- Text2-2
- Text2-3
- Text2-4
- Text2-5
- Text2-6
- Text3-1
- Text3-2
- Text3-3
- Text3-4
- Text3-6
- Text3-7
- Text3-8
- Text3-9
- Text3-10
- Text3-11
- Text3-12
- Text3-13
- Text3-14
- Text3-15
- Text3-16
- Text3-17
- Text3-18
- Text3-19
- Text3-20
- Text3-21
- Text3-22
- Text3-23
- Text3-24
- Text3-25
- Text3-26
- Text3-27
- Text3-28
- Text3-29
- Text3-30
- Text3-31
- Text3-32
- Text3-33
- Text3-34
- Text3-35
- Text3-36
- Text3-37
- Text3-38
- Text3-39
- Text3-40
- Text3-41
- Text3-42
- Text3-43
- Text3-44
- Text3-45
- Text3-46
- Text3-47
- Text3-48
- Text3-49
- Text3-50
- Text3-51
- Text3-52
- Text3-53
- Text3-5
- Text3-54
- Text3-55
- Text3-56
- Citizenship Off
- Type of credit Off
- Marital Status Off
- Housing Off
- Housing1 Off
- ownership Off
- DNA1 Off
- DNA2 Off
- DNA3 Off
- family Off
- BO Off
- Total
- Text31
- Text32
- Text33
- Text34
- Text35
- Text36
- Text37
- Text38
- Text39
- Text310
- Text311
- Text312
- Text313
- Text314
- Text315
- Text316
- Text317
- Text318
- Text319
- ownership1 Off
- Total1
- Total1-2
- Check Box4-1 Off
- Text320
- Text321
- Text322
- Text323
- Text324
- Text325
- Text326
- Text327
- Text328
- Text329
- Check Box4-2 Off
- Check Box4-3 Off
- Check Box4-4 Off
- Check Box4-8 Off
- Check Box4-9 Off
- Text330
- Text331
- Text332
- Text333
- Text334
- Text335
- Text1-1
- Text1-2
- Text1-3
- Text1-4
- Text1-5
- Text1-6
- Text1-7
- Text1-8
- Text1-9
- Text1-10
- Text1-11
- Text1-12
- Text1-13
- Text1-14
- Text1-15
- Text1-16
- Text1-17
- Text1-18
- Text1-19
- Text1-20
- Text1-21
- Text1-22
- Text1-23
- Text1-24
- Text1-25
- Text1-26
- Text1-27
- Text1-28
- Text1-29
- Text1-30
- Text1-31
- Text1-32
- Text1-33
- Text1-34
- Text1-35
- Check Box3-2 Off
- Check Box2-1 Off
- Check Box2-2 Off
- Check Box2-3 Off
- Check Box2-4 Off
- Check Box2-5 Off
- Text1-36
- Text1-37
- Text1-38
- Text1-39
- Text1-40
- Text1-41
- Text1-42
- Text1-43
- Text1-44
- Text1-45
- Text1-46
- Text1-47
- Text1-48
- Text1-49
- Text1-50
- Text1-51
- Text1-52
- Text1-53
- Text1-54
- Text1-55
- Text1-56
- Text1-57
- Text1-58
- Text1-59
- Text1-60
- Text1-61
- Check Box3-11 Off
- A1
- A2
- A3
- A4
- A5
- A6
- A7
- A8
- A9
- A10
- A11
- A12
- Check Box3-1 Off
- Check Box30-1 Off
- Check Box30-2 Off
- Check Box30-4 Off
- Check Box30-5 Off
- Check Box30-7 Off
- Check Box30-8 Off
- Check Box30-9 Off
- Check Box30-10 Off
- Check Box30-11 Off
- Check Box30-12 Off
- A13
- A14
- A15
- A16
- A17 Off
- A18
- A19
- A20
- A21
- A22
- A23
- A24
- A25
- A26
- A27
- A28
- A29
- A30
- A31
- A32
- A33
- A34
- A35
- A36
- A37
- A38 Off
- A39
- A40
- A41
- A42
- A43
- A44
- A45
- A46
- A47
- A48
- A49
- A50
- A51
- A52
- A53
- A54
- A55
- A56
- A57
- A58
- A59
- A60
- A61
- A62
- A63
- A64
- A65
- A66
- A67
- A68
- A69
- A70
- A71
- A72
- A73
- A74
- Loan Purpose Off
- occupancy1 Off
- lien type Off
- lientype Off
- mixed use Off
- manufactured home Off
- deposit1 Off
- deposit2 Off
- B1
- B2
- B3
- B4
- B5
- B6
- B7
- B8
- B9
- B10
- fha Off
- Check Box51 Off
- B11
- B12
- B13
- B14
- B15
- B16
- B17
- B18
- B19 Off
- B20
- B21
- B22 Off
- B23
- B24
- B25
- B26
- B27
- B28
- A
-
- Will you occupy the property as your primary residence Off
- Will you occupy the property as your primary residence1 Off
-
- If yes have you had an ownership interest in another property in the last three years Off
- Text9-2
- B
-
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property Off
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property1 Off
-
- 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 Off
- 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 application1 Off
-
- 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 Off
- 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 application1 Off
-
- new credit Off
- 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) Off
- the Property Assessed Clean Energy Program)1 Off
-
- F
-
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application Off
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application1 Off
-
- G
-
- Are there any outstanding judgments against you Off
- Are there any outstanding judgments against you1 Off
-
- H
-
- Are you currently delinquent or in default on a Federal debt Off
- Are you currently delinquent or in default on a Federal debt1 Off
-
- I
-
- Are you a party to a lawsuit in which you potentially have any personal financial liability Off
- Are you a party to a lawsuit in which you potentially have any personal financial liability1 Off
-
- J
-
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years Off
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years1 Off
-
- 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 Off
- 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 due1 Off
-
- L
-
- Have you had property foreclosed upon in the last 7 years Off
- Have you had property foreclosed upon in the last 7 years1 Off
-
- M
-
- Have you declared bankruptcy within the past 7 years Off
- Have you declared bankruptcy within the past 7 years1 Off
-
- Check Box8-2 Off
- Check Box8-3 Off
- Check Box8-4 Off
- Text9-3
- Text9-5
- Text9-6
- Text97
- military Off
- ethnicity Off
- sex Off
- race Off
- demo Off
- Text12-1
- Check Box11-1 Off
- Check Box11-2 Off
- Check Box11-3 Off
- Check Box11-4 Off
- Check Box11-5 Off
- Check Box11-6 Off
- Check Box11-7 Off
- Check Box11-8 Off
- Check Box11-9 Off
- Text12-2
- Check Box11-10 Off
- Check Box11-11 Off
- Check Box11-12 Off
- Check Box11-13 Off
- Check Box11-14 Off
- Check Box11-15 Off
- Text12-3
- Check Box11-16 Off
- Check Box11-17 Off
- Check Box11-18 Off
- Check Box11-19 Off
- Check Box11-20 Off
- Check Box11-21 Off
- Check Box11-22 Off
- Check Box11-23 Off
- Text12-4
- Check Box11-24 Off
- Check Box11-25 Off
- Check Box11-26 Off
- Check Box11-27 Off
- Check Box11-28 Off
- Check Box11-29 Off
- Text12-5
- Check Box11-30 Off
- Check Box11-31 Off
- citizen Off
- credit Off
- marital status1 Off
- housing-1 Off
- housing-2 Off
- own Off
- C1
- C2
- C3
- C6
- C7
- C8
- C9
- C10
- C11
- C12
- C13
- C14
- C15
- C16
- C17
- C18
- C19
- C20
- C21
- C22
- C23
- C24
- C25
- C26
- C27
- C28
- C29
- C30
- C31
- C32
- C33
- C34
- C35
- Check Box-2 Off
- C36
- C37
- C38
- C39
- C4
- C40
- C41
- C42
- C43
- C44
- C45
- C46
- C47
- Check Box-3 Off
- Check Box-4 Off
- C48
- C49
- C5
- C50
- C51
- C52
- C53
- C54
- C55
- Check Box-1-1 Off
- own1 Off
- Check Box-1 Off
- D1 Off
- D2
- D3
- D4
- D5
- D6
- D7
- D8
- D9
- D10
- D11
- D12
- D13
- D14 Off
- D15 Off
- D16
- D17
- D18
- D19
- D20
- D21
- D22
- D23
- D24 Off
- D25
- D26
- D27
- D28
- D29
- D30
- D31
- D32
- D33
- D34
- D35 Off
- D36
- D37 Off
- D38
- D39
- D40
- D41
- D42
- D43
- D44
- D45
- D46
- D47
- If yes have you had an ownership interest in another property in the last three years1 Off
- new credit1 Off
- Check Box8-1 Off
- Check Box8-1-2 Off
- Check Box8-1-1 Off
- Check Box8-1-3 Off
- Check Box8-1-4 Off
- Military Service mdash Did you (or your deceased spouse) ever serve or are you currently serving in the United States Armed Forces 1 Off
- Check1 Off
- Text9-1-1
- Check2 Off
- Check3 Off
- Check4 Off
- Text9-1
- E1
- E2
- E3
- Was the ethnicity of the Borrower collected on the basis of visual observation or surname1 Off
- Was the sex of the Borrower collected on the basis of visual observation or surname1 Off
- Was the race of the Borrower collected on the basis of visual observation or surname1 Off
- The Demographic Information was provided through1 Off
- F1 Off
- F2 Off
- F3 Off
- F4 Off
- F5 Off
- F6
- F7 Off
- F8 Off
- F9 Off
- F10 Off
- F11 Off
- F12 Off
- F13
- F14 Off
- F15 Off
- F16 Off
- F17 Off
- F18 Off
- F19 Off
- F20 Off
- F21 Off
- F22
- F23 Off
- F24 Off
- F25 Off
- F26 Off
- F27 Off
- F28 Off
- F29
- F30 Off
- F31 Off
- undefined_13-1
- undefined_13-2
- undefined_14-1
- undefined_15-1
- undefined_16-1
- undefined_17-1
- undefined_18-1
- undefined_19-1
- undefined_21-1
- undefined_20-1
- undefined_23-1
- undefined_13_1
- Single-Two Off
- Refi type Off
- refi program Off
- Estate Off
- Title held Off
- Trust Information Off
- Indian Country Land Tenure Off
- Mortgage Type Applied For Off
- Mortgage Lien Type Off
- Amortization Type Off
- G1 Off
- G2 Off
- G3 Off
- G4 Off
- G5 Off
- G6
- G7
- G8
- G9
- G10 Off
- G11 Off
- G12 Off
- G13 Off
- G14 Off
- G15 Off
- G16
- G17
- G18
- G19
- G20
- G21
- G22
- G23 Off
- G24
- G25 Off
- G26
- G27 Off
- G28 Off
- G29
- G30 Off
- G31
- G32 Off
- G33
- G34
- G35
- G36
- G37
- G38
- G39
- G40
- G41
- G42
- Property Held
- refi
- Text18-1
- Text18-2
- Text18-3
- Text18-4
- Text18-5
- Text18-6
- Text18-7
- Text18-8
- Text18-9
- Text18-10
- Text18-11
- Text18-12
- Text18-13
- Text18-14
- Text18-15
- Text18-16
- Text18-17
- Text18-18
- Text18-19
- Lender
- case no
- If you selected ldquoUnmarriedrdquo in Section 1 is there a person who is not your legal spouse but who currently has real property rights similar to those of a legal spouse Off
- Relationship and State Off
- Other-5
- Text19-1
- BName
- Additional Information
- ABN
- Additional Information1
- BSign
- BSDate
- ABSign
- ABDate
- MortageeNameAddress
- NAmeAddress
- Bname1
- DOB1
- DOB2
- SignOfBorr1
- SignOfBorr
- Date Signed
- SignOfBorr2
- SignOfBorr3
- Date Signed3
- Date Signed4
- MortgageeRepSign
- DirectSign
- DirectSign1
- Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union Off
- AppSign
- AppSign1
- AppSign2
- AppSign3
- Nopage38 Off
- Yespage38 Off
- Yes1 Off
- No1 Off
- Yes2 Off
- Yes3 Off
- Yes4 Off
- Yes5 Off
- Yes6 Off
- Yes7 Off
- Yes8 Off
- Yes9 Off
- Yes10 Off
- No2 Off
- No3 Off
- No4 Off
- No5 Off
- No6 Off
- No7 Off
- No8 Off
- No9 Off
- No10 Off
- BorrowerNo Off
- BorrowerYes Off
- AppSignature
- AppSignature1
- CurrentSign
- CurrentSign1
- InterviewSign
- Yes_1 Off
- No_1 Off
- Yes_2 Off
- No_2 Off
- Mail Off
- Phone Off
Section 8 Demographic InformationThis section asks about your ethnicity sex and race
Demographic Information of Borrower
The purposeofcollecting this information is to help ensure thatall applicants are treated fairly and that the housing needs of communities
and neighborhoodsare beingfulfilled 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 providethis information but are encouraged to do so You mayselect one or more designationsfor
Ethnicity and one or more designationsfor Race The law provides that we maynotdiscriminate onthe basis of this information or onwhetheryou chooseto provideit However if you choose notto provide the information and you have madethis application in person Federal
regulations require us to note yourethnicity sex and race on the basis of visual observation or surname The law also provides that we may notdiscriminate on the basis of age or marital status information you providein this application If you do not wish to provide someorall of this
information please check below
Ethnicity Check one or more Race Check one or moreHispanic or Latino AmericanIndian or Alaska Native - Print nameofenrolled
or principaltribeMexican PuertoRican Cuban
OtherHispanic or Latino - Printorigin siansian Indian Chinese Filipino
For exampleArgentinean Colombian Dominican NicaraguanSalvadoran Spaniard andso on
Japanese Korean VietnameseOtherAsian - Print race Forexample Hmong Laotian Thai Pakistani Cambodian andso on
Black or African American
Native Hawaiian or OtherPacific Islander
Native Hawaiian GuamanianorChamorro Samoan
OtherPacific Islander mdash Print race
Not Hispanic or Latino
| do not wish to providethis information
Sex
Female
Male
| do not wish to providethis informationFor example Fijian Tongan and so on
White
| do not wish to providethis information
Wasthe ethnicity of the Borrowercollected on thebasis of visual observation or surnameWasthesex of the Borrowercollected on the basis of visual observation or surnameWastherace of the Borrowercollected on the basis of visual observation or surname
)NO YESNO YESNO YES
Face-to-Face Interview (includes Electronic Media w Video Component) Telephone Interview Faxor Mail Email or Internet
Loan Originator Organization Name
Address
Loan Originator Organization NMLSR ID State License ID
Loan Originator Name
Loan Originator NMLSR ID State License ID
Email Phone (
Signature Date (mmddyyyy)
Borrower NameUniform Residential Loan Application mdash Additional BorrowerFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Pe)aae-emeet)
Community Property State
At least one borrowerlives in a community propertystateThe property is in a community property state
Transaction DetailConversion of Contract for Deed or Land ContractRenovationConstruction-ConversionConstruction-to-Permanent
Single-Closing Two-ClosingConstructionImprovementCosts $
LotAcquired Date
Original Cost of Lot $(mmddyyyy)
Refinance Program
Full DocumentationInterest Rate ReductionStreamlined without Appraisal
Other
Refinance Type
NoCash OutLimited Cash OutCash Out
Energy Improvement
Mortgageloanwill finance energy-related improvements
Propertyis currently subject to a lien that could take priority ovethe first mortgagelien such as a clean energylien paid for througproperty taxes(eg the PropertyAssessed Clean Energyprogram)
Project Type Condominium Cooperative Planned Unit Development (PUD) Propertyis notlocatedin a project
Peiwlivcestetece)a)
Title to the Property Will be Held in What Name(s)
For RefinanceTitle to the Property is Currently Held in What Name(s
Trust Information
tle Will be Held byan Inter Vivos (Living) Trust
Title Will be Held by a Land TrustLeasehold Expiration Date
Mannerin WhichTitle Will be Held Indian Country Land Tenure
Sole OwnershipLife EstateTenancy in Common
Joint Tenancywith Right of Survivorship]Tenancybythe EntiretyOther
Fee Simple Ona ReservationIndividualTrust Land (AllottedRestricted)Tribal Trust Land On a ReservationTribal Trust Land Off ReservationAlaska Native Corporation Land
Estate Will be Held in
Fee Simple(mmddyyyy)
3 Mortgage LoanInformation
Termsof Loan
Note Rate
Loan Term (months)
MortgageLien Type
First LienSubordinate Lien
Mortgage Type Applied For
Conventional USDA-RDFHA VA Other
Amortization Type
Fixed RateAdjustable Rate
If Adjustable Rate
Initial Period Prior to First Adjustment
Subsequent AdjustmentPeriod
Proposed Monthly Paymentfor Property
First Mortgage (P amp I) $
Subordinate Lien(s) (P amp |) $
Other(explain)
Homeowners Insurance $(months)
(months)
Loan Features Property Taxes $
Balloon Balloon Term (months)
Interest Only Interest OnlyTermNegative AmortizationPrepaymentPenalty Prepayment Penalty Term (months) Other
Temporary Interest Rate BuydownInitial Buydown Rate TOTALOther(explain)
Mortgage Insurance $
AssociationProject Dues (Condo Co-Op PUD) $
Supplemental Property Insurance $
(months)
Borrower Name(s)Uniform Residential Loan Application mdash LenderLoan Information
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
L4 Qualifying the Borrower - Minimum Required Funds or Cash Back
DUEFROM BORROWER(S)
A Sales Contract Price
B Improvements Renovations and Repairs
C Land(ifacquired separately)
D For Refinance Balance of Mortgage Loanson the Propertyto be paid off in the Transaction
(See Table 3a Property You Own)
E Credit Cards and Other Debts Paid Off
(See Table 2c Liabilities mdash Credit Cards Other Debts and Leases that You Owe)
F BorrowerClosing Costs (including Prepaid andInitial Escrow Payments)
G Discount Points
HTOTAL DUE FROM BORROWER(s)(Total of A thru G)
TOTALMORTGAGE LOANS
Loan Amount
Loan AmountExcluding Financed Mortgage Insurance (or Mortgage Insurance Equivalent) $
Financed Mortgage Insurance (or Mortgage Insurance Equivalent) Amount $
Other New Mortgage Loanson the Property the Borrower(s) is Buying or Refinancing(See Table 4b Other New MortgageLoanson the Property You are Buying or Refinancing)
KTOTAL MORTGAGELOANS(Totalof| and J)
TOTALCREDITS
L Seller Credits (Enter the amountofBorrower(s) costs paid by the property seller)
MOtherCredits (Enter the sum ofall other credits mdash BorrowerPaid Fees Earnest Money EmployerAssistedHousing Lease Purchase Fund Lot Equity Relocation Funds Sweat Equity Trade Equity Other)
NTOTAL CREDITS(Total of L and M)
CALCULATION
TOTAL DUE FROM BORROWER(s)(Line H)
LESSTOTAL MORTGAGELOANS(Line K) AND TOTAL CREDITS(Line N)
Cash FromTothe Borrower(Line H minusLine K and Line N)NOTE This amountdoesnotinclude reservesor other funds that may be required by the Lenderto be verified
Borrower Name(s)Uniform Residential Loan Application mdash LenderLoan Information
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
Uniform Residential Loan Application mdash Unmarried Addendum
eeCeceetatimC elitleeComeLy
Lenders Instructions for Using the Unmarried Addendum
The Lender may use the Unmarried Addendum only when a Borrowerselected ldquoUnmarriedrdquoin Section 1 and the information collected is
necessary to determine howState property lawsdirectly or indirectly affecting creditworthiness apply including ensuring clear title
For example the Lender may use the Unmarried Addendum whentheBorrowerresides in a State that recognizescivil unions domestic
partnerships or registered reciprocal beneficiary relationships or when the property is located in such a State ldquoStaterdquo meansanystate the
District of Columbia the Commonwealth of Puerto Rico or anyterritory or possession of the United States
Ifyou selected ldquoUnmarriedrdquoin Section 1 is there a person whois not your legal spouse but whocurrently has real property rights similar to
those of a legal spouse +=) NOQ YES
If YES indicate the type of relationship and the State in which the relationship was formed For example indicate if you are in a
civil union domestic partnership registered reciprocal beneficiary relationship or other relationship recognized by the State in which you
currently reside or where the property is located
O Civil Union copy Domestic Partnership copy Registered Reciprocal Beneficiary Relationship copy) Other(explain)
Statea]
Borrower NameUniform Residential Loan Application mdash Unmarried Addendum
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Uniform Residential Loan Application mdash Continuation Sheet
Use this continuation sheet if you need more space to complete the Uniform Residential Loan Application
Borrower Name(First Middle Last Suffix )
Additional Information
Additional Borrower Name(First Middle Last Suffix )
Additional Information
IWefully understand thatit is a federal crime punishable by fine or imprisonment or both to knowingly make anyfalse statements concerningany of the abovefacts as applicable underthe provisions of federal law (18 USC sectsect 1001 et seq)
BorrowerSignature Date (mmddyyyy)
Additional Borrower Signature Date (mmddyyyy)
Uniform Residential Loan Application mdash Continuation SheetFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
INSTRUCTIONS FOR COMPLETING THE UNIFORM RESIDENTIAL LOAN APPLICATION
Use the instructions below to complete the enclosed Uniform Residential Loan Application (Freddie Mac Form 65Fannie Mae Form 1003) To avoid any delays in your application review please provide all of the requested information
If you need to make a correction on the application draw a line through the incorrect text and mark your initials beside the change Donrsquot use correction tape or fluid The application must be completed signed and dated in ink
The Uniform Residential Loan Application (URLA)
The URLA contains the following sections Section 1 Borrower Information Please provide your personal information income and employment
Section 2 Financial Information ndash Assets and Liabilities Please provide information about your financial assets personal financial obligations and debts you owe
Section 3 Financial Information ndash Real Estate Please provide information about property you own and the debts and expenses related to the property
Section 4 Loan and Property Information Please provide information about the loan purpose and the property you are buying or refinancing
Section 5 Declarations Please answer questions about the property how the property will be financed and your past financial history
Section 6 Acknowledgments and Agreements Informs you of your legal obligations related to the mortgage application and asks that you acknowledge certain information will be obtained used and shared
Section 7 Military Service Please provide information about your (or your deceased spousersquos) military service
Section 8 Demographic Information Requests information the Lender is required by law to ask you
Section 9 Loan Originator Information Will be completed by Chase
Uniform Residential Loan Application ndash Additional Borrower
The URLA ndash Additional Borrower contains the following sections Section 1 Borrower Information This is the same as the Borrower Information section of the URLA
Section 2 Financial Information ndash Assets and Liabilities Contains only the following statement for the additional Borrower to complete ldquoMy information for Section 2 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo The name of the other borrower is entered here
Complete a separate URLA for each BorrowermiddotThree or more Borrowers ndash Use any combination of URLA and URLA-Additional Borrower forms in accordance with the above examples
Section 3 Financial Information ndash Real Estate Contains only the following statement for the additional borrower to complete ldquoMy information for Section 3 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 4 Loan and Property Information Contains only the following statement for the additional borrower to complete ldquoMy information for Section 4 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 5 Declarations This is the same as the Declarations section of the URLA
Section 6 Acknowledgments and Agreements Contains only the following statement for the additional borrower to complete ldquoMy signature for Section 6 is on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 7 Military Service This is the same as the Military Service section of the URLA
Section 8 Demographic Information This is the same as the Demographic Information section on the URLA
Section 9 Loan Originator Information This is the same as the Loan Originator Information section of the URLA
Using the URLA and URLA ndash Additional Borrower Together The URLA and the URLA ndash Additional Borrower are used together to collect information for two Borrowers who have joint assets liabilities andor real estate information The URLA and URLA ndash Additional Borrower can also be used for Borrowers who do not have joint information but wish to combine their information on the URLA for ease of use Here are examples of how to use the URLA and URLA ndash Additional Borrower
For one borrower Complete the URLA
For two borrowers with joint financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you dont need to duplicate them on more than one URLA or o In cases where Borrowers are not collaborating when completing the loan application
joint assets liabilities and real estate may be duplicated on each URLA bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you do not need to duplicate them on more than one URLA or
o In cases where Borrowers are not collaborating when completing the loan application joint assets liabilities and real estate may be duplicated on each URLA
For two borrowers with separate financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower Report the assets liabilities and
real estate for the additional Borrower on the URLA or bull Complete a separate URLA for each Borrower
For three or more borrowers use any combination of URLA and URLA ndash Additional Borrower forms described for two borrowers
Uniform Residential Loan Application ndash Unmarried Addendum If any borrower listed on the URLA or URLA ndash Additional Borrower form selects Unmarried in Section 1 (Personal Information) the lender will complete this optional form
The information must be collected to determine how to apply state property laws that directly or indirectly affect creditworthiness including ensuring clear title
Uniform Residential Loan Application ndash Continuation Sheet Use the URLA ndash Continuation Sheet if you need more space to complete either the URLA or URLA ndash Additional Borrower forms
99177-URLAI-0215
HUD Addendum to Uniform Residential Loan Application OMB Approval No HUD 2502-0059 (exp )
Part I - Identifying Information HUDFHA Application for Insurance under the National Housing Act and Borrower Certification
FHA Case No (include any suffix) Mortgagee Case No
Mortgagee ID Sponsor ID Agent ID
Mortgagee Name Address (include ZIP Code) and Telephone Number
Type or print all entries clearly
Name and Address of Sponsor Name and Address of Agent
Borrowers Name amp Present Address (include ZIP Code) Property Address (include name of subdivision lot amp block no amp ZIP Code)
Sponsored Originations
Name of Third-Party Originator NMLS ID of Third-Party Originator
Part II - Borrower Consent for Social Security Administration to Verify Social Security Number I authorize the Social Security Administration (SSA) to verify my Social Security Number (SSN) to the Mortgagee and HUDFHA I authorize SSA to provide explanatory
information to HUDFHA in the event of a discrepancy This consent is valid for 180 days from the date signed unless indicated otherwise by the individual(s) named in this
loan application
Signature(s) of Borrower(s) - Read consent carefully Review accuracy of Social Security Number(s) provided on this application
Borrowerrsquos NameDate of BirthSocial Security Number
Co-Borrowerrsquos Name Date of BirthSocial Security Number
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
Part III - Borrower Notices Information and Acknowledgment Public Reporting Burden
Public reporting burden for this collection of information is estimated to average 10 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 conduct or sponsor and a person is not
required to respond to a collection of information unless that collection displays a valid OMB control number which can be located on the OMB Internet page at
httpwwwreginfogovpublicdoPRAMain
Privacy Act Information
The information requested on the Uniform Residential Loan Application and this Addendum is authorized by the National Housing Act of 1934 12 USC sect 1701 et seq The Debt
Collection Act of 1982 Pub L 97-365 and HUDrsquos Housing and Community Development Act of 1987 42 USC sect 3543 require persons applying for a federally insured loan to
furnish their SSN You must provide all the requested information including your SSN HUD may conduct a computer match to verify the information you provide HUD may
disclose certain information to Federal State and local agencies when relevant to civil criminal or regulatory investigations and prosecutions It will not otherwise be disclosed or
released outside of HUD except as required and permitted by law The information will be used to determine whether you qualify as a mortgagor Failure to provide any of the
requested information including SSN may result in disapproval of your loan application This is notice to you as required by the Right to Financial Privacy Act of 1978 that
HUDFHA has a right of access to financial records held by financial institutions in connection with the consideration or administration of assistance to you Financial records
involving your transaction will be available to HUDFHA without further notice or authorization but will not be disclosed or released by the institution to another Government Agency
or Department without your consent except as required or permitted by law
WARNING This warning applies to all certifications made in this document Anyone who knowingly submits a false claim or makes false statements is subject to criminal and civil penalties including confinement for up to 5 years fines and civil penalties 18 USC sectsect 287 1001 and 31 USC sect 3729
orm HUD-92900-A ( ) Page 1
Borrower Name ____________________________ FHA Case No __________________
Caution Delinquencies Defaults Foreclosures and Abuses Delinquencies defaults foreclosures and abuses of mortgage loans involving programs of the Federal Government can be costly and detrimental to your credit now and in the future The Mortgagee in this transaction its agents and assigns as well as the Federal Government its agencies agents and assigns are authorized to take any and all of the following actions in the event loan payments become delinquent on the mortgage loan described in the attached application (1) Report your name and account information to a credit bureau (2) Assess additional interest and penalty charges for the period of time that payment is not made (3) Assess charges to cover additional administrative costs incurred by the Federal Government to service your account (4) Offset amounts owed to you
under other Federal programs (5) Refer your account to a private attorney collection agency or mortgage servicing agency to collect the amount due foreclose
the mortgage sell the property and seek judgment against you for any deficiency (6) Refer your account to the Department of Justice (DOJ) for litigation in the
courts (7) If you are a current or retired Federal employee take action to offset your salary or civil service retirement benefits (8) Refer your debt to the Internal
Revenue Service for offset against any amount owed to you as an income tax refund and (9) Report any resulting written off debt of yours to the Internal Revenue Service as your taxable income All of these actions may be used to recover any debts owed when it is determined to be in the interest of the Mortgagee or Federal Government or both
As a mortgage loan borrower you will be legally obligated to make the mortgage payments called for by your mortgage loan contract The fact that you dispose of your property after the loan has been made will not relieve you of liability for making these payments Payment of the loan in full is ordinarily the way liability on a mortgage note is ended Some home buyers have the mistaken impression that if they sell their homes when they move to another locality or dispose of it for any other reasons they are no longer liable for the mortgage payments and that liability for these payments is solely that of the new owners Even though the new owners may agree in writing to assume liability for your mortgage payments this assumption agreement will not relieve you from liability to the holder of the note which you signed when you obtained the loan to buy the property Unless you are able to sell the property to a buyer who is acceptable to HUDFHA who will assume the payment of your obligation to the lender you will not be relieved from liability to repay any claim which HUDFHA may be required to pay your lender on account of default in your loan payments The amount of any such claim payment may be a debt owed by you to the Federal Government and subject to established collection procedures
Fair Housing Act I and anyone acting on my behalf are and will remain in compliance with the Fair Housing Act 42 USC sect 3604 et seq with respect to the dwelling or property covered by the loan and in the provision of services or facilities in connection therewith I recognize that any restrictive covenant on this property related to race color religion sex disability familial status or national origin is unlawful under the Fair Housing Act and unenforceable I further recognize that in addition to administrative action by HUD a civil action may be brought by the DOJ in any appropriate US court against any person responsible for a violation of the
applicable law
Certification and Acknowledgment All information in this application is given for the purpose of obtaining a loan to be insured under the National Housing Act and the information in the Uniform Residential Loan Application and this Addendum is true and complete to the best of my knowledge and belief Verification may be obtained from any source named herein I have read and understand the foregoing concerning my liability on the loan and Part III Borrower Notices Information and Acknowledgment
Signature(s) of Borrower(s) - Do not sign unless this application is fully completed Read the certification carefully and review accuracy of this application
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
orm HUD-92900-A ( Page 2
___________________________________
______________________________________________________
______________________________________________________________
- - - - - - - - - - - - - - - - - - - - - - -
Borrower Name ____________________________ FHA Case No __________________
Part IV - Direct Endorsement Approval for a HUD FHA-Insured Mortgage A Underwriting the Borrower
Date Mortgage Approved ______________________________ Date Approval Expires ______________________
For mortgages rated as an ldquoacceptrdquo or ldquoapproverdquo by FHAs TOTAL Mortgage Scorecard
The information submitted to TOTAL was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA4e Final Underwriting Decision (TOTAL) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee Representative Signature
Printed Name
Title
OR
For mortgages rated as a ldquoreferrdquo by FHAs TOTAL Mortgage Scorecard or manually underwritten by a Direct Endorsement underwriter I have personally reviewed and underwritten the borrowerrsquos credit application The information used to underwrite the borrower was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA5d Final Underwriting Decision (Manual) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
B Underwriting the Property
For all mortgages where FHA requires an appraisal I have personally reviewed and underwritten the appraisal according to FHA requirements I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
orm HUD-92900-A ( ) Page 3
Borrower Name ____________________________ FHA Case No __________________
Part V Mortgagees Certification
I have personally reviewed the mortgage documents and the application for insurance endorsement and This mortgage complies with SF Handbook 40001 Section IIA7 Post-Closing and Endorsement to the extent that no defect exists that would have changed the decision to endorse or submit the mortgage for insurance
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee
Name of Mortgageersquos Representative
Title of Mortgageersquos Representative
Signature of the Mortgageersquos Representative Date
orm HUD-92900-A ( ) Page 4
GENERAL AUTHORIZATION FOR A MORTGAGE LOAN ASSUMPTION
Applicant name(s)
Loan number
NOTICES AND DISCLOSURES
Non-discriminatory underwriting guidelines Anyone who inquires about the availability of credit from us has the right to receive a copy of our non-discriminatory underwriting guidelines To request a copy of these guidelines contact your Loan Processor
Attorney note Itrsquos the responsibility of our attorneys to protect our interest You may at your expense request an attorney to represent your interest
Notice to HUDFHA applicants As required by the Right to Financial Privacy Act of 1978 this notice is to inform you that the US Department of Housing and Urban Development (HUD)Federal Housing Administration (FHA) has a right of access to financial records held by financial institutions related to a request for assistance Financial records involving your assumption will be available to HUDFHA without further notice or authorization but wonrsquot be disclosed or released by us to another government agency or department without your consent except as required or permitted by law
Borrower consent to the use of tax return information I understand acknowledge and agree that the Lender and Other Loan Participants can obtain use and share tax return information for purposes of (i) providing an offer (ii) originating maintaining managing monitoring servicing selling insuring and securitizing a loan (iii) marketing or (iv) as otherwise permitted by applicable laws including state and federal privacy and data security laws The Lender includes the Lenderrsquos affiliates agents service providers and any of aforementioned partiesrsquo successors and assigns The Other Loan Participants includes any actual or potential owners of a loan resulting from your loan application or acquirers of any beneficial or other interest in the loan and mortgage insurer guarantor any servicers or service providers for these parties and any of aforementioned partiesrsquo successors and assigns
CERTIFICATION AND AUTHORIZATION
Environmental certification By signing below I represent and warrant that Irsquom not aware of any substances materials or products that may be an environmental hazard such as but not limited to asbestos formaldehyde radon gas lead-based paint fuel or chemical storage tanks (above or below ground) and contaminated soil or water on the property I acknowledge that Chase is relying on this representation and warranty as a material part of its loan application process I also am not aware of any landfill on any portion of the property
Exceptions to the above I further acknowledge (1) receipt of applicable disclosures from the seller in purchase transactions (2) that lead-based paint may exist in housing constructed prior to 1978 (3) that Chase performs no environmental investigation on my behalf and isnrsquot responsible for identifying lead-based paint or any other environmental conditions that might impact the property or its residents and (4) that it is my sole obligation to investigate for potential impact to the property from environmental conditions
Certifications I certify by signing below that (1) all of the loan application information provided is true and complete (2) I understand any intentional or negligent misrepresentation(s) of the information provided in conjunction with my application may result in civil liability andor 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 Chase its agents successors and assigns insurers and any other person who may suffer any loss due to reliance upon any misrepresentation that I have made on the application and (3) any significant change from the information provided at the time of application until the final loan application is signed may have a bearing on the approval of my application for a home loan
Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union
This question is asked because of state laws that extend the same or similar rights benefits and protections of spouses in a marriage to persons who are members of a partnership or union recognized under state law You should consult with your own legal advisor for advice regarding the rights protections benefits responsibilities obligations and duties of those who are registered domestic partners civil union partners or members of other unions recognized under applicable law
CREDIT AUTHORIZATION RELEASE
By signing below I authorize Chase andor my mortgage insurer (if any) to verify my past and present employment earnings records (including information contained in income tax returns that have been filed with the IRS) bank accounts stock holdings and any other information that it finds necessary to process my mortgage loan application or to review it for quality-control purposes I understand that a credit report will be ordered from a credit reporting agency for verification prior to loan closing as part of the application process and may be ordered after closing as part of the Lenderrsquos quality-control program A credit report may also be completed as part of the Lenderrsquos servicing or collection of the loan or in consideration of any other product or service that the Lender may consider offering me in the future and at any time throughout the life of the loan I understand that use of a photocopy of this form may be necessary to verify one or more of my credit references I understand that a photocopy or fax copy of this form will also serve as authorization
By signing below each applicant acknowledges (1) making the above certifications and authorizations and (2) that each applicant has received and understands the above notices and disclosures
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
You do not have to give us this information but if you donrsquot your application for approval as a borrower may be delayed or rejected The information requested in this form is authorized by Title 38 USC Chapter 37 (if VA) by 12 USC Section 1701 et seq (if HUDFHA) by 42 USC Section 1452b (if HUDCPD) and Title 42 USC 1471 et seq or 7 USC 1921 et seq (if USDA FHA)
Updated December 2021 99177-GA-0215
1b
2b
Form 4506-C (September 2020)
Department of the Treasury - Internal Revenue Service
IVES Request for Transcript of Tax Return OMB Number
1545-1872
Do not sign this form unless all applicable lines have been completed Request may be rejected if the form is incomplete or illegible
For more information about Form 4506-C visit wwwirsgov and search IVES
1a Name shown on tax return (if a joint return enter the name shown first)
First social security number on tax return individual taxpayer identification number or employer identification number (see instructions)
2a If a joint return enter spousersquos name shown on tax return Second social security number or individual taxpayer identification number if joint tax return
3 Current name address (including apt room or suite no) city state and ZIP code (see instructions)
4 Previous address shown on the last return filed if different from line 3 (see instructions)
5a IVES participant name address and SOR mailbox ID
DataVerify 875 Greentree Rd 8 Parkway Center Pittsburgh PA 15220
5b Customer file number (if applicable) (see instructions)
Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing (see instructions)
6 Transcript requested Enter the tax form number here (1040 1065 1120 etc) and check the appropriate box below Enter only one tax form number per request 1040
a Return Transcript which includes most of the line items of a tax return as filed with the IRS A tax return transcript does not reflect changes made to the account after the return is processed Transcripts are only available for the following returns Form 1040 series Form 1065 Form 1120 Form 1120-A Form 1120-H Form 1120-L and Form 1120S Return transcripts are available for the current year and returns processed during the prior 3 processing years
b Account Transcript which contains information on the financial status of the account such as payments made on the account penalty assessments and adjustments made by you or the IRS after the return was filed Return information is limited to items such as tax liability and estimated tax payments Account transcripts are available for most returns
c Record of Account which provides the most detailed information as it is a combination of the Return Transcript and the Account Transcript Available for current year and 3 prior tax years
7 Form W-2 Form 1099 series Form 1098 series or Form 5498 series transcript The IRS can provide a transcript that includes data from these information returns State or local information is not included with the Form W-2 information The IRS may be able to provide this transcript information for up to 10 years Information for the current year is generally not available until the year after it is filed with the IRS For example W-2 information for 2016 filed in 2017 will likely not be available from the IRS until 2018 If you need W-2 information for retirement purposes you should contact the Social Security Administration at 1-800-772-1213
Caution If you need a copy of Form W-2 or Form 1099 you should first contact the payer To get a copy of the Form W-2 or Form 1099 filed with your return you must use Form 4506 and request a copy of your return which includes all attachments
8 Year or period requested Enter the ending date of the tax year or period using the mmddyyyy format (see instructions)
12 31 2020 12 31 2019 12 31 2018 Caution Do not sign this form unless all applicable lines have been completed
Signature of taxpayer(s) I declare that I am either the taxpayer whose name is shown on line 1a or 2a or a person authorized to obtain the tax information requested If the request applies to a joint return at least one spouse must sign If signed by a corporate officer 1 percent or more shareholder partner managing member guardian tax matters partner executor receiver administrator trustee or party other than the taxpayer I certify that I have the authority to execute Form 4506-C on behalf of the taxpayer Note This form must be received by IRS within 120 days of the signature date
Signatory attests that heshe has read the attestation clause and upon so reading declares that heshe has the authority to sign the Form 4506-C See instructions
Sign Here
Signature (see instructions) Date Phone number of taxpayer on line 1a or 2a
PrintType name
Title (if line 1a above is a corporation partnership estate or trust)
Spousersquos signature Date
PrintType name
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020) For Privacy Act and Paperwork Reduction Act Notice see page 2
Instructions for Form 4506-C IVES Request for Transcript of Tax Return
Section references are to the Internal Revenue Code unless otherwise noted
Future Developments
For the latest information about Form 4506-C and its instructions go to wwwirsgov and search IVES Information about any recent developments affecting Form 4506-C (such as legislation enacted after we released it) will be posted on that page
Whats New Form 4506-C was created to be utilized by authorized IVES participants to order tax transcripts with the consent of the taxpayer
General Instructions
Caution Do not sign this form unless all applicable lines have been completed
Designated Recipient Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information received pursuant to the taxpayerrsquos consent and holds the recipient subject to penalties for any unauthorized access other use or redisclosure without the taxpayerrsquos express permission or request
Taxpayer Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information provided pursuant to your consent and holds the recipient subject to penalties brought by private right of action for any unauthorized access other use or redisclosure without your express permission or request
Purpose of form Use Form 4506-C to request tax return information through an authorized IVES participant You will designate an IVES participant to receive the information on line 5a
Note If you are unsure of which type of transcript you need check with the party requesting your tax information
Where to file The IVES participant will fax Form 4506-C with the approved IVES cover sheet to their assigned Service Center
Chart for ordering transcripts
If your assigned Service Center is
Fax the requests with the approved coversheet to
Austin Submission Processing Center
Austin IVES Team
844-249-6238
Fresno Submission Processing Center
Fresno IVES Team
844-249-6239
Kansas City Submission Processing Center
Kansas City IVES Team
844-249-8128
Ogden Submission Processing Center
Ogden IVES Team
844-249-8129
Specific Instructions
Line 1b Enter the social security number (SSN) or individual taxpayer identification number (ITIN) for the individual listed on line 1a or enter the employer identification number (EIN) for the business listed on line 1a
Line 3 Enter your current address If you use a PO box include it on this line
Line 4 Enter the address shown on the last return filed if different from the address entered on line 3
Note If the addresses on lines 3 and 4 are different and you have not changed your address with the IRS file Form 8822 Change of Address or Form 8822-BChange of Address or Responsible Party mdash Business with Form 4506-C
Line 5b Enter up to 10 numeric characters to create a unique customer file number that will appear on the transcript The customer file number cannot contain an SSN ITIN or EIN Completion of this line is not required
Note If you use an SSN name or combination of both we will not input the information and the customer file number will reflect a generic entry of 9999999999 on the transcript
Line 8 Enter the end date of the tax year or period requested in mmddyyyy format This may be a calendar year fiscal year or quarter Enter each quarter requested for quarterly returns Example Enter 12312018 for a calendar year 2018 Form 1040 transcript
Signature and date Form 4506-C must be signed and dated by the taxpayer listed on line 1a or 2a The IRS must receive Form 4506-C within 120 days of the date signed by the taxpayer or it will be rejected Ensure that all applicable lines including lines 5a through 8 are completed before signing
You must check the box in the signature area to acknowledge you have the authority to sign and request the information The form will not be processed if unchecked
Individuals Transcripts listed on on line 6 may be furnished to either spouse if jointly filed Only one signature is required Sign Form 4506-C exactly as your name appeared on the original return If you changed your name also sign your current name
Corporations Generally Form 4506-C can be signed by
(1) an officer having legal authority to bind the corporation (2) any person designated by the board of directors or other governing body or (3) any officer or employee on written request by any principal officer and attested to by the secretary or other officer A bona fide shareholder of record owning 1 percent or more of the outstanding stock of the corporation may submit a Form 4506-C but must provide documentation to support the requesters right to receive the information
Partnerships Generally Form 4506-C can be signed by any person who was a member of the partnership during any part of the tax period requested on line 8
All others See section 6103(e) if the taxpayer has died is insolvent is a dissolved corporation or if a trustee guardian executor receiver or administrator is acting for the taxpayer
Note If you are Heir at law Next of kin or Beneficiary you must be able to establish a material interest in the estate or trust
Documentation For entities other than individuals you must attach the authorization document For example this could be the letter from the principal officer authorizing an employee of the corporation or the letters testamentary authorizing an individual to act for an estate
Signature by a representative A representative can sign Form 4506-C for a taxpayer only if the taxpayer has specifically delegated this authority to the representative on Form 2848 line 5 The representative must attach Form 2848 showing the delegation to sign Form 4506-C
Privacy Act and Paperwork Reduction Act Notice We ask for the information on this form to establish your right to gain access to the requested tax information under the Internal Revenue Code We need this information to properly identify the tax information and respond to your request You are not required to request any transcript if you do request a transcript sections 6103 and 6109 and their regulations require you to provide this information including your SSN or EIN If you do not provide this information we may not be able to process your request Providing false or fraudulent information may subject you to penalties
Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and cities states the District of Columbia and US commonwealths and possessions for use in administering their tax laws We may also disclose this information to other countries under a tax treaty to federal and state agencies to enforce federal nontax criminal laws or to federal law enforcement and intelligence agencies to combat terrorism
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law Generally tax returns and return information are confidential as required by section 6103
The time needed to complete and file Form 4506-C will vary depending on individual circumstances The estimated average time is
Learning about the law or the form 10 min Preparing the form 12 min Copying assembling and sending the form to the IRS 20 min
If you have comments concerning the accuracy of these time estimates or suggestions for making Form 4506-C simpler we would be happy to hear from you You can write to
Internal Revenue Service Tax Forms and Publications Division 1111 Constitution Ave NW IR-6526 Washington DC 20224
Do not send the form to this address Instead see Where to file on this page
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020)
Rev April 2021 CHASEO Facts What does Chase do with your personal information
Why Financial companies choose how they share your personal information Federal law gives consumers the right to limit some but not all sharing Federal law also requires us to tell you how we collect share and protect your personal information Please read this notice carefully to understand what we do
What The types of personal information we collect and share depend on the product or service you have with us This information can include bull Social Security number and income bull account balances and transaction history bull credit history and payment history
How All financial companies need to share customers personal information to run their everyday business In the section below we list the reasons financial companies can share their customers personal information the reasons Chase chooses to share and whether you can limit this sharing
Reasons we can share your personal information Does Chase share
Can you limit this sharing
For our everyday business purposes - such as to process your transactions maintain your account(s) respond to court orders and legal investigations or report to credit bureaus
Yes No
For our marketing purposes - to offer our products and services to you
Yes No
For joint marketing with other financial companies Yes No
For our affiliates everyday business purposes - information about your transactions and experiences
Yes No
For our affiliates everyday business purposes - information about your creditworthiness
Yes Yes
For our affiliates to market to you Yes Yes
For nonaffiliates to market to you Yes Yes
a
0
To limit our sharing
bull Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
bull Visit us online chasecomprivacypreferences
Please note If you are a new customer we can begin sharing your information 30 days from the date we sent this notice When you are no longer our customer we continue to share your information as described in this notice However you can contact us at any time to limit our sharing
Questions
Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
PAGE 2
Who we are
Who is providing this notice The US consumer financial companies within the JPMorgan Chase amp Co family including JPMorgan Chase Bank NA Chase Insurance Agency Inc and JP Morgan Securities LLC
What we do
How does Chase protect my To protect your personal information from unauthorized access and use we personal information use security measures that comply with federal law These measures include
computer safeguards and secured files and buildings We authorize our employees to get your information only when they need it to do their work and we require companies that work for us to protect your information
How does Chase collect my We collect your personal information for example when you personal information bull open an account or make deposits or withdrawals from your account
bull pay your bills or apply for a loan bull use your credit or debit card We also collect your personal information from others such as credit bureaus affiliates or other companies
Why cant I limit all sharing Federal law gives you the right to limit only bull sharing for affiliates everyday business purposes - information about your
creditworthiness bull affiliates from using your information to market to you bull sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing See below for more on your rights under state law
What happens when I limit sharing for an account I hold jointly with someone else
Your choices will apply to everyone on your account
Definitions
Affiliates Companies related by common ownership or control They can be financial and non financial companies bull Our affiliates include companies with a Chase or JP Morgan name and financial companies such asjP Morgan Securities LLC
Nonaffiliates Companies not related by common ownership or control They can be financial and non financial companies bull Nonaffiliates we share with can include companies such as retailers auto dealers auto makers and membership clubs
Joint marketing A formal agreement between nonaffiliated financial companies that together market financial products or services to you bull Our joint marketing partners include categories of companies such as insurance companies
Other important information
VT Accounts with a Vermont mailing address are automatically treated as if they have limited the sharing as described on page 1 For joint marketing we will only disclose your name contact information and information about your transactions
NV We are providing you this notice pursuant to Nevada law If you prefer not to receive marketing calls from us you may be placed on our Internal Do Not Call List by calling 1-800-945-9470 or by writing to us at PO Box 734007 Dallas TX 75373-4007
For more information contact us at the address above or email PrivacylnfoJPMChasecom with Nevada Annual Notice in the subject line You may also contact the Nevada Attorney Generals office Bureau of Consumer Protection Office of the Nevada Attorney General 555 E Washington St Suite 3900 Las Vegas NV 89101 telephone number 1-702-486-3132 email BCPINFOagstatenvus
CA Accounts with a California mailing address are automatically treated as if they have limited the sharing with nonaffiliates as described on page 1 CA residents are provided a CA notice for additional choices
CHASE O
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
The following disclosure is required by the USA PATRIOT Act
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 opens an account
What this means to you When you 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 drivers
license or other identifying documents
99177-PAT-0215
VETERAN STATEMENT When this loan was opened the US Department of Veterans Affairs (VA) used the veteran borrowerrsquos entitlement which is a set amount the VA promises to repay a lender if the borrower defaults on the mortgage An assumption will modify who is obligated to pay the existing mortgage loan but all loan termsmdashincluding the entitlementmdashwill remain the same If the veteran borrower is being removed from the loan the entitlement would remain with whoever is assuming the loan because the loan will continue to be serviced by the VA If the applicant is also a veteran and can substitute his or her entitlement for the current entitlement then the current borrowerrsquos entitlement can be released
Please review the following questions and answer as appropriate This form requires completion by both the applicant(s) and current borrower(s)
1 Applicant to Complete
Are you (the applicant) currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the reverse side)
Yes (If yes please provide the information requested below answer the question in section 3 and sign and date this form at the bottom of the reverse side)
Name of applicant(s) who answered ldquoyesrdquo to the above question
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Are you receiving VA disability benefts
Applicant
Yes
No
Co-Applicant
Yes
No
Are you entitled to receive VA disability benefts Yes No Yes No
Have you received VA disability benefts in the past Yes No Yes No
Are you a surviving spouse of a veteran who died on active duty or as the result of a service-related disability
Yes No Yes No
Do you have any VA loans Yes No Yes No
2 Current Borrower to Complete
Is the current borrowerco-borrower currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the page)
Yes (If yes please answer the question in section 3 and sign and date this form at the bottom of the page)
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
________________________________________________________________________________________________
3 Applicant and Current Borrower to Complete
If the answer to the questions in section 1 and 2 are both yes please answer the following question After yoursquove reviewed and completed this entire form please sign and date at the bottom
Applicant Current Borrower
Do you want to apply for a substitution of entitlement Yes Yes No No
In order to complete a substitution of entitlement the veteran applicant must have suffcient entitlement to substitute for that of the current borrower Contact the VA Offce of Jurisdiction for your area for more information Also before the veteran applicant can substitute entitlement on a VA loan heshe must certify that the property securing the loan will be occupied as hisher primary residence Both the applicantrsquos and current borrowerrsquos original certifcate of eligibility will be required If your sales contract is contingent upon the restoration of entitlement please contact your VA Offce of Jurisdiction for complete procedures Otherwise the substitution will be completed after the loan has been approved and closed
Date Applicant printed name Applicant signature
Date Applicant printed name Applicant signature
Date Current Borrower printed name Current Borrower signature
Date Current Borrower printed name Current Borrower signature
Forms completed by Mail Phone
For Chase use only
Interviewer signature Date
99177-VS-0215
- Assumption Application Package_41521-noscannedpages-update-4pdf
-
- 1 FM203 Cover Pagepdf
- 2 FM202 Mortgage Assumption Application Package pagepdf
- 3 The Documents Youll need to Send Uspdf
- 4 FM201 FAQpdf
- 5 FM142 CIWpdf
- 6 FM126 URLApdf
- 7 FM130 URLA Instpdf
-
- Blank Page
-
- 8 92900a Addednum to Loan Applicationpdf
- 9 FM462 Gen Authpdf
- 10 FM220 4506-Cpdf
- 11 FM153 Chase Federal Privacy Noticepdf
- 12 FM144 Info on Opening a New Accountpdf
- 13 FM152 Veteran Statementpdf
-
- Date
- Loan number
- Applicant name
- Phone1
- Loan number 1
- Loan number 2
- Other
- Other_2
- 1
- 2
- undefined_7
- Available hours
- Available hours_2
- undefined_8
- Available hours_3
- undefined_9
- Current address 1
- Neither
- Available hours_4
- Available hours_5
- undefined_10
- Available hours_6
- 1_2
- 2_2
- undefined_11
- Available hours_7
- Available hours_8
- undefined_12
- Available hours_9
- FHA Case No include any suffix
- Mortgagee Case No
- Mortgagee ID
- Sponsor ID
- Agent ID
- Name and Address of Sponsor Name and Address of Agent
- Borrowers Name Present Address include ZIP Code Property Address
- include name of subdivision lot block no ZIP Code
- Name of ThirdParty Originator
- NMLS ID of ThirdParty Originator
- s application
- ty Number
- ty Number_2
- Date Signed_2
- Date Mortgage Approved
- Date Approval Expires
- Printed Name
- Title 1
- DEs ID Number
- DEs ID Number_2
- Mortgagee
- Name of Mortgagees Representative
- Title of Mortgagees Representative
- Signature of the Mortgagees Representative
- Date_2
- Applicant names 1
- Applicant names 2
- Applicant names 3
- Loan number_2
- Date_3
- Applicant printed name
- Social Security number
- Date_4
- Applicant printed name_2
- Social Security number_2
- Date_5
- Applicant printed name_3
- Social Security number_3
- Date_6
- Applicant printed name_4
- Social Security number_4
- 1a Name shown on tax return if a joint return enter the name shown first
- 1b First social security number on tax return individual taxpayer identification number or employer identification number see instructions
- 2a If a joint return enter spouses name shown on tax return
- 2b Second social security number or individual taxpayer identification number if joint tax return
- 4 Previous address shown on the last return filed if different from line 3 see instructions
- 5a IVES participant name address and SOR mailbox ID
- Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing see instructions
- Signature see instructions
- Date_7
- Phone number of taxpayer on line 1a or 2a
- PrintType name
- Here
- Spouses signature
- Date_8
- PrintType name_2
- Name
- Date of birth
- Service number
- Name_2
- Date of birth_2
- Service number_2
- Date_9
- Applicant printed name_5
- Date_10
- Applicant printed name_6
- Date_11
- Current Borrower printed name
- Date_12
- Current Borrower printed name_2
- Date_13
- Text3
- Text10
- undefined_13
- Text15
- undefined_14
- undefined_15
- undefined_16
- undefined_17
- undefined_18
- undefined_19
- undefined_20
- undefined_21
- undefined_23
- Reason for assumption Off
- Requestors relationship to owners Off
- Check one Off
- Check one1 Off
- Day1
- Evening
- Cell phone
- Check one2 Off
- Check one3 Off
- Check one4 Off
- Check one5 Off
- Text2-1
- Text2-2
- Text2-3
- Text2-4
- Text2-5
- Text2-6
- Text3-1
- Text3-2
- Text3-3
- Text3-4
- Text3-6
- Text3-7
- Text3-8
- Text3-9
- Text3-10
- Text3-11
- Text3-12
- Text3-13
- Text3-14
- Text3-15
- Text3-16
- Text3-17
- Text3-18
- Text3-19
- Text3-20
- Text3-21
- Text3-22
- Text3-23
- Text3-24
- Text3-25
- Text3-26
- Text3-27
- Text3-28
- Text3-29
- Text3-30
- Text3-31
- Text3-32
- Text3-33
- Text3-34
- Text3-35
- Text3-36
- Text3-37
- Text3-38
- Text3-39
- Text3-40
- Text3-41
- Text3-42
- Text3-43
- Text3-44
- Text3-45
- Text3-46
- Text3-47
- Text3-48
- Text3-49
- Text3-50
- Text3-51
- Text3-52
- Text3-53
- Text3-5
- Text3-54
- Text3-55
- Text3-56
- Citizenship Off
- Type of credit Off
- Marital Status Off
- Housing Off
- Housing1 Off
- ownership Off
- DNA1 Off
- DNA2 Off
- DNA3 Off
- family Off
- BO Off
- Total
- Text31
- Text32
- Text33
- Text34
- Text35
- Text36
- Text37
- Text38
- Text39
- Text310
- Text311
- Text312
- Text313
- Text314
- Text315
- Text316
- Text317
- Text318
- Text319
- ownership1 Off
- Total1
- Total1-2
- Check Box4-1 Off
- Text320
- Text321
- Text322
- Text323
- Text324
- Text325
- Text326
- Text327
- Text328
- Text329
- Check Box4-2 Off
- Check Box4-3 Off
- Check Box4-4 Off
- Check Box4-8 Off
- Check Box4-9 Off
- Text330
- Text331
- Text332
- Text333
- Text334
- Text335
- Text1-1
- Text1-2
- Text1-3
- Text1-4
- Text1-5
- Text1-6
- Text1-7
- Text1-8
- Text1-9
- Text1-10
- Text1-11
- Text1-12
- Text1-13
- Text1-14
- Text1-15
- Text1-16
- Text1-17
- Text1-18
- Text1-19
- Text1-20
- Text1-21
- Text1-22
- Text1-23
- Text1-24
- Text1-25
- Text1-26
- Text1-27
- Text1-28
- Text1-29
- Text1-30
- Text1-31
- Text1-32
- Text1-33
- Text1-34
- Text1-35
- Check Box3-2 Off
- Check Box2-1 Off
- Check Box2-2 Off
- Check Box2-3 Off
- Check Box2-4 Off
- Check Box2-5 Off
- Text1-36
- Text1-37
- Text1-38
- Text1-39
- Text1-40
- Text1-41
- Text1-42
- Text1-43
- Text1-44
- Text1-45
- Text1-46
- Text1-47
- Text1-48
- Text1-49
- Text1-50
- Text1-51
- Text1-52
- Text1-53
- Text1-54
- Text1-55
- Text1-56
- Text1-57
- Text1-58
- Text1-59
- Text1-60
- Text1-61
- Check Box3-11 Off
- A1
- A2
- A3
- A4
- A5
- A6
- A7
- A8
- A9
- A10
- A11
- A12
- Check Box3-1 Off
- Check Box30-1 Off
- Check Box30-2 Off
- Check Box30-4 Off
- Check Box30-5 Off
- Check Box30-7 Off
- Check Box30-8 Off
- Check Box30-9 Off
- Check Box30-10 Off
- Check Box30-11 Off
- Check Box30-12 Off
- A13
- A14
- A15
- A16
- A17 Off
- A18
- A19
- A20
- A21
- A22
- A23
- A24
- A25
- A26
- A27
- A28
- A29
- A30
- A31
- A32
- A33
- A34
- A35
- A36
- A37
- A38 Off
- A39
- A40
- A41
- A42
- A43
- A44
- A45
- A46
- A47
- A48
- A49
- A50
- A51
- A52
- A53
- A54
- A55
- A56
- A57
- A58
- A59
- A60
- A61
- A62
- A63
- A64
- A65
- A66
- A67
- A68
- A69
- A70
- A71
- A72
- A73
- A74
- Loan Purpose Off
- occupancy1 Off
- lien type Off
- lientype Off
- mixed use Off
- manufactured home Off
- deposit1 Off
- deposit2 Off
- B1
- B2
- B3
- B4
- B5
- B6
- B7
- B8
- B9
- B10
- fha Off
- Check Box51 Off
- B11
- B12
- B13
- B14
- B15
- B16
- B17
- B18
- B19 Off
- B20
- B21
- B22 Off
- B23
- B24
- B25
- B26
- B27
- B28
- A
-
- Will you occupy the property as your primary residence Off
- Will you occupy the property as your primary residence1 Off
-
- If yes have you had an ownership interest in another property in the last three years Off
- Text9-2
- B
-
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property Off
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property1 Off
-
- 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 Off
- 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 application1 Off
-
- 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 Off
- 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 application1 Off
-
- new credit Off
- 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) Off
- the Property Assessed Clean Energy Program)1 Off
-
- F
-
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application Off
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application1 Off
-
- G
-
- Are there any outstanding judgments against you Off
- Are there any outstanding judgments against you1 Off
-
- H
-
- Are you currently delinquent or in default on a Federal debt Off
- Are you currently delinquent or in default on a Federal debt1 Off
-
- I
-
- Are you a party to a lawsuit in which you potentially have any personal financial liability Off
- Are you a party to a lawsuit in which you potentially have any personal financial liability1 Off
-
- J
-
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years Off
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years1 Off
-
- 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 Off
- 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 due1 Off
-
- L
-
- Have you had property foreclosed upon in the last 7 years Off
- Have you had property foreclosed upon in the last 7 years1 Off
-
- M
-
- Have you declared bankruptcy within the past 7 years Off
- Have you declared bankruptcy within the past 7 years1 Off
-
- Check Box8-2 Off
- Check Box8-3 Off
- Check Box8-4 Off
- Text9-3
- Text9-5
- Text9-6
- Text97
- military Off
- ethnicity Off
- sex Off
- race Off
- demo Off
- Text12-1
- Check Box11-1 Off
- Check Box11-2 Off
- Check Box11-3 Off
- Check Box11-4 Off
- Check Box11-5 Off
- Check Box11-6 Off
- Check Box11-7 Off
- Check Box11-8 Off
- Check Box11-9 Off
- Text12-2
- Check Box11-10 Off
- Check Box11-11 Off
- Check Box11-12 Off
- Check Box11-13 Off
- Check Box11-14 Off
- Check Box11-15 Off
- Text12-3
- Check Box11-16 Off
- Check Box11-17 Off
- Check Box11-18 Off
- Check Box11-19 Off
- Check Box11-20 Off
- Check Box11-21 Off
- Check Box11-22 Off
- Check Box11-23 Off
- Text12-4
- Check Box11-24 Off
- Check Box11-25 Off
- Check Box11-26 Off
- Check Box11-27 Off
- Check Box11-28 Off
- Check Box11-29 Off
- Text12-5
- Check Box11-30 Off
- Check Box11-31 Off
- citizen Off
- credit Off
- marital status1 Off
- housing-1 Off
- housing-2 Off
- own Off
- C1
- C2
- C3
- C6
- C7
- C8
- C9
- C10
- C11
- C12
- C13
- C14
- C15
- C16
- C17
- C18
- C19
- C20
- C21
- C22
- C23
- C24
- C25
- C26
- C27
- C28
- C29
- C30
- C31
- C32
- C33
- C34
- C35
- Check Box-2 Off
- C36
- C37
- C38
- C39
- C4
- C40
- C41
- C42
- C43
- C44
- C45
- C46
- C47
- Check Box-3 Off
- Check Box-4 Off
- C48
- C49
- C5
- C50
- C51
- C52
- C53
- C54
- C55
- Check Box-1-1 Off
- own1 Off
- Check Box-1 Off
- D1 Off
- D2
- D3
- D4
- D5
- D6
- D7
- D8
- D9
- D10
- D11
- D12
- D13
- D14 Off
- D15 Off
- D16
- D17
- D18
- D19
- D20
- D21
- D22
- D23
- D24 Off
- D25
- D26
- D27
- D28
- D29
- D30
- D31
- D32
- D33
- D34
- D35 Off
- D36
- D37 Off
- D38
- D39
- D40
- D41
- D42
- D43
- D44
- D45
- D46
- D47
- If yes have you had an ownership interest in another property in the last three years1 Off
- new credit1 Off
- Check Box8-1 Off
- Check Box8-1-2 Off
- Check Box8-1-1 Off
- Check Box8-1-3 Off
- Check Box8-1-4 Off
- Military Service mdash Did you (or your deceased spouse) ever serve or are you currently serving in the United States Armed Forces 1 Off
- Check1 Off
- Text9-1-1
- Check2 Off
- Check3 Off
- Check4 Off
- Text9-1
- E1
- E2
- E3
- Was the ethnicity of the Borrower collected on the basis of visual observation or surname1 Off
- Was the sex of the Borrower collected on the basis of visual observation or surname1 Off
- Was the race of the Borrower collected on the basis of visual observation or surname1 Off
- The Demographic Information was provided through1 Off
- F1 Off
- F2 Off
- F3 Off
- F4 Off
- F5 Off
- F6
- F7 Off
- F8 Off
- F9 Off
- F10 Off
- F11 Off
- F12 Off
- F13
- F14 Off
- F15 Off
- F16 Off
- F17 Off
- F18 Off
- F19 Off
- F20 Off
- F21 Off
- F22
- F23 Off
- F24 Off
- F25 Off
- F26 Off
- F27 Off
- F28 Off
- F29
- F30 Off
- F31 Off
- undefined_13-1
- undefined_13-2
- undefined_14-1
- undefined_15-1
- undefined_16-1
- undefined_17-1
- undefined_18-1
- undefined_19-1
- undefined_21-1
- undefined_20-1
- undefined_23-1
- undefined_13_1
- Single-Two Off
- Refi type Off
- refi program Off
- Estate Off
- Title held Off
- Trust Information Off
- Indian Country Land Tenure Off
- Mortgage Type Applied For Off
- Mortgage Lien Type Off
- Amortization Type Off
- G1 Off
- G2 Off
- G3 Off
- G4 Off
- G5 Off
- G6
- G7
- G8
- G9
- G10 Off
- G11 Off
- G12 Off
- G13 Off
- G14 Off
- G15 Off
- G16
- G17
- G18
- G19
- G20
- G21
- G22
- G23 Off
- G24
- G25 Off
- G26
- G27 Off
- G28 Off
- G29
- G30 Off
- G31
- G32 Off
- G33
- G34
- G35
- G36
- G37
- G38
- G39
- G40
- G41
- G42
- Property Held
- refi
- Text18-1
- Text18-2
- Text18-3
- Text18-4
- Text18-5
- Text18-6
- Text18-7
- Text18-8
- Text18-9
- Text18-10
- Text18-11
- Text18-12
- Text18-13
- Text18-14
- Text18-15
- Text18-16
- Text18-17
- Text18-18
- Text18-19
- Lender
- case no
- If you selected ldquoUnmarriedrdquo in Section 1 is there a person who is not your legal spouse but who currently has real property rights similar to those of a legal spouse Off
- Relationship and State Off
- Other-5
- Text19-1
- BName
- Additional Information
- ABN
- Additional Information1
- BSign
- BSDate
- ABSign
- ABDate
- MortageeNameAddress
- NAmeAddress
- Bname1
- DOB1
- DOB2
- SignOfBorr1
- SignOfBorr
- Date Signed
- SignOfBorr2
- SignOfBorr3
- Date Signed3
- Date Signed4
- MortgageeRepSign
- DirectSign
- DirectSign1
- Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union Off
- AppSign
- AppSign1
- AppSign2
- AppSign3
- Nopage38 Off
- Yespage38 Off
- Yes1 Off
- No1 Off
- Yes2 Off
- Yes3 Off
- Yes4 Off
- Yes5 Off
- Yes6 Off
- Yes7 Off
- Yes8 Off
- Yes9 Off
- Yes10 Off
- No2 Off
- No3 Off
- No4 Off
- No5 Off
- No6 Off
- No7 Off
- No8 Off
- No9 Off
- No10 Off
- BorrowerNo Off
- BorrowerYes Off
- AppSignature
- AppSignature1
- CurrentSign
- CurrentSign1
- InterviewSign
- Yes_1 Off
- No_1 Off
- Yes_2 Off
- No_2 Off
- Mail Off
- Phone Off
Pe)aae-emeet)
Community Property State
At least one borrowerlives in a community propertystateThe property is in a community property state
Transaction DetailConversion of Contract for Deed or Land ContractRenovationConstruction-ConversionConstruction-to-Permanent
Single-Closing Two-ClosingConstructionImprovementCosts $
LotAcquired Date
Original Cost of Lot $(mmddyyyy)
Refinance Program
Full DocumentationInterest Rate ReductionStreamlined without Appraisal
Other
Refinance Type
NoCash OutLimited Cash OutCash Out
Energy Improvement
Mortgageloanwill finance energy-related improvements
Propertyis currently subject to a lien that could take priority ovethe first mortgagelien such as a clean energylien paid for througproperty taxes(eg the PropertyAssessed Clean Energyprogram)
Project Type Condominium Cooperative Planned Unit Development (PUD) Propertyis notlocatedin a project
Peiwlivcestetece)a)
Title to the Property Will be Held in What Name(s)
For RefinanceTitle to the Property is Currently Held in What Name(s
Trust Information
tle Will be Held byan Inter Vivos (Living) Trust
Title Will be Held by a Land TrustLeasehold Expiration Date
Mannerin WhichTitle Will be Held Indian Country Land Tenure
Sole OwnershipLife EstateTenancy in Common
Joint Tenancywith Right of Survivorship]Tenancybythe EntiretyOther
Fee Simple Ona ReservationIndividualTrust Land (AllottedRestricted)Tribal Trust Land On a ReservationTribal Trust Land Off ReservationAlaska Native Corporation Land
Estate Will be Held in
Fee Simple(mmddyyyy)
3 Mortgage LoanInformation
Termsof Loan
Note Rate
Loan Term (months)
MortgageLien Type
First LienSubordinate Lien
Mortgage Type Applied For
Conventional USDA-RDFHA VA Other
Amortization Type
Fixed RateAdjustable Rate
If Adjustable Rate
Initial Period Prior to First Adjustment
Subsequent AdjustmentPeriod
Proposed Monthly Paymentfor Property
First Mortgage (P amp I) $
Subordinate Lien(s) (P amp |) $
Other(explain)
Homeowners Insurance $(months)
(months)
Loan Features Property Taxes $
Balloon Balloon Term (months)
Interest Only Interest OnlyTermNegative AmortizationPrepaymentPenalty Prepayment Penalty Term (months) Other
Temporary Interest Rate BuydownInitial Buydown Rate TOTALOther(explain)
Mortgage Insurance $
AssociationProject Dues (Condo Co-Op PUD) $
Supplemental Property Insurance $
(months)
Borrower Name(s)Uniform Residential Loan Application mdash LenderLoan Information
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
L4 Qualifying the Borrower - Minimum Required Funds or Cash Back
DUEFROM BORROWER(S)
A Sales Contract Price
B Improvements Renovations and Repairs
C Land(ifacquired separately)
D For Refinance Balance of Mortgage Loanson the Propertyto be paid off in the Transaction
(See Table 3a Property You Own)
E Credit Cards and Other Debts Paid Off
(See Table 2c Liabilities mdash Credit Cards Other Debts and Leases that You Owe)
F BorrowerClosing Costs (including Prepaid andInitial Escrow Payments)
G Discount Points
HTOTAL DUE FROM BORROWER(s)(Total of A thru G)
TOTALMORTGAGE LOANS
Loan Amount
Loan AmountExcluding Financed Mortgage Insurance (or Mortgage Insurance Equivalent) $
Financed Mortgage Insurance (or Mortgage Insurance Equivalent) Amount $
Other New Mortgage Loanson the Property the Borrower(s) is Buying or Refinancing(See Table 4b Other New MortgageLoanson the Property You are Buying or Refinancing)
KTOTAL MORTGAGELOANS(Totalof| and J)
TOTALCREDITS
L Seller Credits (Enter the amountofBorrower(s) costs paid by the property seller)
MOtherCredits (Enter the sum ofall other credits mdash BorrowerPaid Fees Earnest Money EmployerAssistedHousing Lease Purchase Fund Lot Equity Relocation Funds Sweat Equity Trade Equity Other)
NTOTAL CREDITS(Total of L and M)
CALCULATION
TOTAL DUE FROM BORROWER(s)(Line H)
LESSTOTAL MORTGAGELOANS(Line K) AND TOTAL CREDITS(Line N)
Cash FromTothe Borrower(Line H minusLine K and Line N)NOTE This amountdoesnotinclude reservesor other funds that may be required by the Lenderto be verified
Borrower Name(s)Uniform Residential Loan Application mdash LenderLoan Information
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
Uniform Residential Loan Application mdash Unmarried Addendum
eeCeceetatimC elitleeComeLy
Lenders Instructions for Using the Unmarried Addendum
The Lender may use the Unmarried Addendum only when a Borrowerselected ldquoUnmarriedrdquoin Section 1 and the information collected is
necessary to determine howState property lawsdirectly or indirectly affecting creditworthiness apply including ensuring clear title
For example the Lender may use the Unmarried Addendum whentheBorrowerresides in a State that recognizescivil unions domestic
partnerships or registered reciprocal beneficiary relationships or when the property is located in such a State ldquoStaterdquo meansanystate the
District of Columbia the Commonwealth of Puerto Rico or anyterritory or possession of the United States
Ifyou selected ldquoUnmarriedrdquoin Section 1 is there a person whois not your legal spouse but whocurrently has real property rights similar to
those of a legal spouse +=) NOQ YES
If YES indicate the type of relationship and the State in which the relationship was formed For example indicate if you are in a
civil union domestic partnership registered reciprocal beneficiary relationship or other relationship recognized by the State in which you
currently reside or where the property is located
O Civil Union copy Domestic Partnership copy Registered Reciprocal Beneficiary Relationship copy) Other(explain)
Statea]
Borrower NameUniform Residential Loan Application mdash Unmarried Addendum
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Uniform Residential Loan Application mdash Continuation Sheet
Use this continuation sheet if you need more space to complete the Uniform Residential Loan Application
Borrower Name(First Middle Last Suffix )
Additional Information
Additional Borrower Name(First Middle Last Suffix )
Additional Information
IWefully understand thatit is a federal crime punishable by fine or imprisonment or both to knowingly make anyfalse statements concerningany of the abovefacts as applicable underthe provisions of federal law (18 USC sectsect 1001 et seq)
BorrowerSignature Date (mmddyyyy)
Additional Borrower Signature Date (mmddyyyy)
Uniform Residential Loan Application mdash Continuation SheetFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
INSTRUCTIONS FOR COMPLETING THE UNIFORM RESIDENTIAL LOAN APPLICATION
Use the instructions below to complete the enclosed Uniform Residential Loan Application (Freddie Mac Form 65Fannie Mae Form 1003) To avoid any delays in your application review please provide all of the requested information
If you need to make a correction on the application draw a line through the incorrect text and mark your initials beside the change Donrsquot use correction tape or fluid The application must be completed signed and dated in ink
The Uniform Residential Loan Application (URLA)
The URLA contains the following sections Section 1 Borrower Information Please provide your personal information income and employment
Section 2 Financial Information ndash Assets and Liabilities Please provide information about your financial assets personal financial obligations and debts you owe
Section 3 Financial Information ndash Real Estate Please provide information about property you own and the debts and expenses related to the property
Section 4 Loan and Property Information Please provide information about the loan purpose and the property you are buying or refinancing
Section 5 Declarations Please answer questions about the property how the property will be financed and your past financial history
Section 6 Acknowledgments and Agreements Informs you of your legal obligations related to the mortgage application and asks that you acknowledge certain information will be obtained used and shared
Section 7 Military Service Please provide information about your (or your deceased spousersquos) military service
Section 8 Demographic Information Requests information the Lender is required by law to ask you
Section 9 Loan Originator Information Will be completed by Chase
Uniform Residential Loan Application ndash Additional Borrower
The URLA ndash Additional Borrower contains the following sections Section 1 Borrower Information This is the same as the Borrower Information section of the URLA
Section 2 Financial Information ndash Assets and Liabilities Contains only the following statement for the additional Borrower to complete ldquoMy information for Section 2 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo The name of the other borrower is entered here
Complete a separate URLA for each BorrowermiddotThree or more Borrowers ndash Use any combination of URLA and URLA-Additional Borrower forms in accordance with the above examples
Section 3 Financial Information ndash Real Estate Contains only the following statement for the additional borrower to complete ldquoMy information for Section 3 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 4 Loan and Property Information Contains only the following statement for the additional borrower to complete ldquoMy information for Section 4 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 5 Declarations This is the same as the Declarations section of the URLA
Section 6 Acknowledgments and Agreements Contains only the following statement for the additional borrower to complete ldquoMy signature for Section 6 is on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 7 Military Service This is the same as the Military Service section of the URLA
Section 8 Demographic Information This is the same as the Demographic Information section on the URLA
Section 9 Loan Originator Information This is the same as the Loan Originator Information section of the URLA
Using the URLA and URLA ndash Additional Borrower Together The URLA and the URLA ndash Additional Borrower are used together to collect information for two Borrowers who have joint assets liabilities andor real estate information The URLA and URLA ndash Additional Borrower can also be used for Borrowers who do not have joint information but wish to combine their information on the URLA for ease of use Here are examples of how to use the URLA and URLA ndash Additional Borrower
For one borrower Complete the URLA
For two borrowers with joint financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you dont need to duplicate them on more than one URLA or o In cases where Borrowers are not collaborating when completing the loan application
joint assets liabilities and real estate may be duplicated on each URLA bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you do not need to duplicate them on more than one URLA or
o In cases where Borrowers are not collaborating when completing the loan application joint assets liabilities and real estate may be duplicated on each URLA
For two borrowers with separate financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower Report the assets liabilities and
real estate for the additional Borrower on the URLA or bull Complete a separate URLA for each Borrower
For three or more borrowers use any combination of URLA and URLA ndash Additional Borrower forms described for two borrowers
Uniform Residential Loan Application ndash Unmarried Addendum If any borrower listed on the URLA or URLA ndash Additional Borrower form selects Unmarried in Section 1 (Personal Information) the lender will complete this optional form
The information must be collected to determine how to apply state property laws that directly or indirectly affect creditworthiness including ensuring clear title
Uniform Residential Loan Application ndash Continuation Sheet Use the URLA ndash Continuation Sheet if you need more space to complete either the URLA or URLA ndash Additional Borrower forms
99177-URLAI-0215
HUD Addendum to Uniform Residential Loan Application OMB Approval No HUD 2502-0059 (exp )
Part I - Identifying Information HUDFHA Application for Insurance under the National Housing Act and Borrower Certification
FHA Case No (include any suffix) Mortgagee Case No
Mortgagee ID Sponsor ID Agent ID
Mortgagee Name Address (include ZIP Code) and Telephone Number
Type or print all entries clearly
Name and Address of Sponsor Name and Address of Agent
Borrowers Name amp Present Address (include ZIP Code) Property Address (include name of subdivision lot amp block no amp ZIP Code)
Sponsored Originations
Name of Third-Party Originator NMLS ID of Third-Party Originator
Part II - Borrower Consent for Social Security Administration to Verify Social Security Number I authorize the Social Security Administration (SSA) to verify my Social Security Number (SSN) to the Mortgagee and HUDFHA I authorize SSA to provide explanatory
information to HUDFHA in the event of a discrepancy This consent is valid for 180 days from the date signed unless indicated otherwise by the individual(s) named in this
loan application
Signature(s) of Borrower(s) - Read consent carefully Review accuracy of Social Security Number(s) provided on this application
Borrowerrsquos NameDate of BirthSocial Security Number
Co-Borrowerrsquos Name Date of BirthSocial Security Number
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
Part III - Borrower Notices Information and Acknowledgment Public Reporting Burden
Public reporting burden for this collection of information is estimated to average 10 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 conduct or sponsor and a person is not
required to respond to a collection of information unless that collection displays a valid OMB control number which can be located on the OMB Internet page at
httpwwwreginfogovpublicdoPRAMain
Privacy Act Information
The information requested on the Uniform Residential Loan Application and this Addendum is authorized by the National Housing Act of 1934 12 USC sect 1701 et seq The Debt
Collection Act of 1982 Pub L 97-365 and HUDrsquos Housing and Community Development Act of 1987 42 USC sect 3543 require persons applying for a federally insured loan to
furnish their SSN You must provide all the requested information including your SSN HUD may conduct a computer match to verify the information you provide HUD may
disclose certain information to Federal State and local agencies when relevant to civil criminal or regulatory investigations and prosecutions It will not otherwise be disclosed or
released outside of HUD except as required and permitted by law The information will be used to determine whether you qualify as a mortgagor Failure to provide any of the
requested information including SSN may result in disapproval of your loan application This is notice to you as required by the Right to Financial Privacy Act of 1978 that
HUDFHA has a right of access to financial records held by financial institutions in connection with the consideration or administration of assistance to you Financial records
involving your transaction will be available to HUDFHA without further notice or authorization but will not be disclosed or released by the institution to another Government Agency
or Department without your consent except as required or permitted by law
WARNING This warning applies to all certifications made in this document Anyone who knowingly submits a false claim or makes false statements is subject to criminal and civil penalties including confinement for up to 5 years fines and civil penalties 18 USC sectsect 287 1001 and 31 USC sect 3729
orm HUD-92900-A ( ) Page 1
Borrower Name ____________________________ FHA Case No __________________
Caution Delinquencies Defaults Foreclosures and Abuses Delinquencies defaults foreclosures and abuses of mortgage loans involving programs of the Federal Government can be costly and detrimental to your credit now and in the future The Mortgagee in this transaction its agents and assigns as well as the Federal Government its agencies agents and assigns are authorized to take any and all of the following actions in the event loan payments become delinquent on the mortgage loan described in the attached application (1) Report your name and account information to a credit bureau (2) Assess additional interest and penalty charges for the period of time that payment is not made (3) Assess charges to cover additional administrative costs incurred by the Federal Government to service your account (4) Offset amounts owed to you
under other Federal programs (5) Refer your account to a private attorney collection agency or mortgage servicing agency to collect the amount due foreclose
the mortgage sell the property and seek judgment against you for any deficiency (6) Refer your account to the Department of Justice (DOJ) for litigation in the
courts (7) If you are a current or retired Federal employee take action to offset your salary or civil service retirement benefits (8) Refer your debt to the Internal
Revenue Service for offset against any amount owed to you as an income tax refund and (9) Report any resulting written off debt of yours to the Internal Revenue Service as your taxable income All of these actions may be used to recover any debts owed when it is determined to be in the interest of the Mortgagee or Federal Government or both
As a mortgage loan borrower you will be legally obligated to make the mortgage payments called for by your mortgage loan contract The fact that you dispose of your property after the loan has been made will not relieve you of liability for making these payments Payment of the loan in full is ordinarily the way liability on a mortgage note is ended Some home buyers have the mistaken impression that if they sell their homes when they move to another locality or dispose of it for any other reasons they are no longer liable for the mortgage payments and that liability for these payments is solely that of the new owners Even though the new owners may agree in writing to assume liability for your mortgage payments this assumption agreement will not relieve you from liability to the holder of the note which you signed when you obtained the loan to buy the property Unless you are able to sell the property to a buyer who is acceptable to HUDFHA who will assume the payment of your obligation to the lender you will not be relieved from liability to repay any claim which HUDFHA may be required to pay your lender on account of default in your loan payments The amount of any such claim payment may be a debt owed by you to the Federal Government and subject to established collection procedures
Fair Housing Act I and anyone acting on my behalf are and will remain in compliance with the Fair Housing Act 42 USC sect 3604 et seq with respect to the dwelling or property covered by the loan and in the provision of services or facilities in connection therewith I recognize that any restrictive covenant on this property related to race color religion sex disability familial status or national origin is unlawful under the Fair Housing Act and unenforceable I further recognize that in addition to administrative action by HUD a civil action may be brought by the DOJ in any appropriate US court against any person responsible for a violation of the
applicable law
Certification and Acknowledgment All information in this application is given for the purpose of obtaining a loan to be insured under the National Housing Act and the information in the Uniform Residential Loan Application and this Addendum is true and complete to the best of my knowledge and belief Verification may be obtained from any source named herein I have read and understand the foregoing concerning my liability on the loan and Part III Borrower Notices Information and Acknowledgment
Signature(s) of Borrower(s) - Do not sign unless this application is fully completed Read the certification carefully and review accuracy of this application
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
orm HUD-92900-A ( Page 2
___________________________________
______________________________________________________
______________________________________________________________
- - - - - - - - - - - - - - - - - - - - - - -
Borrower Name ____________________________ FHA Case No __________________
Part IV - Direct Endorsement Approval for a HUD FHA-Insured Mortgage A Underwriting the Borrower
Date Mortgage Approved ______________________________ Date Approval Expires ______________________
For mortgages rated as an ldquoacceptrdquo or ldquoapproverdquo by FHAs TOTAL Mortgage Scorecard
The information submitted to TOTAL was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA4e Final Underwriting Decision (TOTAL) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee Representative Signature
Printed Name
Title
OR
For mortgages rated as a ldquoreferrdquo by FHAs TOTAL Mortgage Scorecard or manually underwritten by a Direct Endorsement underwriter I have personally reviewed and underwritten the borrowerrsquos credit application The information used to underwrite the borrower was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA5d Final Underwriting Decision (Manual) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
B Underwriting the Property
For all mortgages where FHA requires an appraisal I have personally reviewed and underwritten the appraisal according to FHA requirements I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
orm HUD-92900-A ( ) Page 3
Borrower Name ____________________________ FHA Case No __________________
Part V Mortgagees Certification
I have personally reviewed the mortgage documents and the application for insurance endorsement and This mortgage complies with SF Handbook 40001 Section IIA7 Post-Closing and Endorsement to the extent that no defect exists that would have changed the decision to endorse or submit the mortgage for insurance
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee
Name of Mortgageersquos Representative
Title of Mortgageersquos Representative
Signature of the Mortgageersquos Representative Date
orm HUD-92900-A ( ) Page 4
GENERAL AUTHORIZATION FOR A MORTGAGE LOAN ASSUMPTION
Applicant name(s)
Loan number
NOTICES AND DISCLOSURES
Non-discriminatory underwriting guidelines Anyone who inquires about the availability of credit from us has the right to receive a copy of our non-discriminatory underwriting guidelines To request a copy of these guidelines contact your Loan Processor
Attorney note Itrsquos the responsibility of our attorneys to protect our interest You may at your expense request an attorney to represent your interest
Notice to HUDFHA applicants As required by the Right to Financial Privacy Act of 1978 this notice is to inform you that the US Department of Housing and Urban Development (HUD)Federal Housing Administration (FHA) has a right of access to financial records held by financial institutions related to a request for assistance Financial records involving your assumption will be available to HUDFHA without further notice or authorization but wonrsquot be disclosed or released by us to another government agency or department without your consent except as required or permitted by law
Borrower consent to the use of tax return information I understand acknowledge and agree that the Lender and Other Loan Participants can obtain use and share tax return information for purposes of (i) providing an offer (ii) originating maintaining managing monitoring servicing selling insuring and securitizing a loan (iii) marketing or (iv) as otherwise permitted by applicable laws including state and federal privacy and data security laws The Lender includes the Lenderrsquos affiliates agents service providers and any of aforementioned partiesrsquo successors and assigns The Other Loan Participants includes any actual or potential owners of a loan resulting from your loan application or acquirers of any beneficial or other interest in the loan and mortgage insurer guarantor any servicers or service providers for these parties and any of aforementioned partiesrsquo successors and assigns
CERTIFICATION AND AUTHORIZATION
Environmental certification By signing below I represent and warrant that Irsquom not aware of any substances materials or products that may be an environmental hazard such as but not limited to asbestos formaldehyde radon gas lead-based paint fuel or chemical storage tanks (above or below ground) and contaminated soil or water on the property I acknowledge that Chase is relying on this representation and warranty as a material part of its loan application process I also am not aware of any landfill on any portion of the property
Exceptions to the above I further acknowledge (1) receipt of applicable disclosures from the seller in purchase transactions (2) that lead-based paint may exist in housing constructed prior to 1978 (3) that Chase performs no environmental investigation on my behalf and isnrsquot responsible for identifying lead-based paint or any other environmental conditions that might impact the property or its residents and (4) that it is my sole obligation to investigate for potential impact to the property from environmental conditions
Certifications I certify by signing below that (1) all of the loan application information provided is true and complete (2) I understand any intentional or negligent misrepresentation(s) of the information provided in conjunction with my application may result in civil liability andor 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 Chase its agents successors and assigns insurers and any other person who may suffer any loss due to reliance upon any misrepresentation that I have made on the application and (3) any significant change from the information provided at the time of application until the final loan application is signed may have a bearing on the approval of my application for a home loan
Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union
This question is asked because of state laws that extend the same or similar rights benefits and protections of spouses in a marriage to persons who are members of a partnership or union recognized under state law You should consult with your own legal advisor for advice regarding the rights protections benefits responsibilities obligations and duties of those who are registered domestic partners civil union partners or members of other unions recognized under applicable law
CREDIT AUTHORIZATION RELEASE
By signing below I authorize Chase andor my mortgage insurer (if any) to verify my past and present employment earnings records (including information contained in income tax returns that have been filed with the IRS) bank accounts stock holdings and any other information that it finds necessary to process my mortgage loan application or to review it for quality-control purposes I understand that a credit report will be ordered from a credit reporting agency for verification prior to loan closing as part of the application process and may be ordered after closing as part of the Lenderrsquos quality-control program A credit report may also be completed as part of the Lenderrsquos servicing or collection of the loan or in consideration of any other product or service that the Lender may consider offering me in the future and at any time throughout the life of the loan I understand that use of a photocopy of this form may be necessary to verify one or more of my credit references I understand that a photocopy or fax copy of this form will also serve as authorization
By signing below each applicant acknowledges (1) making the above certifications and authorizations and (2) that each applicant has received and understands the above notices and disclosures
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
You do not have to give us this information but if you donrsquot your application for approval as a borrower may be delayed or rejected The information requested in this form is authorized by Title 38 USC Chapter 37 (if VA) by 12 USC Section 1701 et seq (if HUDFHA) by 42 USC Section 1452b (if HUDCPD) and Title 42 USC 1471 et seq or 7 USC 1921 et seq (if USDA FHA)
Updated December 2021 99177-GA-0215
1b
2b
Form 4506-C (September 2020)
Department of the Treasury - Internal Revenue Service
IVES Request for Transcript of Tax Return OMB Number
1545-1872
Do not sign this form unless all applicable lines have been completed Request may be rejected if the form is incomplete or illegible
For more information about Form 4506-C visit wwwirsgov and search IVES
1a Name shown on tax return (if a joint return enter the name shown first)
First social security number on tax return individual taxpayer identification number or employer identification number (see instructions)
2a If a joint return enter spousersquos name shown on tax return Second social security number or individual taxpayer identification number if joint tax return
3 Current name address (including apt room or suite no) city state and ZIP code (see instructions)
4 Previous address shown on the last return filed if different from line 3 (see instructions)
5a IVES participant name address and SOR mailbox ID
DataVerify 875 Greentree Rd 8 Parkway Center Pittsburgh PA 15220
5b Customer file number (if applicable) (see instructions)
Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing (see instructions)
6 Transcript requested Enter the tax form number here (1040 1065 1120 etc) and check the appropriate box below Enter only one tax form number per request 1040
a Return Transcript which includes most of the line items of a tax return as filed with the IRS A tax return transcript does not reflect changes made to the account after the return is processed Transcripts are only available for the following returns Form 1040 series Form 1065 Form 1120 Form 1120-A Form 1120-H Form 1120-L and Form 1120S Return transcripts are available for the current year and returns processed during the prior 3 processing years
b Account Transcript which contains information on the financial status of the account such as payments made on the account penalty assessments and adjustments made by you or the IRS after the return was filed Return information is limited to items such as tax liability and estimated tax payments Account transcripts are available for most returns
c Record of Account which provides the most detailed information as it is a combination of the Return Transcript and the Account Transcript Available for current year and 3 prior tax years
7 Form W-2 Form 1099 series Form 1098 series or Form 5498 series transcript The IRS can provide a transcript that includes data from these information returns State or local information is not included with the Form W-2 information The IRS may be able to provide this transcript information for up to 10 years Information for the current year is generally not available until the year after it is filed with the IRS For example W-2 information for 2016 filed in 2017 will likely not be available from the IRS until 2018 If you need W-2 information for retirement purposes you should contact the Social Security Administration at 1-800-772-1213
Caution If you need a copy of Form W-2 or Form 1099 you should first contact the payer To get a copy of the Form W-2 or Form 1099 filed with your return you must use Form 4506 and request a copy of your return which includes all attachments
8 Year or period requested Enter the ending date of the tax year or period using the mmddyyyy format (see instructions)
12 31 2020 12 31 2019 12 31 2018 Caution Do not sign this form unless all applicable lines have been completed
Signature of taxpayer(s) I declare that I am either the taxpayer whose name is shown on line 1a or 2a or a person authorized to obtain the tax information requested If the request applies to a joint return at least one spouse must sign If signed by a corporate officer 1 percent or more shareholder partner managing member guardian tax matters partner executor receiver administrator trustee or party other than the taxpayer I certify that I have the authority to execute Form 4506-C on behalf of the taxpayer Note This form must be received by IRS within 120 days of the signature date
Signatory attests that heshe has read the attestation clause and upon so reading declares that heshe has the authority to sign the Form 4506-C See instructions
Sign Here
Signature (see instructions) Date Phone number of taxpayer on line 1a or 2a
PrintType name
Title (if line 1a above is a corporation partnership estate or trust)
Spousersquos signature Date
PrintType name
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020) For Privacy Act and Paperwork Reduction Act Notice see page 2
Instructions for Form 4506-C IVES Request for Transcript of Tax Return
Section references are to the Internal Revenue Code unless otherwise noted
Future Developments
For the latest information about Form 4506-C and its instructions go to wwwirsgov and search IVES Information about any recent developments affecting Form 4506-C (such as legislation enacted after we released it) will be posted on that page
Whats New Form 4506-C was created to be utilized by authorized IVES participants to order tax transcripts with the consent of the taxpayer
General Instructions
Caution Do not sign this form unless all applicable lines have been completed
Designated Recipient Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information received pursuant to the taxpayerrsquos consent and holds the recipient subject to penalties for any unauthorized access other use or redisclosure without the taxpayerrsquos express permission or request
Taxpayer Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information provided pursuant to your consent and holds the recipient subject to penalties brought by private right of action for any unauthorized access other use or redisclosure without your express permission or request
Purpose of form Use Form 4506-C to request tax return information through an authorized IVES participant You will designate an IVES participant to receive the information on line 5a
Note If you are unsure of which type of transcript you need check with the party requesting your tax information
Where to file The IVES participant will fax Form 4506-C with the approved IVES cover sheet to their assigned Service Center
Chart for ordering transcripts
If your assigned Service Center is
Fax the requests with the approved coversheet to
Austin Submission Processing Center
Austin IVES Team
844-249-6238
Fresno Submission Processing Center
Fresno IVES Team
844-249-6239
Kansas City Submission Processing Center
Kansas City IVES Team
844-249-8128
Ogden Submission Processing Center
Ogden IVES Team
844-249-8129
Specific Instructions
Line 1b Enter the social security number (SSN) or individual taxpayer identification number (ITIN) for the individual listed on line 1a or enter the employer identification number (EIN) for the business listed on line 1a
Line 3 Enter your current address If you use a PO box include it on this line
Line 4 Enter the address shown on the last return filed if different from the address entered on line 3
Note If the addresses on lines 3 and 4 are different and you have not changed your address with the IRS file Form 8822 Change of Address or Form 8822-BChange of Address or Responsible Party mdash Business with Form 4506-C
Line 5b Enter up to 10 numeric characters to create a unique customer file number that will appear on the transcript The customer file number cannot contain an SSN ITIN or EIN Completion of this line is not required
Note If you use an SSN name or combination of both we will not input the information and the customer file number will reflect a generic entry of 9999999999 on the transcript
Line 8 Enter the end date of the tax year or period requested in mmddyyyy format This may be a calendar year fiscal year or quarter Enter each quarter requested for quarterly returns Example Enter 12312018 for a calendar year 2018 Form 1040 transcript
Signature and date Form 4506-C must be signed and dated by the taxpayer listed on line 1a or 2a The IRS must receive Form 4506-C within 120 days of the date signed by the taxpayer or it will be rejected Ensure that all applicable lines including lines 5a through 8 are completed before signing
You must check the box in the signature area to acknowledge you have the authority to sign and request the information The form will not be processed if unchecked
Individuals Transcripts listed on on line 6 may be furnished to either spouse if jointly filed Only one signature is required Sign Form 4506-C exactly as your name appeared on the original return If you changed your name also sign your current name
Corporations Generally Form 4506-C can be signed by
(1) an officer having legal authority to bind the corporation (2) any person designated by the board of directors or other governing body or (3) any officer or employee on written request by any principal officer and attested to by the secretary or other officer A bona fide shareholder of record owning 1 percent or more of the outstanding stock of the corporation may submit a Form 4506-C but must provide documentation to support the requesters right to receive the information
Partnerships Generally Form 4506-C can be signed by any person who was a member of the partnership during any part of the tax period requested on line 8
All others See section 6103(e) if the taxpayer has died is insolvent is a dissolved corporation or if a trustee guardian executor receiver or administrator is acting for the taxpayer
Note If you are Heir at law Next of kin or Beneficiary you must be able to establish a material interest in the estate or trust
Documentation For entities other than individuals you must attach the authorization document For example this could be the letter from the principal officer authorizing an employee of the corporation or the letters testamentary authorizing an individual to act for an estate
Signature by a representative A representative can sign Form 4506-C for a taxpayer only if the taxpayer has specifically delegated this authority to the representative on Form 2848 line 5 The representative must attach Form 2848 showing the delegation to sign Form 4506-C
Privacy Act and Paperwork Reduction Act Notice We ask for the information on this form to establish your right to gain access to the requested tax information under the Internal Revenue Code We need this information to properly identify the tax information and respond to your request You are not required to request any transcript if you do request a transcript sections 6103 and 6109 and their regulations require you to provide this information including your SSN or EIN If you do not provide this information we may not be able to process your request Providing false or fraudulent information may subject you to penalties
Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and cities states the District of Columbia and US commonwealths and possessions for use in administering their tax laws We may also disclose this information to other countries under a tax treaty to federal and state agencies to enforce federal nontax criminal laws or to federal law enforcement and intelligence agencies to combat terrorism
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law Generally tax returns and return information are confidential as required by section 6103
The time needed to complete and file Form 4506-C will vary depending on individual circumstances The estimated average time is
Learning about the law or the form 10 min Preparing the form 12 min Copying assembling and sending the form to the IRS 20 min
If you have comments concerning the accuracy of these time estimates or suggestions for making Form 4506-C simpler we would be happy to hear from you You can write to
Internal Revenue Service Tax Forms and Publications Division 1111 Constitution Ave NW IR-6526 Washington DC 20224
Do not send the form to this address Instead see Where to file on this page
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020)
Rev April 2021 CHASEO Facts What does Chase do with your personal information
Why Financial companies choose how they share your personal information Federal law gives consumers the right to limit some but not all sharing Federal law also requires us to tell you how we collect share and protect your personal information Please read this notice carefully to understand what we do
What The types of personal information we collect and share depend on the product or service you have with us This information can include bull Social Security number and income bull account balances and transaction history bull credit history and payment history
How All financial companies need to share customers personal information to run their everyday business In the section below we list the reasons financial companies can share their customers personal information the reasons Chase chooses to share and whether you can limit this sharing
Reasons we can share your personal information Does Chase share
Can you limit this sharing
For our everyday business purposes - such as to process your transactions maintain your account(s) respond to court orders and legal investigations or report to credit bureaus
Yes No
For our marketing purposes - to offer our products and services to you
Yes No
For joint marketing with other financial companies Yes No
For our affiliates everyday business purposes - information about your transactions and experiences
Yes No
For our affiliates everyday business purposes - information about your creditworthiness
Yes Yes
For our affiliates to market to you Yes Yes
For nonaffiliates to market to you Yes Yes
a
0
To limit our sharing
bull Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
bull Visit us online chasecomprivacypreferences
Please note If you are a new customer we can begin sharing your information 30 days from the date we sent this notice When you are no longer our customer we continue to share your information as described in this notice However you can contact us at any time to limit our sharing
Questions
Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
PAGE 2
Who we are
Who is providing this notice The US consumer financial companies within the JPMorgan Chase amp Co family including JPMorgan Chase Bank NA Chase Insurance Agency Inc and JP Morgan Securities LLC
What we do
How does Chase protect my To protect your personal information from unauthorized access and use we personal information use security measures that comply with federal law These measures include
computer safeguards and secured files and buildings We authorize our employees to get your information only when they need it to do their work and we require companies that work for us to protect your information
How does Chase collect my We collect your personal information for example when you personal information bull open an account or make deposits or withdrawals from your account
bull pay your bills or apply for a loan bull use your credit or debit card We also collect your personal information from others such as credit bureaus affiliates or other companies
Why cant I limit all sharing Federal law gives you the right to limit only bull sharing for affiliates everyday business purposes - information about your
creditworthiness bull affiliates from using your information to market to you bull sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing See below for more on your rights under state law
What happens when I limit sharing for an account I hold jointly with someone else
Your choices will apply to everyone on your account
Definitions
Affiliates Companies related by common ownership or control They can be financial and non financial companies bull Our affiliates include companies with a Chase or JP Morgan name and financial companies such asjP Morgan Securities LLC
Nonaffiliates Companies not related by common ownership or control They can be financial and non financial companies bull Nonaffiliates we share with can include companies such as retailers auto dealers auto makers and membership clubs
Joint marketing A formal agreement between nonaffiliated financial companies that together market financial products or services to you bull Our joint marketing partners include categories of companies such as insurance companies
Other important information
VT Accounts with a Vermont mailing address are automatically treated as if they have limited the sharing as described on page 1 For joint marketing we will only disclose your name contact information and information about your transactions
NV We are providing you this notice pursuant to Nevada law If you prefer not to receive marketing calls from us you may be placed on our Internal Do Not Call List by calling 1-800-945-9470 or by writing to us at PO Box 734007 Dallas TX 75373-4007
For more information contact us at the address above or email PrivacylnfoJPMChasecom with Nevada Annual Notice in the subject line You may also contact the Nevada Attorney Generals office Bureau of Consumer Protection Office of the Nevada Attorney General 555 E Washington St Suite 3900 Las Vegas NV 89101 telephone number 1-702-486-3132 email BCPINFOagstatenvus
CA Accounts with a California mailing address are automatically treated as if they have limited the sharing with nonaffiliates as described on page 1 CA residents are provided a CA notice for additional choices
CHASE O
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
The following disclosure is required by the USA PATRIOT Act
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 opens an account
What this means to you When you 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 drivers
license or other identifying documents
99177-PAT-0215
VETERAN STATEMENT When this loan was opened the US Department of Veterans Affairs (VA) used the veteran borrowerrsquos entitlement which is a set amount the VA promises to repay a lender if the borrower defaults on the mortgage An assumption will modify who is obligated to pay the existing mortgage loan but all loan termsmdashincluding the entitlementmdashwill remain the same If the veteran borrower is being removed from the loan the entitlement would remain with whoever is assuming the loan because the loan will continue to be serviced by the VA If the applicant is also a veteran and can substitute his or her entitlement for the current entitlement then the current borrowerrsquos entitlement can be released
Please review the following questions and answer as appropriate This form requires completion by both the applicant(s) and current borrower(s)
1 Applicant to Complete
Are you (the applicant) currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the reverse side)
Yes (If yes please provide the information requested below answer the question in section 3 and sign and date this form at the bottom of the reverse side)
Name of applicant(s) who answered ldquoyesrdquo to the above question
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Are you receiving VA disability benefts
Applicant
Yes
No
Co-Applicant
Yes
No
Are you entitled to receive VA disability benefts Yes No Yes No
Have you received VA disability benefts in the past Yes No Yes No
Are you a surviving spouse of a veteran who died on active duty or as the result of a service-related disability
Yes No Yes No
Do you have any VA loans Yes No Yes No
2 Current Borrower to Complete
Is the current borrowerco-borrower currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the page)
Yes (If yes please answer the question in section 3 and sign and date this form at the bottom of the page)
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
________________________________________________________________________________________________
3 Applicant and Current Borrower to Complete
If the answer to the questions in section 1 and 2 are both yes please answer the following question After yoursquove reviewed and completed this entire form please sign and date at the bottom
Applicant Current Borrower
Do you want to apply for a substitution of entitlement Yes Yes No No
In order to complete a substitution of entitlement the veteran applicant must have suffcient entitlement to substitute for that of the current borrower Contact the VA Offce of Jurisdiction for your area for more information Also before the veteran applicant can substitute entitlement on a VA loan heshe must certify that the property securing the loan will be occupied as hisher primary residence Both the applicantrsquos and current borrowerrsquos original certifcate of eligibility will be required If your sales contract is contingent upon the restoration of entitlement please contact your VA Offce of Jurisdiction for complete procedures Otherwise the substitution will be completed after the loan has been approved and closed
Date Applicant printed name Applicant signature
Date Applicant printed name Applicant signature
Date Current Borrower printed name Current Borrower signature
Date Current Borrower printed name Current Borrower signature
Forms completed by Mail Phone
For Chase use only
Interviewer signature Date
99177-VS-0215
- Assumption Application Package_41521-noscannedpages-update-4pdf
-
- 1 FM203 Cover Pagepdf
- 2 FM202 Mortgage Assumption Application Package pagepdf
- 3 The Documents Youll need to Send Uspdf
- 4 FM201 FAQpdf
- 5 FM142 CIWpdf
- 6 FM126 URLApdf
- 7 FM130 URLA Instpdf
-
- Blank Page
-
- 8 92900a Addednum to Loan Applicationpdf
- 9 FM462 Gen Authpdf
- 10 FM220 4506-Cpdf
- 11 FM153 Chase Federal Privacy Noticepdf
- 12 FM144 Info on Opening a New Accountpdf
- 13 FM152 Veteran Statementpdf
-
- Date
- Loan number
- Applicant name
- Phone1
- Loan number 1
- Loan number 2
- Other
- Other_2
- 1
- 2
- undefined_7
- Available hours
- Available hours_2
- undefined_8
- Available hours_3
- undefined_9
- Current address 1
- Neither
- Available hours_4
- Available hours_5
- undefined_10
- Available hours_6
- 1_2
- 2_2
- undefined_11
- Available hours_7
- Available hours_8
- undefined_12
- Available hours_9
- FHA Case No include any suffix
- Mortgagee Case No
- Mortgagee ID
- Sponsor ID
- Agent ID
- Name and Address of Sponsor Name and Address of Agent
- Borrowers Name Present Address include ZIP Code Property Address
- include name of subdivision lot block no ZIP Code
- Name of ThirdParty Originator
- NMLS ID of ThirdParty Originator
- s application
- ty Number
- ty Number_2
- Date Signed_2
- Date Mortgage Approved
- Date Approval Expires
- Printed Name
- Title 1
- DEs ID Number
- DEs ID Number_2
- Mortgagee
- Name of Mortgagees Representative
- Title of Mortgagees Representative
- Signature of the Mortgagees Representative
- Date_2
- Applicant names 1
- Applicant names 2
- Applicant names 3
- Loan number_2
- Date_3
- Applicant printed name
- Social Security number
- Date_4
- Applicant printed name_2
- Social Security number_2
- Date_5
- Applicant printed name_3
- Social Security number_3
- Date_6
- Applicant printed name_4
- Social Security number_4
- 1a Name shown on tax return if a joint return enter the name shown first
- 1b First social security number on tax return individual taxpayer identification number or employer identification number see instructions
- 2a If a joint return enter spouses name shown on tax return
- 2b Second social security number or individual taxpayer identification number if joint tax return
- 4 Previous address shown on the last return filed if different from line 3 see instructions
- 5a IVES participant name address and SOR mailbox ID
- Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing see instructions
- Signature see instructions
- Date_7
- Phone number of taxpayer on line 1a or 2a
- PrintType name
- Here
- Spouses signature
- Date_8
- PrintType name_2
- Name
- Date of birth
- Service number
- Name_2
- Date of birth_2
- Service number_2
- Date_9
- Applicant printed name_5
- Date_10
- Applicant printed name_6
- Date_11
- Current Borrower printed name
- Date_12
- Current Borrower printed name_2
- Date_13
- Text3
- Text10
- undefined_13
- Text15
- undefined_14
- undefined_15
- undefined_16
- undefined_17
- undefined_18
- undefined_19
- undefined_20
- undefined_21
- undefined_23
- Reason for assumption Off
- Requestors relationship to owners Off
- Check one Off
- Check one1 Off
- Day1
- Evening
- Cell phone
- Check one2 Off
- Check one3 Off
- Check one4 Off
- Check one5 Off
- Text2-1
- Text2-2
- Text2-3
- Text2-4
- Text2-5
- Text2-6
- Text3-1
- Text3-2
- Text3-3
- Text3-4
- Text3-6
- Text3-7
- Text3-8
- Text3-9
- Text3-10
- Text3-11
- Text3-12
- Text3-13
- Text3-14
- Text3-15
- Text3-16
- Text3-17
- Text3-18
- Text3-19
- Text3-20
- Text3-21
- Text3-22
- Text3-23
- Text3-24
- Text3-25
- Text3-26
- Text3-27
- Text3-28
- Text3-29
- Text3-30
- Text3-31
- Text3-32
- Text3-33
- Text3-34
- Text3-35
- Text3-36
- Text3-37
- Text3-38
- Text3-39
- Text3-40
- Text3-41
- Text3-42
- Text3-43
- Text3-44
- Text3-45
- Text3-46
- Text3-47
- Text3-48
- Text3-49
- Text3-50
- Text3-51
- Text3-52
- Text3-53
- Text3-5
- Text3-54
- Text3-55
- Text3-56
- Citizenship Off
- Type of credit Off
- Marital Status Off
- Housing Off
- Housing1 Off
- ownership Off
- DNA1 Off
- DNA2 Off
- DNA3 Off
- family Off
- BO Off
- Total
- Text31
- Text32
- Text33
- Text34
- Text35
- Text36
- Text37
- Text38
- Text39
- Text310
- Text311
- Text312
- Text313
- Text314
- Text315
- Text316
- Text317
- Text318
- Text319
- ownership1 Off
- Total1
- Total1-2
- Check Box4-1 Off
- Text320
- Text321
- Text322
- Text323
- Text324
- Text325
- Text326
- Text327
- Text328
- Text329
- Check Box4-2 Off
- Check Box4-3 Off
- Check Box4-4 Off
- Check Box4-8 Off
- Check Box4-9 Off
- Text330
- Text331
- Text332
- Text333
- Text334
- Text335
- Text1-1
- Text1-2
- Text1-3
- Text1-4
- Text1-5
- Text1-6
- Text1-7
- Text1-8
- Text1-9
- Text1-10
- Text1-11
- Text1-12
- Text1-13
- Text1-14
- Text1-15
- Text1-16
- Text1-17
- Text1-18
- Text1-19
- Text1-20
- Text1-21
- Text1-22
- Text1-23
- Text1-24
- Text1-25
- Text1-26
- Text1-27
- Text1-28
- Text1-29
- Text1-30
- Text1-31
- Text1-32
- Text1-33
- Text1-34
- Text1-35
- Check Box3-2 Off
- Check Box2-1 Off
- Check Box2-2 Off
- Check Box2-3 Off
- Check Box2-4 Off
- Check Box2-5 Off
- Text1-36
- Text1-37
- Text1-38
- Text1-39
- Text1-40
- Text1-41
- Text1-42
- Text1-43
- Text1-44
- Text1-45
- Text1-46
- Text1-47
- Text1-48
- Text1-49
- Text1-50
- Text1-51
- Text1-52
- Text1-53
- Text1-54
- Text1-55
- Text1-56
- Text1-57
- Text1-58
- Text1-59
- Text1-60
- Text1-61
- Check Box3-11 Off
- A1
- A2
- A3
- A4
- A5
- A6
- A7
- A8
- A9
- A10
- A11
- A12
- Check Box3-1 Off
- Check Box30-1 Off
- Check Box30-2 Off
- Check Box30-4 Off
- Check Box30-5 Off
- Check Box30-7 Off
- Check Box30-8 Off
- Check Box30-9 Off
- Check Box30-10 Off
- Check Box30-11 Off
- Check Box30-12 Off
- A13
- A14
- A15
- A16
- A17 Off
- A18
- A19
- A20
- A21
- A22
- A23
- A24
- A25
- A26
- A27
- A28
- A29
- A30
- A31
- A32
- A33
- A34
- A35
- A36
- A37
- A38 Off
- A39
- A40
- A41
- A42
- A43
- A44
- A45
- A46
- A47
- A48
- A49
- A50
- A51
- A52
- A53
- A54
- A55
- A56
- A57
- A58
- A59
- A60
- A61
- A62
- A63
- A64
- A65
- A66
- A67
- A68
- A69
- A70
- A71
- A72
- A73
- A74
- Loan Purpose Off
- occupancy1 Off
- lien type Off
- lientype Off
- mixed use Off
- manufactured home Off
- deposit1 Off
- deposit2 Off
- B1
- B2
- B3
- B4
- B5
- B6
- B7
- B8
- B9
- B10
- fha Off
- Check Box51 Off
- B11
- B12
- B13
- B14
- B15
- B16
- B17
- B18
- B19 Off
- B20
- B21
- B22 Off
- B23
- B24
- B25
- B26
- B27
- B28
- A
-
- Will you occupy the property as your primary residence Off
- Will you occupy the property as your primary residence1 Off
-
- If yes have you had an ownership interest in another property in the last three years Off
- Text9-2
- B
-
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property Off
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property1 Off
-
- 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 Off
- 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 application1 Off
-
- 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 Off
- 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 application1 Off
-
- new credit Off
- 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) Off
- the Property Assessed Clean Energy Program)1 Off
-
- F
-
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application Off
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application1 Off
-
- G
-
- Are there any outstanding judgments against you Off
- Are there any outstanding judgments against you1 Off
-
- H
-
- Are you currently delinquent or in default on a Federal debt Off
- Are you currently delinquent or in default on a Federal debt1 Off
-
- I
-
- Are you a party to a lawsuit in which you potentially have any personal financial liability Off
- Are you a party to a lawsuit in which you potentially have any personal financial liability1 Off
-
- J
-
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years Off
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years1 Off
-
- 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 Off
- 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 due1 Off
-
- L
-
- Have you had property foreclosed upon in the last 7 years Off
- Have you had property foreclosed upon in the last 7 years1 Off
-
- M
-
- Have you declared bankruptcy within the past 7 years Off
- Have you declared bankruptcy within the past 7 years1 Off
-
- Check Box8-2 Off
- Check Box8-3 Off
- Check Box8-4 Off
- Text9-3
- Text9-5
- Text9-6
- Text97
- military Off
- ethnicity Off
- sex Off
- race Off
- demo Off
- Text12-1
- Check Box11-1 Off
- Check Box11-2 Off
- Check Box11-3 Off
- Check Box11-4 Off
- Check Box11-5 Off
- Check Box11-6 Off
- Check Box11-7 Off
- Check Box11-8 Off
- Check Box11-9 Off
- Text12-2
- Check Box11-10 Off
- Check Box11-11 Off
- Check Box11-12 Off
- Check Box11-13 Off
- Check Box11-14 Off
- Check Box11-15 Off
- Text12-3
- Check Box11-16 Off
- Check Box11-17 Off
- Check Box11-18 Off
- Check Box11-19 Off
- Check Box11-20 Off
- Check Box11-21 Off
- Check Box11-22 Off
- Check Box11-23 Off
- Text12-4
- Check Box11-24 Off
- Check Box11-25 Off
- Check Box11-26 Off
- Check Box11-27 Off
- Check Box11-28 Off
- Check Box11-29 Off
- Text12-5
- Check Box11-30 Off
- Check Box11-31 Off
- citizen Off
- credit Off
- marital status1 Off
- housing-1 Off
- housing-2 Off
- own Off
- C1
- C2
- C3
- C6
- C7
- C8
- C9
- C10
- C11
- C12
- C13
- C14
- C15
- C16
- C17
- C18
- C19
- C20
- C21
- C22
- C23
- C24
- C25
- C26
- C27
- C28
- C29
- C30
- C31
- C32
- C33
- C34
- C35
- Check Box-2 Off
- C36
- C37
- C38
- C39
- C4
- C40
- C41
- C42
- C43
- C44
- C45
- C46
- C47
- Check Box-3 Off
- Check Box-4 Off
- C48
- C49
- C5
- C50
- C51
- C52
- C53
- C54
- C55
- Check Box-1-1 Off
- own1 Off
- Check Box-1 Off
- D1 Off
- D2
- D3
- D4
- D5
- D6
- D7
- D8
- D9
- D10
- D11
- D12
- D13
- D14 Off
- D15 Off
- D16
- D17
- D18
- D19
- D20
- D21
- D22
- D23
- D24 Off
- D25
- D26
- D27
- D28
- D29
- D30
- D31
- D32
- D33
- D34
- D35 Off
- D36
- D37 Off
- D38
- D39
- D40
- D41
- D42
- D43
- D44
- D45
- D46
- D47
- If yes have you had an ownership interest in another property in the last three years1 Off
- new credit1 Off
- Check Box8-1 Off
- Check Box8-1-2 Off
- Check Box8-1-1 Off
- Check Box8-1-3 Off
- Check Box8-1-4 Off
- Military Service mdash Did you (or your deceased spouse) ever serve or are you currently serving in the United States Armed Forces 1 Off
- Check1 Off
- Text9-1-1
- Check2 Off
- Check3 Off
- Check4 Off
- Text9-1
- E1
- E2
- E3
- Was the ethnicity of the Borrower collected on the basis of visual observation or surname1 Off
- Was the sex of the Borrower collected on the basis of visual observation or surname1 Off
- Was the race of the Borrower collected on the basis of visual observation or surname1 Off
- The Demographic Information was provided through1 Off
- F1 Off
- F2 Off
- F3 Off
- F4 Off
- F5 Off
- F6
- F7 Off
- F8 Off
- F9 Off
- F10 Off
- F11 Off
- F12 Off
- F13
- F14 Off
- F15 Off
- F16 Off
- F17 Off
- F18 Off
- F19 Off
- F20 Off
- F21 Off
- F22
- F23 Off
- F24 Off
- F25 Off
- F26 Off
- F27 Off
- F28 Off
- F29
- F30 Off
- F31 Off
- undefined_13-1
- undefined_13-2
- undefined_14-1
- undefined_15-1
- undefined_16-1
- undefined_17-1
- undefined_18-1
- undefined_19-1
- undefined_21-1
- undefined_20-1
- undefined_23-1
- undefined_13_1
- Single-Two Off
- Refi type Off
- refi program Off
- Estate Off
- Title held Off
- Trust Information Off
- Indian Country Land Tenure Off
- Mortgage Type Applied For Off
- Mortgage Lien Type Off
- Amortization Type Off
- G1 Off
- G2 Off
- G3 Off
- G4 Off
- G5 Off
- G6
- G7
- G8
- G9
- G10 Off
- G11 Off
- G12 Off
- G13 Off
- G14 Off
- G15 Off
- G16
- G17
- G18
- G19
- G20
- G21
- G22
- G23 Off
- G24
- G25 Off
- G26
- G27 Off
- G28 Off
- G29
- G30 Off
- G31
- G32 Off
- G33
- G34
- G35
- G36
- G37
- G38
- G39
- G40
- G41
- G42
- Property Held
- refi
- Text18-1
- Text18-2
- Text18-3
- Text18-4
- Text18-5
- Text18-6
- Text18-7
- Text18-8
- Text18-9
- Text18-10
- Text18-11
- Text18-12
- Text18-13
- Text18-14
- Text18-15
- Text18-16
- Text18-17
- Text18-18
- Text18-19
- Lender
- case no
- If you selected ldquoUnmarriedrdquo in Section 1 is there a person who is not your legal spouse but who currently has real property rights similar to those of a legal spouse Off
- Relationship and State Off
- Other-5
- Text19-1
- BName
- Additional Information
- ABN
- Additional Information1
- BSign
- BSDate
- ABSign
- ABDate
- MortageeNameAddress
- NAmeAddress
- Bname1
- DOB1
- DOB2
- SignOfBorr1
- SignOfBorr
- Date Signed
- SignOfBorr2
- SignOfBorr3
- Date Signed3
- Date Signed4
- MortgageeRepSign
- DirectSign
- DirectSign1
- Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union Off
- AppSign
- AppSign1
- AppSign2
- AppSign3
- Nopage38 Off
- Yespage38 Off
- Yes1 Off
- No1 Off
- Yes2 Off
- Yes3 Off
- Yes4 Off
- Yes5 Off
- Yes6 Off
- Yes7 Off
- Yes8 Off
- Yes9 Off
- Yes10 Off
- No2 Off
- No3 Off
- No4 Off
- No5 Off
- No6 Off
- No7 Off
- No8 Off
- No9 Off
- No10 Off
- BorrowerNo Off
- BorrowerYes Off
- AppSignature
- AppSignature1
- CurrentSign
- CurrentSign1
- InterviewSign
- Yes_1 Off
- No_1 Off
- Yes_2 Off
- No_2 Off
- Mail Off
- Phone Off
L4 Qualifying the Borrower - Minimum Required Funds or Cash Back
DUEFROM BORROWER(S)
A Sales Contract Price
B Improvements Renovations and Repairs
C Land(ifacquired separately)
D For Refinance Balance of Mortgage Loanson the Propertyto be paid off in the Transaction
(See Table 3a Property You Own)
E Credit Cards and Other Debts Paid Off
(See Table 2c Liabilities mdash Credit Cards Other Debts and Leases that You Owe)
F BorrowerClosing Costs (including Prepaid andInitial Escrow Payments)
G Discount Points
HTOTAL DUE FROM BORROWER(s)(Total of A thru G)
TOTALMORTGAGE LOANS
Loan Amount
Loan AmountExcluding Financed Mortgage Insurance (or Mortgage Insurance Equivalent) $
Financed Mortgage Insurance (or Mortgage Insurance Equivalent) Amount $
Other New Mortgage Loanson the Property the Borrower(s) is Buying or Refinancing(See Table 4b Other New MortgageLoanson the Property You are Buying or Refinancing)
KTOTAL MORTGAGELOANS(Totalof| and J)
TOTALCREDITS
L Seller Credits (Enter the amountofBorrower(s) costs paid by the property seller)
MOtherCredits (Enter the sum ofall other credits mdash BorrowerPaid Fees Earnest Money EmployerAssistedHousing Lease Purchase Fund Lot Equity Relocation Funds Sweat Equity Trade Equity Other)
NTOTAL CREDITS(Total of L and M)
CALCULATION
TOTAL DUE FROM BORROWER(s)(Line H)
LESSTOTAL MORTGAGELOANS(Line K) AND TOTAL CREDITS(Line N)
Cash FromTothe Borrower(Line H minusLine K and Line N)NOTE This amountdoesnotinclude reservesor other funds that may be required by the Lenderto be verified
Borrower Name(s)Uniform Residential Loan Application mdash LenderLoan Information
Freddie Mac Form 65 + Fannie Mae Form 1003Effective 12021
Uniform Residential Loan Application mdash Unmarried Addendum
eeCeceetatimC elitleeComeLy
Lenders Instructions for Using the Unmarried Addendum
The Lender may use the Unmarried Addendum only when a Borrowerselected ldquoUnmarriedrdquoin Section 1 and the information collected is
necessary to determine howState property lawsdirectly or indirectly affecting creditworthiness apply including ensuring clear title
For example the Lender may use the Unmarried Addendum whentheBorrowerresides in a State that recognizescivil unions domestic
partnerships or registered reciprocal beneficiary relationships or when the property is located in such a State ldquoStaterdquo meansanystate the
District of Columbia the Commonwealth of Puerto Rico or anyterritory or possession of the United States
Ifyou selected ldquoUnmarriedrdquoin Section 1 is there a person whois not your legal spouse but whocurrently has real property rights similar to
those of a legal spouse +=) NOQ YES
If YES indicate the type of relationship and the State in which the relationship was formed For example indicate if you are in a
civil union domestic partnership registered reciprocal beneficiary relationship or other relationship recognized by the State in which you
currently reside or where the property is located
O Civil Union copy Domestic Partnership copy Registered Reciprocal Beneficiary Relationship copy) Other(explain)
Statea]
Borrower NameUniform Residential Loan Application mdash Unmarried Addendum
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Uniform Residential Loan Application mdash Continuation Sheet
Use this continuation sheet if you need more space to complete the Uniform Residential Loan Application
Borrower Name(First Middle Last Suffix )
Additional Information
Additional Borrower Name(First Middle Last Suffix )
Additional Information
IWefully understand thatit is a federal crime punishable by fine or imprisonment or both to knowingly make anyfalse statements concerningany of the abovefacts as applicable underthe provisions of federal law (18 USC sectsect 1001 et seq)
BorrowerSignature Date (mmddyyyy)
Additional Borrower Signature Date (mmddyyyy)
Uniform Residential Loan Application mdash Continuation SheetFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
INSTRUCTIONS FOR COMPLETING THE UNIFORM RESIDENTIAL LOAN APPLICATION
Use the instructions below to complete the enclosed Uniform Residential Loan Application (Freddie Mac Form 65Fannie Mae Form 1003) To avoid any delays in your application review please provide all of the requested information
If you need to make a correction on the application draw a line through the incorrect text and mark your initials beside the change Donrsquot use correction tape or fluid The application must be completed signed and dated in ink
The Uniform Residential Loan Application (URLA)
The URLA contains the following sections Section 1 Borrower Information Please provide your personal information income and employment
Section 2 Financial Information ndash Assets and Liabilities Please provide information about your financial assets personal financial obligations and debts you owe
Section 3 Financial Information ndash Real Estate Please provide information about property you own and the debts and expenses related to the property
Section 4 Loan and Property Information Please provide information about the loan purpose and the property you are buying or refinancing
Section 5 Declarations Please answer questions about the property how the property will be financed and your past financial history
Section 6 Acknowledgments and Agreements Informs you of your legal obligations related to the mortgage application and asks that you acknowledge certain information will be obtained used and shared
Section 7 Military Service Please provide information about your (or your deceased spousersquos) military service
Section 8 Demographic Information Requests information the Lender is required by law to ask you
Section 9 Loan Originator Information Will be completed by Chase
Uniform Residential Loan Application ndash Additional Borrower
The URLA ndash Additional Borrower contains the following sections Section 1 Borrower Information This is the same as the Borrower Information section of the URLA
Section 2 Financial Information ndash Assets and Liabilities Contains only the following statement for the additional Borrower to complete ldquoMy information for Section 2 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo The name of the other borrower is entered here
Complete a separate URLA for each BorrowermiddotThree or more Borrowers ndash Use any combination of URLA and URLA-Additional Borrower forms in accordance with the above examples
Section 3 Financial Information ndash Real Estate Contains only the following statement for the additional borrower to complete ldquoMy information for Section 3 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 4 Loan and Property Information Contains only the following statement for the additional borrower to complete ldquoMy information for Section 4 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 5 Declarations This is the same as the Declarations section of the URLA
Section 6 Acknowledgments and Agreements Contains only the following statement for the additional borrower to complete ldquoMy signature for Section 6 is on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 7 Military Service This is the same as the Military Service section of the URLA
Section 8 Demographic Information This is the same as the Demographic Information section on the URLA
Section 9 Loan Originator Information This is the same as the Loan Originator Information section of the URLA
Using the URLA and URLA ndash Additional Borrower Together The URLA and the URLA ndash Additional Borrower are used together to collect information for two Borrowers who have joint assets liabilities andor real estate information The URLA and URLA ndash Additional Borrower can also be used for Borrowers who do not have joint information but wish to combine their information on the URLA for ease of use Here are examples of how to use the URLA and URLA ndash Additional Borrower
For one borrower Complete the URLA
For two borrowers with joint financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you dont need to duplicate them on more than one URLA or o In cases where Borrowers are not collaborating when completing the loan application
joint assets liabilities and real estate may be duplicated on each URLA bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you do not need to duplicate them on more than one URLA or
o In cases where Borrowers are not collaborating when completing the loan application joint assets liabilities and real estate may be duplicated on each URLA
For two borrowers with separate financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower Report the assets liabilities and
real estate for the additional Borrower on the URLA or bull Complete a separate URLA for each Borrower
For three or more borrowers use any combination of URLA and URLA ndash Additional Borrower forms described for two borrowers
Uniform Residential Loan Application ndash Unmarried Addendum If any borrower listed on the URLA or URLA ndash Additional Borrower form selects Unmarried in Section 1 (Personal Information) the lender will complete this optional form
The information must be collected to determine how to apply state property laws that directly or indirectly affect creditworthiness including ensuring clear title
Uniform Residential Loan Application ndash Continuation Sheet Use the URLA ndash Continuation Sheet if you need more space to complete either the URLA or URLA ndash Additional Borrower forms
99177-URLAI-0215
HUD Addendum to Uniform Residential Loan Application OMB Approval No HUD 2502-0059 (exp )
Part I - Identifying Information HUDFHA Application for Insurance under the National Housing Act and Borrower Certification
FHA Case No (include any suffix) Mortgagee Case No
Mortgagee ID Sponsor ID Agent ID
Mortgagee Name Address (include ZIP Code) and Telephone Number
Type or print all entries clearly
Name and Address of Sponsor Name and Address of Agent
Borrowers Name amp Present Address (include ZIP Code) Property Address (include name of subdivision lot amp block no amp ZIP Code)
Sponsored Originations
Name of Third-Party Originator NMLS ID of Third-Party Originator
Part II - Borrower Consent for Social Security Administration to Verify Social Security Number I authorize the Social Security Administration (SSA) to verify my Social Security Number (SSN) to the Mortgagee and HUDFHA I authorize SSA to provide explanatory
information to HUDFHA in the event of a discrepancy This consent is valid for 180 days from the date signed unless indicated otherwise by the individual(s) named in this
loan application
Signature(s) of Borrower(s) - Read consent carefully Review accuracy of Social Security Number(s) provided on this application
Borrowerrsquos NameDate of BirthSocial Security Number
Co-Borrowerrsquos Name Date of BirthSocial Security Number
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
Part III - Borrower Notices Information and Acknowledgment Public Reporting Burden
Public reporting burden for this collection of information is estimated to average 10 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 conduct or sponsor and a person is not
required to respond to a collection of information unless that collection displays a valid OMB control number which can be located on the OMB Internet page at
httpwwwreginfogovpublicdoPRAMain
Privacy Act Information
The information requested on the Uniform Residential Loan Application and this Addendum is authorized by the National Housing Act of 1934 12 USC sect 1701 et seq The Debt
Collection Act of 1982 Pub L 97-365 and HUDrsquos Housing and Community Development Act of 1987 42 USC sect 3543 require persons applying for a federally insured loan to
furnish their SSN You must provide all the requested information including your SSN HUD may conduct a computer match to verify the information you provide HUD may
disclose certain information to Federal State and local agencies when relevant to civil criminal or regulatory investigations and prosecutions It will not otherwise be disclosed or
released outside of HUD except as required and permitted by law The information will be used to determine whether you qualify as a mortgagor Failure to provide any of the
requested information including SSN may result in disapproval of your loan application This is notice to you as required by the Right to Financial Privacy Act of 1978 that
HUDFHA has a right of access to financial records held by financial institutions in connection with the consideration or administration of assistance to you Financial records
involving your transaction will be available to HUDFHA without further notice or authorization but will not be disclosed or released by the institution to another Government Agency
or Department without your consent except as required or permitted by law
WARNING This warning applies to all certifications made in this document Anyone who knowingly submits a false claim or makes false statements is subject to criminal and civil penalties including confinement for up to 5 years fines and civil penalties 18 USC sectsect 287 1001 and 31 USC sect 3729
orm HUD-92900-A ( ) Page 1
Borrower Name ____________________________ FHA Case No __________________
Caution Delinquencies Defaults Foreclosures and Abuses Delinquencies defaults foreclosures and abuses of mortgage loans involving programs of the Federal Government can be costly and detrimental to your credit now and in the future The Mortgagee in this transaction its agents and assigns as well as the Federal Government its agencies agents and assigns are authorized to take any and all of the following actions in the event loan payments become delinquent on the mortgage loan described in the attached application (1) Report your name and account information to a credit bureau (2) Assess additional interest and penalty charges for the period of time that payment is not made (3) Assess charges to cover additional administrative costs incurred by the Federal Government to service your account (4) Offset amounts owed to you
under other Federal programs (5) Refer your account to a private attorney collection agency or mortgage servicing agency to collect the amount due foreclose
the mortgage sell the property and seek judgment against you for any deficiency (6) Refer your account to the Department of Justice (DOJ) for litigation in the
courts (7) If you are a current or retired Federal employee take action to offset your salary or civil service retirement benefits (8) Refer your debt to the Internal
Revenue Service for offset against any amount owed to you as an income tax refund and (9) Report any resulting written off debt of yours to the Internal Revenue Service as your taxable income All of these actions may be used to recover any debts owed when it is determined to be in the interest of the Mortgagee or Federal Government or both
As a mortgage loan borrower you will be legally obligated to make the mortgage payments called for by your mortgage loan contract The fact that you dispose of your property after the loan has been made will not relieve you of liability for making these payments Payment of the loan in full is ordinarily the way liability on a mortgage note is ended Some home buyers have the mistaken impression that if they sell their homes when they move to another locality or dispose of it for any other reasons they are no longer liable for the mortgage payments and that liability for these payments is solely that of the new owners Even though the new owners may agree in writing to assume liability for your mortgage payments this assumption agreement will not relieve you from liability to the holder of the note which you signed when you obtained the loan to buy the property Unless you are able to sell the property to a buyer who is acceptable to HUDFHA who will assume the payment of your obligation to the lender you will not be relieved from liability to repay any claim which HUDFHA may be required to pay your lender on account of default in your loan payments The amount of any such claim payment may be a debt owed by you to the Federal Government and subject to established collection procedures
Fair Housing Act I and anyone acting on my behalf are and will remain in compliance with the Fair Housing Act 42 USC sect 3604 et seq with respect to the dwelling or property covered by the loan and in the provision of services or facilities in connection therewith I recognize that any restrictive covenant on this property related to race color religion sex disability familial status or national origin is unlawful under the Fair Housing Act and unenforceable I further recognize that in addition to administrative action by HUD a civil action may be brought by the DOJ in any appropriate US court against any person responsible for a violation of the
applicable law
Certification and Acknowledgment All information in this application is given for the purpose of obtaining a loan to be insured under the National Housing Act and the information in the Uniform Residential Loan Application and this Addendum is true and complete to the best of my knowledge and belief Verification may be obtained from any source named herein I have read and understand the foregoing concerning my liability on the loan and Part III Borrower Notices Information and Acknowledgment
Signature(s) of Borrower(s) - Do not sign unless this application is fully completed Read the certification carefully and review accuracy of this application
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
orm HUD-92900-A ( Page 2
___________________________________
______________________________________________________
______________________________________________________________
- - - - - - - - - - - - - - - - - - - - - - -
Borrower Name ____________________________ FHA Case No __________________
Part IV - Direct Endorsement Approval for a HUD FHA-Insured Mortgage A Underwriting the Borrower
Date Mortgage Approved ______________________________ Date Approval Expires ______________________
For mortgages rated as an ldquoacceptrdquo or ldquoapproverdquo by FHAs TOTAL Mortgage Scorecard
The information submitted to TOTAL was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA4e Final Underwriting Decision (TOTAL) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee Representative Signature
Printed Name
Title
OR
For mortgages rated as a ldquoreferrdquo by FHAs TOTAL Mortgage Scorecard or manually underwritten by a Direct Endorsement underwriter I have personally reviewed and underwritten the borrowerrsquos credit application The information used to underwrite the borrower was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA5d Final Underwriting Decision (Manual) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
B Underwriting the Property
For all mortgages where FHA requires an appraisal I have personally reviewed and underwritten the appraisal according to FHA requirements I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
orm HUD-92900-A ( ) Page 3
Borrower Name ____________________________ FHA Case No __________________
Part V Mortgagees Certification
I have personally reviewed the mortgage documents and the application for insurance endorsement and This mortgage complies with SF Handbook 40001 Section IIA7 Post-Closing and Endorsement to the extent that no defect exists that would have changed the decision to endorse or submit the mortgage for insurance
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee
Name of Mortgageersquos Representative
Title of Mortgageersquos Representative
Signature of the Mortgageersquos Representative Date
orm HUD-92900-A ( ) Page 4
GENERAL AUTHORIZATION FOR A MORTGAGE LOAN ASSUMPTION
Applicant name(s)
Loan number
NOTICES AND DISCLOSURES
Non-discriminatory underwriting guidelines Anyone who inquires about the availability of credit from us has the right to receive a copy of our non-discriminatory underwriting guidelines To request a copy of these guidelines contact your Loan Processor
Attorney note Itrsquos the responsibility of our attorneys to protect our interest You may at your expense request an attorney to represent your interest
Notice to HUDFHA applicants As required by the Right to Financial Privacy Act of 1978 this notice is to inform you that the US Department of Housing and Urban Development (HUD)Federal Housing Administration (FHA) has a right of access to financial records held by financial institutions related to a request for assistance Financial records involving your assumption will be available to HUDFHA without further notice or authorization but wonrsquot be disclosed or released by us to another government agency or department without your consent except as required or permitted by law
Borrower consent to the use of tax return information I understand acknowledge and agree that the Lender and Other Loan Participants can obtain use and share tax return information for purposes of (i) providing an offer (ii) originating maintaining managing monitoring servicing selling insuring and securitizing a loan (iii) marketing or (iv) as otherwise permitted by applicable laws including state and federal privacy and data security laws The Lender includes the Lenderrsquos affiliates agents service providers and any of aforementioned partiesrsquo successors and assigns The Other Loan Participants includes any actual or potential owners of a loan resulting from your loan application or acquirers of any beneficial or other interest in the loan and mortgage insurer guarantor any servicers or service providers for these parties and any of aforementioned partiesrsquo successors and assigns
CERTIFICATION AND AUTHORIZATION
Environmental certification By signing below I represent and warrant that Irsquom not aware of any substances materials or products that may be an environmental hazard such as but not limited to asbestos formaldehyde radon gas lead-based paint fuel or chemical storage tanks (above or below ground) and contaminated soil or water on the property I acknowledge that Chase is relying on this representation and warranty as a material part of its loan application process I also am not aware of any landfill on any portion of the property
Exceptions to the above I further acknowledge (1) receipt of applicable disclosures from the seller in purchase transactions (2) that lead-based paint may exist in housing constructed prior to 1978 (3) that Chase performs no environmental investigation on my behalf and isnrsquot responsible for identifying lead-based paint or any other environmental conditions that might impact the property or its residents and (4) that it is my sole obligation to investigate for potential impact to the property from environmental conditions
Certifications I certify by signing below that (1) all of the loan application information provided is true and complete (2) I understand any intentional or negligent misrepresentation(s) of the information provided in conjunction with my application may result in civil liability andor 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 Chase its agents successors and assigns insurers and any other person who may suffer any loss due to reliance upon any misrepresentation that I have made on the application and (3) any significant change from the information provided at the time of application until the final loan application is signed may have a bearing on the approval of my application for a home loan
Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union
This question is asked because of state laws that extend the same or similar rights benefits and protections of spouses in a marriage to persons who are members of a partnership or union recognized under state law You should consult with your own legal advisor for advice regarding the rights protections benefits responsibilities obligations and duties of those who are registered domestic partners civil union partners or members of other unions recognized under applicable law
CREDIT AUTHORIZATION RELEASE
By signing below I authorize Chase andor my mortgage insurer (if any) to verify my past and present employment earnings records (including information contained in income tax returns that have been filed with the IRS) bank accounts stock holdings and any other information that it finds necessary to process my mortgage loan application or to review it for quality-control purposes I understand that a credit report will be ordered from a credit reporting agency for verification prior to loan closing as part of the application process and may be ordered after closing as part of the Lenderrsquos quality-control program A credit report may also be completed as part of the Lenderrsquos servicing or collection of the loan or in consideration of any other product or service that the Lender may consider offering me in the future and at any time throughout the life of the loan I understand that use of a photocopy of this form may be necessary to verify one or more of my credit references I understand that a photocopy or fax copy of this form will also serve as authorization
By signing below each applicant acknowledges (1) making the above certifications and authorizations and (2) that each applicant has received and understands the above notices and disclosures
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
You do not have to give us this information but if you donrsquot your application for approval as a borrower may be delayed or rejected The information requested in this form is authorized by Title 38 USC Chapter 37 (if VA) by 12 USC Section 1701 et seq (if HUDFHA) by 42 USC Section 1452b (if HUDCPD) and Title 42 USC 1471 et seq or 7 USC 1921 et seq (if USDA FHA)
Updated December 2021 99177-GA-0215
1b
2b
Form 4506-C (September 2020)
Department of the Treasury - Internal Revenue Service
IVES Request for Transcript of Tax Return OMB Number
1545-1872
Do not sign this form unless all applicable lines have been completed Request may be rejected if the form is incomplete or illegible
For more information about Form 4506-C visit wwwirsgov and search IVES
1a Name shown on tax return (if a joint return enter the name shown first)
First social security number on tax return individual taxpayer identification number or employer identification number (see instructions)
2a If a joint return enter spousersquos name shown on tax return Second social security number or individual taxpayer identification number if joint tax return
3 Current name address (including apt room or suite no) city state and ZIP code (see instructions)
4 Previous address shown on the last return filed if different from line 3 (see instructions)
5a IVES participant name address and SOR mailbox ID
DataVerify 875 Greentree Rd 8 Parkway Center Pittsburgh PA 15220
5b Customer file number (if applicable) (see instructions)
Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing (see instructions)
6 Transcript requested Enter the tax form number here (1040 1065 1120 etc) and check the appropriate box below Enter only one tax form number per request 1040
a Return Transcript which includes most of the line items of a tax return as filed with the IRS A tax return transcript does not reflect changes made to the account after the return is processed Transcripts are only available for the following returns Form 1040 series Form 1065 Form 1120 Form 1120-A Form 1120-H Form 1120-L and Form 1120S Return transcripts are available for the current year and returns processed during the prior 3 processing years
b Account Transcript which contains information on the financial status of the account such as payments made on the account penalty assessments and adjustments made by you or the IRS after the return was filed Return information is limited to items such as tax liability and estimated tax payments Account transcripts are available for most returns
c Record of Account which provides the most detailed information as it is a combination of the Return Transcript and the Account Transcript Available for current year and 3 prior tax years
7 Form W-2 Form 1099 series Form 1098 series or Form 5498 series transcript The IRS can provide a transcript that includes data from these information returns State or local information is not included with the Form W-2 information The IRS may be able to provide this transcript information for up to 10 years Information for the current year is generally not available until the year after it is filed with the IRS For example W-2 information for 2016 filed in 2017 will likely not be available from the IRS until 2018 If you need W-2 information for retirement purposes you should contact the Social Security Administration at 1-800-772-1213
Caution If you need a copy of Form W-2 or Form 1099 you should first contact the payer To get a copy of the Form W-2 or Form 1099 filed with your return you must use Form 4506 and request a copy of your return which includes all attachments
8 Year or period requested Enter the ending date of the tax year or period using the mmddyyyy format (see instructions)
12 31 2020 12 31 2019 12 31 2018 Caution Do not sign this form unless all applicable lines have been completed
Signature of taxpayer(s) I declare that I am either the taxpayer whose name is shown on line 1a or 2a or a person authorized to obtain the tax information requested If the request applies to a joint return at least one spouse must sign If signed by a corporate officer 1 percent or more shareholder partner managing member guardian tax matters partner executor receiver administrator trustee or party other than the taxpayer I certify that I have the authority to execute Form 4506-C on behalf of the taxpayer Note This form must be received by IRS within 120 days of the signature date
Signatory attests that heshe has read the attestation clause and upon so reading declares that heshe has the authority to sign the Form 4506-C See instructions
Sign Here
Signature (see instructions) Date Phone number of taxpayer on line 1a or 2a
PrintType name
Title (if line 1a above is a corporation partnership estate or trust)
Spousersquos signature Date
PrintType name
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020) For Privacy Act and Paperwork Reduction Act Notice see page 2
Instructions for Form 4506-C IVES Request for Transcript of Tax Return
Section references are to the Internal Revenue Code unless otherwise noted
Future Developments
For the latest information about Form 4506-C and its instructions go to wwwirsgov and search IVES Information about any recent developments affecting Form 4506-C (such as legislation enacted after we released it) will be posted on that page
Whats New Form 4506-C was created to be utilized by authorized IVES participants to order tax transcripts with the consent of the taxpayer
General Instructions
Caution Do not sign this form unless all applicable lines have been completed
Designated Recipient Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information received pursuant to the taxpayerrsquos consent and holds the recipient subject to penalties for any unauthorized access other use or redisclosure without the taxpayerrsquos express permission or request
Taxpayer Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information provided pursuant to your consent and holds the recipient subject to penalties brought by private right of action for any unauthorized access other use or redisclosure without your express permission or request
Purpose of form Use Form 4506-C to request tax return information through an authorized IVES participant You will designate an IVES participant to receive the information on line 5a
Note If you are unsure of which type of transcript you need check with the party requesting your tax information
Where to file The IVES participant will fax Form 4506-C with the approved IVES cover sheet to their assigned Service Center
Chart for ordering transcripts
If your assigned Service Center is
Fax the requests with the approved coversheet to
Austin Submission Processing Center
Austin IVES Team
844-249-6238
Fresno Submission Processing Center
Fresno IVES Team
844-249-6239
Kansas City Submission Processing Center
Kansas City IVES Team
844-249-8128
Ogden Submission Processing Center
Ogden IVES Team
844-249-8129
Specific Instructions
Line 1b Enter the social security number (SSN) or individual taxpayer identification number (ITIN) for the individual listed on line 1a or enter the employer identification number (EIN) for the business listed on line 1a
Line 3 Enter your current address If you use a PO box include it on this line
Line 4 Enter the address shown on the last return filed if different from the address entered on line 3
Note If the addresses on lines 3 and 4 are different and you have not changed your address with the IRS file Form 8822 Change of Address or Form 8822-BChange of Address or Responsible Party mdash Business with Form 4506-C
Line 5b Enter up to 10 numeric characters to create a unique customer file number that will appear on the transcript The customer file number cannot contain an SSN ITIN or EIN Completion of this line is not required
Note If you use an SSN name or combination of both we will not input the information and the customer file number will reflect a generic entry of 9999999999 on the transcript
Line 8 Enter the end date of the tax year or period requested in mmddyyyy format This may be a calendar year fiscal year or quarter Enter each quarter requested for quarterly returns Example Enter 12312018 for a calendar year 2018 Form 1040 transcript
Signature and date Form 4506-C must be signed and dated by the taxpayer listed on line 1a or 2a The IRS must receive Form 4506-C within 120 days of the date signed by the taxpayer or it will be rejected Ensure that all applicable lines including lines 5a through 8 are completed before signing
You must check the box in the signature area to acknowledge you have the authority to sign and request the information The form will not be processed if unchecked
Individuals Transcripts listed on on line 6 may be furnished to either spouse if jointly filed Only one signature is required Sign Form 4506-C exactly as your name appeared on the original return If you changed your name also sign your current name
Corporations Generally Form 4506-C can be signed by
(1) an officer having legal authority to bind the corporation (2) any person designated by the board of directors or other governing body or (3) any officer or employee on written request by any principal officer and attested to by the secretary or other officer A bona fide shareholder of record owning 1 percent or more of the outstanding stock of the corporation may submit a Form 4506-C but must provide documentation to support the requesters right to receive the information
Partnerships Generally Form 4506-C can be signed by any person who was a member of the partnership during any part of the tax period requested on line 8
All others See section 6103(e) if the taxpayer has died is insolvent is a dissolved corporation or if a trustee guardian executor receiver or administrator is acting for the taxpayer
Note If you are Heir at law Next of kin or Beneficiary you must be able to establish a material interest in the estate or trust
Documentation For entities other than individuals you must attach the authorization document For example this could be the letter from the principal officer authorizing an employee of the corporation or the letters testamentary authorizing an individual to act for an estate
Signature by a representative A representative can sign Form 4506-C for a taxpayer only if the taxpayer has specifically delegated this authority to the representative on Form 2848 line 5 The representative must attach Form 2848 showing the delegation to sign Form 4506-C
Privacy Act and Paperwork Reduction Act Notice We ask for the information on this form to establish your right to gain access to the requested tax information under the Internal Revenue Code We need this information to properly identify the tax information and respond to your request You are not required to request any transcript if you do request a transcript sections 6103 and 6109 and their regulations require you to provide this information including your SSN or EIN If you do not provide this information we may not be able to process your request Providing false or fraudulent information may subject you to penalties
Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and cities states the District of Columbia and US commonwealths and possessions for use in administering their tax laws We may also disclose this information to other countries under a tax treaty to federal and state agencies to enforce federal nontax criminal laws or to federal law enforcement and intelligence agencies to combat terrorism
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law Generally tax returns and return information are confidential as required by section 6103
The time needed to complete and file Form 4506-C will vary depending on individual circumstances The estimated average time is
Learning about the law or the form 10 min Preparing the form 12 min Copying assembling and sending the form to the IRS 20 min
If you have comments concerning the accuracy of these time estimates or suggestions for making Form 4506-C simpler we would be happy to hear from you You can write to
Internal Revenue Service Tax Forms and Publications Division 1111 Constitution Ave NW IR-6526 Washington DC 20224
Do not send the form to this address Instead see Where to file on this page
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020)
Rev April 2021 CHASEO Facts What does Chase do with your personal information
Why Financial companies choose how they share your personal information Federal law gives consumers the right to limit some but not all sharing Federal law also requires us to tell you how we collect share and protect your personal information Please read this notice carefully to understand what we do
What The types of personal information we collect and share depend on the product or service you have with us This information can include bull Social Security number and income bull account balances and transaction history bull credit history and payment history
How All financial companies need to share customers personal information to run their everyday business In the section below we list the reasons financial companies can share their customers personal information the reasons Chase chooses to share and whether you can limit this sharing
Reasons we can share your personal information Does Chase share
Can you limit this sharing
For our everyday business purposes - such as to process your transactions maintain your account(s) respond to court orders and legal investigations or report to credit bureaus
Yes No
For our marketing purposes - to offer our products and services to you
Yes No
For joint marketing with other financial companies Yes No
For our affiliates everyday business purposes - information about your transactions and experiences
Yes No
For our affiliates everyday business purposes - information about your creditworthiness
Yes Yes
For our affiliates to market to you Yes Yes
For nonaffiliates to market to you Yes Yes
a
0
To limit our sharing
bull Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
bull Visit us online chasecomprivacypreferences
Please note If you are a new customer we can begin sharing your information 30 days from the date we sent this notice When you are no longer our customer we continue to share your information as described in this notice However you can contact us at any time to limit our sharing
Questions
Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
PAGE 2
Who we are
Who is providing this notice The US consumer financial companies within the JPMorgan Chase amp Co family including JPMorgan Chase Bank NA Chase Insurance Agency Inc and JP Morgan Securities LLC
What we do
How does Chase protect my To protect your personal information from unauthorized access and use we personal information use security measures that comply with federal law These measures include
computer safeguards and secured files and buildings We authorize our employees to get your information only when they need it to do their work and we require companies that work for us to protect your information
How does Chase collect my We collect your personal information for example when you personal information bull open an account or make deposits or withdrawals from your account
bull pay your bills or apply for a loan bull use your credit or debit card We also collect your personal information from others such as credit bureaus affiliates or other companies
Why cant I limit all sharing Federal law gives you the right to limit only bull sharing for affiliates everyday business purposes - information about your
creditworthiness bull affiliates from using your information to market to you bull sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing See below for more on your rights under state law
What happens when I limit sharing for an account I hold jointly with someone else
Your choices will apply to everyone on your account
Definitions
Affiliates Companies related by common ownership or control They can be financial and non financial companies bull Our affiliates include companies with a Chase or JP Morgan name and financial companies such asjP Morgan Securities LLC
Nonaffiliates Companies not related by common ownership or control They can be financial and non financial companies bull Nonaffiliates we share with can include companies such as retailers auto dealers auto makers and membership clubs
Joint marketing A formal agreement between nonaffiliated financial companies that together market financial products or services to you bull Our joint marketing partners include categories of companies such as insurance companies
Other important information
VT Accounts with a Vermont mailing address are automatically treated as if they have limited the sharing as described on page 1 For joint marketing we will only disclose your name contact information and information about your transactions
NV We are providing you this notice pursuant to Nevada law If you prefer not to receive marketing calls from us you may be placed on our Internal Do Not Call List by calling 1-800-945-9470 or by writing to us at PO Box 734007 Dallas TX 75373-4007
For more information contact us at the address above or email PrivacylnfoJPMChasecom with Nevada Annual Notice in the subject line You may also contact the Nevada Attorney Generals office Bureau of Consumer Protection Office of the Nevada Attorney General 555 E Washington St Suite 3900 Las Vegas NV 89101 telephone number 1-702-486-3132 email BCPINFOagstatenvus
CA Accounts with a California mailing address are automatically treated as if they have limited the sharing with nonaffiliates as described on page 1 CA residents are provided a CA notice for additional choices
CHASE O
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
The following disclosure is required by the USA PATRIOT Act
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 opens an account
What this means to you When you 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 drivers
license or other identifying documents
99177-PAT-0215
VETERAN STATEMENT When this loan was opened the US Department of Veterans Affairs (VA) used the veteran borrowerrsquos entitlement which is a set amount the VA promises to repay a lender if the borrower defaults on the mortgage An assumption will modify who is obligated to pay the existing mortgage loan but all loan termsmdashincluding the entitlementmdashwill remain the same If the veteran borrower is being removed from the loan the entitlement would remain with whoever is assuming the loan because the loan will continue to be serviced by the VA If the applicant is also a veteran and can substitute his or her entitlement for the current entitlement then the current borrowerrsquos entitlement can be released
Please review the following questions and answer as appropriate This form requires completion by both the applicant(s) and current borrower(s)
1 Applicant to Complete
Are you (the applicant) currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the reverse side)
Yes (If yes please provide the information requested below answer the question in section 3 and sign and date this form at the bottom of the reverse side)
Name of applicant(s) who answered ldquoyesrdquo to the above question
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Are you receiving VA disability benefts
Applicant
Yes
No
Co-Applicant
Yes
No
Are you entitled to receive VA disability benefts Yes No Yes No
Have you received VA disability benefts in the past Yes No Yes No
Are you a surviving spouse of a veteran who died on active duty or as the result of a service-related disability
Yes No Yes No
Do you have any VA loans Yes No Yes No
2 Current Borrower to Complete
Is the current borrowerco-borrower currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the page)
Yes (If yes please answer the question in section 3 and sign and date this form at the bottom of the page)
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
________________________________________________________________________________________________
3 Applicant and Current Borrower to Complete
If the answer to the questions in section 1 and 2 are both yes please answer the following question After yoursquove reviewed and completed this entire form please sign and date at the bottom
Applicant Current Borrower
Do you want to apply for a substitution of entitlement Yes Yes No No
In order to complete a substitution of entitlement the veteran applicant must have suffcient entitlement to substitute for that of the current borrower Contact the VA Offce of Jurisdiction for your area for more information Also before the veteran applicant can substitute entitlement on a VA loan heshe must certify that the property securing the loan will be occupied as hisher primary residence Both the applicantrsquos and current borrowerrsquos original certifcate of eligibility will be required If your sales contract is contingent upon the restoration of entitlement please contact your VA Offce of Jurisdiction for complete procedures Otherwise the substitution will be completed after the loan has been approved and closed
Date Applicant printed name Applicant signature
Date Applicant printed name Applicant signature
Date Current Borrower printed name Current Borrower signature
Date Current Borrower printed name Current Borrower signature
Forms completed by Mail Phone
For Chase use only
Interviewer signature Date
99177-VS-0215
- Assumption Application Package_41521-noscannedpages-update-4pdf
-
- 1 FM203 Cover Pagepdf
- 2 FM202 Mortgage Assumption Application Package pagepdf
- 3 The Documents Youll need to Send Uspdf
- 4 FM201 FAQpdf
- 5 FM142 CIWpdf
- 6 FM126 URLApdf
- 7 FM130 URLA Instpdf
-
- Blank Page
-
- 8 92900a Addednum to Loan Applicationpdf
- 9 FM462 Gen Authpdf
- 10 FM220 4506-Cpdf
- 11 FM153 Chase Federal Privacy Noticepdf
- 12 FM144 Info on Opening a New Accountpdf
- 13 FM152 Veteran Statementpdf
-
- Date
- Loan number
- Applicant name
- Phone1
- Loan number 1
- Loan number 2
- Other
- Other_2
- 1
- 2
- undefined_7
- Available hours
- Available hours_2
- undefined_8
- Available hours_3
- undefined_9
- Current address 1
- Neither
- Available hours_4
- Available hours_5
- undefined_10
- Available hours_6
- 1_2
- 2_2
- undefined_11
- Available hours_7
- Available hours_8
- undefined_12
- Available hours_9
- FHA Case No include any suffix
- Mortgagee Case No
- Mortgagee ID
- Sponsor ID
- Agent ID
- Name and Address of Sponsor Name and Address of Agent
- Borrowers Name Present Address include ZIP Code Property Address
- include name of subdivision lot block no ZIP Code
- Name of ThirdParty Originator
- NMLS ID of ThirdParty Originator
- s application
- ty Number
- ty Number_2
- Date Signed_2
- Date Mortgage Approved
- Date Approval Expires
- Printed Name
- Title 1
- DEs ID Number
- DEs ID Number_2
- Mortgagee
- Name of Mortgagees Representative
- Title of Mortgagees Representative
- Signature of the Mortgagees Representative
- Date_2
- Applicant names 1
- Applicant names 2
- Applicant names 3
- Loan number_2
- Date_3
- Applicant printed name
- Social Security number
- Date_4
- Applicant printed name_2
- Social Security number_2
- Date_5
- Applicant printed name_3
- Social Security number_3
- Date_6
- Applicant printed name_4
- Social Security number_4
- 1a Name shown on tax return if a joint return enter the name shown first
- 1b First social security number on tax return individual taxpayer identification number or employer identification number see instructions
- 2a If a joint return enter spouses name shown on tax return
- 2b Second social security number or individual taxpayer identification number if joint tax return
- 4 Previous address shown on the last return filed if different from line 3 see instructions
- 5a IVES participant name address and SOR mailbox ID
- Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing see instructions
- Signature see instructions
- Date_7
- Phone number of taxpayer on line 1a or 2a
- PrintType name
- Here
- Spouses signature
- Date_8
- PrintType name_2
- Name
- Date of birth
- Service number
- Name_2
- Date of birth_2
- Service number_2
- Date_9
- Applicant printed name_5
- Date_10
- Applicant printed name_6
- Date_11
- Current Borrower printed name
- Date_12
- Current Borrower printed name_2
- Date_13
- Text3
- Text10
- undefined_13
- Text15
- undefined_14
- undefined_15
- undefined_16
- undefined_17
- undefined_18
- undefined_19
- undefined_20
- undefined_21
- undefined_23
- Reason for assumption Off
- Requestors relationship to owners Off
- Check one Off
- Check one1 Off
- Day1
- Evening
- Cell phone
- Check one2 Off
- Check one3 Off
- Check one4 Off
- Check one5 Off
- Text2-1
- Text2-2
- Text2-3
- Text2-4
- Text2-5
- Text2-6
- Text3-1
- Text3-2
- Text3-3
- Text3-4
- Text3-6
- Text3-7
- Text3-8
- Text3-9
- Text3-10
- Text3-11
- Text3-12
- Text3-13
- Text3-14
- Text3-15
- Text3-16
- Text3-17
- Text3-18
- Text3-19
- Text3-20
- Text3-21
- Text3-22
- Text3-23
- Text3-24
- Text3-25
- Text3-26
- Text3-27
- Text3-28
- Text3-29
- Text3-30
- Text3-31
- Text3-32
- Text3-33
- Text3-34
- Text3-35
- Text3-36
- Text3-37
- Text3-38
- Text3-39
- Text3-40
- Text3-41
- Text3-42
- Text3-43
- Text3-44
- Text3-45
- Text3-46
- Text3-47
- Text3-48
- Text3-49
- Text3-50
- Text3-51
- Text3-52
- Text3-53
- Text3-5
- Text3-54
- Text3-55
- Text3-56
- Citizenship Off
- Type of credit Off
- Marital Status Off
- Housing Off
- Housing1 Off
- ownership Off
- DNA1 Off
- DNA2 Off
- DNA3 Off
- family Off
- BO Off
- Total
- Text31
- Text32
- Text33
- Text34
- Text35
- Text36
- Text37
- Text38
- Text39
- Text310
- Text311
- Text312
- Text313
- Text314
- Text315
- Text316
- Text317
- Text318
- Text319
- ownership1 Off
- Total1
- Total1-2
- Check Box4-1 Off
- Text320
- Text321
- Text322
- Text323
- Text324
- Text325
- Text326
- Text327
- Text328
- Text329
- Check Box4-2 Off
- Check Box4-3 Off
- Check Box4-4 Off
- Check Box4-8 Off
- Check Box4-9 Off
- Text330
- Text331
- Text332
- Text333
- Text334
- Text335
- Text1-1
- Text1-2
- Text1-3
- Text1-4
- Text1-5
- Text1-6
- Text1-7
- Text1-8
- Text1-9
- Text1-10
- Text1-11
- Text1-12
- Text1-13
- Text1-14
- Text1-15
- Text1-16
- Text1-17
- Text1-18
- Text1-19
- Text1-20
- Text1-21
- Text1-22
- Text1-23
- Text1-24
- Text1-25
- Text1-26
- Text1-27
- Text1-28
- Text1-29
- Text1-30
- Text1-31
- Text1-32
- Text1-33
- Text1-34
- Text1-35
- Check Box3-2 Off
- Check Box2-1 Off
- Check Box2-2 Off
- Check Box2-3 Off
- Check Box2-4 Off
- Check Box2-5 Off
- Text1-36
- Text1-37
- Text1-38
- Text1-39
- Text1-40
- Text1-41
- Text1-42
- Text1-43
- Text1-44
- Text1-45
- Text1-46
- Text1-47
- Text1-48
- Text1-49
- Text1-50
- Text1-51
- Text1-52
- Text1-53
- Text1-54
- Text1-55
- Text1-56
- Text1-57
- Text1-58
- Text1-59
- Text1-60
- Text1-61
- Check Box3-11 Off
- A1
- A2
- A3
- A4
- A5
- A6
- A7
- A8
- A9
- A10
- A11
- A12
- Check Box3-1 Off
- Check Box30-1 Off
- Check Box30-2 Off
- Check Box30-4 Off
- Check Box30-5 Off
- Check Box30-7 Off
- Check Box30-8 Off
- Check Box30-9 Off
- Check Box30-10 Off
- Check Box30-11 Off
- Check Box30-12 Off
- A13
- A14
- A15
- A16
- A17 Off
- A18
- A19
- A20
- A21
- A22
- A23
- A24
- A25
- A26
- A27
- A28
- A29
- A30
- A31
- A32
- A33
- A34
- A35
- A36
- A37
- A38 Off
- A39
- A40
- A41
- A42
- A43
- A44
- A45
- A46
- A47
- A48
- A49
- A50
- A51
- A52
- A53
- A54
- A55
- A56
- A57
- A58
- A59
- A60
- A61
- A62
- A63
- A64
- A65
- A66
- A67
- A68
- A69
- A70
- A71
- A72
- A73
- A74
- Loan Purpose Off
- occupancy1 Off
- lien type Off
- lientype Off
- mixed use Off
- manufactured home Off
- deposit1 Off
- deposit2 Off
- B1
- B2
- B3
- B4
- B5
- B6
- B7
- B8
- B9
- B10
- fha Off
- Check Box51 Off
- B11
- B12
- B13
- B14
- B15
- B16
- B17
- B18
- B19 Off
- B20
- B21
- B22 Off
- B23
- B24
- B25
- B26
- B27
- B28
- A
-
- Will you occupy the property as your primary residence Off
- Will you occupy the property as your primary residence1 Off
-
- If yes have you had an ownership interest in another property in the last three years Off
- Text9-2
- B
-
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property Off
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property1 Off
-
- 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 Off
- 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 application1 Off
-
- 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 Off
- 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 application1 Off
-
- new credit Off
- 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) Off
- the Property Assessed Clean Energy Program)1 Off
-
- F
-
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application Off
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application1 Off
-
- G
-
- Are there any outstanding judgments against you Off
- Are there any outstanding judgments against you1 Off
-
- H
-
- Are you currently delinquent or in default on a Federal debt Off
- Are you currently delinquent or in default on a Federal debt1 Off
-
- I
-
- Are you a party to a lawsuit in which you potentially have any personal financial liability Off
- Are you a party to a lawsuit in which you potentially have any personal financial liability1 Off
-
- J
-
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years Off
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years1 Off
-
- 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 Off
- 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 due1 Off
-
- L
-
- Have you had property foreclosed upon in the last 7 years Off
- Have you had property foreclosed upon in the last 7 years1 Off
-
- M
-
- Have you declared bankruptcy within the past 7 years Off
- Have you declared bankruptcy within the past 7 years1 Off
-
- Check Box8-2 Off
- Check Box8-3 Off
- Check Box8-4 Off
- Text9-3
- Text9-5
- Text9-6
- Text97
- military Off
- ethnicity Off
- sex Off
- race Off
- demo Off
- Text12-1
- Check Box11-1 Off
- Check Box11-2 Off
- Check Box11-3 Off
- Check Box11-4 Off
- Check Box11-5 Off
- Check Box11-6 Off
- Check Box11-7 Off
- Check Box11-8 Off
- Check Box11-9 Off
- Text12-2
- Check Box11-10 Off
- Check Box11-11 Off
- Check Box11-12 Off
- Check Box11-13 Off
- Check Box11-14 Off
- Check Box11-15 Off
- Text12-3
- Check Box11-16 Off
- Check Box11-17 Off
- Check Box11-18 Off
- Check Box11-19 Off
- Check Box11-20 Off
- Check Box11-21 Off
- Check Box11-22 Off
- Check Box11-23 Off
- Text12-4
- Check Box11-24 Off
- Check Box11-25 Off
- Check Box11-26 Off
- Check Box11-27 Off
- Check Box11-28 Off
- Check Box11-29 Off
- Text12-5
- Check Box11-30 Off
- Check Box11-31 Off
- citizen Off
- credit Off
- marital status1 Off
- housing-1 Off
- housing-2 Off
- own Off
- C1
- C2
- C3
- C6
- C7
- C8
- C9
- C10
- C11
- C12
- C13
- C14
- C15
- C16
- C17
- C18
- C19
- C20
- C21
- C22
- C23
- C24
- C25
- C26
- C27
- C28
- C29
- C30
- C31
- C32
- C33
- C34
- C35
- Check Box-2 Off
- C36
- C37
- C38
- C39
- C4
- C40
- C41
- C42
- C43
- C44
- C45
- C46
- C47
- Check Box-3 Off
- Check Box-4 Off
- C48
- C49
- C5
- C50
- C51
- C52
- C53
- C54
- C55
- Check Box-1-1 Off
- own1 Off
- Check Box-1 Off
- D1 Off
- D2
- D3
- D4
- D5
- D6
- D7
- D8
- D9
- D10
- D11
- D12
- D13
- D14 Off
- D15 Off
- D16
- D17
- D18
- D19
- D20
- D21
- D22
- D23
- D24 Off
- D25
- D26
- D27
- D28
- D29
- D30
- D31
- D32
- D33
- D34
- D35 Off
- D36
- D37 Off
- D38
- D39
- D40
- D41
- D42
- D43
- D44
- D45
- D46
- D47
- If yes have you had an ownership interest in another property in the last three years1 Off
- new credit1 Off
- Check Box8-1 Off
- Check Box8-1-2 Off
- Check Box8-1-1 Off
- Check Box8-1-3 Off
- Check Box8-1-4 Off
- Military Service mdash Did you (or your deceased spouse) ever serve or are you currently serving in the United States Armed Forces 1 Off
- Check1 Off
- Text9-1-1
- Check2 Off
- Check3 Off
- Check4 Off
- Text9-1
- E1
- E2
- E3
- Was the ethnicity of the Borrower collected on the basis of visual observation or surname1 Off
- Was the sex of the Borrower collected on the basis of visual observation or surname1 Off
- Was the race of the Borrower collected on the basis of visual observation or surname1 Off
- The Demographic Information was provided through1 Off
- F1 Off
- F2 Off
- F3 Off
- F4 Off
- F5 Off
- F6
- F7 Off
- F8 Off
- F9 Off
- F10 Off
- F11 Off
- F12 Off
- F13
- F14 Off
- F15 Off
- F16 Off
- F17 Off
- F18 Off
- F19 Off
- F20 Off
- F21 Off
- F22
- F23 Off
- F24 Off
- F25 Off
- F26 Off
- F27 Off
- F28 Off
- F29
- F30 Off
- F31 Off
- undefined_13-1
- undefined_13-2
- undefined_14-1
- undefined_15-1
- undefined_16-1
- undefined_17-1
- undefined_18-1
- undefined_19-1
- undefined_21-1
- undefined_20-1
- undefined_23-1
- undefined_13_1
- Single-Two Off
- Refi type Off
- refi program Off
- Estate Off
- Title held Off
- Trust Information Off
- Indian Country Land Tenure Off
- Mortgage Type Applied For Off
- Mortgage Lien Type Off
- Amortization Type Off
- G1 Off
- G2 Off
- G3 Off
- G4 Off
- G5 Off
- G6
- G7
- G8
- G9
- G10 Off
- G11 Off
- G12 Off
- G13 Off
- G14 Off
- G15 Off
- G16
- G17
- G18
- G19
- G20
- G21
- G22
- G23 Off
- G24
- G25 Off
- G26
- G27 Off
- G28 Off
- G29
- G30 Off
- G31
- G32 Off
- G33
- G34
- G35
- G36
- G37
- G38
- G39
- G40
- G41
- G42
- Property Held
- refi
- Text18-1
- Text18-2
- Text18-3
- Text18-4
- Text18-5
- Text18-6
- Text18-7
- Text18-8
- Text18-9
- Text18-10
- Text18-11
- Text18-12
- Text18-13
- Text18-14
- Text18-15
- Text18-16
- Text18-17
- Text18-18
- Text18-19
- Lender
- case no
- If you selected ldquoUnmarriedrdquo in Section 1 is there a person who is not your legal spouse but who currently has real property rights similar to those of a legal spouse Off
- Relationship and State Off
- Other-5
- Text19-1
- BName
- Additional Information
- ABN
- Additional Information1
- BSign
- BSDate
- ABSign
- ABDate
- MortageeNameAddress
- NAmeAddress
- Bname1
- DOB1
- DOB2
- SignOfBorr1
- SignOfBorr
- Date Signed
- SignOfBorr2
- SignOfBorr3
- Date Signed3
- Date Signed4
- MortgageeRepSign
- DirectSign
- DirectSign1
- Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union Off
- AppSign
- AppSign1
- AppSign2
- AppSign3
- Nopage38 Off
- Yespage38 Off
- Yes1 Off
- No1 Off
- Yes2 Off
- Yes3 Off
- Yes4 Off
- Yes5 Off
- Yes6 Off
- Yes7 Off
- Yes8 Off
- Yes9 Off
- Yes10 Off
- No2 Off
- No3 Off
- No4 Off
- No5 Off
- No6 Off
- No7 Off
- No8 Off
- No9 Off
- No10 Off
- BorrowerNo Off
- BorrowerYes Off
- AppSignature
- AppSignature1
- CurrentSign
- CurrentSign1
- InterviewSign
- Yes_1 Off
- No_1 Off
- Yes_2 Off
- No_2 Off
- Mail Off
- Phone Off
Uniform Residential Loan Application mdash Unmarried Addendum
eeCeceetatimC elitleeComeLy
Lenders Instructions for Using the Unmarried Addendum
The Lender may use the Unmarried Addendum only when a Borrowerselected ldquoUnmarriedrdquoin Section 1 and the information collected is
necessary to determine howState property lawsdirectly or indirectly affecting creditworthiness apply including ensuring clear title
For example the Lender may use the Unmarried Addendum whentheBorrowerresides in a State that recognizescivil unions domestic
partnerships or registered reciprocal beneficiary relationships or when the property is located in such a State ldquoStaterdquo meansanystate the
District of Columbia the Commonwealth of Puerto Rico or anyterritory or possession of the United States
Ifyou selected ldquoUnmarriedrdquoin Section 1 is there a person whois not your legal spouse but whocurrently has real property rights similar to
those of a legal spouse +=) NOQ YES
If YES indicate the type of relationship and the State in which the relationship was formed For example indicate if you are in a
civil union domestic partnership registered reciprocal beneficiary relationship or other relationship recognized by the State in which you
currently reside or where the property is located
O Civil Union copy Domestic Partnership copy Registered Reciprocal Beneficiary Relationship copy) Other(explain)
Statea]
Borrower NameUniform Residential Loan Application mdash Unmarried Addendum
Freddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
Uniform Residential Loan Application mdash Continuation Sheet
Use this continuation sheet if you need more space to complete the Uniform Residential Loan Application
Borrower Name(First Middle Last Suffix )
Additional Information
Additional Borrower Name(First Middle Last Suffix )
Additional Information
IWefully understand thatit is a federal crime punishable by fine or imprisonment or both to knowingly make anyfalse statements concerningany of the abovefacts as applicable underthe provisions of federal law (18 USC sectsect 1001 et seq)
BorrowerSignature Date (mmddyyyy)
Additional Borrower Signature Date (mmddyyyy)
Uniform Residential Loan Application mdash Continuation SheetFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
INSTRUCTIONS FOR COMPLETING THE UNIFORM RESIDENTIAL LOAN APPLICATION
Use the instructions below to complete the enclosed Uniform Residential Loan Application (Freddie Mac Form 65Fannie Mae Form 1003) To avoid any delays in your application review please provide all of the requested information
If you need to make a correction on the application draw a line through the incorrect text and mark your initials beside the change Donrsquot use correction tape or fluid The application must be completed signed and dated in ink
The Uniform Residential Loan Application (URLA)
The URLA contains the following sections Section 1 Borrower Information Please provide your personal information income and employment
Section 2 Financial Information ndash Assets and Liabilities Please provide information about your financial assets personal financial obligations and debts you owe
Section 3 Financial Information ndash Real Estate Please provide information about property you own and the debts and expenses related to the property
Section 4 Loan and Property Information Please provide information about the loan purpose and the property you are buying or refinancing
Section 5 Declarations Please answer questions about the property how the property will be financed and your past financial history
Section 6 Acknowledgments and Agreements Informs you of your legal obligations related to the mortgage application and asks that you acknowledge certain information will be obtained used and shared
Section 7 Military Service Please provide information about your (or your deceased spousersquos) military service
Section 8 Demographic Information Requests information the Lender is required by law to ask you
Section 9 Loan Originator Information Will be completed by Chase
Uniform Residential Loan Application ndash Additional Borrower
The URLA ndash Additional Borrower contains the following sections Section 1 Borrower Information This is the same as the Borrower Information section of the URLA
Section 2 Financial Information ndash Assets and Liabilities Contains only the following statement for the additional Borrower to complete ldquoMy information for Section 2 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo The name of the other borrower is entered here
Complete a separate URLA for each BorrowermiddotThree or more Borrowers ndash Use any combination of URLA and URLA-Additional Borrower forms in accordance with the above examples
Section 3 Financial Information ndash Real Estate Contains only the following statement for the additional borrower to complete ldquoMy information for Section 3 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 4 Loan and Property Information Contains only the following statement for the additional borrower to complete ldquoMy information for Section 4 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 5 Declarations This is the same as the Declarations section of the URLA
Section 6 Acknowledgments and Agreements Contains only the following statement for the additional borrower to complete ldquoMy signature for Section 6 is on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 7 Military Service This is the same as the Military Service section of the URLA
Section 8 Demographic Information This is the same as the Demographic Information section on the URLA
Section 9 Loan Originator Information This is the same as the Loan Originator Information section of the URLA
Using the URLA and URLA ndash Additional Borrower Together The URLA and the URLA ndash Additional Borrower are used together to collect information for two Borrowers who have joint assets liabilities andor real estate information The URLA and URLA ndash Additional Borrower can also be used for Borrowers who do not have joint information but wish to combine their information on the URLA for ease of use Here are examples of how to use the URLA and URLA ndash Additional Borrower
For one borrower Complete the URLA
For two borrowers with joint financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you dont need to duplicate them on more than one URLA or o In cases where Borrowers are not collaborating when completing the loan application
joint assets liabilities and real estate may be duplicated on each URLA bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you do not need to duplicate them on more than one URLA or
o In cases where Borrowers are not collaborating when completing the loan application joint assets liabilities and real estate may be duplicated on each URLA
For two borrowers with separate financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower Report the assets liabilities and
real estate for the additional Borrower on the URLA or bull Complete a separate URLA for each Borrower
For three or more borrowers use any combination of URLA and URLA ndash Additional Borrower forms described for two borrowers
Uniform Residential Loan Application ndash Unmarried Addendum If any borrower listed on the URLA or URLA ndash Additional Borrower form selects Unmarried in Section 1 (Personal Information) the lender will complete this optional form
The information must be collected to determine how to apply state property laws that directly or indirectly affect creditworthiness including ensuring clear title
Uniform Residential Loan Application ndash Continuation Sheet Use the URLA ndash Continuation Sheet if you need more space to complete either the URLA or URLA ndash Additional Borrower forms
99177-URLAI-0215
HUD Addendum to Uniform Residential Loan Application OMB Approval No HUD 2502-0059 (exp )
Part I - Identifying Information HUDFHA Application for Insurance under the National Housing Act and Borrower Certification
FHA Case No (include any suffix) Mortgagee Case No
Mortgagee ID Sponsor ID Agent ID
Mortgagee Name Address (include ZIP Code) and Telephone Number
Type or print all entries clearly
Name and Address of Sponsor Name and Address of Agent
Borrowers Name amp Present Address (include ZIP Code) Property Address (include name of subdivision lot amp block no amp ZIP Code)
Sponsored Originations
Name of Third-Party Originator NMLS ID of Third-Party Originator
Part II - Borrower Consent for Social Security Administration to Verify Social Security Number I authorize the Social Security Administration (SSA) to verify my Social Security Number (SSN) to the Mortgagee and HUDFHA I authorize SSA to provide explanatory
information to HUDFHA in the event of a discrepancy This consent is valid for 180 days from the date signed unless indicated otherwise by the individual(s) named in this
loan application
Signature(s) of Borrower(s) - Read consent carefully Review accuracy of Social Security Number(s) provided on this application
Borrowerrsquos NameDate of BirthSocial Security Number
Co-Borrowerrsquos Name Date of BirthSocial Security Number
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
Part III - Borrower Notices Information and Acknowledgment Public Reporting Burden
Public reporting burden for this collection of information is estimated to average 10 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 conduct or sponsor and a person is not
required to respond to a collection of information unless that collection displays a valid OMB control number which can be located on the OMB Internet page at
httpwwwreginfogovpublicdoPRAMain
Privacy Act Information
The information requested on the Uniform Residential Loan Application and this Addendum is authorized by the National Housing Act of 1934 12 USC sect 1701 et seq The Debt
Collection Act of 1982 Pub L 97-365 and HUDrsquos Housing and Community Development Act of 1987 42 USC sect 3543 require persons applying for a federally insured loan to
furnish their SSN You must provide all the requested information including your SSN HUD may conduct a computer match to verify the information you provide HUD may
disclose certain information to Federal State and local agencies when relevant to civil criminal or regulatory investigations and prosecutions It will not otherwise be disclosed or
released outside of HUD except as required and permitted by law The information will be used to determine whether you qualify as a mortgagor Failure to provide any of the
requested information including SSN may result in disapproval of your loan application This is notice to you as required by the Right to Financial Privacy Act of 1978 that
HUDFHA has a right of access to financial records held by financial institutions in connection with the consideration or administration of assistance to you Financial records
involving your transaction will be available to HUDFHA without further notice or authorization but will not be disclosed or released by the institution to another Government Agency
or Department without your consent except as required or permitted by law
WARNING This warning applies to all certifications made in this document Anyone who knowingly submits a false claim or makes false statements is subject to criminal and civil penalties including confinement for up to 5 years fines and civil penalties 18 USC sectsect 287 1001 and 31 USC sect 3729
orm HUD-92900-A ( ) Page 1
Borrower Name ____________________________ FHA Case No __________________
Caution Delinquencies Defaults Foreclosures and Abuses Delinquencies defaults foreclosures and abuses of mortgage loans involving programs of the Federal Government can be costly and detrimental to your credit now and in the future The Mortgagee in this transaction its agents and assigns as well as the Federal Government its agencies agents and assigns are authorized to take any and all of the following actions in the event loan payments become delinquent on the mortgage loan described in the attached application (1) Report your name and account information to a credit bureau (2) Assess additional interest and penalty charges for the period of time that payment is not made (3) Assess charges to cover additional administrative costs incurred by the Federal Government to service your account (4) Offset amounts owed to you
under other Federal programs (5) Refer your account to a private attorney collection agency or mortgage servicing agency to collect the amount due foreclose
the mortgage sell the property and seek judgment against you for any deficiency (6) Refer your account to the Department of Justice (DOJ) for litigation in the
courts (7) If you are a current or retired Federal employee take action to offset your salary or civil service retirement benefits (8) Refer your debt to the Internal
Revenue Service for offset against any amount owed to you as an income tax refund and (9) Report any resulting written off debt of yours to the Internal Revenue Service as your taxable income All of these actions may be used to recover any debts owed when it is determined to be in the interest of the Mortgagee or Federal Government or both
As a mortgage loan borrower you will be legally obligated to make the mortgage payments called for by your mortgage loan contract The fact that you dispose of your property after the loan has been made will not relieve you of liability for making these payments Payment of the loan in full is ordinarily the way liability on a mortgage note is ended Some home buyers have the mistaken impression that if they sell their homes when they move to another locality or dispose of it for any other reasons they are no longer liable for the mortgage payments and that liability for these payments is solely that of the new owners Even though the new owners may agree in writing to assume liability for your mortgage payments this assumption agreement will not relieve you from liability to the holder of the note which you signed when you obtained the loan to buy the property Unless you are able to sell the property to a buyer who is acceptable to HUDFHA who will assume the payment of your obligation to the lender you will not be relieved from liability to repay any claim which HUDFHA may be required to pay your lender on account of default in your loan payments The amount of any such claim payment may be a debt owed by you to the Federal Government and subject to established collection procedures
Fair Housing Act I and anyone acting on my behalf are and will remain in compliance with the Fair Housing Act 42 USC sect 3604 et seq with respect to the dwelling or property covered by the loan and in the provision of services or facilities in connection therewith I recognize that any restrictive covenant on this property related to race color religion sex disability familial status or national origin is unlawful under the Fair Housing Act and unenforceable I further recognize that in addition to administrative action by HUD a civil action may be brought by the DOJ in any appropriate US court against any person responsible for a violation of the
applicable law
Certification and Acknowledgment All information in this application is given for the purpose of obtaining a loan to be insured under the National Housing Act and the information in the Uniform Residential Loan Application and this Addendum is true and complete to the best of my knowledge and belief Verification may be obtained from any source named herein I have read and understand the foregoing concerning my liability on the loan and Part III Borrower Notices Information and Acknowledgment
Signature(s) of Borrower(s) - Do not sign unless this application is fully completed Read the certification carefully and review accuracy of this application
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
orm HUD-92900-A ( Page 2
___________________________________
______________________________________________________
______________________________________________________________
- - - - - - - - - - - - - - - - - - - - - - -
Borrower Name ____________________________ FHA Case No __________________
Part IV - Direct Endorsement Approval for a HUD FHA-Insured Mortgage A Underwriting the Borrower
Date Mortgage Approved ______________________________ Date Approval Expires ______________________
For mortgages rated as an ldquoacceptrdquo or ldquoapproverdquo by FHAs TOTAL Mortgage Scorecard
The information submitted to TOTAL was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA4e Final Underwriting Decision (TOTAL) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee Representative Signature
Printed Name
Title
OR
For mortgages rated as a ldquoreferrdquo by FHAs TOTAL Mortgage Scorecard or manually underwritten by a Direct Endorsement underwriter I have personally reviewed and underwritten the borrowerrsquos credit application The information used to underwrite the borrower was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA5d Final Underwriting Decision (Manual) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
B Underwriting the Property
For all mortgages where FHA requires an appraisal I have personally reviewed and underwritten the appraisal according to FHA requirements I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
orm HUD-92900-A ( ) Page 3
Borrower Name ____________________________ FHA Case No __________________
Part V Mortgagees Certification
I have personally reviewed the mortgage documents and the application for insurance endorsement and This mortgage complies with SF Handbook 40001 Section IIA7 Post-Closing and Endorsement to the extent that no defect exists that would have changed the decision to endorse or submit the mortgage for insurance
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee
Name of Mortgageersquos Representative
Title of Mortgageersquos Representative
Signature of the Mortgageersquos Representative Date
orm HUD-92900-A ( ) Page 4
GENERAL AUTHORIZATION FOR A MORTGAGE LOAN ASSUMPTION
Applicant name(s)
Loan number
NOTICES AND DISCLOSURES
Non-discriminatory underwriting guidelines Anyone who inquires about the availability of credit from us has the right to receive a copy of our non-discriminatory underwriting guidelines To request a copy of these guidelines contact your Loan Processor
Attorney note Itrsquos the responsibility of our attorneys to protect our interest You may at your expense request an attorney to represent your interest
Notice to HUDFHA applicants As required by the Right to Financial Privacy Act of 1978 this notice is to inform you that the US Department of Housing and Urban Development (HUD)Federal Housing Administration (FHA) has a right of access to financial records held by financial institutions related to a request for assistance Financial records involving your assumption will be available to HUDFHA without further notice or authorization but wonrsquot be disclosed or released by us to another government agency or department without your consent except as required or permitted by law
Borrower consent to the use of tax return information I understand acknowledge and agree that the Lender and Other Loan Participants can obtain use and share tax return information for purposes of (i) providing an offer (ii) originating maintaining managing monitoring servicing selling insuring and securitizing a loan (iii) marketing or (iv) as otherwise permitted by applicable laws including state and federal privacy and data security laws The Lender includes the Lenderrsquos affiliates agents service providers and any of aforementioned partiesrsquo successors and assigns The Other Loan Participants includes any actual or potential owners of a loan resulting from your loan application or acquirers of any beneficial or other interest in the loan and mortgage insurer guarantor any servicers or service providers for these parties and any of aforementioned partiesrsquo successors and assigns
CERTIFICATION AND AUTHORIZATION
Environmental certification By signing below I represent and warrant that Irsquom not aware of any substances materials or products that may be an environmental hazard such as but not limited to asbestos formaldehyde radon gas lead-based paint fuel or chemical storage tanks (above or below ground) and contaminated soil or water on the property I acknowledge that Chase is relying on this representation and warranty as a material part of its loan application process I also am not aware of any landfill on any portion of the property
Exceptions to the above I further acknowledge (1) receipt of applicable disclosures from the seller in purchase transactions (2) that lead-based paint may exist in housing constructed prior to 1978 (3) that Chase performs no environmental investigation on my behalf and isnrsquot responsible for identifying lead-based paint or any other environmental conditions that might impact the property or its residents and (4) that it is my sole obligation to investigate for potential impact to the property from environmental conditions
Certifications I certify by signing below that (1) all of the loan application information provided is true and complete (2) I understand any intentional or negligent misrepresentation(s) of the information provided in conjunction with my application may result in civil liability andor 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 Chase its agents successors and assigns insurers and any other person who may suffer any loss due to reliance upon any misrepresentation that I have made on the application and (3) any significant change from the information provided at the time of application until the final loan application is signed may have a bearing on the approval of my application for a home loan
Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union
This question is asked because of state laws that extend the same or similar rights benefits and protections of spouses in a marriage to persons who are members of a partnership or union recognized under state law You should consult with your own legal advisor for advice regarding the rights protections benefits responsibilities obligations and duties of those who are registered domestic partners civil union partners or members of other unions recognized under applicable law
CREDIT AUTHORIZATION RELEASE
By signing below I authorize Chase andor my mortgage insurer (if any) to verify my past and present employment earnings records (including information contained in income tax returns that have been filed with the IRS) bank accounts stock holdings and any other information that it finds necessary to process my mortgage loan application or to review it for quality-control purposes I understand that a credit report will be ordered from a credit reporting agency for verification prior to loan closing as part of the application process and may be ordered after closing as part of the Lenderrsquos quality-control program A credit report may also be completed as part of the Lenderrsquos servicing or collection of the loan or in consideration of any other product or service that the Lender may consider offering me in the future and at any time throughout the life of the loan I understand that use of a photocopy of this form may be necessary to verify one or more of my credit references I understand that a photocopy or fax copy of this form will also serve as authorization
By signing below each applicant acknowledges (1) making the above certifications and authorizations and (2) that each applicant has received and understands the above notices and disclosures
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
You do not have to give us this information but if you donrsquot your application for approval as a borrower may be delayed or rejected The information requested in this form is authorized by Title 38 USC Chapter 37 (if VA) by 12 USC Section 1701 et seq (if HUDFHA) by 42 USC Section 1452b (if HUDCPD) and Title 42 USC 1471 et seq or 7 USC 1921 et seq (if USDA FHA)
Updated December 2021 99177-GA-0215
1b
2b
Form 4506-C (September 2020)
Department of the Treasury - Internal Revenue Service
IVES Request for Transcript of Tax Return OMB Number
1545-1872
Do not sign this form unless all applicable lines have been completed Request may be rejected if the form is incomplete or illegible
For more information about Form 4506-C visit wwwirsgov and search IVES
1a Name shown on tax return (if a joint return enter the name shown first)
First social security number on tax return individual taxpayer identification number or employer identification number (see instructions)
2a If a joint return enter spousersquos name shown on tax return Second social security number or individual taxpayer identification number if joint tax return
3 Current name address (including apt room or suite no) city state and ZIP code (see instructions)
4 Previous address shown on the last return filed if different from line 3 (see instructions)
5a IVES participant name address and SOR mailbox ID
DataVerify 875 Greentree Rd 8 Parkway Center Pittsburgh PA 15220
5b Customer file number (if applicable) (see instructions)
Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing (see instructions)
6 Transcript requested Enter the tax form number here (1040 1065 1120 etc) and check the appropriate box below Enter only one tax form number per request 1040
a Return Transcript which includes most of the line items of a tax return as filed with the IRS A tax return transcript does not reflect changes made to the account after the return is processed Transcripts are only available for the following returns Form 1040 series Form 1065 Form 1120 Form 1120-A Form 1120-H Form 1120-L and Form 1120S Return transcripts are available for the current year and returns processed during the prior 3 processing years
b Account Transcript which contains information on the financial status of the account such as payments made on the account penalty assessments and adjustments made by you or the IRS after the return was filed Return information is limited to items such as tax liability and estimated tax payments Account transcripts are available for most returns
c Record of Account which provides the most detailed information as it is a combination of the Return Transcript and the Account Transcript Available for current year and 3 prior tax years
7 Form W-2 Form 1099 series Form 1098 series or Form 5498 series transcript The IRS can provide a transcript that includes data from these information returns State or local information is not included with the Form W-2 information The IRS may be able to provide this transcript information for up to 10 years Information for the current year is generally not available until the year after it is filed with the IRS For example W-2 information for 2016 filed in 2017 will likely not be available from the IRS until 2018 If you need W-2 information for retirement purposes you should contact the Social Security Administration at 1-800-772-1213
Caution If you need a copy of Form W-2 or Form 1099 you should first contact the payer To get a copy of the Form W-2 or Form 1099 filed with your return you must use Form 4506 and request a copy of your return which includes all attachments
8 Year or period requested Enter the ending date of the tax year or period using the mmddyyyy format (see instructions)
12 31 2020 12 31 2019 12 31 2018 Caution Do not sign this form unless all applicable lines have been completed
Signature of taxpayer(s) I declare that I am either the taxpayer whose name is shown on line 1a or 2a or a person authorized to obtain the tax information requested If the request applies to a joint return at least one spouse must sign If signed by a corporate officer 1 percent or more shareholder partner managing member guardian tax matters partner executor receiver administrator trustee or party other than the taxpayer I certify that I have the authority to execute Form 4506-C on behalf of the taxpayer Note This form must be received by IRS within 120 days of the signature date
Signatory attests that heshe has read the attestation clause and upon so reading declares that heshe has the authority to sign the Form 4506-C See instructions
Sign Here
Signature (see instructions) Date Phone number of taxpayer on line 1a or 2a
PrintType name
Title (if line 1a above is a corporation partnership estate or trust)
Spousersquos signature Date
PrintType name
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020) For Privacy Act and Paperwork Reduction Act Notice see page 2
Instructions for Form 4506-C IVES Request for Transcript of Tax Return
Section references are to the Internal Revenue Code unless otherwise noted
Future Developments
For the latest information about Form 4506-C and its instructions go to wwwirsgov and search IVES Information about any recent developments affecting Form 4506-C (such as legislation enacted after we released it) will be posted on that page
Whats New Form 4506-C was created to be utilized by authorized IVES participants to order tax transcripts with the consent of the taxpayer
General Instructions
Caution Do not sign this form unless all applicable lines have been completed
Designated Recipient Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information received pursuant to the taxpayerrsquos consent and holds the recipient subject to penalties for any unauthorized access other use or redisclosure without the taxpayerrsquos express permission or request
Taxpayer Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information provided pursuant to your consent and holds the recipient subject to penalties brought by private right of action for any unauthorized access other use or redisclosure without your express permission or request
Purpose of form Use Form 4506-C to request tax return information through an authorized IVES participant You will designate an IVES participant to receive the information on line 5a
Note If you are unsure of which type of transcript you need check with the party requesting your tax information
Where to file The IVES participant will fax Form 4506-C with the approved IVES cover sheet to their assigned Service Center
Chart for ordering transcripts
If your assigned Service Center is
Fax the requests with the approved coversheet to
Austin Submission Processing Center
Austin IVES Team
844-249-6238
Fresno Submission Processing Center
Fresno IVES Team
844-249-6239
Kansas City Submission Processing Center
Kansas City IVES Team
844-249-8128
Ogden Submission Processing Center
Ogden IVES Team
844-249-8129
Specific Instructions
Line 1b Enter the social security number (SSN) or individual taxpayer identification number (ITIN) for the individual listed on line 1a or enter the employer identification number (EIN) for the business listed on line 1a
Line 3 Enter your current address If you use a PO box include it on this line
Line 4 Enter the address shown on the last return filed if different from the address entered on line 3
Note If the addresses on lines 3 and 4 are different and you have not changed your address with the IRS file Form 8822 Change of Address or Form 8822-BChange of Address or Responsible Party mdash Business with Form 4506-C
Line 5b Enter up to 10 numeric characters to create a unique customer file number that will appear on the transcript The customer file number cannot contain an SSN ITIN or EIN Completion of this line is not required
Note If you use an SSN name or combination of both we will not input the information and the customer file number will reflect a generic entry of 9999999999 on the transcript
Line 8 Enter the end date of the tax year or period requested in mmddyyyy format This may be a calendar year fiscal year or quarter Enter each quarter requested for quarterly returns Example Enter 12312018 for a calendar year 2018 Form 1040 transcript
Signature and date Form 4506-C must be signed and dated by the taxpayer listed on line 1a or 2a The IRS must receive Form 4506-C within 120 days of the date signed by the taxpayer or it will be rejected Ensure that all applicable lines including lines 5a through 8 are completed before signing
You must check the box in the signature area to acknowledge you have the authority to sign and request the information The form will not be processed if unchecked
Individuals Transcripts listed on on line 6 may be furnished to either spouse if jointly filed Only one signature is required Sign Form 4506-C exactly as your name appeared on the original return If you changed your name also sign your current name
Corporations Generally Form 4506-C can be signed by
(1) an officer having legal authority to bind the corporation (2) any person designated by the board of directors or other governing body or (3) any officer or employee on written request by any principal officer and attested to by the secretary or other officer A bona fide shareholder of record owning 1 percent or more of the outstanding stock of the corporation may submit a Form 4506-C but must provide documentation to support the requesters right to receive the information
Partnerships Generally Form 4506-C can be signed by any person who was a member of the partnership during any part of the tax period requested on line 8
All others See section 6103(e) if the taxpayer has died is insolvent is a dissolved corporation or if a trustee guardian executor receiver or administrator is acting for the taxpayer
Note If you are Heir at law Next of kin or Beneficiary you must be able to establish a material interest in the estate or trust
Documentation For entities other than individuals you must attach the authorization document For example this could be the letter from the principal officer authorizing an employee of the corporation or the letters testamentary authorizing an individual to act for an estate
Signature by a representative A representative can sign Form 4506-C for a taxpayer only if the taxpayer has specifically delegated this authority to the representative on Form 2848 line 5 The representative must attach Form 2848 showing the delegation to sign Form 4506-C
Privacy Act and Paperwork Reduction Act Notice We ask for the information on this form to establish your right to gain access to the requested tax information under the Internal Revenue Code We need this information to properly identify the tax information and respond to your request You are not required to request any transcript if you do request a transcript sections 6103 and 6109 and their regulations require you to provide this information including your SSN or EIN If you do not provide this information we may not be able to process your request Providing false or fraudulent information may subject you to penalties
Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and cities states the District of Columbia and US commonwealths and possessions for use in administering their tax laws We may also disclose this information to other countries under a tax treaty to federal and state agencies to enforce federal nontax criminal laws or to federal law enforcement and intelligence agencies to combat terrorism
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law Generally tax returns and return information are confidential as required by section 6103
The time needed to complete and file Form 4506-C will vary depending on individual circumstances The estimated average time is
Learning about the law or the form 10 min Preparing the form 12 min Copying assembling and sending the form to the IRS 20 min
If you have comments concerning the accuracy of these time estimates or suggestions for making Form 4506-C simpler we would be happy to hear from you You can write to
Internal Revenue Service Tax Forms and Publications Division 1111 Constitution Ave NW IR-6526 Washington DC 20224
Do not send the form to this address Instead see Where to file on this page
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020)
Rev April 2021 CHASEO Facts What does Chase do with your personal information
Why Financial companies choose how they share your personal information Federal law gives consumers the right to limit some but not all sharing Federal law also requires us to tell you how we collect share and protect your personal information Please read this notice carefully to understand what we do
What The types of personal information we collect and share depend on the product or service you have with us This information can include bull Social Security number and income bull account balances and transaction history bull credit history and payment history
How All financial companies need to share customers personal information to run their everyday business In the section below we list the reasons financial companies can share their customers personal information the reasons Chase chooses to share and whether you can limit this sharing
Reasons we can share your personal information Does Chase share
Can you limit this sharing
For our everyday business purposes - such as to process your transactions maintain your account(s) respond to court orders and legal investigations or report to credit bureaus
Yes No
For our marketing purposes - to offer our products and services to you
Yes No
For joint marketing with other financial companies Yes No
For our affiliates everyday business purposes - information about your transactions and experiences
Yes No
For our affiliates everyday business purposes - information about your creditworthiness
Yes Yes
For our affiliates to market to you Yes Yes
For nonaffiliates to market to you Yes Yes
a
0
To limit our sharing
bull Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
bull Visit us online chasecomprivacypreferences
Please note If you are a new customer we can begin sharing your information 30 days from the date we sent this notice When you are no longer our customer we continue to share your information as described in this notice However you can contact us at any time to limit our sharing
Questions
Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
PAGE 2
Who we are
Who is providing this notice The US consumer financial companies within the JPMorgan Chase amp Co family including JPMorgan Chase Bank NA Chase Insurance Agency Inc and JP Morgan Securities LLC
What we do
How does Chase protect my To protect your personal information from unauthorized access and use we personal information use security measures that comply with federal law These measures include
computer safeguards and secured files and buildings We authorize our employees to get your information only when they need it to do their work and we require companies that work for us to protect your information
How does Chase collect my We collect your personal information for example when you personal information bull open an account or make deposits or withdrawals from your account
bull pay your bills or apply for a loan bull use your credit or debit card We also collect your personal information from others such as credit bureaus affiliates or other companies
Why cant I limit all sharing Federal law gives you the right to limit only bull sharing for affiliates everyday business purposes - information about your
creditworthiness bull affiliates from using your information to market to you bull sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing See below for more on your rights under state law
What happens when I limit sharing for an account I hold jointly with someone else
Your choices will apply to everyone on your account
Definitions
Affiliates Companies related by common ownership or control They can be financial and non financial companies bull Our affiliates include companies with a Chase or JP Morgan name and financial companies such asjP Morgan Securities LLC
Nonaffiliates Companies not related by common ownership or control They can be financial and non financial companies bull Nonaffiliates we share with can include companies such as retailers auto dealers auto makers and membership clubs
Joint marketing A formal agreement between nonaffiliated financial companies that together market financial products or services to you bull Our joint marketing partners include categories of companies such as insurance companies
Other important information
VT Accounts with a Vermont mailing address are automatically treated as if they have limited the sharing as described on page 1 For joint marketing we will only disclose your name contact information and information about your transactions
NV We are providing you this notice pursuant to Nevada law If you prefer not to receive marketing calls from us you may be placed on our Internal Do Not Call List by calling 1-800-945-9470 or by writing to us at PO Box 734007 Dallas TX 75373-4007
For more information contact us at the address above or email PrivacylnfoJPMChasecom with Nevada Annual Notice in the subject line You may also contact the Nevada Attorney Generals office Bureau of Consumer Protection Office of the Nevada Attorney General 555 E Washington St Suite 3900 Las Vegas NV 89101 telephone number 1-702-486-3132 email BCPINFOagstatenvus
CA Accounts with a California mailing address are automatically treated as if they have limited the sharing with nonaffiliates as described on page 1 CA residents are provided a CA notice for additional choices
CHASE O
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
The following disclosure is required by the USA PATRIOT Act
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 opens an account
What this means to you When you 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 drivers
license or other identifying documents
99177-PAT-0215
VETERAN STATEMENT When this loan was opened the US Department of Veterans Affairs (VA) used the veteran borrowerrsquos entitlement which is a set amount the VA promises to repay a lender if the borrower defaults on the mortgage An assumption will modify who is obligated to pay the existing mortgage loan but all loan termsmdashincluding the entitlementmdashwill remain the same If the veteran borrower is being removed from the loan the entitlement would remain with whoever is assuming the loan because the loan will continue to be serviced by the VA If the applicant is also a veteran and can substitute his or her entitlement for the current entitlement then the current borrowerrsquos entitlement can be released
Please review the following questions and answer as appropriate This form requires completion by both the applicant(s) and current borrower(s)
1 Applicant to Complete
Are you (the applicant) currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the reverse side)
Yes (If yes please provide the information requested below answer the question in section 3 and sign and date this form at the bottom of the reverse side)
Name of applicant(s) who answered ldquoyesrdquo to the above question
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Are you receiving VA disability benefts
Applicant
Yes
No
Co-Applicant
Yes
No
Are you entitled to receive VA disability benefts Yes No Yes No
Have you received VA disability benefts in the past Yes No Yes No
Are you a surviving spouse of a veteran who died on active duty or as the result of a service-related disability
Yes No Yes No
Do you have any VA loans Yes No Yes No
2 Current Borrower to Complete
Is the current borrowerco-borrower currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the page)
Yes (If yes please answer the question in section 3 and sign and date this form at the bottom of the page)
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
________________________________________________________________________________________________
3 Applicant and Current Borrower to Complete
If the answer to the questions in section 1 and 2 are both yes please answer the following question After yoursquove reviewed and completed this entire form please sign and date at the bottom
Applicant Current Borrower
Do you want to apply for a substitution of entitlement Yes Yes No No
In order to complete a substitution of entitlement the veteran applicant must have suffcient entitlement to substitute for that of the current borrower Contact the VA Offce of Jurisdiction for your area for more information Also before the veteran applicant can substitute entitlement on a VA loan heshe must certify that the property securing the loan will be occupied as hisher primary residence Both the applicantrsquos and current borrowerrsquos original certifcate of eligibility will be required If your sales contract is contingent upon the restoration of entitlement please contact your VA Offce of Jurisdiction for complete procedures Otherwise the substitution will be completed after the loan has been approved and closed
Date Applicant printed name Applicant signature
Date Applicant printed name Applicant signature
Date Current Borrower printed name Current Borrower signature
Date Current Borrower printed name Current Borrower signature
Forms completed by Mail Phone
For Chase use only
Interviewer signature Date
99177-VS-0215
- Assumption Application Package_41521-noscannedpages-update-4pdf
-
- 1 FM203 Cover Pagepdf
- 2 FM202 Mortgage Assumption Application Package pagepdf
- 3 The Documents Youll need to Send Uspdf
- 4 FM201 FAQpdf
- 5 FM142 CIWpdf
- 6 FM126 URLApdf
- 7 FM130 URLA Instpdf
-
- Blank Page
-
- 8 92900a Addednum to Loan Applicationpdf
- 9 FM462 Gen Authpdf
- 10 FM220 4506-Cpdf
- 11 FM153 Chase Federal Privacy Noticepdf
- 12 FM144 Info on Opening a New Accountpdf
- 13 FM152 Veteran Statementpdf
-
- Date
- Loan number
- Applicant name
- Phone1
- Loan number 1
- Loan number 2
- Other
- Other_2
- 1
- 2
- undefined_7
- Available hours
- Available hours_2
- undefined_8
- Available hours_3
- undefined_9
- Current address 1
- Neither
- Available hours_4
- Available hours_5
- undefined_10
- Available hours_6
- 1_2
- 2_2
- undefined_11
- Available hours_7
- Available hours_8
- undefined_12
- Available hours_9
- FHA Case No include any suffix
- Mortgagee Case No
- Mortgagee ID
- Sponsor ID
- Agent ID
- Name and Address of Sponsor Name and Address of Agent
- Borrowers Name Present Address include ZIP Code Property Address
- include name of subdivision lot block no ZIP Code
- Name of ThirdParty Originator
- NMLS ID of ThirdParty Originator
- s application
- ty Number
- ty Number_2
- Date Signed_2
- Date Mortgage Approved
- Date Approval Expires
- Printed Name
- Title 1
- DEs ID Number
- DEs ID Number_2
- Mortgagee
- Name of Mortgagees Representative
- Title of Mortgagees Representative
- Signature of the Mortgagees Representative
- Date_2
- Applicant names 1
- Applicant names 2
- Applicant names 3
- Loan number_2
- Date_3
- Applicant printed name
- Social Security number
- Date_4
- Applicant printed name_2
- Social Security number_2
- Date_5
- Applicant printed name_3
- Social Security number_3
- Date_6
- Applicant printed name_4
- Social Security number_4
- 1a Name shown on tax return if a joint return enter the name shown first
- 1b First social security number on tax return individual taxpayer identification number or employer identification number see instructions
- 2a If a joint return enter spouses name shown on tax return
- 2b Second social security number or individual taxpayer identification number if joint tax return
- 4 Previous address shown on the last return filed if different from line 3 see instructions
- 5a IVES participant name address and SOR mailbox ID
- Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing see instructions
- Signature see instructions
- Date_7
- Phone number of taxpayer on line 1a or 2a
- PrintType name
- Here
- Spouses signature
- Date_8
- PrintType name_2
- Name
- Date of birth
- Service number
- Name_2
- Date of birth_2
- Service number_2
- Date_9
- Applicant printed name_5
- Date_10
- Applicant printed name_6
- Date_11
- Current Borrower printed name
- Date_12
- Current Borrower printed name_2
- Date_13
- Text3
- Text10
- undefined_13
- Text15
- undefined_14
- undefined_15
- undefined_16
- undefined_17
- undefined_18
- undefined_19
- undefined_20
- undefined_21
- undefined_23
- Reason for assumption Off
- Requestors relationship to owners Off
- Check one Off
- Check one1 Off
- Day1
- Evening
- Cell phone
- Check one2 Off
- Check one3 Off
- Check one4 Off
- Check one5 Off
- Text2-1
- Text2-2
- Text2-3
- Text2-4
- Text2-5
- Text2-6
- Text3-1
- Text3-2
- Text3-3
- Text3-4
- Text3-6
- Text3-7
- Text3-8
- Text3-9
- Text3-10
- Text3-11
- Text3-12
- Text3-13
- Text3-14
- Text3-15
- Text3-16
- Text3-17
- Text3-18
- Text3-19
- Text3-20
- Text3-21
- Text3-22
- Text3-23
- Text3-24
- Text3-25
- Text3-26
- Text3-27
- Text3-28
- Text3-29
- Text3-30
- Text3-31
- Text3-32
- Text3-33
- Text3-34
- Text3-35
- Text3-36
- Text3-37
- Text3-38
- Text3-39
- Text3-40
- Text3-41
- Text3-42
- Text3-43
- Text3-44
- Text3-45
- Text3-46
- Text3-47
- Text3-48
- Text3-49
- Text3-50
- Text3-51
- Text3-52
- Text3-53
- Text3-5
- Text3-54
- Text3-55
- Text3-56
- Citizenship Off
- Type of credit Off
- Marital Status Off
- Housing Off
- Housing1 Off
- ownership Off
- DNA1 Off
- DNA2 Off
- DNA3 Off
- family Off
- BO Off
- Total
- Text31
- Text32
- Text33
- Text34
- Text35
- Text36
- Text37
- Text38
- Text39
- Text310
- Text311
- Text312
- Text313
- Text314
- Text315
- Text316
- Text317
- Text318
- Text319
- ownership1 Off
- Total1
- Total1-2
- Check Box4-1 Off
- Text320
- Text321
- Text322
- Text323
- Text324
- Text325
- Text326
- Text327
- Text328
- Text329
- Check Box4-2 Off
- Check Box4-3 Off
- Check Box4-4 Off
- Check Box4-8 Off
- Check Box4-9 Off
- Text330
- Text331
- Text332
- Text333
- Text334
- Text335
- Text1-1
- Text1-2
- Text1-3
- Text1-4
- Text1-5
- Text1-6
- Text1-7
- Text1-8
- Text1-9
- Text1-10
- Text1-11
- Text1-12
- Text1-13
- Text1-14
- Text1-15
- Text1-16
- Text1-17
- Text1-18
- Text1-19
- Text1-20
- Text1-21
- Text1-22
- Text1-23
- Text1-24
- Text1-25
- Text1-26
- Text1-27
- Text1-28
- Text1-29
- Text1-30
- Text1-31
- Text1-32
- Text1-33
- Text1-34
- Text1-35
- Check Box3-2 Off
- Check Box2-1 Off
- Check Box2-2 Off
- Check Box2-3 Off
- Check Box2-4 Off
- Check Box2-5 Off
- Text1-36
- Text1-37
- Text1-38
- Text1-39
- Text1-40
- Text1-41
- Text1-42
- Text1-43
- Text1-44
- Text1-45
- Text1-46
- Text1-47
- Text1-48
- Text1-49
- Text1-50
- Text1-51
- Text1-52
- Text1-53
- Text1-54
- Text1-55
- Text1-56
- Text1-57
- Text1-58
- Text1-59
- Text1-60
- Text1-61
- Check Box3-11 Off
- A1
- A2
- A3
- A4
- A5
- A6
- A7
- A8
- A9
- A10
- A11
- A12
- Check Box3-1 Off
- Check Box30-1 Off
- Check Box30-2 Off
- Check Box30-4 Off
- Check Box30-5 Off
- Check Box30-7 Off
- Check Box30-8 Off
- Check Box30-9 Off
- Check Box30-10 Off
- Check Box30-11 Off
- Check Box30-12 Off
- A13
- A14
- A15
- A16
- A17 Off
- A18
- A19
- A20
- A21
- A22
- A23
- A24
- A25
- A26
- A27
- A28
- A29
- A30
- A31
- A32
- A33
- A34
- A35
- A36
- A37
- A38 Off
- A39
- A40
- A41
- A42
- A43
- A44
- A45
- A46
- A47
- A48
- A49
- A50
- A51
- A52
- A53
- A54
- A55
- A56
- A57
- A58
- A59
- A60
- A61
- A62
- A63
- A64
- A65
- A66
- A67
- A68
- A69
- A70
- A71
- A72
- A73
- A74
- Loan Purpose Off
- occupancy1 Off
- lien type Off
- lientype Off
- mixed use Off
- manufactured home Off
- deposit1 Off
- deposit2 Off
- B1
- B2
- B3
- B4
- B5
- B6
- B7
- B8
- B9
- B10
- fha Off
- Check Box51 Off
- B11
- B12
- B13
- B14
- B15
- B16
- B17
- B18
- B19 Off
- B20
- B21
- B22 Off
- B23
- B24
- B25
- B26
- B27
- B28
- A
-
- Will you occupy the property as your primary residence Off
- Will you occupy the property as your primary residence1 Off
-
- If yes have you had an ownership interest in another property in the last three years Off
- Text9-2
- B
-
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property Off
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property1 Off
-
- 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 Off
- 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 application1 Off
-
- 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 Off
- 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 application1 Off
-
- new credit Off
- 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) Off
- the Property Assessed Clean Energy Program)1 Off
-
- F
-
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application Off
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application1 Off
-
- G
-
- Are there any outstanding judgments against you Off
- Are there any outstanding judgments against you1 Off
-
- H
-
- Are you currently delinquent or in default on a Federal debt Off
- Are you currently delinquent or in default on a Federal debt1 Off
-
- I
-
- Are you a party to a lawsuit in which you potentially have any personal financial liability Off
- Are you a party to a lawsuit in which you potentially have any personal financial liability1 Off
-
- J
-
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years Off
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years1 Off
-
- 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 Off
- 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 due1 Off
-
- L
-
- Have you had property foreclosed upon in the last 7 years Off
- Have you had property foreclosed upon in the last 7 years1 Off
-
- M
-
- Have you declared bankruptcy within the past 7 years Off
- Have you declared bankruptcy within the past 7 years1 Off
-
- Check Box8-2 Off
- Check Box8-3 Off
- Check Box8-4 Off
- Text9-3
- Text9-5
- Text9-6
- Text97
- military Off
- ethnicity Off
- sex Off
- race Off
- demo Off
- Text12-1
- Check Box11-1 Off
- Check Box11-2 Off
- Check Box11-3 Off
- Check Box11-4 Off
- Check Box11-5 Off
- Check Box11-6 Off
- Check Box11-7 Off
- Check Box11-8 Off
- Check Box11-9 Off
- Text12-2
- Check Box11-10 Off
- Check Box11-11 Off
- Check Box11-12 Off
- Check Box11-13 Off
- Check Box11-14 Off
- Check Box11-15 Off
- Text12-3
- Check Box11-16 Off
- Check Box11-17 Off
- Check Box11-18 Off
- Check Box11-19 Off
- Check Box11-20 Off
- Check Box11-21 Off
- Check Box11-22 Off
- Check Box11-23 Off
- Text12-4
- Check Box11-24 Off
- Check Box11-25 Off
- Check Box11-26 Off
- Check Box11-27 Off
- Check Box11-28 Off
- Check Box11-29 Off
- Text12-5
- Check Box11-30 Off
- Check Box11-31 Off
- citizen Off
- credit Off
- marital status1 Off
- housing-1 Off
- housing-2 Off
- own Off
- C1
- C2
- C3
- C6
- C7
- C8
- C9
- C10
- C11
- C12
- C13
- C14
- C15
- C16
- C17
- C18
- C19
- C20
- C21
- C22
- C23
- C24
- C25
- C26
- C27
- C28
- C29
- C30
- C31
- C32
- C33
- C34
- C35
- Check Box-2 Off
- C36
- C37
- C38
- C39
- C4
- C40
- C41
- C42
- C43
- C44
- C45
- C46
- C47
- Check Box-3 Off
- Check Box-4 Off
- C48
- C49
- C5
- C50
- C51
- C52
- C53
- C54
- C55
- Check Box-1-1 Off
- own1 Off
- Check Box-1 Off
- D1 Off
- D2
- D3
- D4
- D5
- D6
- D7
- D8
- D9
- D10
- D11
- D12
- D13
- D14 Off
- D15 Off
- D16
- D17
- D18
- D19
- D20
- D21
- D22
- D23
- D24 Off
- D25
- D26
- D27
- D28
- D29
- D30
- D31
- D32
- D33
- D34
- D35 Off
- D36
- D37 Off
- D38
- D39
- D40
- D41
- D42
- D43
- D44
- D45
- D46
- D47
- If yes have you had an ownership interest in another property in the last three years1 Off
- new credit1 Off
- Check Box8-1 Off
- Check Box8-1-2 Off
- Check Box8-1-1 Off
- Check Box8-1-3 Off
- Check Box8-1-4 Off
- Military Service mdash Did you (or your deceased spouse) ever serve or are you currently serving in the United States Armed Forces 1 Off
- Check1 Off
- Text9-1-1
- Check2 Off
- Check3 Off
- Check4 Off
- Text9-1
- E1
- E2
- E3
- Was the ethnicity of the Borrower collected on the basis of visual observation or surname1 Off
- Was the sex of the Borrower collected on the basis of visual observation or surname1 Off
- Was the race of the Borrower collected on the basis of visual observation or surname1 Off
- The Demographic Information was provided through1 Off
- F1 Off
- F2 Off
- F3 Off
- F4 Off
- F5 Off
- F6
- F7 Off
- F8 Off
- F9 Off
- F10 Off
- F11 Off
- F12 Off
- F13
- F14 Off
- F15 Off
- F16 Off
- F17 Off
- F18 Off
- F19 Off
- F20 Off
- F21 Off
- F22
- F23 Off
- F24 Off
- F25 Off
- F26 Off
- F27 Off
- F28 Off
- F29
- F30 Off
- F31 Off
- undefined_13-1
- undefined_13-2
- undefined_14-1
- undefined_15-1
- undefined_16-1
- undefined_17-1
- undefined_18-1
- undefined_19-1
- undefined_21-1
- undefined_20-1
- undefined_23-1
- undefined_13_1
- Single-Two Off
- Refi type Off
- refi program Off
- Estate Off
- Title held Off
- Trust Information Off
- Indian Country Land Tenure Off
- Mortgage Type Applied For Off
- Mortgage Lien Type Off
- Amortization Type Off
- G1 Off
- G2 Off
- G3 Off
- G4 Off
- G5 Off
- G6
- G7
- G8
- G9
- G10 Off
- G11 Off
- G12 Off
- G13 Off
- G14 Off
- G15 Off
- G16
- G17
- G18
- G19
- G20
- G21
- G22
- G23 Off
- G24
- G25 Off
- G26
- G27 Off
- G28 Off
- G29
- G30 Off
- G31
- G32 Off
- G33
- G34
- G35
- G36
- G37
- G38
- G39
- G40
- G41
- G42
- Property Held
- refi
- Text18-1
- Text18-2
- Text18-3
- Text18-4
- Text18-5
- Text18-6
- Text18-7
- Text18-8
- Text18-9
- Text18-10
- Text18-11
- Text18-12
- Text18-13
- Text18-14
- Text18-15
- Text18-16
- Text18-17
- Text18-18
- Text18-19
- Lender
- case no
- If you selected ldquoUnmarriedrdquo in Section 1 is there a person who is not your legal spouse but who currently has real property rights similar to those of a legal spouse Off
- Relationship and State Off
- Other-5
- Text19-1
- BName
- Additional Information
- ABN
- Additional Information1
- BSign
- BSDate
- ABSign
- ABDate
- MortageeNameAddress
- NAmeAddress
- Bname1
- DOB1
- DOB2
- SignOfBorr1
- SignOfBorr
- Date Signed
- SignOfBorr2
- SignOfBorr3
- Date Signed3
- Date Signed4
- MortgageeRepSign
- DirectSign
- DirectSign1
- Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union Off
- AppSign
- AppSign1
- AppSign2
- AppSign3
- Nopage38 Off
- Yespage38 Off
- Yes1 Off
- No1 Off
- Yes2 Off
- Yes3 Off
- Yes4 Off
- Yes5 Off
- Yes6 Off
- Yes7 Off
- Yes8 Off
- Yes9 Off
- Yes10 Off
- No2 Off
- No3 Off
- No4 Off
- No5 Off
- No6 Off
- No7 Off
- No8 Off
- No9 Off
- No10 Off
- BorrowerNo Off
- BorrowerYes Off
- AppSignature
- AppSignature1
- CurrentSign
- CurrentSign1
- InterviewSign
- Yes_1 Off
- No_1 Off
- Yes_2 Off
- No_2 Off
- Mail Off
- Phone Off
Uniform Residential Loan Application mdash Continuation Sheet
Use this continuation sheet if you need more space to complete the Uniform Residential Loan Application
Borrower Name(First Middle Last Suffix )
Additional Information
Additional Borrower Name(First Middle Last Suffix )
Additional Information
IWefully understand thatit is a federal crime punishable by fine or imprisonment or both to knowingly make anyfalse statements concerningany of the abovefacts as applicable underthe provisions of federal law (18 USC sectsect 1001 et seq)
BorrowerSignature Date (mmddyyyy)
Additional Borrower Signature Date (mmddyyyy)
Uniform Residential Loan Application mdash Continuation SheetFreddie Mac Form 65 + Fannie Mae Form 1003
Effective 12021
INSTRUCTIONS FOR COMPLETING THE UNIFORM RESIDENTIAL LOAN APPLICATION
Use the instructions below to complete the enclosed Uniform Residential Loan Application (Freddie Mac Form 65Fannie Mae Form 1003) To avoid any delays in your application review please provide all of the requested information
If you need to make a correction on the application draw a line through the incorrect text and mark your initials beside the change Donrsquot use correction tape or fluid The application must be completed signed and dated in ink
The Uniform Residential Loan Application (URLA)
The URLA contains the following sections Section 1 Borrower Information Please provide your personal information income and employment
Section 2 Financial Information ndash Assets and Liabilities Please provide information about your financial assets personal financial obligations and debts you owe
Section 3 Financial Information ndash Real Estate Please provide information about property you own and the debts and expenses related to the property
Section 4 Loan and Property Information Please provide information about the loan purpose and the property you are buying or refinancing
Section 5 Declarations Please answer questions about the property how the property will be financed and your past financial history
Section 6 Acknowledgments and Agreements Informs you of your legal obligations related to the mortgage application and asks that you acknowledge certain information will be obtained used and shared
Section 7 Military Service Please provide information about your (or your deceased spousersquos) military service
Section 8 Demographic Information Requests information the Lender is required by law to ask you
Section 9 Loan Originator Information Will be completed by Chase
Uniform Residential Loan Application ndash Additional Borrower
The URLA ndash Additional Borrower contains the following sections Section 1 Borrower Information This is the same as the Borrower Information section of the URLA
Section 2 Financial Information ndash Assets and Liabilities Contains only the following statement for the additional Borrower to complete ldquoMy information for Section 2 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo The name of the other borrower is entered here
Complete a separate URLA for each BorrowermiddotThree or more Borrowers ndash Use any combination of URLA and URLA-Additional Borrower forms in accordance with the above examples
Section 3 Financial Information ndash Real Estate Contains only the following statement for the additional borrower to complete ldquoMy information for Section 3 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 4 Loan and Property Information Contains only the following statement for the additional borrower to complete ldquoMy information for Section 4 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 5 Declarations This is the same as the Declarations section of the URLA
Section 6 Acknowledgments and Agreements Contains only the following statement for the additional borrower to complete ldquoMy signature for Section 6 is on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 7 Military Service This is the same as the Military Service section of the URLA
Section 8 Demographic Information This is the same as the Demographic Information section on the URLA
Section 9 Loan Originator Information This is the same as the Loan Originator Information section of the URLA
Using the URLA and URLA ndash Additional Borrower Together The URLA and the URLA ndash Additional Borrower are used together to collect information for two Borrowers who have joint assets liabilities andor real estate information The URLA and URLA ndash Additional Borrower can also be used for Borrowers who do not have joint information but wish to combine their information on the URLA for ease of use Here are examples of how to use the URLA and URLA ndash Additional Borrower
For one borrower Complete the URLA
For two borrowers with joint financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you dont need to duplicate them on more than one URLA or o In cases where Borrowers are not collaborating when completing the loan application
joint assets liabilities and real estate may be duplicated on each URLA bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you do not need to duplicate them on more than one URLA or
o In cases where Borrowers are not collaborating when completing the loan application joint assets liabilities and real estate may be duplicated on each URLA
For two borrowers with separate financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower Report the assets liabilities and
real estate for the additional Borrower on the URLA or bull Complete a separate URLA for each Borrower
For three or more borrowers use any combination of URLA and URLA ndash Additional Borrower forms described for two borrowers
Uniform Residential Loan Application ndash Unmarried Addendum If any borrower listed on the URLA or URLA ndash Additional Borrower form selects Unmarried in Section 1 (Personal Information) the lender will complete this optional form
The information must be collected to determine how to apply state property laws that directly or indirectly affect creditworthiness including ensuring clear title
Uniform Residential Loan Application ndash Continuation Sheet Use the URLA ndash Continuation Sheet if you need more space to complete either the URLA or URLA ndash Additional Borrower forms
99177-URLAI-0215
HUD Addendum to Uniform Residential Loan Application OMB Approval No HUD 2502-0059 (exp )
Part I - Identifying Information HUDFHA Application for Insurance under the National Housing Act and Borrower Certification
FHA Case No (include any suffix) Mortgagee Case No
Mortgagee ID Sponsor ID Agent ID
Mortgagee Name Address (include ZIP Code) and Telephone Number
Type or print all entries clearly
Name and Address of Sponsor Name and Address of Agent
Borrowers Name amp Present Address (include ZIP Code) Property Address (include name of subdivision lot amp block no amp ZIP Code)
Sponsored Originations
Name of Third-Party Originator NMLS ID of Third-Party Originator
Part II - Borrower Consent for Social Security Administration to Verify Social Security Number I authorize the Social Security Administration (SSA) to verify my Social Security Number (SSN) to the Mortgagee and HUDFHA I authorize SSA to provide explanatory
information to HUDFHA in the event of a discrepancy This consent is valid for 180 days from the date signed unless indicated otherwise by the individual(s) named in this
loan application
Signature(s) of Borrower(s) - Read consent carefully Review accuracy of Social Security Number(s) provided on this application
Borrowerrsquos NameDate of BirthSocial Security Number
Co-Borrowerrsquos Name Date of BirthSocial Security Number
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
Part III - Borrower Notices Information and Acknowledgment Public Reporting Burden
Public reporting burden for this collection of information is estimated to average 10 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 conduct or sponsor and a person is not
required to respond to a collection of information unless that collection displays a valid OMB control number which can be located on the OMB Internet page at
httpwwwreginfogovpublicdoPRAMain
Privacy Act Information
The information requested on the Uniform Residential Loan Application and this Addendum is authorized by the National Housing Act of 1934 12 USC sect 1701 et seq The Debt
Collection Act of 1982 Pub L 97-365 and HUDrsquos Housing and Community Development Act of 1987 42 USC sect 3543 require persons applying for a federally insured loan to
furnish their SSN You must provide all the requested information including your SSN HUD may conduct a computer match to verify the information you provide HUD may
disclose certain information to Federal State and local agencies when relevant to civil criminal or regulatory investigations and prosecutions It will not otherwise be disclosed or
released outside of HUD except as required and permitted by law The information will be used to determine whether you qualify as a mortgagor Failure to provide any of the
requested information including SSN may result in disapproval of your loan application This is notice to you as required by the Right to Financial Privacy Act of 1978 that
HUDFHA has a right of access to financial records held by financial institutions in connection with the consideration or administration of assistance to you Financial records
involving your transaction will be available to HUDFHA without further notice or authorization but will not be disclosed or released by the institution to another Government Agency
or Department without your consent except as required or permitted by law
WARNING This warning applies to all certifications made in this document Anyone who knowingly submits a false claim or makes false statements is subject to criminal and civil penalties including confinement for up to 5 years fines and civil penalties 18 USC sectsect 287 1001 and 31 USC sect 3729
orm HUD-92900-A ( ) Page 1
Borrower Name ____________________________ FHA Case No __________________
Caution Delinquencies Defaults Foreclosures and Abuses Delinquencies defaults foreclosures and abuses of mortgage loans involving programs of the Federal Government can be costly and detrimental to your credit now and in the future The Mortgagee in this transaction its agents and assigns as well as the Federal Government its agencies agents and assigns are authorized to take any and all of the following actions in the event loan payments become delinquent on the mortgage loan described in the attached application (1) Report your name and account information to a credit bureau (2) Assess additional interest and penalty charges for the period of time that payment is not made (3) Assess charges to cover additional administrative costs incurred by the Federal Government to service your account (4) Offset amounts owed to you
under other Federal programs (5) Refer your account to a private attorney collection agency or mortgage servicing agency to collect the amount due foreclose
the mortgage sell the property and seek judgment against you for any deficiency (6) Refer your account to the Department of Justice (DOJ) for litigation in the
courts (7) If you are a current or retired Federal employee take action to offset your salary or civil service retirement benefits (8) Refer your debt to the Internal
Revenue Service for offset against any amount owed to you as an income tax refund and (9) Report any resulting written off debt of yours to the Internal Revenue Service as your taxable income All of these actions may be used to recover any debts owed when it is determined to be in the interest of the Mortgagee or Federal Government or both
As a mortgage loan borrower you will be legally obligated to make the mortgage payments called for by your mortgage loan contract The fact that you dispose of your property after the loan has been made will not relieve you of liability for making these payments Payment of the loan in full is ordinarily the way liability on a mortgage note is ended Some home buyers have the mistaken impression that if they sell their homes when they move to another locality or dispose of it for any other reasons they are no longer liable for the mortgage payments and that liability for these payments is solely that of the new owners Even though the new owners may agree in writing to assume liability for your mortgage payments this assumption agreement will not relieve you from liability to the holder of the note which you signed when you obtained the loan to buy the property Unless you are able to sell the property to a buyer who is acceptable to HUDFHA who will assume the payment of your obligation to the lender you will not be relieved from liability to repay any claim which HUDFHA may be required to pay your lender on account of default in your loan payments The amount of any such claim payment may be a debt owed by you to the Federal Government and subject to established collection procedures
Fair Housing Act I and anyone acting on my behalf are and will remain in compliance with the Fair Housing Act 42 USC sect 3604 et seq with respect to the dwelling or property covered by the loan and in the provision of services or facilities in connection therewith I recognize that any restrictive covenant on this property related to race color religion sex disability familial status or national origin is unlawful under the Fair Housing Act and unenforceable I further recognize that in addition to administrative action by HUD a civil action may be brought by the DOJ in any appropriate US court against any person responsible for a violation of the
applicable law
Certification and Acknowledgment All information in this application is given for the purpose of obtaining a loan to be insured under the National Housing Act and the information in the Uniform Residential Loan Application and this Addendum is true and complete to the best of my knowledge and belief Verification may be obtained from any source named herein I have read and understand the foregoing concerning my liability on the loan and Part III Borrower Notices Information and Acknowledgment
Signature(s) of Borrower(s) - Do not sign unless this application is fully completed Read the certification carefully and review accuracy of this application
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
orm HUD-92900-A ( Page 2
___________________________________
______________________________________________________
______________________________________________________________
- - - - - - - - - - - - - - - - - - - - - - -
Borrower Name ____________________________ FHA Case No __________________
Part IV - Direct Endorsement Approval for a HUD FHA-Insured Mortgage A Underwriting the Borrower
Date Mortgage Approved ______________________________ Date Approval Expires ______________________
For mortgages rated as an ldquoacceptrdquo or ldquoapproverdquo by FHAs TOTAL Mortgage Scorecard
The information submitted to TOTAL was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA4e Final Underwriting Decision (TOTAL) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee Representative Signature
Printed Name
Title
OR
For mortgages rated as a ldquoreferrdquo by FHAs TOTAL Mortgage Scorecard or manually underwritten by a Direct Endorsement underwriter I have personally reviewed and underwritten the borrowerrsquos credit application The information used to underwrite the borrower was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA5d Final Underwriting Decision (Manual) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
B Underwriting the Property
For all mortgages where FHA requires an appraisal I have personally reviewed and underwritten the appraisal according to FHA requirements I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
orm HUD-92900-A ( ) Page 3
Borrower Name ____________________________ FHA Case No __________________
Part V Mortgagees Certification
I have personally reviewed the mortgage documents and the application for insurance endorsement and This mortgage complies with SF Handbook 40001 Section IIA7 Post-Closing and Endorsement to the extent that no defect exists that would have changed the decision to endorse or submit the mortgage for insurance
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee
Name of Mortgageersquos Representative
Title of Mortgageersquos Representative
Signature of the Mortgageersquos Representative Date
orm HUD-92900-A ( ) Page 4
GENERAL AUTHORIZATION FOR A MORTGAGE LOAN ASSUMPTION
Applicant name(s)
Loan number
NOTICES AND DISCLOSURES
Non-discriminatory underwriting guidelines Anyone who inquires about the availability of credit from us has the right to receive a copy of our non-discriminatory underwriting guidelines To request a copy of these guidelines contact your Loan Processor
Attorney note Itrsquos the responsibility of our attorneys to protect our interest You may at your expense request an attorney to represent your interest
Notice to HUDFHA applicants As required by the Right to Financial Privacy Act of 1978 this notice is to inform you that the US Department of Housing and Urban Development (HUD)Federal Housing Administration (FHA) has a right of access to financial records held by financial institutions related to a request for assistance Financial records involving your assumption will be available to HUDFHA without further notice or authorization but wonrsquot be disclosed or released by us to another government agency or department without your consent except as required or permitted by law
Borrower consent to the use of tax return information I understand acknowledge and agree that the Lender and Other Loan Participants can obtain use and share tax return information for purposes of (i) providing an offer (ii) originating maintaining managing monitoring servicing selling insuring and securitizing a loan (iii) marketing or (iv) as otherwise permitted by applicable laws including state and federal privacy and data security laws The Lender includes the Lenderrsquos affiliates agents service providers and any of aforementioned partiesrsquo successors and assigns The Other Loan Participants includes any actual or potential owners of a loan resulting from your loan application or acquirers of any beneficial or other interest in the loan and mortgage insurer guarantor any servicers or service providers for these parties and any of aforementioned partiesrsquo successors and assigns
CERTIFICATION AND AUTHORIZATION
Environmental certification By signing below I represent and warrant that Irsquom not aware of any substances materials or products that may be an environmental hazard such as but not limited to asbestos formaldehyde radon gas lead-based paint fuel or chemical storage tanks (above or below ground) and contaminated soil or water on the property I acknowledge that Chase is relying on this representation and warranty as a material part of its loan application process I also am not aware of any landfill on any portion of the property
Exceptions to the above I further acknowledge (1) receipt of applicable disclosures from the seller in purchase transactions (2) that lead-based paint may exist in housing constructed prior to 1978 (3) that Chase performs no environmental investigation on my behalf and isnrsquot responsible for identifying lead-based paint or any other environmental conditions that might impact the property or its residents and (4) that it is my sole obligation to investigate for potential impact to the property from environmental conditions
Certifications I certify by signing below that (1) all of the loan application information provided is true and complete (2) I understand any intentional or negligent misrepresentation(s) of the information provided in conjunction with my application may result in civil liability andor 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 Chase its agents successors and assigns insurers and any other person who may suffer any loss due to reliance upon any misrepresentation that I have made on the application and (3) any significant change from the information provided at the time of application until the final loan application is signed may have a bearing on the approval of my application for a home loan
Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union
This question is asked because of state laws that extend the same or similar rights benefits and protections of spouses in a marriage to persons who are members of a partnership or union recognized under state law You should consult with your own legal advisor for advice regarding the rights protections benefits responsibilities obligations and duties of those who are registered domestic partners civil union partners or members of other unions recognized under applicable law
CREDIT AUTHORIZATION RELEASE
By signing below I authorize Chase andor my mortgage insurer (if any) to verify my past and present employment earnings records (including information contained in income tax returns that have been filed with the IRS) bank accounts stock holdings and any other information that it finds necessary to process my mortgage loan application or to review it for quality-control purposes I understand that a credit report will be ordered from a credit reporting agency for verification prior to loan closing as part of the application process and may be ordered after closing as part of the Lenderrsquos quality-control program A credit report may also be completed as part of the Lenderrsquos servicing or collection of the loan or in consideration of any other product or service that the Lender may consider offering me in the future and at any time throughout the life of the loan I understand that use of a photocopy of this form may be necessary to verify one or more of my credit references I understand that a photocopy or fax copy of this form will also serve as authorization
By signing below each applicant acknowledges (1) making the above certifications and authorizations and (2) that each applicant has received and understands the above notices and disclosures
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
You do not have to give us this information but if you donrsquot your application for approval as a borrower may be delayed or rejected The information requested in this form is authorized by Title 38 USC Chapter 37 (if VA) by 12 USC Section 1701 et seq (if HUDFHA) by 42 USC Section 1452b (if HUDCPD) and Title 42 USC 1471 et seq or 7 USC 1921 et seq (if USDA FHA)
Updated December 2021 99177-GA-0215
1b
2b
Form 4506-C (September 2020)
Department of the Treasury - Internal Revenue Service
IVES Request for Transcript of Tax Return OMB Number
1545-1872
Do not sign this form unless all applicable lines have been completed Request may be rejected if the form is incomplete or illegible
For more information about Form 4506-C visit wwwirsgov and search IVES
1a Name shown on tax return (if a joint return enter the name shown first)
First social security number on tax return individual taxpayer identification number or employer identification number (see instructions)
2a If a joint return enter spousersquos name shown on tax return Second social security number or individual taxpayer identification number if joint tax return
3 Current name address (including apt room or suite no) city state and ZIP code (see instructions)
4 Previous address shown on the last return filed if different from line 3 (see instructions)
5a IVES participant name address and SOR mailbox ID
DataVerify 875 Greentree Rd 8 Parkway Center Pittsburgh PA 15220
5b Customer file number (if applicable) (see instructions)
Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing (see instructions)
6 Transcript requested Enter the tax form number here (1040 1065 1120 etc) and check the appropriate box below Enter only one tax form number per request 1040
a Return Transcript which includes most of the line items of a tax return as filed with the IRS A tax return transcript does not reflect changes made to the account after the return is processed Transcripts are only available for the following returns Form 1040 series Form 1065 Form 1120 Form 1120-A Form 1120-H Form 1120-L and Form 1120S Return transcripts are available for the current year and returns processed during the prior 3 processing years
b Account Transcript which contains information on the financial status of the account such as payments made on the account penalty assessments and adjustments made by you or the IRS after the return was filed Return information is limited to items such as tax liability and estimated tax payments Account transcripts are available for most returns
c Record of Account which provides the most detailed information as it is a combination of the Return Transcript and the Account Transcript Available for current year and 3 prior tax years
7 Form W-2 Form 1099 series Form 1098 series or Form 5498 series transcript The IRS can provide a transcript that includes data from these information returns State or local information is not included with the Form W-2 information The IRS may be able to provide this transcript information for up to 10 years Information for the current year is generally not available until the year after it is filed with the IRS For example W-2 information for 2016 filed in 2017 will likely not be available from the IRS until 2018 If you need W-2 information for retirement purposes you should contact the Social Security Administration at 1-800-772-1213
Caution If you need a copy of Form W-2 or Form 1099 you should first contact the payer To get a copy of the Form W-2 or Form 1099 filed with your return you must use Form 4506 and request a copy of your return which includes all attachments
8 Year or period requested Enter the ending date of the tax year or period using the mmddyyyy format (see instructions)
12 31 2020 12 31 2019 12 31 2018 Caution Do not sign this form unless all applicable lines have been completed
Signature of taxpayer(s) I declare that I am either the taxpayer whose name is shown on line 1a or 2a or a person authorized to obtain the tax information requested If the request applies to a joint return at least one spouse must sign If signed by a corporate officer 1 percent or more shareholder partner managing member guardian tax matters partner executor receiver administrator trustee or party other than the taxpayer I certify that I have the authority to execute Form 4506-C on behalf of the taxpayer Note This form must be received by IRS within 120 days of the signature date
Signatory attests that heshe has read the attestation clause and upon so reading declares that heshe has the authority to sign the Form 4506-C See instructions
Sign Here
Signature (see instructions) Date Phone number of taxpayer on line 1a or 2a
PrintType name
Title (if line 1a above is a corporation partnership estate or trust)
Spousersquos signature Date
PrintType name
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020) For Privacy Act and Paperwork Reduction Act Notice see page 2
Instructions for Form 4506-C IVES Request for Transcript of Tax Return
Section references are to the Internal Revenue Code unless otherwise noted
Future Developments
For the latest information about Form 4506-C and its instructions go to wwwirsgov and search IVES Information about any recent developments affecting Form 4506-C (such as legislation enacted after we released it) will be posted on that page
Whats New Form 4506-C was created to be utilized by authorized IVES participants to order tax transcripts with the consent of the taxpayer
General Instructions
Caution Do not sign this form unless all applicable lines have been completed
Designated Recipient Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information received pursuant to the taxpayerrsquos consent and holds the recipient subject to penalties for any unauthorized access other use or redisclosure without the taxpayerrsquos express permission or request
Taxpayer Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information provided pursuant to your consent and holds the recipient subject to penalties brought by private right of action for any unauthorized access other use or redisclosure without your express permission or request
Purpose of form Use Form 4506-C to request tax return information through an authorized IVES participant You will designate an IVES participant to receive the information on line 5a
Note If you are unsure of which type of transcript you need check with the party requesting your tax information
Where to file The IVES participant will fax Form 4506-C with the approved IVES cover sheet to their assigned Service Center
Chart for ordering transcripts
If your assigned Service Center is
Fax the requests with the approved coversheet to
Austin Submission Processing Center
Austin IVES Team
844-249-6238
Fresno Submission Processing Center
Fresno IVES Team
844-249-6239
Kansas City Submission Processing Center
Kansas City IVES Team
844-249-8128
Ogden Submission Processing Center
Ogden IVES Team
844-249-8129
Specific Instructions
Line 1b Enter the social security number (SSN) or individual taxpayer identification number (ITIN) for the individual listed on line 1a or enter the employer identification number (EIN) for the business listed on line 1a
Line 3 Enter your current address If you use a PO box include it on this line
Line 4 Enter the address shown on the last return filed if different from the address entered on line 3
Note If the addresses on lines 3 and 4 are different and you have not changed your address with the IRS file Form 8822 Change of Address or Form 8822-BChange of Address or Responsible Party mdash Business with Form 4506-C
Line 5b Enter up to 10 numeric characters to create a unique customer file number that will appear on the transcript The customer file number cannot contain an SSN ITIN or EIN Completion of this line is not required
Note If you use an SSN name or combination of both we will not input the information and the customer file number will reflect a generic entry of 9999999999 on the transcript
Line 8 Enter the end date of the tax year or period requested in mmddyyyy format This may be a calendar year fiscal year or quarter Enter each quarter requested for quarterly returns Example Enter 12312018 for a calendar year 2018 Form 1040 transcript
Signature and date Form 4506-C must be signed and dated by the taxpayer listed on line 1a or 2a The IRS must receive Form 4506-C within 120 days of the date signed by the taxpayer or it will be rejected Ensure that all applicable lines including lines 5a through 8 are completed before signing
You must check the box in the signature area to acknowledge you have the authority to sign and request the information The form will not be processed if unchecked
Individuals Transcripts listed on on line 6 may be furnished to either spouse if jointly filed Only one signature is required Sign Form 4506-C exactly as your name appeared on the original return If you changed your name also sign your current name
Corporations Generally Form 4506-C can be signed by
(1) an officer having legal authority to bind the corporation (2) any person designated by the board of directors or other governing body or (3) any officer or employee on written request by any principal officer and attested to by the secretary or other officer A bona fide shareholder of record owning 1 percent or more of the outstanding stock of the corporation may submit a Form 4506-C but must provide documentation to support the requesters right to receive the information
Partnerships Generally Form 4506-C can be signed by any person who was a member of the partnership during any part of the tax period requested on line 8
All others See section 6103(e) if the taxpayer has died is insolvent is a dissolved corporation or if a trustee guardian executor receiver or administrator is acting for the taxpayer
Note If you are Heir at law Next of kin or Beneficiary you must be able to establish a material interest in the estate or trust
Documentation For entities other than individuals you must attach the authorization document For example this could be the letter from the principal officer authorizing an employee of the corporation or the letters testamentary authorizing an individual to act for an estate
Signature by a representative A representative can sign Form 4506-C for a taxpayer only if the taxpayer has specifically delegated this authority to the representative on Form 2848 line 5 The representative must attach Form 2848 showing the delegation to sign Form 4506-C
Privacy Act and Paperwork Reduction Act Notice We ask for the information on this form to establish your right to gain access to the requested tax information under the Internal Revenue Code We need this information to properly identify the tax information and respond to your request You are not required to request any transcript if you do request a transcript sections 6103 and 6109 and their regulations require you to provide this information including your SSN or EIN If you do not provide this information we may not be able to process your request Providing false or fraudulent information may subject you to penalties
Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and cities states the District of Columbia and US commonwealths and possessions for use in administering their tax laws We may also disclose this information to other countries under a tax treaty to federal and state agencies to enforce federal nontax criminal laws or to federal law enforcement and intelligence agencies to combat terrorism
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law Generally tax returns and return information are confidential as required by section 6103
The time needed to complete and file Form 4506-C will vary depending on individual circumstances The estimated average time is
Learning about the law or the form 10 min Preparing the form 12 min Copying assembling and sending the form to the IRS 20 min
If you have comments concerning the accuracy of these time estimates or suggestions for making Form 4506-C simpler we would be happy to hear from you You can write to
Internal Revenue Service Tax Forms and Publications Division 1111 Constitution Ave NW IR-6526 Washington DC 20224
Do not send the form to this address Instead see Where to file on this page
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020)
Rev April 2021 CHASEO Facts What does Chase do with your personal information
Why Financial companies choose how they share your personal information Federal law gives consumers the right to limit some but not all sharing Federal law also requires us to tell you how we collect share and protect your personal information Please read this notice carefully to understand what we do
What The types of personal information we collect and share depend on the product or service you have with us This information can include bull Social Security number and income bull account balances and transaction history bull credit history and payment history
How All financial companies need to share customers personal information to run their everyday business In the section below we list the reasons financial companies can share their customers personal information the reasons Chase chooses to share and whether you can limit this sharing
Reasons we can share your personal information Does Chase share
Can you limit this sharing
For our everyday business purposes - such as to process your transactions maintain your account(s) respond to court orders and legal investigations or report to credit bureaus
Yes No
For our marketing purposes - to offer our products and services to you
Yes No
For joint marketing with other financial companies Yes No
For our affiliates everyday business purposes - information about your transactions and experiences
Yes No
For our affiliates everyday business purposes - information about your creditworthiness
Yes Yes
For our affiliates to market to you Yes Yes
For nonaffiliates to market to you Yes Yes
a
0
To limit our sharing
bull Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
bull Visit us online chasecomprivacypreferences
Please note If you are a new customer we can begin sharing your information 30 days from the date we sent this notice When you are no longer our customer we continue to share your information as described in this notice However you can contact us at any time to limit our sharing
Questions
Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
PAGE 2
Who we are
Who is providing this notice The US consumer financial companies within the JPMorgan Chase amp Co family including JPMorgan Chase Bank NA Chase Insurance Agency Inc and JP Morgan Securities LLC
What we do
How does Chase protect my To protect your personal information from unauthorized access and use we personal information use security measures that comply with federal law These measures include
computer safeguards and secured files and buildings We authorize our employees to get your information only when they need it to do their work and we require companies that work for us to protect your information
How does Chase collect my We collect your personal information for example when you personal information bull open an account or make deposits or withdrawals from your account
bull pay your bills or apply for a loan bull use your credit or debit card We also collect your personal information from others such as credit bureaus affiliates or other companies
Why cant I limit all sharing Federal law gives you the right to limit only bull sharing for affiliates everyday business purposes - information about your
creditworthiness bull affiliates from using your information to market to you bull sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing See below for more on your rights under state law
What happens when I limit sharing for an account I hold jointly with someone else
Your choices will apply to everyone on your account
Definitions
Affiliates Companies related by common ownership or control They can be financial and non financial companies bull Our affiliates include companies with a Chase or JP Morgan name and financial companies such asjP Morgan Securities LLC
Nonaffiliates Companies not related by common ownership or control They can be financial and non financial companies bull Nonaffiliates we share with can include companies such as retailers auto dealers auto makers and membership clubs
Joint marketing A formal agreement between nonaffiliated financial companies that together market financial products or services to you bull Our joint marketing partners include categories of companies such as insurance companies
Other important information
VT Accounts with a Vermont mailing address are automatically treated as if they have limited the sharing as described on page 1 For joint marketing we will only disclose your name contact information and information about your transactions
NV We are providing you this notice pursuant to Nevada law If you prefer not to receive marketing calls from us you may be placed on our Internal Do Not Call List by calling 1-800-945-9470 or by writing to us at PO Box 734007 Dallas TX 75373-4007
For more information contact us at the address above or email PrivacylnfoJPMChasecom with Nevada Annual Notice in the subject line You may also contact the Nevada Attorney Generals office Bureau of Consumer Protection Office of the Nevada Attorney General 555 E Washington St Suite 3900 Las Vegas NV 89101 telephone number 1-702-486-3132 email BCPINFOagstatenvus
CA Accounts with a California mailing address are automatically treated as if they have limited the sharing with nonaffiliates as described on page 1 CA residents are provided a CA notice for additional choices
CHASE O
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
The following disclosure is required by the USA PATRIOT Act
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 opens an account
What this means to you When you 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 drivers
license or other identifying documents
99177-PAT-0215
VETERAN STATEMENT When this loan was opened the US Department of Veterans Affairs (VA) used the veteran borrowerrsquos entitlement which is a set amount the VA promises to repay a lender if the borrower defaults on the mortgage An assumption will modify who is obligated to pay the existing mortgage loan but all loan termsmdashincluding the entitlementmdashwill remain the same If the veteran borrower is being removed from the loan the entitlement would remain with whoever is assuming the loan because the loan will continue to be serviced by the VA If the applicant is also a veteran and can substitute his or her entitlement for the current entitlement then the current borrowerrsquos entitlement can be released
Please review the following questions and answer as appropriate This form requires completion by both the applicant(s) and current borrower(s)
1 Applicant to Complete
Are you (the applicant) currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the reverse side)
Yes (If yes please provide the information requested below answer the question in section 3 and sign and date this form at the bottom of the reverse side)
Name of applicant(s) who answered ldquoyesrdquo to the above question
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Are you receiving VA disability benefts
Applicant
Yes
No
Co-Applicant
Yes
No
Are you entitled to receive VA disability benefts Yes No Yes No
Have you received VA disability benefts in the past Yes No Yes No
Are you a surviving spouse of a veteran who died on active duty or as the result of a service-related disability
Yes No Yes No
Do you have any VA loans Yes No Yes No
2 Current Borrower to Complete
Is the current borrowerco-borrower currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the page)
Yes (If yes please answer the question in section 3 and sign and date this form at the bottom of the page)
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
________________________________________________________________________________________________
3 Applicant and Current Borrower to Complete
If the answer to the questions in section 1 and 2 are both yes please answer the following question After yoursquove reviewed and completed this entire form please sign and date at the bottom
Applicant Current Borrower
Do you want to apply for a substitution of entitlement Yes Yes No No
In order to complete a substitution of entitlement the veteran applicant must have suffcient entitlement to substitute for that of the current borrower Contact the VA Offce of Jurisdiction for your area for more information Also before the veteran applicant can substitute entitlement on a VA loan heshe must certify that the property securing the loan will be occupied as hisher primary residence Both the applicantrsquos and current borrowerrsquos original certifcate of eligibility will be required If your sales contract is contingent upon the restoration of entitlement please contact your VA Offce of Jurisdiction for complete procedures Otherwise the substitution will be completed after the loan has been approved and closed
Date Applicant printed name Applicant signature
Date Applicant printed name Applicant signature
Date Current Borrower printed name Current Borrower signature
Date Current Borrower printed name Current Borrower signature
Forms completed by Mail Phone
For Chase use only
Interviewer signature Date
99177-VS-0215
- Assumption Application Package_41521-noscannedpages-update-4pdf
-
- 1 FM203 Cover Pagepdf
- 2 FM202 Mortgage Assumption Application Package pagepdf
- 3 The Documents Youll need to Send Uspdf
- 4 FM201 FAQpdf
- 5 FM142 CIWpdf
- 6 FM126 URLApdf
- 7 FM130 URLA Instpdf
-
- Blank Page
-
- 8 92900a Addednum to Loan Applicationpdf
- 9 FM462 Gen Authpdf
- 10 FM220 4506-Cpdf
- 11 FM153 Chase Federal Privacy Noticepdf
- 12 FM144 Info on Opening a New Accountpdf
- 13 FM152 Veteran Statementpdf
-
- Date
- Loan number
- Applicant name
- Phone1
- Loan number 1
- Loan number 2
- Other
- Other_2
- 1
- 2
- undefined_7
- Available hours
- Available hours_2
- undefined_8
- Available hours_3
- undefined_9
- Current address 1
- Neither
- Available hours_4
- Available hours_5
- undefined_10
- Available hours_6
- 1_2
- 2_2
- undefined_11
- Available hours_7
- Available hours_8
- undefined_12
- Available hours_9
- FHA Case No include any suffix
- Mortgagee Case No
- Mortgagee ID
- Sponsor ID
- Agent ID
- Name and Address of Sponsor Name and Address of Agent
- Borrowers Name Present Address include ZIP Code Property Address
- include name of subdivision lot block no ZIP Code
- Name of ThirdParty Originator
- NMLS ID of ThirdParty Originator
- s application
- ty Number
- ty Number_2
- Date Signed_2
- Date Mortgage Approved
- Date Approval Expires
- Printed Name
- Title 1
- DEs ID Number
- DEs ID Number_2
- Mortgagee
- Name of Mortgagees Representative
- Title of Mortgagees Representative
- Signature of the Mortgagees Representative
- Date_2
- Applicant names 1
- Applicant names 2
- Applicant names 3
- Loan number_2
- Date_3
- Applicant printed name
- Social Security number
- Date_4
- Applicant printed name_2
- Social Security number_2
- Date_5
- Applicant printed name_3
- Social Security number_3
- Date_6
- Applicant printed name_4
- Social Security number_4
- 1a Name shown on tax return if a joint return enter the name shown first
- 1b First social security number on tax return individual taxpayer identification number or employer identification number see instructions
- 2a If a joint return enter spouses name shown on tax return
- 2b Second social security number or individual taxpayer identification number if joint tax return
- 4 Previous address shown on the last return filed if different from line 3 see instructions
- 5a IVES participant name address and SOR mailbox ID
- Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing see instructions
- Signature see instructions
- Date_7
- Phone number of taxpayer on line 1a or 2a
- PrintType name
- Here
- Spouses signature
- Date_8
- PrintType name_2
- Name
- Date of birth
- Service number
- Name_2
- Date of birth_2
- Service number_2
- Date_9
- Applicant printed name_5
- Date_10
- Applicant printed name_6
- Date_11
- Current Borrower printed name
- Date_12
- Current Borrower printed name_2
- Date_13
- Text3
- Text10
- undefined_13
- Text15
- undefined_14
- undefined_15
- undefined_16
- undefined_17
- undefined_18
- undefined_19
- undefined_20
- undefined_21
- undefined_23
- Reason for assumption Off
- Requestors relationship to owners Off
- Check one Off
- Check one1 Off
- Day1
- Evening
- Cell phone
- Check one2 Off
- Check one3 Off
- Check one4 Off
- Check one5 Off
- Text2-1
- Text2-2
- Text2-3
- Text2-4
- Text2-5
- Text2-6
- Text3-1
- Text3-2
- Text3-3
- Text3-4
- Text3-6
- Text3-7
- Text3-8
- Text3-9
- Text3-10
- Text3-11
- Text3-12
- Text3-13
- Text3-14
- Text3-15
- Text3-16
- Text3-17
- Text3-18
- Text3-19
- Text3-20
- Text3-21
- Text3-22
- Text3-23
- Text3-24
- Text3-25
- Text3-26
- Text3-27
- Text3-28
- Text3-29
- Text3-30
- Text3-31
- Text3-32
- Text3-33
- Text3-34
- Text3-35
- Text3-36
- Text3-37
- Text3-38
- Text3-39
- Text3-40
- Text3-41
- Text3-42
- Text3-43
- Text3-44
- Text3-45
- Text3-46
- Text3-47
- Text3-48
- Text3-49
- Text3-50
- Text3-51
- Text3-52
- Text3-53
- Text3-5
- Text3-54
- Text3-55
- Text3-56
- Citizenship Off
- Type of credit Off
- Marital Status Off
- Housing Off
- Housing1 Off
- ownership Off
- DNA1 Off
- DNA2 Off
- DNA3 Off
- family Off
- BO Off
- Total
- Text31
- Text32
- Text33
- Text34
- Text35
- Text36
- Text37
- Text38
- Text39
- Text310
- Text311
- Text312
- Text313
- Text314
- Text315
- Text316
- Text317
- Text318
- Text319
- ownership1 Off
- Total1
- Total1-2
- Check Box4-1 Off
- Text320
- Text321
- Text322
- Text323
- Text324
- Text325
- Text326
- Text327
- Text328
- Text329
- Check Box4-2 Off
- Check Box4-3 Off
- Check Box4-4 Off
- Check Box4-8 Off
- Check Box4-9 Off
- Text330
- Text331
- Text332
- Text333
- Text334
- Text335
- Text1-1
- Text1-2
- Text1-3
- Text1-4
- Text1-5
- Text1-6
- Text1-7
- Text1-8
- Text1-9
- Text1-10
- Text1-11
- Text1-12
- Text1-13
- Text1-14
- Text1-15
- Text1-16
- Text1-17
- Text1-18
- Text1-19
- Text1-20
- Text1-21
- Text1-22
- Text1-23
- Text1-24
- Text1-25
- Text1-26
- Text1-27
- Text1-28
- Text1-29
- Text1-30
- Text1-31
- Text1-32
- Text1-33
- Text1-34
- Text1-35
- Check Box3-2 Off
- Check Box2-1 Off
- Check Box2-2 Off
- Check Box2-3 Off
- Check Box2-4 Off
- Check Box2-5 Off
- Text1-36
- Text1-37
- Text1-38
- Text1-39
- Text1-40
- Text1-41
- Text1-42
- Text1-43
- Text1-44
- Text1-45
- Text1-46
- Text1-47
- Text1-48
- Text1-49
- Text1-50
- Text1-51
- Text1-52
- Text1-53
- Text1-54
- Text1-55
- Text1-56
- Text1-57
- Text1-58
- Text1-59
- Text1-60
- Text1-61
- Check Box3-11 Off
- A1
- A2
- A3
- A4
- A5
- A6
- A7
- A8
- A9
- A10
- A11
- A12
- Check Box3-1 Off
- Check Box30-1 Off
- Check Box30-2 Off
- Check Box30-4 Off
- Check Box30-5 Off
- Check Box30-7 Off
- Check Box30-8 Off
- Check Box30-9 Off
- Check Box30-10 Off
- Check Box30-11 Off
- Check Box30-12 Off
- A13
- A14
- A15
- A16
- A17 Off
- A18
- A19
- A20
- A21
- A22
- A23
- A24
- A25
- A26
- A27
- A28
- A29
- A30
- A31
- A32
- A33
- A34
- A35
- A36
- A37
- A38 Off
- A39
- A40
- A41
- A42
- A43
- A44
- A45
- A46
- A47
- A48
- A49
- A50
- A51
- A52
- A53
- A54
- A55
- A56
- A57
- A58
- A59
- A60
- A61
- A62
- A63
- A64
- A65
- A66
- A67
- A68
- A69
- A70
- A71
- A72
- A73
- A74
- Loan Purpose Off
- occupancy1 Off
- lien type Off
- lientype Off
- mixed use Off
- manufactured home Off
- deposit1 Off
- deposit2 Off
- B1
- B2
- B3
- B4
- B5
- B6
- B7
- B8
- B9
- B10
- fha Off
- Check Box51 Off
- B11
- B12
- B13
- B14
- B15
- B16
- B17
- B18
- B19 Off
- B20
- B21
- B22 Off
- B23
- B24
- B25
- B26
- B27
- B28
- A
-
- Will you occupy the property as your primary residence Off
- Will you occupy the property as your primary residence1 Off
-
- If yes have you had an ownership interest in another property in the last three years Off
- Text9-2
- B
-
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property Off
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property1 Off
-
- 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 Off
- 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 application1 Off
-
- 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 Off
- 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 application1 Off
-
- new credit Off
- 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) Off
- the Property Assessed Clean Energy Program)1 Off
-
- F
-
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application Off
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application1 Off
-
- G
-
- Are there any outstanding judgments against you Off
- Are there any outstanding judgments against you1 Off
-
- H
-
- Are you currently delinquent or in default on a Federal debt Off
- Are you currently delinquent or in default on a Federal debt1 Off
-
- I
-
- Are you a party to a lawsuit in which you potentially have any personal financial liability Off
- Are you a party to a lawsuit in which you potentially have any personal financial liability1 Off
-
- J
-
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years Off
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years1 Off
-
- 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 Off
- 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 due1 Off
-
- L
-
- Have you had property foreclosed upon in the last 7 years Off
- Have you had property foreclosed upon in the last 7 years1 Off
-
- M
-
- Have you declared bankruptcy within the past 7 years Off
- Have you declared bankruptcy within the past 7 years1 Off
-
- Check Box8-2 Off
- Check Box8-3 Off
- Check Box8-4 Off
- Text9-3
- Text9-5
- Text9-6
- Text97
- military Off
- ethnicity Off
- sex Off
- race Off
- demo Off
- Text12-1
- Check Box11-1 Off
- Check Box11-2 Off
- Check Box11-3 Off
- Check Box11-4 Off
- Check Box11-5 Off
- Check Box11-6 Off
- Check Box11-7 Off
- Check Box11-8 Off
- Check Box11-9 Off
- Text12-2
- Check Box11-10 Off
- Check Box11-11 Off
- Check Box11-12 Off
- Check Box11-13 Off
- Check Box11-14 Off
- Check Box11-15 Off
- Text12-3
- Check Box11-16 Off
- Check Box11-17 Off
- Check Box11-18 Off
- Check Box11-19 Off
- Check Box11-20 Off
- Check Box11-21 Off
- Check Box11-22 Off
- Check Box11-23 Off
- Text12-4
- Check Box11-24 Off
- Check Box11-25 Off
- Check Box11-26 Off
- Check Box11-27 Off
- Check Box11-28 Off
- Check Box11-29 Off
- Text12-5
- Check Box11-30 Off
- Check Box11-31 Off
- citizen Off
- credit Off
- marital status1 Off
- housing-1 Off
- housing-2 Off
- own Off
- C1
- C2
- C3
- C6
- C7
- C8
- C9
- C10
- C11
- C12
- C13
- C14
- C15
- C16
- C17
- C18
- C19
- C20
- C21
- C22
- C23
- C24
- C25
- C26
- C27
- C28
- C29
- C30
- C31
- C32
- C33
- C34
- C35
- Check Box-2 Off
- C36
- C37
- C38
- C39
- C4
- C40
- C41
- C42
- C43
- C44
- C45
- C46
- C47
- Check Box-3 Off
- Check Box-4 Off
- C48
- C49
- C5
- C50
- C51
- C52
- C53
- C54
- C55
- Check Box-1-1 Off
- own1 Off
- Check Box-1 Off
- D1 Off
- D2
- D3
- D4
- D5
- D6
- D7
- D8
- D9
- D10
- D11
- D12
- D13
- D14 Off
- D15 Off
- D16
- D17
- D18
- D19
- D20
- D21
- D22
- D23
- D24 Off
- D25
- D26
- D27
- D28
- D29
- D30
- D31
- D32
- D33
- D34
- D35 Off
- D36
- D37 Off
- D38
- D39
- D40
- D41
- D42
- D43
- D44
- D45
- D46
- D47
- If yes have you had an ownership interest in another property in the last three years1 Off
- new credit1 Off
- Check Box8-1 Off
- Check Box8-1-2 Off
- Check Box8-1-1 Off
- Check Box8-1-3 Off
- Check Box8-1-4 Off
- Military Service mdash Did you (or your deceased spouse) ever serve or are you currently serving in the United States Armed Forces 1 Off
- Check1 Off
- Text9-1-1
- Check2 Off
- Check3 Off
- Check4 Off
- Text9-1
- E1
- E2
- E3
- Was the ethnicity of the Borrower collected on the basis of visual observation or surname1 Off
- Was the sex of the Borrower collected on the basis of visual observation or surname1 Off
- Was the race of the Borrower collected on the basis of visual observation or surname1 Off
- The Demographic Information was provided through1 Off
- F1 Off
- F2 Off
- F3 Off
- F4 Off
- F5 Off
- F6
- F7 Off
- F8 Off
- F9 Off
- F10 Off
- F11 Off
- F12 Off
- F13
- F14 Off
- F15 Off
- F16 Off
- F17 Off
- F18 Off
- F19 Off
- F20 Off
- F21 Off
- F22
- F23 Off
- F24 Off
- F25 Off
- F26 Off
- F27 Off
- F28 Off
- F29
- F30 Off
- F31 Off
- undefined_13-1
- undefined_13-2
- undefined_14-1
- undefined_15-1
- undefined_16-1
- undefined_17-1
- undefined_18-1
- undefined_19-1
- undefined_21-1
- undefined_20-1
- undefined_23-1
- undefined_13_1
- Single-Two Off
- Refi type Off
- refi program Off
- Estate Off
- Title held Off
- Trust Information Off
- Indian Country Land Tenure Off
- Mortgage Type Applied For Off
- Mortgage Lien Type Off
- Amortization Type Off
- G1 Off
- G2 Off
- G3 Off
- G4 Off
- G5 Off
- G6
- G7
- G8
- G9
- G10 Off
- G11 Off
- G12 Off
- G13 Off
- G14 Off
- G15 Off
- G16
- G17
- G18
- G19
- G20
- G21
- G22
- G23 Off
- G24
- G25 Off
- G26
- G27 Off
- G28 Off
- G29
- G30 Off
- G31
- G32 Off
- G33
- G34
- G35
- G36
- G37
- G38
- G39
- G40
- G41
- G42
- Property Held
- refi
- Text18-1
- Text18-2
- Text18-3
- Text18-4
- Text18-5
- Text18-6
- Text18-7
- Text18-8
- Text18-9
- Text18-10
- Text18-11
- Text18-12
- Text18-13
- Text18-14
- Text18-15
- Text18-16
- Text18-17
- Text18-18
- Text18-19
- Lender
- case no
- If you selected ldquoUnmarriedrdquo in Section 1 is there a person who is not your legal spouse but who currently has real property rights similar to those of a legal spouse Off
- Relationship and State Off
- Other-5
- Text19-1
- BName
- Additional Information
- ABN
- Additional Information1
- BSign
- BSDate
- ABSign
- ABDate
- MortageeNameAddress
- NAmeAddress
- Bname1
- DOB1
- DOB2
- SignOfBorr1
- SignOfBorr
- Date Signed
- SignOfBorr2
- SignOfBorr3
- Date Signed3
- Date Signed4
- MortgageeRepSign
- DirectSign
- DirectSign1
- Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union Off
- AppSign
- AppSign1
- AppSign2
- AppSign3
- Nopage38 Off
- Yespage38 Off
- Yes1 Off
- No1 Off
- Yes2 Off
- Yes3 Off
- Yes4 Off
- Yes5 Off
- Yes6 Off
- Yes7 Off
- Yes8 Off
- Yes9 Off
- Yes10 Off
- No2 Off
- No3 Off
- No4 Off
- No5 Off
- No6 Off
- No7 Off
- No8 Off
- No9 Off
- No10 Off
- BorrowerNo Off
- BorrowerYes Off
- AppSignature
- AppSignature1
- CurrentSign
- CurrentSign1
- InterviewSign
- Yes_1 Off
- No_1 Off
- Yes_2 Off
- No_2 Off
- Mail Off
- Phone Off
INSTRUCTIONS FOR COMPLETING THE UNIFORM RESIDENTIAL LOAN APPLICATION
Use the instructions below to complete the enclosed Uniform Residential Loan Application (Freddie Mac Form 65Fannie Mae Form 1003) To avoid any delays in your application review please provide all of the requested information
If you need to make a correction on the application draw a line through the incorrect text and mark your initials beside the change Donrsquot use correction tape or fluid The application must be completed signed and dated in ink
The Uniform Residential Loan Application (URLA)
The URLA contains the following sections Section 1 Borrower Information Please provide your personal information income and employment
Section 2 Financial Information ndash Assets and Liabilities Please provide information about your financial assets personal financial obligations and debts you owe
Section 3 Financial Information ndash Real Estate Please provide information about property you own and the debts and expenses related to the property
Section 4 Loan and Property Information Please provide information about the loan purpose and the property you are buying or refinancing
Section 5 Declarations Please answer questions about the property how the property will be financed and your past financial history
Section 6 Acknowledgments and Agreements Informs you of your legal obligations related to the mortgage application and asks that you acknowledge certain information will be obtained used and shared
Section 7 Military Service Please provide information about your (or your deceased spousersquos) military service
Section 8 Demographic Information Requests information the Lender is required by law to ask you
Section 9 Loan Originator Information Will be completed by Chase
Uniform Residential Loan Application ndash Additional Borrower
The URLA ndash Additional Borrower contains the following sections Section 1 Borrower Information This is the same as the Borrower Information section of the URLA
Section 2 Financial Information ndash Assets and Liabilities Contains only the following statement for the additional Borrower to complete ldquoMy information for Section 2 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo The name of the other borrower is entered here
Complete a separate URLA for each BorrowermiddotThree or more Borrowers ndash Use any combination of URLA and URLA-Additional Borrower forms in accordance with the above examples
Section 3 Financial Information ndash Real Estate Contains only the following statement for the additional borrower to complete ldquoMy information for Section 3 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 4 Loan and Property Information Contains only the following statement for the additional borrower to complete ldquoMy information for Section 4 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 5 Declarations This is the same as the Declarations section of the URLA
Section 6 Acknowledgments and Agreements Contains only the following statement for the additional borrower to complete ldquoMy signature for Section 6 is on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 7 Military Service This is the same as the Military Service section of the URLA
Section 8 Demographic Information This is the same as the Demographic Information section on the URLA
Section 9 Loan Originator Information This is the same as the Loan Originator Information section of the URLA
Using the URLA and URLA ndash Additional Borrower Together The URLA and the URLA ndash Additional Borrower are used together to collect information for two Borrowers who have joint assets liabilities andor real estate information The URLA and URLA ndash Additional Borrower can also be used for Borrowers who do not have joint information but wish to combine their information on the URLA for ease of use Here are examples of how to use the URLA and URLA ndash Additional Borrower
For one borrower Complete the URLA
For two borrowers with joint financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you dont need to duplicate them on more than one URLA or o In cases where Borrowers are not collaborating when completing the loan application
joint assets liabilities and real estate may be duplicated on each URLA bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you do not need to duplicate them on more than one URLA or
o In cases where Borrowers are not collaborating when completing the loan application joint assets liabilities and real estate may be duplicated on each URLA
For two borrowers with separate financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower Report the assets liabilities and
real estate for the additional Borrower on the URLA or bull Complete a separate URLA for each Borrower
For three or more borrowers use any combination of URLA and URLA ndash Additional Borrower forms described for two borrowers
Uniform Residential Loan Application ndash Unmarried Addendum If any borrower listed on the URLA or URLA ndash Additional Borrower form selects Unmarried in Section 1 (Personal Information) the lender will complete this optional form
The information must be collected to determine how to apply state property laws that directly or indirectly affect creditworthiness including ensuring clear title
Uniform Residential Loan Application ndash Continuation Sheet Use the URLA ndash Continuation Sheet if you need more space to complete either the URLA or URLA ndash Additional Borrower forms
99177-URLAI-0215
HUD Addendum to Uniform Residential Loan Application OMB Approval No HUD 2502-0059 (exp )
Part I - Identifying Information HUDFHA Application for Insurance under the National Housing Act and Borrower Certification
FHA Case No (include any suffix) Mortgagee Case No
Mortgagee ID Sponsor ID Agent ID
Mortgagee Name Address (include ZIP Code) and Telephone Number
Type or print all entries clearly
Name and Address of Sponsor Name and Address of Agent
Borrowers Name amp Present Address (include ZIP Code) Property Address (include name of subdivision lot amp block no amp ZIP Code)
Sponsored Originations
Name of Third-Party Originator NMLS ID of Third-Party Originator
Part II - Borrower Consent for Social Security Administration to Verify Social Security Number I authorize the Social Security Administration (SSA) to verify my Social Security Number (SSN) to the Mortgagee and HUDFHA I authorize SSA to provide explanatory
information to HUDFHA in the event of a discrepancy This consent is valid for 180 days from the date signed unless indicated otherwise by the individual(s) named in this
loan application
Signature(s) of Borrower(s) - Read consent carefully Review accuracy of Social Security Number(s) provided on this application
Borrowerrsquos NameDate of BirthSocial Security Number
Co-Borrowerrsquos Name Date of BirthSocial Security Number
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
Part III - Borrower Notices Information and Acknowledgment Public Reporting Burden
Public reporting burden for this collection of information is estimated to average 10 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 conduct or sponsor and a person is not
required to respond to a collection of information unless that collection displays a valid OMB control number which can be located on the OMB Internet page at
httpwwwreginfogovpublicdoPRAMain
Privacy Act Information
The information requested on the Uniform Residential Loan Application and this Addendum is authorized by the National Housing Act of 1934 12 USC sect 1701 et seq The Debt
Collection Act of 1982 Pub L 97-365 and HUDrsquos Housing and Community Development Act of 1987 42 USC sect 3543 require persons applying for a federally insured loan to
furnish their SSN You must provide all the requested information including your SSN HUD may conduct a computer match to verify the information you provide HUD may
disclose certain information to Federal State and local agencies when relevant to civil criminal or regulatory investigations and prosecutions It will not otherwise be disclosed or
released outside of HUD except as required and permitted by law The information will be used to determine whether you qualify as a mortgagor Failure to provide any of the
requested information including SSN may result in disapproval of your loan application This is notice to you as required by the Right to Financial Privacy Act of 1978 that
HUDFHA has a right of access to financial records held by financial institutions in connection with the consideration or administration of assistance to you Financial records
involving your transaction will be available to HUDFHA without further notice or authorization but will not be disclosed or released by the institution to another Government Agency
or Department without your consent except as required or permitted by law
WARNING This warning applies to all certifications made in this document Anyone who knowingly submits a false claim or makes false statements is subject to criminal and civil penalties including confinement for up to 5 years fines and civil penalties 18 USC sectsect 287 1001 and 31 USC sect 3729
orm HUD-92900-A ( ) Page 1
Borrower Name ____________________________ FHA Case No __________________
Caution Delinquencies Defaults Foreclosures and Abuses Delinquencies defaults foreclosures and abuses of mortgage loans involving programs of the Federal Government can be costly and detrimental to your credit now and in the future The Mortgagee in this transaction its agents and assigns as well as the Federal Government its agencies agents and assigns are authorized to take any and all of the following actions in the event loan payments become delinquent on the mortgage loan described in the attached application (1) Report your name and account information to a credit bureau (2) Assess additional interest and penalty charges for the period of time that payment is not made (3) Assess charges to cover additional administrative costs incurred by the Federal Government to service your account (4) Offset amounts owed to you
under other Federal programs (5) Refer your account to a private attorney collection agency or mortgage servicing agency to collect the amount due foreclose
the mortgage sell the property and seek judgment against you for any deficiency (6) Refer your account to the Department of Justice (DOJ) for litigation in the
courts (7) If you are a current or retired Federal employee take action to offset your salary or civil service retirement benefits (8) Refer your debt to the Internal
Revenue Service for offset against any amount owed to you as an income tax refund and (9) Report any resulting written off debt of yours to the Internal Revenue Service as your taxable income All of these actions may be used to recover any debts owed when it is determined to be in the interest of the Mortgagee or Federal Government or both
As a mortgage loan borrower you will be legally obligated to make the mortgage payments called for by your mortgage loan contract The fact that you dispose of your property after the loan has been made will not relieve you of liability for making these payments Payment of the loan in full is ordinarily the way liability on a mortgage note is ended Some home buyers have the mistaken impression that if they sell their homes when they move to another locality or dispose of it for any other reasons they are no longer liable for the mortgage payments and that liability for these payments is solely that of the new owners Even though the new owners may agree in writing to assume liability for your mortgage payments this assumption agreement will not relieve you from liability to the holder of the note which you signed when you obtained the loan to buy the property Unless you are able to sell the property to a buyer who is acceptable to HUDFHA who will assume the payment of your obligation to the lender you will not be relieved from liability to repay any claim which HUDFHA may be required to pay your lender on account of default in your loan payments The amount of any such claim payment may be a debt owed by you to the Federal Government and subject to established collection procedures
Fair Housing Act I and anyone acting on my behalf are and will remain in compliance with the Fair Housing Act 42 USC sect 3604 et seq with respect to the dwelling or property covered by the loan and in the provision of services or facilities in connection therewith I recognize that any restrictive covenant on this property related to race color religion sex disability familial status or national origin is unlawful under the Fair Housing Act and unenforceable I further recognize that in addition to administrative action by HUD a civil action may be brought by the DOJ in any appropriate US court against any person responsible for a violation of the
applicable law
Certification and Acknowledgment All information in this application is given for the purpose of obtaining a loan to be insured under the National Housing Act and the information in the Uniform Residential Loan Application and this Addendum is true and complete to the best of my knowledge and belief Verification may be obtained from any source named herein I have read and understand the foregoing concerning my liability on the loan and Part III Borrower Notices Information and Acknowledgment
Signature(s) of Borrower(s) - Do not sign unless this application is fully completed Read the certification carefully and review accuracy of this application
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
orm HUD-92900-A ( Page 2
___________________________________
______________________________________________________
______________________________________________________________
- - - - - - - - - - - - - - - - - - - - - - -
Borrower Name ____________________________ FHA Case No __________________
Part IV - Direct Endorsement Approval for a HUD FHA-Insured Mortgage A Underwriting the Borrower
Date Mortgage Approved ______________________________ Date Approval Expires ______________________
For mortgages rated as an ldquoacceptrdquo or ldquoapproverdquo by FHAs TOTAL Mortgage Scorecard
The information submitted to TOTAL was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA4e Final Underwriting Decision (TOTAL) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee Representative Signature
Printed Name
Title
OR
For mortgages rated as a ldquoreferrdquo by FHAs TOTAL Mortgage Scorecard or manually underwritten by a Direct Endorsement underwriter I have personally reviewed and underwritten the borrowerrsquos credit application The information used to underwrite the borrower was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA5d Final Underwriting Decision (Manual) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
B Underwriting the Property
For all mortgages where FHA requires an appraisal I have personally reviewed and underwritten the appraisal according to FHA requirements I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
orm HUD-92900-A ( ) Page 3
Borrower Name ____________________________ FHA Case No __________________
Part V Mortgagees Certification
I have personally reviewed the mortgage documents and the application for insurance endorsement and This mortgage complies with SF Handbook 40001 Section IIA7 Post-Closing and Endorsement to the extent that no defect exists that would have changed the decision to endorse or submit the mortgage for insurance
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee
Name of Mortgageersquos Representative
Title of Mortgageersquos Representative
Signature of the Mortgageersquos Representative Date
orm HUD-92900-A ( ) Page 4
GENERAL AUTHORIZATION FOR A MORTGAGE LOAN ASSUMPTION
Applicant name(s)
Loan number
NOTICES AND DISCLOSURES
Non-discriminatory underwriting guidelines Anyone who inquires about the availability of credit from us has the right to receive a copy of our non-discriminatory underwriting guidelines To request a copy of these guidelines contact your Loan Processor
Attorney note Itrsquos the responsibility of our attorneys to protect our interest You may at your expense request an attorney to represent your interest
Notice to HUDFHA applicants As required by the Right to Financial Privacy Act of 1978 this notice is to inform you that the US Department of Housing and Urban Development (HUD)Federal Housing Administration (FHA) has a right of access to financial records held by financial institutions related to a request for assistance Financial records involving your assumption will be available to HUDFHA without further notice or authorization but wonrsquot be disclosed or released by us to another government agency or department without your consent except as required or permitted by law
Borrower consent to the use of tax return information I understand acknowledge and agree that the Lender and Other Loan Participants can obtain use and share tax return information for purposes of (i) providing an offer (ii) originating maintaining managing monitoring servicing selling insuring and securitizing a loan (iii) marketing or (iv) as otherwise permitted by applicable laws including state and federal privacy and data security laws The Lender includes the Lenderrsquos affiliates agents service providers and any of aforementioned partiesrsquo successors and assigns The Other Loan Participants includes any actual or potential owners of a loan resulting from your loan application or acquirers of any beneficial or other interest in the loan and mortgage insurer guarantor any servicers or service providers for these parties and any of aforementioned partiesrsquo successors and assigns
CERTIFICATION AND AUTHORIZATION
Environmental certification By signing below I represent and warrant that Irsquom not aware of any substances materials or products that may be an environmental hazard such as but not limited to asbestos formaldehyde radon gas lead-based paint fuel or chemical storage tanks (above or below ground) and contaminated soil or water on the property I acknowledge that Chase is relying on this representation and warranty as a material part of its loan application process I also am not aware of any landfill on any portion of the property
Exceptions to the above I further acknowledge (1) receipt of applicable disclosures from the seller in purchase transactions (2) that lead-based paint may exist in housing constructed prior to 1978 (3) that Chase performs no environmental investigation on my behalf and isnrsquot responsible for identifying lead-based paint or any other environmental conditions that might impact the property or its residents and (4) that it is my sole obligation to investigate for potential impact to the property from environmental conditions
Certifications I certify by signing below that (1) all of the loan application information provided is true and complete (2) I understand any intentional or negligent misrepresentation(s) of the information provided in conjunction with my application may result in civil liability andor 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 Chase its agents successors and assigns insurers and any other person who may suffer any loss due to reliance upon any misrepresentation that I have made on the application and (3) any significant change from the information provided at the time of application until the final loan application is signed may have a bearing on the approval of my application for a home loan
Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union
This question is asked because of state laws that extend the same or similar rights benefits and protections of spouses in a marriage to persons who are members of a partnership or union recognized under state law You should consult with your own legal advisor for advice regarding the rights protections benefits responsibilities obligations and duties of those who are registered domestic partners civil union partners or members of other unions recognized under applicable law
CREDIT AUTHORIZATION RELEASE
By signing below I authorize Chase andor my mortgage insurer (if any) to verify my past and present employment earnings records (including information contained in income tax returns that have been filed with the IRS) bank accounts stock holdings and any other information that it finds necessary to process my mortgage loan application or to review it for quality-control purposes I understand that a credit report will be ordered from a credit reporting agency for verification prior to loan closing as part of the application process and may be ordered after closing as part of the Lenderrsquos quality-control program A credit report may also be completed as part of the Lenderrsquos servicing or collection of the loan or in consideration of any other product or service that the Lender may consider offering me in the future and at any time throughout the life of the loan I understand that use of a photocopy of this form may be necessary to verify one or more of my credit references I understand that a photocopy or fax copy of this form will also serve as authorization
By signing below each applicant acknowledges (1) making the above certifications and authorizations and (2) that each applicant has received and understands the above notices and disclosures
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
You do not have to give us this information but if you donrsquot your application for approval as a borrower may be delayed or rejected The information requested in this form is authorized by Title 38 USC Chapter 37 (if VA) by 12 USC Section 1701 et seq (if HUDFHA) by 42 USC Section 1452b (if HUDCPD) and Title 42 USC 1471 et seq or 7 USC 1921 et seq (if USDA FHA)
Updated December 2021 99177-GA-0215
1b
2b
Form 4506-C (September 2020)
Department of the Treasury - Internal Revenue Service
IVES Request for Transcript of Tax Return OMB Number
1545-1872
Do not sign this form unless all applicable lines have been completed Request may be rejected if the form is incomplete or illegible
For more information about Form 4506-C visit wwwirsgov and search IVES
1a Name shown on tax return (if a joint return enter the name shown first)
First social security number on tax return individual taxpayer identification number or employer identification number (see instructions)
2a If a joint return enter spousersquos name shown on tax return Second social security number or individual taxpayer identification number if joint tax return
3 Current name address (including apt room or suite no) city state and ZIP code (see instructions)
4 Previous address shown on the last return filed if different from line 3 (see instructions)
5a IVES participant name address and SOR mailbox ID
DataVerify 875 Greentree Rd 8 Parkway Center Pittsburgh PA 15220
5b Customer file number (if applicable) (see instructions)
Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing (see instructions)
6 Transcript requested Enter the tax form number here (1040 1065 1120 etc) and check the appropriate box below Enter only one tax form number per request 1040
a Return Transcript which includes most of the line items of a tax return as filed with the IRS A tax return transcript does not reflect changes made to the account after the return is processed Transcripts are only available for the following returns Form 1040 series Form 1065 Form 1120 Form 1120-A Form 1120-H Form 1120-L and Form 1120S Return transcripts are available for the current year and returns processed during the prior 3 processing years
b Account Transcript which contains information on the financial status of the account such as payments made on the account penalty assessments and adjustments made by you or the IRS after the return was filed Return information is limited to items such as tax liability and estimated tax payments Account transcripts are available for most returns
c Record of Account which provides the most detailed information as it is a combination of the Return Transcript and the Account Transcript Available for current year and 3 prior tax years
7 Form W-2 Form 1099 series Form 1098 series or Form 5498 series transcript The IRS can provide a transcript that includes data from these information returns State or local information is not included with the Form W-2 information The IRS may be able to provide this transcript information for up to 10 years Information for the current year is generally not available until the year after it is filed with the IRS For example W-2 information for 2016 filed in 2017 will likely not be available from the IRS until 2018 If you need W-2 information for retirement purposes you should contact the Social Security Administration at 1-800-772-1213
Caution If you need a copy of Form W-2 or Form 1099 you should first contact the payer To get a copy of the Form W-2 or Form 1099 filed with your return you must use Form 4506 and request a copy of your return which includes all attachments
8 Year or period requested Enter the ending date of the tax year or period using the mmddyyyy format (see instructions)
12 31 2020 12 31 2019 12 31 2018 Caution Do not sign this form unless all applicable lines have been completed
Signature of taxpayer(s) I declare that I am either the taxpayer whose name is shown on line 1a or 2a or a person authorized to obtain the tax information requested If the request applies to a joint return at least one spouse must sign If signed by a corporate officer 1 percent or more shareholder partner managing member guardian tax matters partner executor receiver administrator trustee or party other than the taxpayer I certify that I have the authority to execute Form 4506-C on behalf of the taxpayer Note This form must be received by IRS within 120 days of the signature date
Signatory attests that heshe has read the attestation clause and upon so reading declares that heshe has the authority to sign the Form 4506-C See instructions
Sign Here
Signature (see instructions) Date Phone number of taxpayer on line 1a or 2a
PrintType name
Title (if line 1a above is a corporation partnership estate or trust)
Spousersquos signature Date
PrintType name
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020) For Privacy Act and Paperwork Reduction Act Notice see page 2
Instructions for Form 4506-C IVES Request for Transcript of Tax Return
Section references are to the Internal Revenue Code unless otherwise noted
Future Developments
For the latest information about Form 4506-C and its instructions go to wwwirsgov and search IVES Information about any recent developments affecting Form 4506-C (such as legislation enacted after we released it) will be posted on that page
Whats New Form 4506-C was created to be utilized by authorized IVES participants to order tax transcripts with the consent of the taxpayer
General Instructions
Caution Do not sign this form unless all applicable lines have been completed
Designated Recipient Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information received pursuant to the taxpayerrsquos consent and holds the recipient subject to penalties for any unauthorized access other use or redisclosure without the taxpayerrsquos express permission or request
Taxpayer Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information provided pursuant to your consent and holds the recipient subject to penalties brought by private right of action for any unauthorized access other use or redisclosure without your express permission or request
Purpose of form Use Form 4506-C to request tax return information through an authorized IVES participant You will designate an IVES participant to receive the information on line 5a
Note If you are unsure of which type of transcript you need check with the party requesting your tax information
Where to file The IVES participant will fax Form 4506-C with the approved IVES cover sheet to their assigned Service Center
Chart for ordering transcripts
If your assigned Service Center is
Fax the requests with the approved coversheet to
Austin Submission Processing Center
Austin IVES Team
844-249-6238
Fresno Submission Processing Center
Fresno IVES Team
844-249-6239
Kansas City Submission Processing Center
Kansas City IVES Team
844-249-8128
Ogden Submission Processing Center
Ogden IVES Team
844-249-8129
Specific Instructions
Line 1b Enter the social security number (SSN) or individual taxpayer identification number (ITIN) for the individual listed on line 1a or enter the employer identification number (EIN) for the business listed on line 1a
Line 3 Enter your current address If you use a PO box include it on this line
Line 4 Enter the address shown on the last return filed if different from the address entered on line 3
Note If the addresses on lines 3 and 4 are different and you have not changed your address with the IRS file Form 8822 Change of Address or Form 8822-BChange of Address or Responsible Party mdash Business with Form 4506-C
Line 5b Enter up to 10 numeric characters to create a unique customer file number that will appear on the transcript The customer file number cannot contain an SSN ITIN or EIN Completion of this line is not required
Note If you use an SSN name or combination of both we will not input the information and the customer file number will reflect a generic entry of 9999999999 on the transcript
Line 8 Enter the end date of the tax year or period requested in mmddyyyy format This may be a calendar year fiscal year or quarter Enter each quarter requested for quarterly returns Example Enter 12312018 for a calendar year 2018 Form 1040 transcript
Signature and date Form 4506-C must be signed and dated by the taxpayer listed on line 1a or 2a The IRS must receive Form 4506-C within 120 days of the date signed by the taxpayer or it will be rejected Ensure that all applicable lines including lines 5a through 8 are completed before signing
You must check the box in the signature area to acknowledge you have the authority to sign and request the information The form will not be processed if unchecked
Individuals Transcripts listed on on line 6 may be furnished to either spouse if jointly filed Only one signature is required Sign Form 4506-C exactly as your name appeared on the original return If you changed your name also sign your current name
Corporations Generally Form 4506-C can be signed by
(1) an officer having legal authority to bind the corporation (2) any person designated by the board of directors or other governing body or (3) any officer or employee on written request by any principal officer and attested to by the secretary or other officer A bona fide shareholder of record owning 1 percent or more of the outstanding stock of the corporation may submit a Form 4506-C but must provide documentation to support the requesters right to receive the information
Partnerships Generally Form 4506-C can be signed by any person who was a member of the partnership during any part of the tax period requested on line 8
All others See section 6103(e) if the taxpayer has died is insolvent is a dissolved corporation or if a trustee guardian executor receiver or administrator is acting for the taxpayer
Note If you are Heir at law Next of kin or Beneficiary you must be able to establish a material interest in the estate or trust
Documentation For entities other than individuals you must attach the authorization document For example this could be the letter from the principal officer authorizing an employee of the corporation or the letters testamentary authorizing an individual to act for an estate
Signature by a representative A representative can sign Form 4506-C for a taxpayer only if the taxpayer has specifically delegated this authority to the representative on Form 2848 line 5 The representative must attach Form 2848 showing the delegation to sign Form 4506-C
Privacy Act and Paperwork Reduction Act Notice We ask for the information on this form to establish your right to gain access to the requested tax information under the Internal Revenue Code We need this information to properly identify the tax information and respond to your request You are not required to request any transcript if you do request a transcript sections 6103 and 6109 and their regulations require you to provide this information including your SSN or EIN If you do not provide this information we may not be able to process your request Providing false or fraudulent information may subject you to penalties
Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and cities states the District of Columbia and US commonwealths and possessions for use in administering their tax laws We may also disclose this information to other countries under a tax treaty to federal and state agencies to enforce federal nontax criminal laws or to federal law enforcement and intelligence agencies to combat terrorism
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law Generally tax returns and return information are confidential as required by section 6103
The time needed to complete and file Form 4506-C will vary depending on individual circumstances The estimated average time is
Learning about the law or the form 10 min Preparing the form 12 min Copying assembling and sending the form to the IRS 20 min
If you have comments concerning the accuracy of these time estimates or suggestions for making Form 4506-C simpler we would be happy to hear from you You can write to
Internal Revenue Service Tax Forms and Publications Division 1111 Constitution Ave NW IR-6526 Washington DC 20224
Do not send the form to this address Instead see Where to file on this page
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020)
Rev April 2021 CHASEO Facts What does Chase do with your personal information
Why Financial companies choose how they share your personal information Federal law gives consumers the right to limit some but not all sharing Federal law also requires us to tell you how we collect share and protect your personal information Please read this notice carefully to understand what we do
What The types of personal information we collect and share depend on the product or service you have with us This information can include bull Social Security number and income bull account balances and transaction history bull credit history and payment history
How All financial companies need to share customers personal information to run their everyday business In the section below we list the reasons financial companies can share their customers personal information the reasons Chase chooses to share and whether you can limit this sharing
Reasons we can share your personal information Does Chase share
Can you limit this sharing
For our everyday business purposes - such as to process your transactions maintain your account(s) respond to court orders and legal investigations or report to credit bureaus
Yes No
For our marketing purposes - to offer our products and services to you
Yes No
For joint marketing with other financial companies Yes No
For our affiliates everyday business purposes - information about your transactions and experiences
Yes No
For our affiliates everyday business purposes - information about your creditworthiness
Yes Yes
For our affiliates to market to you Yes Yes
For nonaffiliates to market to you Yes Yes
a
0
To limit our sharing
bull Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
bull Visit us online chasecomprivacypreferences
Please note If you are a new customer we can begin sharing your information 30 days from the date we sent this notice When you are no longer our customer we continue to share your information as described in this notice However you can contact us at any time to limit our sharing
Questions
Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
PAGE 2
Who we are
Who is providing this notice The US consumer financial companies within the JPMorgan Chase amp Co family including JPMorgan Chase Bank NA Chase Insurance Agency Inc and JP Morgan Securities LLC
What we do
How does Chase protect my To protect your personal information from unauthorized access and use we personal information use security measures that comply with federal law These measures include
computer safeguards and secured files and buildings We authorize our employees to get your information only when they need it to do their work and we require companies that work for us to protect your information
How does Chase collect my We collect your personal information for example when you personal information bull open an account or make deposits or withdrawals from your account
bull pay your bills or apply for a loan bull use your credit or debit card We also collect your personal information from others such as credit bureaus affiliates or other companies
Why cant I limit all sharing Federal law gives you the right to limit only bull sharing for affiliates everyday business purposes - information about your
creditworthiness bull affiliates from using your information to market to you bull sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing See below for more on your rights under state law
What happens when I limit sharing for an account I hold jointly with someone else
Your choices will apply to everyone on your account
Definitions
Affiliates Companies related by common ownership or control They can be financial and non financial companies bull Our affiliates include companies with a Chase or JP Morgan name and financial companies such asjP Morgan Securities LLC
Nonaffiliates Companies not related by common ownership or control They can be financial and non financial companies bull Nonaffiliates we share with can include companies such as retailers auto dealers auto makers and membership clubs
Joint marketing A formal agreement between nonaffiliated financial companies that together market financial products or services to you bull Our joint marketing partners include categories of companies such as insurance companies
Other important information
VT Accounts with a Vermont mailing address are automatically treated as if they have limited the sharing as described on page 1 For joint marketing we will only disclose your name contact information and information about your transactions
NV We are providing you this notice pursuant to Nevada law If you prefer not to receive marketing calls from us you may be placed on our Internal Do Not Call List by calling 1-800-945-9470 or by writing to us at PO Box 734007 Dallas TX 75373-4007
For more information contact us at the address above or email PrivacylnfoJPMChasecom with Nevada Annual Notice in the subject line You may also contact the Nevada Attorney Generals office Bureau of Consumer Protection Office of the Nevada Attorney General 555 E Washington St Suite 3900 Las Vegas NV 89101 telephone number 1-702-486-3132 email BCPINFOagstatenvus
CA Accounts with a California mailing address are automatically treated as if they have limited the sharing with nonaffiliates as described on page 1 CA residents are provided a CA notice for additional choices
CHASE O
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
The following disclosure is required by the USA PATRIOT Act
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 opens an account
What this means to you When you 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 drivers
license or other identifying documents
99177-PAT-0215
VETERAN STATEMENT When this loan was opened the US Department of Veterans Affairs (VA) used the veteran borrowerrsquos entitlement which is a set amount the VA promises to repay a lender if the borrower defaults on the mortgage An assumption will modify who is obligated to pay the existing mortgage loan but all loan termsmdashincluding the entitlementmdashwill remain the same If the veteran borrower is being removed from the loan the entitlement would remain with whoever is assuming the loan because the loan will continue to be serviced by the VA If the applicant is also a veteran and can substitute his or her entitlement for the current entitlement then the current borrowerrsquos entitlement can be released
Please review the following questions and answer as appropriate This form requires completion by both the applicant(s) and current borrower(s)
1 Applicant to Complete
Are you (the applicant) currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the reverse side)
Yes (If yes please provide the information requested below answer the question in section 3 and sign and date this form at the bottom of the reverse side)
Name of applicant(s) who answered ldquoyesrdquo to the above question
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Are you receiving VA disability benefts
Applicant
Yes
No
Co-Applicant
Yes
No
Are you entitled to receive VA disability benefts Yes No Yes No
Have you received VA disability benefts in the past Yes No Yes No
Are you a surviving spouse of a veteran who died on active duty or as the result of a service-related disability
Yes No Yes No
Do you have any VA loans Yes No Yes No
2 Current Borrower to Complete
Is the current borrowerco-borrower currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the page)
Yes (If yes please answer the question in section 3 and sign and date this form at the bottom of the page)
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
________________________________________________________________________________________________
3 Applicant and Current Borrower to Complete
If the answer to the questions in section 1 and 2 are both yes please answer the following question After yoursquove reviewed and completed this entire form please sign and date at the bottom
Applicant Current Borrower
Do you want to apply for a substitution of entitlement Yes Yes No No
In order to complete a substitution of entitlement the veteran applicant must have suffcient entitlement to substitute for that of the current borrower Contact the VA Offce of Jurisdiction for your area for more information Also before the veteran applicant can substitute entitlement on a VA loan heshe must certify that the property securing the loan will be occupied as hisher primary residence Both the applicantrsquos and current borrowerrsquos original certifcate of eligibility will be required If your sales contract is contingent upon the restoration of entitlement please contact your VA Offce of Jurisdiction for complete procedures Otherwise the substitution will be completed after the loan has been approved and closed
Date Applicant printed name Applicant signature
Date Applicant printed name Applicant signature
Date Current Borrower printed name Current Borrower signature
Date Current Borrower printed name Current Borrower signature
Forms completed by Mail Phone
For Chase use only
Interviewer signature Date
99177-VS-0215
- Assumption Application Package_41521-noscannedpages-update-4pdf
-
- 1 FM203 Cover Pagepdf
- 2 FM202 Mortgage Assumption Application Package pagepdf
- 3 The Documents Youll need to Send Uspdf
- 4 FM201 FAQpdf
- 5 FM142 CIWpdf
- 6 FM126 URLApdf
- 7 FM130 URLA Instpdf
-
- Blank Page
-
- 8 92900a Addednum to Loan Applicationpdf
- 9 FM462 Gen Authpdf
- 10 FM220 4506-Cpdf
- 11 FM153 Chase Federal Privacy Noticepdf
- 12 FM144 Info on Opening a New Accountpdf
- 13 FM152 Veteran Statementpdf
-
- Date
- Loan number
- Applicant name
- Phone1
- Loan number 1
- Loan number 2
- Other
- Other_2
- 1
- 2
- undefined_7
- Available hours
- Available hours_2
- undefined_8
- Available hours_3
- undefined_9
- Current address 1
- Neither
- Available hours_4
- Available hours_5
- undefined_10
- Available hours_6
- 1_2
- 2_2
- undefined_11
- Available hours_7
- Available hours_8
- undefined_12
- Available hours_9
- FHA Case No include any suffix
- Mortgagee Case No
- Mortgagee ID
- Sponsor ID
- Agent ID
- Name and Address of Sponsor Name and Address of Agent
- Borrowers Name Present Address include ZIP Code Property Address
- include name of subdivision lot block no ZIP Code
- Name of ThirdParty Originator
- NMLS ID of ThirdParty Originator
- s application
- ty Number
- ty Number_2
- Date Signed_2
- Date Mortgage Approved
- Date Approval Expires
- Printed Name
- Title 1
- DEs ID Number
- DEs ID Number_2
- Mortgagee
- Name of Mortgagees Representative
- Title of Mortgagees Representative
- Signature of the Mortgagees Representative
- Date_2
- Applicant names 1
- Applicant names 2
- Applicant names 3
- Loan number_2
- Date_3
- Applicant printed name
- Social Security number
- Date_4
- Applicant printed name_2
- Social Security number_2
- Date_5
- Applicant printed name_3
- Social Security number_3
- Date_6
- Applicant printed name_4
- Social Security number_4
- 1a Name shown on tax return if a joint return enter the name shown first
- 1b First social security number on tax return individual taxpayer identification number or employer identification number see instructions
- 2a If a joint return enter spouses name shown on tax return
- 2b Second social security number or individual taxpayer identification number if joint tax return
- 4 Previous address shown on the last return filed if different from line 3 see instructions
- 5a IVES participant name address and SOR mailbox ID
- Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing see instructions
- Signature see instructions
- Date_7
- Phone number of taxpayer on line 1a or 2a
- PrintType name
- Here
- Spouses signature
- Date_8
- PrintType name_2
- Name
- Date of birth
- Service number
- Name_2
- Date of birth_2
- Service number_2
- Date_9
- Applicant printed name_5
- Date_10
- Applicant printed name_6
- Date_11
- Current Borrower printed name
- Date_12
- Current Borrower printed name_2
- Date_13
- Text3
- Text10
- undefined_13
- Text15
- undefined_14
- undefined_15
- undefined_16
- undefined_17
- undefined_18
- undefined_19
- undefined_20
- undefined_21
- undefined_23
- Reason for assumption Off
- Requestors relationship to owners Off
- Check one Off
- Check one1 Off
- Day1
- Evening
- Cell phone
- Check one2 Off
- Check one3 Off
- Check one4 Off
- Check one5 Off
- Text2-1
- Text2-2
- Text2-3
- Text2-4
- Text2-5
- Text2-6
- Text3-1
- Text3-2
- Text3-3
- Text3-4
- Text3-6
- Text3-7
- Text3-8
- Text3-9
- Text3-10
- Text3-11
- Text3-12
- Text3-13
- Text3-14
- Text3-15
- Text3-16
- Text3-17
- Text3-18
- Text3-19
- Text3-20
- Text3-21
- Text3-22
- Text3-23
- Text3-24
- Text3-25
- Text3-26
- Text3-27
- Text3-28
- Text3-29
- Text3-30
- Text3-31
- Text3-32
- Text3-33
- Text3-34
- Text3-35
- Text3-36
- Text3-37
- Text3-38
- Text3-39
- Text3-40
- Text3-41
- Text3-42
- Text3-43
- Text3-44
- Text3-45
- Text3-46
- Text3-47
- Text3-48
- Text3-49
- Text3-50
- Text3-51
- Text3-52
- Text3-53
- Text3-5
- Text3-54
- Text3-55
- Text3-56
- Citizenship Off
- Type of credit Off
- Marital Status Off
- Housing Off
- Housing1 Off
- ownership Off
- DNA1 Off
- DNA2 Off
- DNA3 Off
- family Off
- BO Off
- Total
- Text31
- Text32
- Text33
- Text34
- Text35
- Text36
- Text37
- Text38
- Text39
- Text310
- Text311
- Text312
- Text313
- Text314
- Text315
- Text316
- Text317
- Text318
- Text319
- ownership1 Off
- Total1
- Total1-2
- Check Box4-1 Off
- Text320
- Text321
- Text322
- Text323
- Text324
- Text325
- Text326
- Text327
- Text328
- Text329
- Check Box4-2 Off
- Check Box4-3 Off
- Check Box4-4 Off
- Check Box4-8 Off
- Check Box4-9 Off
- Text330
- Text331
- Text332
- Text333
- Text334
- Text335
- Text1-1
- Text1-2
- Text1-3
- Text1-4
- Text1-5
- Text1-6
- Text1-7
- Text1-8
- Text1-9
- Text1-10
- Text1-11
- Text1-12
- Text1-13
- Text1-14
- Text1-15
- Text1-16
- Text1-17
- Text1-18
- Text1-19
- Text1-20
- Text1-21
- Text1-22
- Text1-23
- Text1-24
- Text1-25
- Text1-26
- Text1-27
- Text1-28
- Text1-29
- Text1-30
- Text1-31
- Text1-32
- Text1-33
- Text1-34
- Text1-35
- Check Box3-2 Off
- Check Box2-1 Off
- Check Box2-2 Off
- Check Box2-3 Off
- Check Box2-4 Off
- Check Box2-5 Off
- Text1-36
- Text1-37
- Text1-38
- Text1-39
- Text1-40
- Text1-41
- Text1-42
- Text1-43
- Text1-44
- Text1-45
- Text1-46
- Text1-47
- Text1-48
- Text1-49
- Text1-50
- Text1-51
- Text1-52
- Text1-53
- Text1-54
- Text1-55
- Text1-56
- Text1-57
- Text1-58
- Text1-59
- Text1-60
- Text1-61
- Check Box3-11 Off
- A1
- A2
- A3
- A4
- A5
- A6
- A7
- A8
- A9
- A10
- A11
- A12
- Check Box3-1 Off
- Check Box30-1 Off
- Check Box30-2 Off
- Check Box30-4 Off
- Check Box30-5 Off
- Check Box30-7 Off
- Check Box30-8 Off
- Check Box30-9 Off
- Check Box30-10 Off
- Check Box30-11 Off
- Check Box30-12 Off
- A13
- A14
- A15
- A16
- A17 Off
- A18
- A19
- A20
- A21
- A22
- A23
- A24
- A25
- A26
- A27
- A28
- A29
- A30
- A31
- A32
- A33
- A34
- A35
- A36
- A37
- A38 Off
- A39
- A40
- A41
- A42
- A43
- A44
- A45
- A46
- A47
- A48
- A49
- A50
- A51
- A52
- A53
- A54
- A55
- A56
- A57
- A58
- A59
- A60
- A61
- A62
- A63
- A64
- A65
- A66
- A67
- A68
- A69
- A70
- A71
- A72
- A73
- A74
- Loan Purpose Off
- occupancy1 Off
- lien type Off
- lientype Off
- mixed use Off
- manufactured home Off
- deposit1 Off
- deposit2 Off
- B1
- B2
- B3
- B4
- B5
- B6
- B7
- B8
- B9
- B10
- fha Off
- Check Box51 Off
- B11
- B12
- B13
- B14
- B15
- B16
- B17
- B18
- B19 Off
- B20
- B21
- B22 Off
- B23
- B24
- B25
- B26
- B27
- B28
- A
-
- Will you occupy the property as your primary residence Off
- Will you occupy the property as your primary residence1 Off
-
- If yes have you had an ownership interest in another property in the last three years Off
- Text9-2
- B
-
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property Off
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property1 Off
-
- 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 Off
- 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 application1 Off
-
- 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 Off
- 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 application1 Off
-
- new credit Off
- 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) Off
- the Property Assessed Clean Energy Program)1 Off
-
- F
-
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application Off
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application1 Off
-
- G
-
- Are there any outstanding judgments against you Off
- Are there any outstanding judgments against you1 Off
-
- H
-
- Are you currently delinquent or in default on a Federal debt Off
- Are you currently delinquent or in default on a Federal debt1 Off
-
- I
-
- Are you a party to a lawsuit in which you potentially have any personal financial liability Off
- Are you a party to a lawsuit in which you potentially have any personal financial liability1 Off
-
- J
-
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years Off
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years1 Off
-
- 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 Off
- 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 due1 Off
-
- L
-
- Have you had property foreclosed upon in the last 7 years Off
- Have you had property foreclosed upon in the last 7 years1 Off
-
- M
-
- Have you declared bankruptcy within the past 7 years Off
- Have you declared bankruptcy within the past 7 years1 Off
-
- Check Box8-2 Off
- Check Box8-3 Off
- Check Box8-4 Off
- Text9-3
- Text9-5
- Text9-6
- Text97
- military Off
- ethnicity Off
- sex Off
- race Off
- demo Off
- Text12-1
- Check Box11-1 Off
- Check Box11-2 Off
- Check Box11-3 Off
- Check Box11-4 Off
- Check Box11-5 Off
- Check Box11-6 Off
- Check Box11-7 Off
- Check Box11-8 Off
- Check Box11-9 Off
- Text12-2
- Check Box11-10 Off
- Check Box11-11 Off
- Check Box11-12 Off
- Check Box11-13 Off
- Check Box11-14 Off
- Check Box11-15 Off
- Text12-3
- Check Box11-16 Off
- Check Box11-17 Off
- Check Box11-18 Off
- Check Box11-19 Off
- Check Box11-20 Off
- Check Box11-21 Off
- Check Box11-22 Off
- Check Box11-23 Off
- Text12-4
- Check Box11-24 Off
- Check Box11-25 Off
- Check Box11-26 Off
- Check Box11-27 Off
- Check Box11-28 Off
- Check Box11-29 Off
- Text12-5
- Check Box11-30 Off
- Check Box11-31 Off
- citizen Off
- credit Off
- marital status1 Off
- housing-1 Off
- housing-2 Off
- own Off
- C1
- C2
- C3
- C6
- C7
- C8
- C9
- C10
- C11
- C12
- C13
- C14
- C15
- C16
- C17
- C18
- C19
- C20
- C21
- C22
- C23
- C24
- C25
- C26
- C27
- C28
- C29
- C30
- C31
- C32
- C33
- C34
- C35
- Check Box-2 Off
- C36
- C37
- C38
- C39
- C4
- C40
- C41
- C42
- C43
- C44
- C45
- C46
- C47
- Check Box-3 Off
- Check Box-4 Off
- C48
- C49
- C5
- C50
- C51
- C52
- C53
- C54
- C55
- Check Box-1-1 Off
- own1 Off
- Check Box-1 Off
- D1 Off
- D2
- D3
- D4
- D5
- D6
- D7
- D8
- D9
- D10
- D11
- D12
- D13
- D14 Off
- D15 Off
- D16
- D17
- D18
- D19
- D20
- D21
- D22
- D23
- D24 Off
- D25
- D26
- D27
- D28
- D29
- D30
- D31
- D32
- D33
- D34
- D35 Off
- D36
- D37 Off
- D38
- D39
- D40
- D41
- D42
- D43
- D44
- D45
- D46
- D47
- If yes have you had an ownership interest in another property in the last three years1 Off
- new credit1 Off
- Check Box8-1 Off
- Check Box8-1-2 Off
- Check Box8-1-1 Off
- Check Box8-1-3 Off
- Check Box8-1-4 Off
- Military Service mdash Did you (or your deceased spouse) ever serve or are you currently serving in the United States Armed Forces 1 Off
- Check1 Off
- Text9-1-1
- Check2 Off
- Check3 Off
- Check4 Off
- Text9-1
- E1
- E2
- E3
- Was the ethnicity of the Borrower collected on the basis of visual observation or surname1 Off
- Was the sex of the Borrower collected on the basis of visual observation or surname1 Off
- Was the race of the Borrower collected on the basis of visual observation or surname1 Off
- The Demographic Information was provided through1 Off
- F1 Off
- F2 Off
- F3 Off
- F4 Off
- F5 Off
- F6
- F7 Off
- F8 Off
- F9 Off
- F10 Off
- F11 Off
- F12 Off
- F13
- F14 Off
- F15 Off
- F16 Off
- F17 Off
- F18 Off
- F19 Off
- F20 Off
- F21 Off
- F22
- F23 Off
- F24 Off
- F25 Off
- F26 Off
- F27 Off
- F28 Off
- F29
- F30 Off
- F31 Off
- undefined_13-1
- undefined_13-2
- undefined_14-1
- undefined_15-1
- undefined_16-1
- undefined_17-1
- undefined_18-1
- undefined_19-1
- undefined_21-1
- undefined_20-1
- undefined_23-1
- undefined_13_1
- Single-Two Off
- Refi type Off
- refi program Off
- Estate Off
- Title held Off
- Trust Information Off
- Indian Country Land Tenure Off
- Mortgage Type Applied For Off
- Mortgage Lien Type Off
- Amortization Type Off
- G1 Off
- G2 Off
- G3 Off
- G4 Off
- G5 Off
- G6
- G7
- G8
- G9
- G10 Off
- G11 Off
- G12 Off
- G13 Off
- G14 Off
- G15 Off
- G16
- G17
- G18
- G19
- G20
- G21
- G22
- G23 Off
- G24
- G25 Off
- G26
- G27 Off
- G28 Off
- G29
- G30 Off
- G31
- G32 Off
- G33
- G34
- G35
- G36
- G37
- G38
- G39
- G40
- G41
- G42
- Property Held
- refi
- Text18-1
- Text18-2
- Text18-3
- Text18-4
- Text18-5
- Text18-6
- Text18-7
- Text18-8
- Text18-9
- Text18-10
- Text18-11
- Text18-12
- Text18-13
- Text18-14
- Text18-15
- Text18-16
- Text18-17
- Text18-18
- Text18-19
- Lender
- case no
- If you selected ldquoUnmarriedrdquo in Section 1 is there a person who is not your legal spouse but who currently has real property rights similar to those of a legal spouse Off
- Relationship and State Off
- Other-5
- Text19-1
- BName
- Additional Information
- ABN
- Additional Information1
- BSign
- BSDate
- ABSign
- ABDate
- MortageeNameAddress
- NAmeAddress
- Bname1
- DOB1
- DOB2
- SignOfBorr1
- SignOfBorr
- Date Signed
- SignOfBorr2
- SignOfBorr3
- Date Signed3
- Date Signed4
- MortgageeRepSign
- DirectSign
- DirectSign1
- Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union Off
- AppSign
- AppSign1
- AppSign2
- AppSign3
- Nopage38 Off
- Yespage38 Off
- Yes1 Off
- No1 Off
- Yes2 Off
- Yes3 Off
- Yes4 Off
- Yes5 Off
- Yes6 Off
- Yes7 Off
- Yes8 Off
- Yes9 Off
- Yes10 Off
- No2 Off
- No3 Off
- No4 Off
- No5 Off
- No6 Off
- No7 Off
- No8 Off
- No9 Off
- No10 Off
- BorrowerNo Off
- BorrowerYes Off
- AppSignature
- AppSignature1
- CurrentSign
- CurrentSign1
- InterviewSign
- Yes_1 Off
- No_1 Off
- Yes_2 Off
- No_2 Off
- Mail Off
- Phone Off
Complete a separate URLA for each BorrowermiddotThree or more Borrowers ndash Use any combination of URLA and URLA-Additional Borrower forms in accordance with the above examples
Section 3 Financial Information ndash Real Estate Contains only the following statement for the additional borrower to complete ldquoMy information for Section 3 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 4 Loan and Property Information Contains only the following statement for the additional borrower to complete ldquoMy information for Section 4 is listed on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 5 Declarations This is the same as the Declarations section of the URLA
Section 6 Acknowledgments and Agreements Contains only the following statement for the additional borrower to complete ldquoMy signature for Section 6 is on the Uniform Residential Loan Application with (name of Borrower)rdquo
Section 7 Military Service This is the same as the Military Service section of the URLA
Section 8 Demographic Information This is the same as the Demographic Information section on the URLA
Section 9 Loan Originator Information This is the same as the Loan Originator Information section of the URLA
Using the URLA and URLA ndash Additional Borrower Together The URLA and the URLA ndash Additional Borrower are used together to collect information for two Borrowers who have joint assets liabilities andor real estate information The URLA and URLA ndash Additional Borrower can also be used for Borrowers who do not have joint information but wish to combine their information on the URLA for ease of use Here are examples of how to use the URLA and URLA ndash Additional Borrower
For one borrower Complete the URLA
For two borrowers with joint financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you dont need to duplicate them on more than one URLA or o In cases where Borrowers are not collaborating when completing the loan application
joint assets liabilities and real estate may be duplicated on each URLA bull Complete the URLA plus the URLA ndash Additional Borrower
o Report the assets liabilities and real estate for the additional Borrower on the URLA or o Complete a separate URLA for each Borrower Report joint assets liabilities and real
estate on only one URLA you do not need to duplicate them on more than one URLA or
o In cases where Borrowers are not collaborating when completing the loan application joint assets liabilities and real estate may be duplicated on each URLA
For two borrowers with separate financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower Report the assets liabilities and
real estate for the additional Borrower on the URLA or bull Complete a separate URLA for each Borrower
For three or more borrowers use any combination of URLA and URLA ndash Additional Borrower forms described for two borrowers
Uniform Residential Loan Application ndash Unmarried Addendum If any borrower listed on the URLA or URLA ndash Additional Borrower form selects Unmarried in Section 1 (Personal Information) the lender will complete this optional form
The information must be collected to determine how to apply state property laws that directly or indirectly affect creditworthiness including ensuring clear title
Uniform Residential Loan Application ndash Continuation Sheet Use the URLA ndash Continuation Sheet if you need more space to complete either the URLA or URLA ndash Additional Borrower forms
99177-URLAI-0215
HUD Addendum to Uniform Residential Loan Application OMB Approval No HUD 2502-0059 (exp )
Part I - Identifying Information HUDFHA Application for Insurance under the National Housing Act and Borrower Certification
FHA Case No (include any suffix) Mortgagee Case No
Mortgagee ID Sponsor ID Agent ID
Mortgagee Name Address (include ZIP Code) and Telephone Number
Type or print all entries clearly
Name and Address of Sponsor Name and Address of Agent
Borrowers Name amp Present Address (include ZIP Code) Property Address (include name of subdivision lot amp block no amp ZIP Code)
Sponsored Originations
Name of Third-Party Originator NMLS ID of Third-Party Originator
Part II - Borrower Consent for Social Security Administration to Verify Social Security Number I authorize the Social Security Administration (SSA) to verify my Social Security Number (SSN) to the Mortgagee and HUDFHA I authorize SSA to provide explanatory
information to HUDFHA in the event of a discrepancy This consent is valid for 180 days from the date signed unless indicated otherwise by the individual(s) named in this
loan application
Signature(s) of Borrower(s) - Read consent carefully Review accuracy of Social Security Number(s) provided on this application
Borrowerrsquos NameDate of BirthSocial Security Number
Co-Borrowerrsquos Name Date of BirthSocial Security Number
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
Part III - Borrower Notices Information and Acknowledgment Public Reporting Burden
Public reporting burden for this collection of information is estimated to average 10 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 conduct or sponsor and a person is not
required to respond to a collection of information unless that collection displays a valid OMB control number which can be located on the OMB Internet page at
httpwwwreginfogovpublicdoPRAMain
Privacy Act Information
The information requested on the Uniform Residential Loan Application and this Addendum is authorized by the National Housing Act of 1934 12 USC sect 1701 et seq The Debt
Collection Act of 1982 Pub L 97-365 and HUDrsquos Housing and Community Development Act of 1987 42 USC sect 3543 require persons applying for a federally insured loan to
furnish their SSN You must provide all the requested information including your SSN HUD may conduct a computer match to verify the information you provide HUD may
disclose certain information to Federal State and local agencies when relevant to civil criminal or regulatory investigations and prosecutions It will not otherwise be disclosed or
released outside of HUD except as required and permitted by law The information will be used to determine whether you qualify as a mortgagor Failure to provide any of the
requested information including SSN may result in disapproval of your loan application This is notice to you as required by the Right to Financial Privacy Act of 1978 that
HUDFHA has a right of access to financial records held by financial institutions in connection with the consideration or administration of assistance to you Financial records
involving your transaction will be available to HUDFHA without further notice or authorization but will not be disclosed or released by the institution to another Government Agency
or Department without your consent except as required or permitted by law
WARNING This warning applies to all certifications made in this document Anyone who knowingly submits a false claim or makes false statements is subject to criminal and civil penalties including confinement for up to 5 years fines and civil penalties 18 USC sectsect 287 1001 and 31 USC sect 3729
orm HUD-92900-A ( ) Page 1
Borrower Name ____________________________ FHA Case No __________________
Caution Delinquencies Defaults Foreclosures and Abuses Delinquencies defaults foreclosures and abuses of mortgage loans involving programs of the Federal Government can be costly and detrimental to your credit now and in the future The Mortgagee in this transaction its agents and assigns as well as the Federal Government its agencies agents and assigns are authorized to take any and all of the following actions in the event loan payments become delinquent on the mortgage loan described in the attached application (1) Report your name and account information to a credit bureau (2) Assess additional interest and penalty charges for the period of time that payment is not made (3) Assess charges to cover additional administrative costs incurred by the Federal Government to service your account (4) Offset amounts owed to you
under other Federal programs (5) Refer your account to a private attorney collection agency or mortgage servicing agency to collect the amount due foreclose
the mortgage sell the property and seek judgment against you for any deficiency (6) Refer your account to the Department of Justice (DOJ) for litigation in the
courts (7) If you are a current or retired Federal employee take action to offset your salary or civil service retirement benefits (8) Refer your debt to the Internal
Revenue Service for offset against any amount owed to you as an income tax refund and (9) Report any resulting written off debt of yours to the Internal Revenue Service as your taxable income All of these actions may be used to recover any debts owed when it is determined to be in the interest of the Mortgagee or Federal Government or both
As a mortgage loan borrower you will be legally obligated to make the mortgage payments called for by your mortgage loan contract The fact that you dispose of your property after the loan has been made will not relieve you of liability for making these payments Payment of the loan in full is ordinarily the way liability on a mortgage note is ended Some home buyers have the mistaken impression that if they sell their homes when they move to another locality or dispose of it for any other reasons they are no longer liable for the mortgage payments and that liability for these payments is solely that of the new owners Even though the new owners may agree in writing to assume liability for your mortgage payments this assumption agreement will not relieve you from liability to the holder of the note which you signed when you obtained the loan to buy the property Unless you are able to sell the property to a buyer who is acceptable to HUDFHA who will assume the payment of your obligation to the lender you will not be relieved from liability to repay any claim which HUDFHA may be required to pay your lender on account of default in your loan payments The amount of any such claim payment may be a debt owed by you to the Federal Government and subject to established collection procedures
Fair Housing Act I and anyone acting on my behalf are and will remain in compliance with the Fair Housing Act 42 USC sect 3604 et seq with respect to the dwelling or property covered by the loan and in the provision of services or facilities in connection therewith I recognize that any restrictive covenant on this property related to race color religion sex disability familial status or national origin is unlawful under the Fair Housing Act and unenforceable I further recognize that in addition to administrative action by HUD a civil action may be brought by the DOJ in any appropriate US court against any person responsible for a violation of the
applicable law
Certification and Acknowledgment All information in this application is given for the purpose of obtaining a loan to be insured under the National Housing Act and the information in the Uniform Residential Loan Application and this Addendum is true and complete to the best of my knowledge and belief Verification may be obtained from any source named herein I have read and understand the foregoing concerning my liability on the loan and Part III Borrower Notices Information and Acknowledgment
Signature(s) of Borrower(s) - Do not sign unless this application is fully completed Read the certification carefully and review accuracy of this application
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
orm HUD-92900-A ( Page 2
___________________________________
______________________________________________________
______________________________________________________________
- - - - - - - - - - - - - - - - - - - - - - -
Borrower Name ____________________________ FHA Case No __________________
Part IV - Direct Endorsement Approval for a HUD FHA-Insured Mortgage A Underwriting the Borrower
Date Mortgage Approved ______________________________ Date Approval Expires ______________________
For mortgages rated as an ldquoacceptrdquo or ldquoapproverdquo by FHAs TOTAL Mortgage Scorecard
The information submitted to TOTAL was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA4e Final Underwriting Decision (TOTAL) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee Representative Signature
Printed Name
Title
OR
For mortgages rated as a ldquoreferrdquo by FHAs TOTAL Mortgage Scorecard or manually underwritten by a Direct Endorsement underwriter I have personally reviewed and underwritten the borrowerrsquos credit application The information used to underwrite the borrower was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA5d Final Underwriting Decision (Manual) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
B Underwriting the Property
For all mortgages where FHA requires an appraisal I have personally reviewed and underwritten the appraisal according to FHA requirements I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
orm HUD-92900-A ( ) Page 3
Borrower Name ____________________________ FHA Case No __________________
Part V Mortgagees Certification
I have personally reviewed the mortgage documents and the application for insurance endorsement and This mortgage complies with SF Handbook 40001 Section IIA7 Post-Closing and Endorsement to the extent that no defect exists that would have changed the decision to endorse or submit the mortgage for insurance
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee
Name of Mortgageersquos Representative
Title of Mortgageersquos Representative
Signature of the Mortgageersquos Representative Date
orm HUD-92900-A ( ) Page 4
GENERAL AUTHORIZATION FOR A MORTGAGE LOAN ASSUMPTION
Applicant name(s)
Loan number
NOTICES AND DISCLOSURES
Non-discriminatory underwriting guidelines Anyone who inquires about the availability of credit from us has the right to receive a copy of our non-discriminatory underwriting guidelines To request a copy of these guidelines contact your Loan Processor
Attorney note Itrsquos the responsibility of our attorneys to protect our interest You may at your expense request an attorney to represent your interest
Notice to HUDFHA applicants As required by the Right to Financial Privacy Act of 1978 this notice is to inform you that the US Department of Housing and Urban Development (HUD)Federal Housing Administration (FHA) has a right of access to financial records held by financial institutions related to a request for assistance Financial records involving your assumption will be available to HUDFHA without further notice or authorization but wonrsquot be disclosed or released by us to another government agency or department without your consent except as required or permitted by law
Borrower consent to the use of tax return information I understand acknowledge and agree that the Lender and Other Loan Participants can obtain use and share tax return information for purposes of (i) providing an offer (ii) originating maintaining managing monitoring servicing selling insuring and securitizing a loan (iii) marketing or (iv) as otherwise permitted by applicable laws including state and federal privacy and data security laws The Lender includes the Lenderrsquos affiliates agents service providers and any of aforementioned partiesrsquo successors and assigns The Other Loan Participants includes any actual or potential owners of a loan resulting from your loan application or acquirers of any beneficial or other interest in the loan and mortgage insurer guarantor any servicers or service providers for these parties and any of aforementioned partiesrsquo successors and assigns
CERTIFICATION AND AUTHORIZATION
Environmental certification By signing below I represent and warrant that Irsquom not aware of any substances materials or products that may be an environmental hazard such as but not limited to asbestos formaldehyde radon gas lead-based paint fuel or chemical storage tanks (above or below ground) and contaminated soil or water on the property I acknowledge that Chase is relying on this representation and warranty as a material part of its loan application process I also am not aware of any landfill on any portion of the property
Exceptions to the above I further acknowledge (1) receipt of applicable disclosures from the seller in purchase transactions (2) that lead-based paint may exist in housing constructed prior to 1978 (3) that Chase performs no environmental investigation on my behalf and isnrsquot responsible for identifying lead-based paint or any other environmental conditions that might impact the property or its residents and (4) that it is my sole obligation to investigate for potential impact to the property from environmental conditions
Certifications I certify by signing below that (1) all of the loan application information provided is true and complete (2) I understand any intentional or negligent misrepresentation(s) of the information provided in conjunction with my application may result in civil liability andor 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 Chase its agents successors and assigns insurers and any other person who may suffer any loss due to reliance upon any misrepresentation that I have made on the application and (3) any significant change from the information provided at the time of application until the final loan application is signed may have a bearing on the approval of my application for a home loan
Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union
This question is asked because of state laws that extend the same or similar rights benefits and protections of spouses in a marriage to persons who are members of a partnership or union recognized under state law You should consult with your own legal advisor for advice regarding the rights protections benefits responsibilities obligations and duties of those who are registered domestic partners civil union partners or members of other unions recognized under applicable law
CREDIT AUTHORIZATION RELEASE
By signing below I authorize Chase andor my mortgage insurer (if any) to verify my past and present employment earnings records (including information contained in income tax returns that have been filed with the IRS) bank accounts stock holdings and any other information that it finds necessary to process my mortgage loan application or to review it for quality-control purposes I understand that a credit report will be ordered from a credit reporting agency for verification prior to loan closing as part of the application process and may be ordered after closing as part of the Lenderrsquos quality-control program A credit report may also be completed as part of the Lenderrsquos servicing or collection of the loan or in consideration of any other product or service that the Lender may consider offering me in the future and at any time throughout the life of the loan I understand that use of a photocopy of this form may be necessary to verify one or more of my credit references I understand that a photocopy or fax copy of this form will also serve as authorization
By signing below each applicant acknowledges (1) making the above certifications and authorizations and (2) that each applicant has received and understands the above notices and disclosures
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
You do not have to give us this information but if you donrsquot your application for approval as a borrower may be delayed or rejected The information requested in this form is authorized by Title 38 USC Chapter 37 (if VA) by 12 USC Section 1701 et seq (if HUDFHA) by 42 USC Section 1452b (if HUDCPD) and Title 42 USC 1471 et seq or 7 USC 1921 et seq (if USDA FHA)
Updated December 2021 99177-GA-0215
1b
2b
Form 4506-C (September 2020)
Department of the Treasury - Internal Revenue Service
IVES Request for Transcript of Tax Return OMB Number
1545-1872
Do not sign this form unless all applicable lines have been completed Request may be rejected if the form is incomplete or illegible
For more information about Form 4506-C visit wwwirsgov and search IVES
1a Name shown on tax return (if a joint return enter the name shown first)
First social security number on tax return individual taxpayer identification number or employer identification number (see instructions)
2a If a joint return enter spousersquos name shown on tax return Second social security number or individual taxpayer identification number if joint tax return
3 Current name address (including apt room or suite no) city state and ZIP code (see instructions)
4 Previous address shown on the last return filed if different from line 3 (see instructions)
5a IVES participant name address and SOR mailbox ID
DataVerify 875 Greentree Rd 8 Parkway Center Pittsburgh PA 15220
5b Customer file number (if applicable) (see instructions)
Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing (see instructions)
6 Transcript requested Enter the tax form number here (1040 1065 1120 etc) and check the appropriate box below Enter only one tax form number per request 1040
a Return Transcript which includes most of the line items of a tax return as filed with the IRS A tax return transcript does not reflect changes made to the account after the return is processed Transcripts are only available for the following returns Form 1040 series Form 1065 Form 1120 Form 1120-A Form 1120-H Form 1120-L and Form 1120S Return transcripts are available for the current year and returns processed during the prior 3 processing years
b Account Transcript which contains information on the financial status of the account such as payments made on the account penalty assessments and adjustments made by you or the IRS after the return was filed Return information is limited to items such as tax liability and estimated tax payments Account transcripts are available for most returns
c Record of Account which provides the most detailed information as it is a combination of the Return Transcript and the Account Transcript Available for current year and 3 prior tax years
7 Form W-2 Form 1099 series Form 1098 series or Form 5498 series transcript The IRS can provide a transcript that includes data from these information returns State or local information is not included with the Form W-2 information The IRS may be able to provide this transcript information for up to 10 years Information for the current year is generally not available until the year after it is filed with the IRS For example W-2 information for 2016 filed in 2017 will likely not be available from the IRS until 2018 If you need W-2 information for retirement purposes you should contact the Social Security Administration at 1-800-772-1213
Caution If you need a copy of Form W-2 or Form 1099 you should first contact the payer To get a copy of the Form W-2 or Form 1099 filed with your return you must use Form 4506 and request a copy of your return which includes all attachments
8 Year or period requested Enter the ending date of the tax year or period using the mmddyyyy format (see instructions)
12 31 2020 12 31 2019 12 31 2018 Caution Do not sign this form unless all applicable lines have been completed
Signature of taxpayer(s) I declare that I am either the taxpayer whose name is shown on line 1a or 2a or a person authorized to obtain the tax information requested If the request applies to a joint return at least one spouse must sign If signed by a corporate officer 1 percent or more shareholder partner managing member guardian tax matters partner executor receiver administrator trustee or party other than the taxpayer I certify that I have the authority to execute Form 4506-C on behalf of the taxpayer Note This form must be received by IRS within 120 days of the signature date
Signatory attests that heshe has read the attestation clause and upon so reading declares that heshe has the authority to sign the Form 4506-C See instructions
Sign Here
Signature (see instructions) Date Phone number of taxpayer on line 1a or 2a
PrintType name
Title (if line 1a above is a corporation partnership estate or trust)
Spousersquos signature Date
PrintType name
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020) For Privacy Act and Paperwork Reduction Act Notice see page 2
Instructions for Form 4506-C IVES Request for Transcript of Tax Return
Section references are to the Internal Revenue Code unless otherwise noted
Future Developments
For the latest information about Form 4506-C and its instructions go to wwwirsgov and search IVES Information about any recent developments affecting Form 4506-C (such as legislation enacted after we released it) will be posted on that page
Whats New Form 4506-C was created to be utilized by authorized IVES participants to order tax transcripts with the consent of the taxpayer
General Instructions
Caution Do not sign this form unless all applicable lines have been completed
Designated Recipient Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information received pursuant to the taxpayerrsquos consent and holds the recipient subject to penalties for any unauthorized access other use or redisclosure without the taxpayerrsquos express permission or request
Taxpayer Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information provided pursuant to your consent and holds the recipient subject to penalties brought by private right of action for any unauthorized access other use or redisclosure without your express permission or request
Purpose of form Use Form 4506-C to request tax return information through an authorized IVES participant You will designate an IVES participant to receive the information on line 5a
Note If you are unsure of which type of transcript you need check with the party requesting your tax information
Where to file The IVES participant will fax Form 4506-C with the approved IVES cover sheet to their assigned Service Center
Chart for ordering transcripts
If your assigned Service Center is
Fax the requests with the approved coversheet to
Austin Submission Processing Center
Austin IVES Team
844-249-6238
Fresno Submission Processing Center
Fresno IVES Team
844-249-6239
Kansas City Submission Processing Center
Kansas City IVES Team
844-249-8128
Ogden Submission Processing Center
Ogden IVES Team
844-249-8129
Specific Instructions
Line 1b Enter the social security number (SSN) or individual taxpayer identification number (ITIN) for the individual listed on line 1a or enter the employer identification number (EIN) for the business listed on line 1a
Line 3 Enter your current address If you use a PO box include it on this line
Line 4 Enter the address shown on the last return filed if different from the address entered on line 3
Note If the addresses on lines 3 and 4 are different and you have not changed your address with the IRS file Form 8822 Change of Address or Form 8822-BChange of Address or Responsible Party mdash Business with Form 4506-C
Line 5b Enter up to 10 numeric characters to create a unique customer file number that will appear on the transcript The customer file number cannot contain an SSN ITIN or EIN Completion of this line is not required
Note If you use an SSN name or combination of both we will not input the information and the customer file number will reflect a generic entry of 9999999999 on the transcript
Line 8 Enter the end date of the tax year or period requested in mmddyyyy format This may be a calendar year fiscal year or quarter Enter each quarter requested for quarterly returns Example Enter 12312018 for a calendar year 2018 Form 1040 transcript
Signature and date Form 4506-C must be signed and dated by the taxpayer listed on line 1a or 2a The IRS must receive Form 4506-C within 120 days of the date signed by the taxpayer or it will be rejected Ensure that all applicable lines including lines 5a through 8 are completed before signing
You must check the box in the signature area to acknowledge you have the authority to sign and request the information The form will not be processed if unchecked
Individuals Transcripts listed on on line 6 may be furnished to either spouse if jointly filed Only one signature is required Sign Form 4506-C exactly as your name appeared on the original return If you changed your name also sign your current name
Corporations Generally Form 4506-C can be signed by
(1) an officer having legal authority to bind the corporation (2) any person designated by the board of directors or other governing body or (3) any officer or employee on written request by any principal officer and attested to by the secretary or other officer A bona fide shareholder of record owning 1 percent or more of the outstanding stock of the corporation may submit a Form 4506-C but must provide documentation to support the requesters right to receive the information
Partnerships Generally Form 4506-C can be signed by any person who was a member of the partnership during any part of the tax period requested on line 8
All others See section 6103(e) if the taxpayer has died is insolvent is a dissolved corporation or if a trustee guardian executor receiver or administrator is acting for the taxpayer
Note If you are Heir at law Next of kin or Beneficiary you must be able to establish a material interest in the estate or trust
Documentation For entities other than individuals you must attach the authorization document For example this could be the letter from the principal officer authorizing an employee of the corporation or the letters testamentary authorizing an individual to act for an estate
Signature by a representative A representative can sign Form 4506-C for a taxpayer only if the taxpayer has specifically delegated this authority to the representative on Form 2848 line 5 The representative must attach Form 2848 showing the delegation to sign Form 4506-C
Privacy Act and Paperwork Reduction Act Notice We ask for the information on this form to establish your right to gain access to the requested tax information under the Internal Revenue Code We need this information to properly identify the tax information and respond to your request You are not required to request any transcript if you do request a transcript sections 6103 and 6109 and their regulations require you to provide this information including your SSN or EIN If you do not provide this information we may not be able to process your request Providing false or fraudulent information may subject you to penalties
Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and cities states the District of Columbia and US commonwealths and possessions for use in administering their tax laws We may also disclose this information to other countries under a tax treaty to federal and state agencies to enforce federal nontax criminal laws or to federal law enforcement and intelligence agencies to combat terrorism
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law Generally tax returns and return information are confidential as required by section 6103
The time needed to complete and file Form 4506-C will vary depending on individual circumstances The estimated average time is
Learning about the law or the form 10 min Preparing the form 12 min Copying assembling and sending the form to the IRS 20 min
If you have comments concerning the accuracy of these time estimates or suggestions for making Form 4506-C simpler we would be happy to hear from you You can write to
Internal Revenue Service Tax Forms and Publications Division 1111 Constitution Ave NW IR-6526 Washington DC 20224
Do not send the form to this address Instead see Where to file on this page
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020)
Rev April 2021 CHASEO Facts What does Chase do with your personal information
Why Financial companies choose how they share your personal information Federal law gives consumers the right to limit some but not all sharing Federal law also requires us to tell you how we collect share and protect your personal information Please read this notice carefully to understand what we do
What The types of personal information we collect and share depend on the product or service you have with us This information can include bull Social Security number and income bull account balances and transaction history bull credit history and payment history
How All financial companies need to share customers personal information to run their everyday business In the section below we list the reasons financial companies can share their customers personal information the reasons Chase chooses to share and whether you can limit this sharing
Reasons we can share your personal information Does Chase share
Can you limit this sharing
For our everyday business purposes - such as to process your transactions maintain your account(s) respond to court orders and legal investigations or report to credit bureaus
Yes No
For our marketing purposes - to offer our products and services to you
Yes No
For joint marketing with other financial companies Yes No
For our affiliates everyday business purposes - information about your transactions and experiences
Yes No
For our affiliates everyday business purposes - information about your creditworthiness
Yes Yes
For our affiliates to market to you Yes Yes
For nonaffiliates to market to you Yes Yes
a
0
To limit our sharing
bull Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
bull Visit us online chasecomprivacypreferences
Please note If you are a new customer we can begin sharing your information 30 days from the date we sent this notice When you are no longer our customer we continue to share your information as described in this notice However you can contact us at any time to limit our sharing
Questions
Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
PAGE 2
Who we are
Who is providing this notice The US consumer financial companies within the JPMorgan Chase amp Co family including JPMorgan Chase Bank NA Chase Insurance Agency Inc and JP Morgan Securities LLC
What we do
How does Chase protect my To protect your personal information from unauthorized access and use we personal information use security measures that comply with federal law These measures include
computer safeguards and secured files and buildings We authorize our employees to get your information only when they need it to do their work and we require companies that work for us to protect your information
How does Chase collect my We collect your personal information for example when you personal information bull open an account or make deposits or withdrawals from your account
bull pay your bills or apply for a loan bull use your credit or debit card We also collect your personal information from others such as credit bureaus affiliates or other companies
Why cant I limit all sharing Federal law gives you the right to limit only bull sharing for affiliates everyday business purposes - information about your
creditworthiness bull affiliates from using your information to market to you bull sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing See below for more on your rights under state law
What happens when I limit sharing for an account I hold jointly with someone else
Your choices will apply to everyone on your account
Definitions
Affiliates Companies related by common ownership or control They can be financial and non financial companies bull Our affiliates include companies with a Chase or JP Morgan name and financial companies such asjP Morgan Securities LLC
Nonaffiliates Companies not related by common ownership or control They can be financial and non financial companies bull Nonaffiliates we share with can include companies such as retailers auto dealers auto makers and membership clubs
Joint marketing A formal agreement between nonaffiliated financial companies that together market financial products or services to you bull Our joint marketing partners include categories of companies such as insurance companies
Other important information
VT Accounts with a Vermont mailing address are automatically treated as if they have limited the sharing as described on page 1 For joint marketing we will only disclose your name contact information and information about your transactions
NV We are providing you this notice pursuant to Nevada law If you prefer not to receive marketing calls from us you may be placed on our Internal Do Not Call List by calling 1-800-945-9470 or by writing to us at PO Box 734007 Dallas TX 75373-4007
For more information contact us at the address above or email PrivacylnfoJPMChasecom with Nevada Annual Notice in the subject line You may also contact the Nevada Attorney Generals office Bureau of Consumer Protection Office of the Nevada Attorney General 555 E Washington St Suite 3900 Las Vegas NV 89101 telephone number 1-702-486-3132 email BCPINFOagstatenvus
CA Accounts with a California mailing address are automatically treated as if they have limited the sharing with nonaffiliates as described on page 1 CA residents are provided a CA notice for additional choices
CHASE O
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
The following disclosure is required by the USA PATRIOT Act
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 opens an account
What this means to you When you 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 drivers
license or other identifying documents
99177-PAT-0215
VETERAN STATEMENT When this loan was opened the US Department of Veterans Affairs (VA) used the veteran borrowerrsquos entitlement which is a set amount the VA promises to repay a lender if the borrower defaults on the mortgage An assumption will modify who is obligated to pay the existing mortgage loan but all loan termsmdashincluding the entitlementmdashwill remain the same If the veteran borrower is being removed from the loan the entitlement would remain with whoever is assuming the loan because the loan will continue to be serviced by the VA If the applicant is also a veteran and can substitute his or her entitlement for the current entitlement then the current borrowerrsquos entitlement can be released
Please review the following questions and answer as appropriate This form requires completion by both the applicant(s) and current borrower(s)
1 Applicant to Complete
Are you (the applicant) currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the reverse side)
Yes (If yes please provide the information requested below answer the question in section 3 and sign and date this form at the bottom of the reverse side)
Name of applicant(s) who answered ldquoyesrdquo to the above question
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Are you receiving VA disability benefts
Applicant
Yes
No
Co-Applicant
Yes
No
Are you entitled to receive VA disability benefts Yes No Yes No
Have you received VA disability benefts in the past Yes No Yes No
Are you a surviving spouse of a veteran who died on active duty or as the result of a service-related disability
Yes No Yes No
Do you have any VA loans Yes No Yes No
2 Current Borrower to Complete
Is the current borrowerco-borrower currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the page)
Yes (If yes please answer the question in section 3 and sign and date this form at the bottom of the page)
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
________________________________________________________________________________________________
3 Applicant and Current Borrower to Complete
If the answer to the questions in section 1 and 2 are both yes please answer the following question After yoursquove reviewed and completed this entire form please sign and date at the bottom
Applicant Current Borrower
Do you want to apply for a substitution of entitlement Yes Yes No No
In order to complete a substitution of entitlement the veteran applicant must have suffcient entitlement to substitute for that of the current borrower Contact the VA Offce of Jurisdiction for your area for more information Also before the veteran applicant can substitute entitlement on a VA loan heshe must certify that the property securing the loan will be occupied as hisher primary residence Both the applicantrsquos and current borrowerrsquos original certifcate of eligibility will be required If your sales contract is contingent upon the restoration of entitlement please contact your VA Offce of Jurisdiction for complete procedures Otherwise the substitution will be completed after the loan has been approved and closed
Date Applicant printed name Applicant signature
Date Applicant printed name Applicant signature
Date Current Borrower printed name Current Borrower signature
Date Current Borrower printed name Current Borrower signature
Forms completed by Mail Phone
For Chase use only
Interviewer signature Date
99177-VS-0215
- Assumption Application Package_41521-noscannedpages-update-4pdf
-
- 1 FM203 Cover Pagepdf
- 2 FM202 Mortgage Assumption Application Package pagepdf
- 3 The Documents Youll need to Send Uspdf
- 4 FM201 FAQpdf
- 5 FM142 CIWpdf
- 6 FM126 URLApdf
- 7 FM130 URLA Instpdf
-
- Blank Page
-
- 8 92900a Addednum to Loan Applicationpdf
- 9 FM462 Gen Authpdf
- 10 FM220 4506-Cpdf
- 11 FM153 Chase Federal Privacy Noticepdf
- 12 FM144 Info on Opening a New Accountpdf
- 13 FM152 Veteran Statementpdf
-
- Date
- Loan number
- Applicant name
- Phone1
- Loan number 1
- Loan number 2
- Other
- Other_2
- 1
- 2
- undefined_7
- Available hours
- Available hours_2
- undefined_8
- Available hours_3
- undefined_9
- Current address 1
- Neither
- Available hours_4
- Available hours_5
- undefined_10
- Available hours_6
- 1_2
- 2_2
- undefined_11
- Available hours_7
- Available hours_8
- undefined_12
- Available hours_9
- FHA Case No include any suffix
- Mortgagee Case No
- Mortgagee ID
- Sponsor ID
- Agent ID
- Name and Address of Sponsor Name and Address of Agent
- Borrowers Name Present Address include ZIP Code Property Address
- include name of subdivision lot block no ZIP Code
- Name of ThirdParty Originator
- NMLS ID of ThirdParty Originator
- s application
- ty Number
- ty Number_2
- Date Signed_2
- Date Mortgage Approved
- Date Approval Expires
- Printed Name
- Title 1
- DEs ID Number
- DEs ID Number_2
- Mortgagee
- Name of Mortgagees Representative
- Title of Mortgagees Representative
- Signature of the Mortgagees Representative
- Date_2
- Applicant names 1
- Applicant names 2
- Applicant names 3
- Loan number_2
- Date_3
- Applicant printed name
- Social Security number
- Date_4
- Applicant printed name_2
- Social Security number_2
- Date_5
- Applicant printed name_3
- Social Security number_3
- Date_6
- Applicant printed name_4
- Social Security number_4
- 1a Name shown on tax return if a joint return enter the name shown first
- 1b First social security number on tax return individual taxpayer identification number or employer identification number see instructions
- 2a If a joint return enter spouses name shown on tax return
- 2b Second social security number or individual taxpayer identification number if joint tax return
- 4 Previous address shown on the last return filed if different from line 3 see instructions
- 5a IVES participant name address and SOR mailbox ID
- Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing see instructions
- Signature see instructions
- Date_7
- Phone number of taxpayer on line 1a or 2a
- PrintType name
- Here
- Spouses signature
- Date_8
- PrintType name_2
- Name
- Date of birth
- Service number
- Name_2
- Date of birth_2
- Service number_2
- Date_9
- Applicant printed name_5
- Date_10
- Applicant printed name_6
- Date_11
- Current Borrower printed name
- Date_12
- Current Borrower printed name_2
- Date_13
- Text3
- Text10
- undefined_13
- Text15
- undefined_14
- undefined_15
- undefined_16
- undefined_17
- undefined_18
- undefined_19
- undefined_20
- undefined_21
- undefined_23
- Reason for assumption Off
- Requestors relationship to owners Off
- Check one Off
- Check one1 Off
- Day1
- Evening
- Cell phone
- Check one2 Off
- Check one3 Off
- Check one4 Off
- Check one5 Off
- Text2-1
- Text2-2
- Text2-3
- Text2-4
- Text2-5
- Text2-6
- Text3-1
- Text3-2
- Text3-3
- Text3-4
- Text3-6
- Text3-7
- Text3-8
- Text3-9
- Text3-10
- Text3-11
- Text3-12
- Text3-13
- Text3-14
- Text3-15
- Text3-16
- Text3-17
- Text3-18
- Text3-19
- Text3-20
- Text3-21
- Text3-22
- Text3-23
- Text3-24
- Text3-25
- Text3-26
- Text3-27
- Text3-28
- Text3-29
- Text3-30
- Text3-31
- Text3-32
- Text3-33
- Text3-34
- Text3-35
- Text3-36
- Text3-37
- Text3-38
- Text3-39
- Text3-40
- Text3-41
- Text3-42
- Text3-43
- Text3-44
- Text3-45
- Text3-46
- Text3-47
- Text3-48
- Text3-49
- Text3-50
- Text3-51
- Text3-52
- Text3-53
- Text3-5
- Text3-54
- Text3-55
- Text3-56
- Citizenship Off
- Type of credit Off
- Marital Status Off
- Housing Off
- Housing1 Off
- ownership Off
- DNA1 Off
- DNA2 Off
- DNA3 Off
- family Off
- BO Off
- Total
- Text31
- Text32
- Text33
- Text34
- Text35
- Text36
- Text37
- Text38
- Text39
- Text310
- Text311
- Text312
- Text313
- Text314
- Text315
- Text316
- Text317
- Text318
- Text319
- ownership1 Off
- Total1
- Total1-2
- Check Box4-1 Off
- Text320
- Text321
- Text322
- Text323
- Text324
- Text325
- Text326
- Text327
- Text328
- Text329
- Check Box4-2 Off
- Check Box4-3 Off
- Check Box4-4 Off
- Check Box4-8 Off
- Check Box4-9 Off
- Text330
- Text331
- Text332
- Text333
- Text334
- Text335
- Text1-1
- Text1-2
- Text1-3
- Text1-4
- Text1-5
- Text1-6
- Text1-7
- Text1-8
- Text1-9
- Text1-10
- Text1-11
- Text1-12
- Text1-13
- Text1-14
- Text1-15
- Text1-16
- Text1-17
- Text1-18
- Text1-19
- Text1-20
- Text1-21
- Text1-22
- Text1-23
- Text1-24
- Text1-25
- Text1-26
- Text1-27
- Text1-28
- Text1-29
- Text1-30
- Text1-31
- Text1-32
- Text1-33
- Text1-34
- Text1-35
- Check Box3-2 Off
- Check Box2-1 Off
- Check Box2-2 Off
- Check Box2-3 Off
- Check Box2-4 Off
- Check Box2-5 Off
- Text1-36
- Text1-37
- Text1-38
- Text1-39
- Text1-40
- Text1-41
- Text1-42
- Text1-43
- Text1-44
- Text1-45
- Text1-46
- Text1-47
- Text1-48
- Text1-49
- Text1-50
- Text1-51
- Text1-52
- Text1-53
- Text1-54
- Text1-55
- Text1-56
- Text1-57
- Text1-58
- Text1-59
- Text1-60
- Text1-61
- Check Box3-11 Off
- A1
- A2
- A3
- A4
- A5
- A6
- A7
- A8
- A9
- A10
- A11
- A12
- Check Box3-1 Off
- Check Box30-1 Off
- Check Box30-2 Off
- Check Box30-4 Off
- Check Box30-5 Off
- Check Box30-7 Off
- Check Box30-8 Off
- Check Box30-9 Off
- Check Box30-10 Off
- Check Box30-11 Off
- Check Box30-12 Off
- A13
- A14
- A15
- A16
- A17 Off
- A18
- A19
- A20
- A21
- A22
- A23
- A24
- A25
- A26
- A27
- A28
- A29
- A30
- A31
- A32
- A33
- A34
- A35
- A36
- A37
- A38 Off
- A39
- A40
- A41
- A42
- A43
- A44
- A45
- A46
- A47
- A48
- A49
- A50
- A51
- A52
- A53
- A54
- A55
- A56
- A57
- A58
- A59
- A60
- A61
- A62
- A63
- A64
- A65
- A66
- A67
- A68
- A69
- A70
- A71
- A72
- A73
- A74
- Loan Purpose Off
- occupancy1 Off
- lien type Off
- lientype Off
- mixed use Off
- manufactured home Off
- deposit1 Off
- deposit2 Off
- B1
- B2
- B3
- B4
- B5
- B6
- B7
- B8
- B9
- B10
- fha Off
- Check Box51 Off
- B11
- B12
- B13
- B14
- B15
- B16
- B17
- B18
- B19 Off
- B20
- B21
- B22 Off
- B23
- B24
- B25
- B26
- B27
- B28
- A
-
- Will you occupy the property as your primary residence Off
- Will you occupy the property as your primary residence1 Off
-
- If yes have you had an ownership interest in another property in the last three years Off
- Text9-2
- B
-
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property Off
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property1 Off
-
- 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 Off
- 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 application1 Off
-
- 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 Off
- 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 application1 Off
-
- new credit Off
- 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) Off
- the Property Assessed Clean Energy Program)1 Off
-
- F
-
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application Off
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application1 Off
-
- G
-
- Are there any outstanding judgments against you Off
- Are there any outstanding judgments against you1 Off
-
- H
-
- Are you currently delinquent or in default on a Federal debt Off
- Are you currently delinquent or in default on a Federal debt1 Off
-
- I
-
- Are you a party to a lawsuit in which you potentially have any personal financial liability Off
- Are you a party to a lawsuit in which you potentially have any personal financial liability1 Off
-
- J
-
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years Off
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years1 Off
-
- 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 Off
- 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 due1 Off
-
- L
-
- Have you had property foreclosed upon in the last 7 years Off
- Have you had property foreclosed upon in the last 7 years1 Off
-
- M
-
- Have you declared bankruptcy within the past 7 years Off
- Have you declared bankruptcy within the past 7 years1 Off
-
- Check Box8-2 Off
- Check Box8-3 Off
- Check Box8-4 Off
- Text9-3
- Text9-5
- Text9-6
- Text97
- military Off
- ethnicity Off
- sex Off
- race Off
- demo Off
- Text12-1
- Check Box11-1 Off
- Check Box11-2 Off
- Check Box11-3 Off
- Check Box11-4 Off
- Check Box11-5 Off
- Check Box11-6 Off
- Check Box11-7 Off
- Check Box11-8 Off
- Check Box11-9 Off
- Text12-2
- Check Box11-10 Off
- Check Box11-11 Off
- Check Box11-12 Off
- Check Box11-13 Off
- Check Box11-14 Off
- Check Box11-15 Off
- Text12-3
- Check Box11-16 Off
- Check Box11-17 Off
- Check Box11-18 Off
- Check Box11-19 Off
- Check Box11-20 Off
- Check Box11-21 Off
- Check Box11-22 Off
- Check Box11-23 Off
- Text12-4
- Check Box11-24 Off
- Check Box11-25 Off
- Check Box11-26 Off
- Check Box11-27 Off
- Check Box11-28 Off
- Check Box11-29 Off
- Text12-5
- Check Box11-30 Off
- Check Box11-31 Off
- citizen Off
- credit Off
- marital status1 Off
- housing-1 Off
- housing-2 Off
- own Off
- C1
- C2
- C3
- C6
- C7
- C8
- C9
- C10
- C11
- C12
- C13
- C14
- C15
- C16
- C17
- C18
- C19
- C20
- C21
- C22
- C23
- C24
- C25
- C26
- C27
- C28
- C29
- C30
- C31
- C32
- C33
- C34
- C35
- Check Box-2 Off
- C36
- C37
- C38
- C39
- C4
- C40
- C41
- C42
- C43
- C44
- C45
- C46
- C47
- Check Box-3 Off
- Check Box-4 Off
- C48
- C49
- C5
- C50
- C51
- C52
- C53
- C54
- C55
- Check Box-1-1 Off
- own1 Off
- Check Box-1 Off
- D1 Off
- D2
- D3
- D4
- D5
- D6
- D7
- D8
- D9
- D10
- D11
- D12
- D13
- D14 Off
- D15 Off
- D16
- D17
- D18
- D19
- D20
- D21
- D22
- D23
- D24 Off
- D25
- D26
- D27
- D28
- D29
- D30
- D31
- D32
- D33
- D34
- D35 Off
- D36
- D37 Off
- D38
- D39
- D40
- D41
- D42
- D43
- D44
- D45
- D46
- D47
- If yes have you had an ownership interest in another property in the last three years1 Off
- new credit1 Off
- Check Box8-1 Off
- Check Box8-1-2 Off
- Check Box8-1-1 Off
- Check Box8-1-3 Off
- Check Box8-1-4 Off
- Military Service mdash Did you (or your deceased spouse) ever serve or are you currently serving in the United States Armed Forces 1 Off
- Check1 Off
- Text9-1-1
- Check2 Off
- Check3 Off
- Check4 Off
- Text9-1
- E1
- E2
- E3
- Was the ethnicity of the Borrower collected on the basis of visual observation or surname1 Off
- Was the sex of the Borrower collected on the basis of visual observation or surname1 Off
- Was the race of the Borrower collected on the basis of visual observation or surname1 Off
- The Demographic Information was provided through1 Off
- F1 Off
- F2 Off
- F3 Off
- F4 Off
- F5 Off
- F6
- F7 Off
- F8 Off
- F9 Off
- F10 Off
- F11 Off
- F12 Off
- F13
- F14 Off
- F15 Off
- F16 Off
- F17 Off
- F18 Off
- F19 Off
- F20 Off
- F21 Off
- F22
- F23 Off
- F24 Off
- F25 Off
- F26 Off
- F27 Off
- F28 Off
- F29
- F30 Off
- F31 Off
- undefined_13-1
- undefined_13-2
- undefined_14-1
- undefined_15-1
- undefined_16-1
- undefined_17-1
- undefined_18-1
- undefined_19-1
- undefined_21-1
- undefined_20-1
- undefined_23-1
- undefined_13_1
- Single-Two Off
- Refi type Off
- refi program Off
- Estate Off
- Title held Off
- Trust Information Off
- Indian Country Land Tenure Off
- Mortgage Type Applied For Off
- Mortgage Lien Type Off
- Amortization Type Off
- G1 Off
- G2 Off
- G3 Off
- G4 Off
- G5 Off
- G6
- G7
- G8
- G9
- G10 Off
- G11 Off
- G12 Off
- G13 Off
- G14 Off
- G15 Off
- G16
- G17
- G18
- G19
- G20
- G21
- G22
- G23 Off
- G24
- G25 Off
- G26
- G27 Off
- G28 Off
- G29
- G30 Off
- G31
- G32 Off
- G33
- G34
- G35
- G36
- G37
- G38
- G39
- G40
- G41
- G42
- Property Held
- refi
- Text18-1
- Text18-2
- Text18-3
- Text18-4
- Text18-5
- Text18-6
- Text18-7
- Text18-8
- Text18-9
- Text18-10
- Text18-11
- Text18-12
- Text18-13
- Text18-14
- Text18-15
- Text18-16
- Text18-17
- Text18-18
- Text18-19
- Lender
- case no
- If you selected ldquoUnmarriedrdquo in Section 1 is there a person who is not your legal spouse but who currently has real property rights similar to those of a legal spouse Off
- Relationship and State Off
- Other-5
- Text19-1
- BName
- Additional Information
- ABN
- Additional Information1
- BSign
- BSDate
- ABSign
- ABDate
- MortageeNameAddress
- NAmeAddress
- Bname1
- DOB1
- DOB2
- SignOfBorr1
- SignOfBorr
- Date Signed
- SignOfBorr2
- SignOfBorr3
- Date Signed3
- Date Signed4
- MortgageeRepSign
- DirectSign
- DirectSign1
- Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union Off
- AppSign
- AppSign1
- AppSign2
- AppSign3
- Nopage38 Off
- Yespage38 Off
- Yes1 Off
- No1 Off
- Yes2 Off
- Yes3 Off
- Yes4 Off
- Yes5 Off
- Yes6 Off
- Yes7 Off
- Yes8 Off
- Yes9 Off
- Yes10 Off
- No2 Off
- No3 Off
- No4 Off
- No5 Off
- No6 Off
- No7 Off
- No8 Off
- No9 Off
- No10 Off
- BorrowerNo Off
- BorrowerYes Off
- AppSignature
- AppSignature1
- CurrentSign
- CurrentSign1
- InterviewSign
- Yes_1 Off
- No_1 Off
- Yes_2 Off
- No_2 Off
- Mail Off
- Phone Off
For two borrowers with separate financial information do one of the following bull Complete the URLA plus the URLA ndash Additional Borrower Report the assets liabilities and
real estate for the additional Borrower on the URLA or bull Complete a separate URLA for each Borrower
For three or more borrowers use any combination of URLA and URLA ndash Additional Borrower forms described for two borrowers
Uniform Residential Loan Application ndash Unmarried Addendum If any borrower listed on the URLA or URLA ndash Additional Borrower form selects Unmarried in Section 1 (Personal Information) the lender will complete this optional form
The information must be collected to determine how to apply state property laws that directly or indirectly affect creditworthiness including ensuring clear title
Uniform Residential Loan Application ndash Continuation Sheet Use the URLA ndash Continuation Sheet if you need more space to complete either the URLA or URLA ndash Additional Borrower forms
99177-URLAI-0215
HUD Addendum to Uniform Residential Loan Application OMB Approval No HUD 2502-0059 (exp )
Part I - Identifying Information HUDFHA Application for Insurance under the National Housing Act and Borrower Certification
FHA Case No (include any suffix) Mortgagee Case No
Mortgagee ID Sponsor ID Agent ID
Mortgagee Name Address (include ZIP Code) and Telephone Number
Type or print all entries clearly
Name and Address of Sponsor Name and Address of Agent
Borrowers Name amp Present Address (include ZIP Code) Property Address (include name of subdivision lot amp block no amp ZIP Code)
Sponsored Originations
Name of Third-Party Originator NMLS ID of Third-Party Originator
Part II - Borrower Consent for Social Security Administration to Verify Social Security Number I authorize the Social Security Administration (SSA) to verify my Social Security Number (SSN) to the Mortgagee and HUDFHA I authorize SSA to provide explanatory
information to HUDFHA in the event of a discrepancy This consent is valid for 180 days from the date signed unless indicated otherwise by the individual(s) named in this
loan application
Signature(s) of Borrower(s) - Read consent carefully Review accuracy of Social Security Number(s) provided on this application
Borrowerrsquos NameDate of BirthSocial Security Number
Co-Borrowerrsquos Name Date of BirthSocial Security Number
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
Part III - Borrower Notices Information and Acknowledgment Public Reporting Burden
Public reporting burden for this collection of information is estimated to average 10 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 conduct or sponsor and a person is not
required to respond to a collection of information unless that collection displays a valid OMB control number which can be located on the OMB Internet page at
httpwwwreginfogovpublicdoPRAMain
Privacy Act Information
The information requested on the Uniform Residential Loan Application and this Addendum is authorized by the National Housing Act of 1934 12 USC sect 1701 et seq The Debt
Collection Act of 1982 Pub L 97-365 and HUDrsquos Housing and Community Development Act of 1987 42 USC sect 3543 require persons applying for a federally insured loan to
furnish their SSN You must provide all the requested information including your SSN HUD may conduct a computer match to verify the information you provide HUD may
disclose certain information to Federal State and local agencies when relevant to civil criminal or regulatory investigations and prosecutions It will not otherwise be disclosed or
released outside of HUD except as required and permitted by law The information will be used to determine whether you qualify as a mortgagor Failure to provide any of the
requested information including SSN may result in disapproval of your loan application This is notice to you as required by the Right to Financial Privacy Act of 1978 that
HUDFHA has a right of access to financial records held by financial institutions in connection with the consideration or administration of assistance to you Financial records
involving your transaction will be available to HUDFHA without further notice or authorization but will not be disclosed or released by the institution to another Government Agency
or Department without your consent except as required or permitted by law
WARNING This warning applies to all certifications made in this document Anyone who knowingly submits a false claim or makes false statements is subject to criminal and civil penalties including confinement for up to 5 years fines and civil penalties 18 USC sectsect 287 1001 and 31 USC sect 3729
orm HUD-92900-A ( ) Page 1
Borrower Name ____________________________ FHA Case No __________________
Caution Delinquencies Defaults Foreclosures and Abuses Delinquencies defaults foreclosures and abuses of mortgage loans involving programs of the Federal Government can be costly and detrimental to your credit now and in the future The Mortgagee in this transaction its agents and assigns as well as the Federal Government its agencies agents and assigns are authorized to take any and all of the following actions in the event loan payments become delinquent on the mortgage loan described in the attached application (1) Report your name and account information to a credit bureau (2) Assess additional interest and penalty charges for the period of time that payment is not made (3) Assess charges to cover additional administrative costs incurred by the Federal Government to service your account (4) Offset amounts owed to you
under other Federal programs (5) Refer your account to a private attorney collection agency or mortgage servicing agency to collect the amount due foreclose
the mortgage sell the property and seek judgment against you for any deficiency (6) Refer your account to the Department of Justice (DOJ) for litigation in the
courts (7) If you are a current or retired Federal employee take action to offset your salary or civil service retirement benefits (8) Refer your debt to the Internal
Revenue Service for offset against any amount owed to you as an income tax refund and (9) Report any resulting written off debt of yours to the Internal Revenue Service as your taxable income All of these actions may be used to recover any debts owed when it is determined to be in the interest of the Mortgagee or Federal Government or both
As a mortgage loan borrower you will be legally obligated to make the mortgage payments called for by your mortgage loan contract The fact that you dispose of your property after the loan has been made will not relieve you of liability for making these payments Payment of the loan in full is ordinarily the way liability on a mortgage note is ended Some home buyers have the mistaken impression that if they sell their homes when they move to another locality or dispose of it for any other reasons they are no longer liable for the mortgage payments and that liability for these payments is solely that of the new owners Even though the new owners may agree in writing to assume liability for your mortgage payments this assumption agreement will not relieve you from liability to the holder of the note which you signed when you obtained the loan to buy the property Unless you are able to sell the property to a buyer who is acceptable to HUDFHA who will assume the payment of your obligation to the lender you will not be relieved from liability to repay any claim which HUDFHA may be required to pay your lender on account of default in your loan payments The amount of any such claim payment may be a debt owed by you to the Federal Government and subject to established collection procedures
Fair Housing Act I and anyone acting on my behalf are and will remain in compliance with the Fair Housing Act 42 USC sect 3604 et seq with respect to the dwelling or property covered by the loan and in the provision of services or facilities in connection therewith I recognize that any restrictive covenant on this property related to race color religion sex disability familial status or national origin is unlawful under the Fair Housing Act and unenforceable I further recognize that in addition to administrative action by HUD a civil action may be brought by the DOJ in any appropriate US court against any person responsible for a violation of the
applicable law
Certification and Acknowledgment All information in this application is given for the purpose of obtaining a loan to be insured under the National Housing Act and the information in the Uniform Residential Loan Application and this Addendum is true and complete to the best of my knowledge and belief Verification may be obtained from any source named herein I have read and understand the foregoing concerning my liability on the loan and Part III Borrower Notices Information and Acknowledgment
Signature(s) of Borrower(s) - Do not sign unless this application is fully completed Read the certification carefully and review accuracy of this application
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
orm HUD-92900-A ( Page 2
___________________________________
______________________________________________________
______________________________________________________________
- - - - - - - - - - - - - - - - - - - - - - -
Borrower Name ____________________________ FHA Case No __________________
Part IV - Direct Endorsement Approval for a HUD FHA-Insured Mortgage A Underwriting the Borrower
Date Mortgage Approved ______________________________ Date Approval Expires ______________________
For mortgages rated as an ldquoacceptrdquo or ldquoapproverdquo by FHAs TOTAL Mortgage Scorecard
The information submitted to TOTAL was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA4e Final Underwriting Decision (TOTAL) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee Representative Signature
Printed Name
Title
OR
For mortgages rated as a ldquoreferrdquo by FHAs TOTAL Mortgage Scorecard or manually underwritten by a Direct Endorsement underwriter I have personally reviewed and underwritten the borrowerrsquos credit application The information used to underwrite the borrower was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA5d Final Underwriting Decision (Manual) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
B Underwriting the Property
For all mortgages where FHA requires an appraisal I have personally reviewed and underwritten the appraisal according to FHA requirements I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
orm HUD-92900-A ( ) Page 3
Borrower Name ____________________________ FHA Case No __________________
Part V Mortgagees Certification
I have personally reviewed the mortgage documents and the application for insurance endorsement and This mortgage complies with SF Handbook 40001 Section IIA7 Post-Closing and Endorsement to the extent that no defect exists that would have changed the decision to endorse or submit the mortgage for insurance
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee
Name of Mortgageersquos Representative
Title of Mortgageersquos Representative
Signature of the Mortgageersquos Representative Date
orm HUD-92900-A ( ) Page 4
GENERAL AUTHORIZATION FOR A MORTGAGE LOAN ASSUMPTION
Applicant name(s)
Loan number
NOTICES AND DISCLOSURES
Non-discriminatory underwriting guidelines Anyone who inquires about the availability of credit from us has the right to receive a copy of our non-discriminatory underwriting guidelines To request a copy of these guidelines contact your Loan Processor
Attorney note Itrsquos the responsibility of our attorneys to protect our interest You may at your expense request an attorney to represent your interest
Notice to HUDFHA applicants As required by the Right to Financial Privacy Act of 1978 this notice is to inform you that the US Department of Housing and Urban Development (HUD)Federal Housing Administration (FHA) has a right of access to financial records held by financial institutions related to a request for assistance Financial records involving your assumption will be available to HUDFHA without further notice or authorization but wonrsquot be disclosed or released by us to another government agency or department without your consent except as required or permitted by law
Borrower consent to the use of tax return information I understand acknowledge and agree that the Lender and Other Loan Participants can obtain use and share tax return information for purposes of (i) providing an offer (ii) originating maintaining managing monitoring servicing selling insuring and securitizing a loan (iii) marketing or (iv) as otherwise permitted by applicable laws including state and federal privacy and data security laws The Lender includes the Lenderrsquos affiliates agents service providers and any of aforementioned partiesrsquo successors and assigns The Other Loan Participants includes any actual or potential owners of a loan resulting from your loan application or acquirers of any beneficial or other interest in the loan and mortgage insurer guarantor any servicers or service providers for these parties and any of aforementioned partiesrsquo successors and assigns
CERTIFICATION AND AUTHORIZATION
Environmental certification By signing below I represent and warrant that Irsquom not aware of any substances materials or products that may be an environmental hazard such as but not limited to asbestos formaldehyde radon gas lead-based paint fuel or chemical storage tanks (above or below ground) and contaminated soil or water on the property I acknowledge that Chase is relying on this representation and warranty as a material part of its loan application process I also am not aware of any landfill on any portion of the property
Exceptions to the above I further acknowledge (1) receipt of applicable disclosures from the seller in purchase transactions (2) that lead-based paint may exist in housing constructed prior to 1978 (3) that Chase performs no environmental investigation on my behalf and isnrsquot responsible for identifying lead-based paint or any other environmental conditions that might impact the property or its residents and (4) that it is my sole obligation to investigate for potential impact to the property from environmental conditions
Certifications I certify by signing below that (1) all of the loan application information provided is true and complete (2) I understand any intentional or negligent misrepresentation(s) of the information provided in conjunction with my application may result in civil liability andor 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 Chase its agents successors and assigns insurers and any other person who may suffer any loss due to reliance upon any misrepresentation that I have made on the application and (3) any significant change from the information provided at the time of application until the final loan application is signed may have a bearing on the approval of my application for a home loan
Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union
This question is asked because of state laws that extend the same or similar rights benefits and protections of spouses in a marriage to persons who are members of a partnership or union recognized under state law You should consult with your own legal advisor for advice regarding the rights protections benefits responsibilities obligations and duties of those who are registered domestic partners civil union partners or members of other unions recognized under applicable law
CREDIT AUTHORIZATION RELEASE
By signing below I authorize Chase andor my mortgage insurer (if any) to verify my past and present employment earnings records (including information contained in income tax returns that have been filed with the IRS) bank accounts stock holdings and any other information that it finds necessary to process my mortgage loan application or to review it for quality-control purposes I understand that a credit report will be ordered from a credit reporting agency for verification prior to loan closing as part of the application process and may be ordered after closing as part of the Lenderrsquos quality-control program A credit report may also be completed as part of the Lenderrsquos servicing or collection of the loan or in consideration of any other product or service that the Lender may consider offering me in the future and at any time throughout the life of the loan I understand that use of a photocopy of this form may be necessary to verify one or more of my credit references I understand that a photocopy or fax copy of this form will also serve as authorization
By signing below each applicant acknowledges (1) making the above certifications and authorizations and (2) that each applicant has received and understands the above notices and disclosures
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
You do not have to give us this information but if you donrsquot your application for approval as a borrower may be delayed or rejected The information requested in this form is authorized by Title 38 USC Chapter 37 (if VA) by 12 USC Section 1701 et seq (if HUDFHA) by 42 USC Section 1452b (if HUDCPD) and Title 42 USC 1471 et seq or 7 USC 1921 et seq (if USDA FHA)
Updated December 2021 99177-GA-0215
1b
2b
Form 4506-C (September 2020)
Department of the Treasury - Internal Revenue Service
IVES Request for Transcript of Tax Return OMB Number
1545-1872
Do not sign this form unless all applicable lines have been completed Request may be rejected if the form is incomplete or illegible
For more information about Form 4506-C visit wwwirsgov and search IVES
1a Name shown on tax return (if a joint return enter the name shown first)
First social security number on tax return individual taxpayer identification number or employer identification number (see instructions)
2a If a joint return enter spousersquos name shown on tax return Second social security number or individual taxpayer identification number if joint tax return
3 Current name address (including apt room or suite no) city state and ZIP code (see instructions)
4 Previous address shown on the last return filed if different from line 3 (see instructions)
5a IVES participant name address and SOR mailbox ID
DataVerify 875 Greentree Rd 8 Parkway Center Pittsburgh PA 15220
5b Customer file number (if applicable) (see instructions)
Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing (see instructions)
6 Transcript requested Enter the tax form number here (1040 1065 1120 etc) and check the appropriate box below Enter only one tax form number per request 1040
a Return Transcript which includes most of the line items of a tax return as filed with the IRS A tax return transcript does not reflect changes made to the account after the return is processed Transcripts are only available for the following returns Form 1040 series Form 1065 Form 1120 Form 1120-A Form 1120-H Form 1120-L and Form 1120S Return transcripts are available for the current year and returns processed during the prior 3 processing years
b Account Transcript which contains information on the financial status of the account such as payments made on the account penalty assessments and adjustments made by you or the IRS after the return was filed Return information is limited to items such as tax liability and estimated tax payments Account transcripts are available for most returns
c Record of Account which provides the most detailed information as it is a combination of the Return Transcript and the Account Transcript Available for current year and 3 prior tax years
7 Form W-2 Form 1099 series Form 1098 series or Form 5498 series transcript The IRS can provide a transcript that includes data from these information returns State or local information is not included with the Form W-2 information The IRS may be able to provide this transcript information for up to 10 years Information for the current year is generally not available until the year after it is filed with the IRS For example W-2 information for 2016 filed in 2017 will likely not be available from the IRS until 2018 If you need W-2 information for retirement purposes you should contact the Social Security Administration at 1-800-772-1213
Caution If you need a copy of Form W-2 or Form 1099 you should first contact the payer To get a copy of the Form W-2 or Form 1099 filed with your return you must use Form 4506 and request a copy of your return which includes all attachments
8 Year or period requested Enter the ending date of the tax year or period using the mmddyyyy format (see instructions)
12 31 2020 12 31 2019 12 31 2018 Caution Do not sign this form unless all applicable lines have been completed
Signature of taxpayer(s) I declare that I am either the taxpayer whose name is shown on line 1a or 2a or a person authorized to obtain the tax information requested If the request applies to a joint return at least one spouse must sign If signed by a corporate officer 1 percent or more shareholder partner managing member guardian tax matters partner executor receiver administrator trustee or party other than the taxpayer I certify that I have the authority to execute Form 4506-C on behalf of the taxpayer Note This form must be received by IRS within 120 days of the signature date
Signatory attests that heshe has read the attestation clause and upon so reading declares that heshe has the authority to sign the Form 4506-C See instructions
Sign Here
Signature (see instructions) Date Phone number of taxpayer on line 1a or 2a
PrintType name
Title (if line 1a above is a corporation partnership estate or trust)
Spousersquos signature Date
PrintType name
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020) For Privacy Act and Paperwork Reduction Act Notice see page 2
Instructions for Form 4506-C IVES Request for Transcript of Tax Return
Section references are to the Internal Revenue Code unless otherwise noted
Future Developments
For the latest information about Form 4506-C and its instructions go to wwwirsgov and search IVES Information about any recent developments affecting Form 4506-C (such as legislation enacted after we released it) will be posted on that page
Whats New Form 4506-C was created to be utilized by authorized IVES participants to order tax transcripts with the consent of the taxpayer
General Instructions
Caution Do not sign this form unless all applicable lines have been completed
Designated Recipient Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information received pursuant to the taxpayerrsquos consent and holds the recipient subject to penalties for any unauthorized access other use or redisclosure without the taxpayerrsquos express permission or request
Taxpayer Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information provided pursuant to your consent and holds the recipient subject to penalties brought by private right of action for any unauthorized access other use or redisclosure without your express permission or request
Purpose of form Use Form 4506-C to request tax return information through an authorized IVES participant You will designate an IVES participant to receive the information on line 5a
Note If you are unsure of which type of transcript you need check with the party requesting your tax information
Where to file The IVES participant will fax Form 4506-C with the approved IVES cover sheet to their assigned Service Center
Chart for ordering transcripts
If your assigned Service Center is
Fax the requests with the approved coversheet to
Austin Submission Processing Center
Austin IVES Team
844-249-6238
Fresno Submission Processing Center
Fresno IVES Team
844-249-6239
Kansas City Submission Processing Center
Kansas City IVES Team
844-249-8128
Ogden Submission Processing Center
Ogden IVES Team
844-249-8129
Specific Instructions
Line 1b Enter the social security number (SSN) or individual taxpayer identification number (ITIN) for the individual listed on line 1a or enter the employer identification number (EIN) for the business listed on line 1a
Line 3 Enter your current address If you use a PO box include it on this line
Line 4 Enter the address shown on the last return filed if different from the address entered on line 3
Note If the addresses on lines 3 and 4 are different and you have not changed your address with the IRS file Form 8822 Change of Address or Form 8822-BChange of Address or Responsible Party mdash Business with Form 4506-C
Line 5b Enter up to 10 numeric characters to create a unique customer file number that will appear on the transcript The customer file number cannot contain an SSN ITIN or EIN Completion of this line is not required
Note If you use an SSN name or combination of both we will not input the information and the customer file number will reflect a generic entry of 9999999999 on the transcript
Line 8 Enter the end date of the tax year or period requested in mmddyyyy format This may be a calendar year fiscal year or quarter Enter each quarter requested for quarterly returns Example Enter 12312018 for a calendar year 2018 Form 1040 transcript
Signature and date Form 4506-C must be signed and dated by the taxpayer listed on line 1a or 2a The IRS must receive Form 4506-C within 120 days of the date signed by the taxpayer or it will be rejected Ensure that all applicable lines including lines 5a through 8 are completed before signing
You must check the box in the signature area to acknowledge you have the authority to sign and request the information The form will not be processed if unchecked
Individuals Transcripts listed on on line 6 may be furnished to either spouse if jointly filed Only one signature is required Sign Form 4506-C exactly as your name appeared on the original return If you changed your name also sign your current name
Corporations Generally Form 4506-C can be signed by
(1) an officer having legal authority to bind the corporation (2) any person designated by the board of directors or other governing body or (3) any officer or employee on written request by any principal officer and attested to by the secretary or other officer A bona fide shareholder of record owning 1 percent or more of the outstanding stock of the corporation may submit a Form 4506-C but must provide documentation to support the requesters right to receive the information
Partnerships Generally Form 4506-C can be signed by any person who was a member of the partnership during any part of the tax period requested on line 8
All others See section 6103(e) if the taxpayer has died is insolvent is a dissolved corporation or if a trustee guardian executor receiver or administrator is acting for the taxpayer
Note If you are Heir at law Next of kin or Beneficiary you must be able to establish a material interest in the estate or trust
Documentation For entities other than individuals you must attach the authorization document For example this could be the letter from the principal officer authorizing an employee of the corporation or the letters testamentary authorizing an individual to act for an estate
Signature by a representative A representative can sign Form 4506-C for a taxpayer only if the taxpayer has specifically delegated this authority to the representative on Form 2848 line 5 The representative must attach Form 2848 showing the delegation to sign Form 4506-C
Privacy Act and Paperwork Reduction Act Notice We ask for the information on this form to establish your right to gain access to the requested tax information under the Internal Revenue Code We need this information to properly identify the tax information and respond to your request You are not required to request any transcript if you do request a transcript sections 6103 and 6109 and their regulations require you to provide this information including your SSN or EIN If you do not provide this information we may not be able to process your request Providing false or fraudulent information may subject you to penalties
Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and cities states the District of Columbia and US commonwealths and possessions for use in administering their tax laws We may also disclose this information to other countries under a tax treaty to federal and state agencies to enforce federal nontax criminal laws or to federal law enforcement and intelligence agencies to combat terrorism
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law Generally tax returns and return information are confidential as required by section 6103
The time needed to complete and file Form 4506-C will vary depending on individual circumstances The estimated average time is
Learning about the law or the form 10 min Preparing the form 12 min Copying assembling and sending the form to the IRS 20 min
If you have comments concerning the accuracy of these time estimates or suggestions for making Form 4506-C simpler we would be happy to hear from you You can write to
Internal Revenue Service Tax Forms and Publications Division 1111 Constitution Ave NW IR-6526 Washington DC 20224
Do not send the form to this address Instead see Where to file on this page
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020)
Rev April 2021 CHASEO Facts What does Chase do with your personal information
Why Financial companies choose how they share your personal information Federal law gives consumers the right to limit some but not all sharing Federal law also requires us to tell you how we collect share and protect your personal information Please read this notice carefully to understand what we do
What The types of personal information we collect and share depend on the product or service you have with us This information can include bull Social Security number and income bull account balances and transaction history bull credit history and payment history
How All financial companies need to share customers personal information to run their everyday business In the section below we list the reasons financial companies can share their customers personal information the reasons Chase chooses to share and whether you can limit this sharing
Reasons we can share your personal information Does Chase share
Can you limit this sharing
For our everyday business purposes - such as to process your transactions maintain your account(s) respond to court orders and legal investigations or report to credit bureaus
Yes No
For our marketing purposes - to offer our products and services to you
Yes No
For joint marketing with other financial companies Yes No
For our affiliates everyday business purposes - information about your transactions and experiences
Yes No
For our affiliates everyday business purposes - information about your creditworthiness
Yes Yes
For our affiliates to market to you Yes Yes
For nonaffiliates to market to you Yes Yes
a
0
To limit our sharing
bull Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
bull Visit us online chasecomprivacypreferences
Please note If you are a new customer we can begin sharing your information 30 days from the date we sent this notice When you are no longer our customer we continue to share your information as described in this notice However you can contact us at any time to limit our sharing
Questions
Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
PAGE 2
Who we are
Who is providing this notice The US consumer financial companies within the JPMorgan Chase amp Co family including JPMorgan Chase Bank NA Chase Insurance Agency Inc and JP Morgan Securities LLC
What we do
How does Chase protect my To protect your personal information from unauthorized access and use we personal information use security measures that comply with federal law These measures include
computer safeguards and secured files and buildings We authorize our employees to get your information only when they need it to do their work and we require companies that work for us to protect your information
How does Chase collect my We collect your personal information for example when you personal information bull open an account or make deposits or withdrawals from your account
bull pay your bills or apply for a loan bull use your credit or debit card We also collect your personal information from others such as credit bureaus affiliates or other companies
Why cant I limit all sharing Federal law gives you the right to limit only bull sharing for affiliates everyday business purposes - information about your
creditworthiness bull affiliates from using your information to market to you bull sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing See below for more on your rights under state law
What happens when I limit sharing for an account I hold jointly with someone else
Your choices will apply to everyone on your account
Definitions
Affiliates Companies related by common ownership or control They can be financial and non financial companies bull Our affiliates include companies with a Chase or JP Morgan name and financial companies such asjP Morgan Securities LLC
Nonaffiliates Companies not related by common ownership or control They can be financial and non financial companies bull Nonaffiliates we share with can include companies such as retailers auto dealers auto makers and membership clubs
Joint marketing A formal agreement between nonaffiliated financial companies that together market financial products or services to you bull Our joint marketing partners include categories of companies such as insurance companies
Other important information
VT Accounts with a Vermont mailing address are automatically treated as if they have limited the sharing as described on page 1 For joint marketing we will only disclose your name contact information and information about your transactions
NV We are providing you this notice pursuant to Nevada law If you prefer not to receive marketing calls from us you may be placed on our Internal Do Not Call List by calling 1-800-945-9470 or by writing to us at PO Box 734007 Dallas TX 75373-4007
For more information contact us at the address above or email PrivacylnfoJPMChasecom with Nevada Annual Notice in the subject line You may also contact the Nevada Attorney Generals office Bureau of Consumer Protection Office of the Nevada Attorney General 555 E Washington St Suite 3900 Las Vegas NV 89101 telephone number 1-702-486-3132 email BCPINFOagstatenvus
CA Accounts with a California mailing address are automatically treated as if they have limited the sharing with nonaffiliates as described on page 1 CA residents are provided a CA notice for additional choices
CHASE O
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
The following disclosure is required by the USA PATRIOT Act
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 opens an account
What this means to you When you 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 drivers
license or other identifying documents
99177-PAT-0215
VETERAN STATEMENT When this loan was opened the US Department of Veterans Affairs (VA) used the veteran borrowerrsquos entitlement which is a set amount the VA promises to repay a lender if the borrower defaults on the mortgage An assumption will modify who is obligated to pay the existing mortgage loan but all loan termsmdashincluding the entitlementmdashwill remain the same If the veteran borrower is being removed from the loan the entitlement would remain with whoever is assuming the loan because the loan will continue to be serviced by the VA If the applicant is also a veteran and can substitute his or her entitlement for the current entitlement then the current borrowerrsquos entitlement can be released
Please review the following questions and answer as appropriate This form requires completion by both the applicant(s) and current borrower(s)
1 Applicant to Complete
Are you (the applicant) currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the reverse side)
Yes (If yes please provide the information requested below answer the question in section 3 and sign and date this form at the bottom of the reverse side)
Name of applicant(s) who answered ldquoyesrdquo to the above question
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Are you receiving VA disability benefts
Applicant
Yes
No
Co-Applicant
Yes
No
Are you entitled to receive VA disability benefts Yes No Yes No
Have you received VA disability benefts in the past Yes No Yes No
Are you a surviving spouse of a veteran who died on active duty or as the result of a service-related disability
Yes No Yes No
Do you have any VA loans Yes No Yes No
2 Current Borrower to Complete
Is the current borrowerco-borrower currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the page)
Yes (If yes please answer the question in section 3 and sign and date this form at the bottom of the page)
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
________________________________________________________________________________________________
3 Applicant and Current Borrower to Complete
If the answer to the questions in section 1 and 2 are both yes please answer the following question After yoursquove reviewed and completed this entire form please sign and date at the bottom
Applicant Current Borrower
Do you want to apply for a substitution of entitlement Yes Yes No No
In order to complete a substitution of entitlement the veteran applicant must have suffcient entitlement to substitute for that of the current borrower Contact the VA Offce of Jurisdiction for your area for more information Also before the veteran applicant can substitute entitlement on a VA loan heshe must certify that the property securing the loan will be occupied as hisher primary residence Both the applicantrsquos and current borrowerrsquos original certifcate of eligibility will be required If your sales contract is contingent upon the restoration of entitlement please contact your VA Offce of Jurisdiction for complete procedures Otherwise the substitution will be completed after the loan has been approved and closed
Date Applicant printed name Applicant signature
Date Applicant printed name Applicant signature
Date Current Borrower printed name Current Borrower signature
Date Current Borrower printed name Current Borrower signature
Forms completed by Mail Phone
For Chase use only
Interviewer signature Date
99177-VS-0215
- Assumption Application Package_41521-noscannedpages-update-4pdf
-
- 1 FM203 Cover Pagepdf
- 2 FM202 Mortgage Assumption Application Package pagepdf
- 3 The Documents Youll need to Send Uspdf
- 4 FM201 FAQpdf
- 5 FM142 CIWpdf
- 6 FM126 URLApdf
- 7 FM130 URLA Instpdf
-
- Blank Page
-
- 8 92900a Addednum to Loan Applicationpdf
- 9 FM462 Gen Authpdf
- 10 FM220 4506-Cpdf
- 11 FM153 Chase Federal Privacy Noticepdf
- 12 FM144 Info on Opening a New Accountpdf
- 13 FM152 Veteran Statementpdf
-
- Date
- Loan number
- Applicant name
- Phone1
- Loan number 1
- Loan number 2
- Other
- Other_2
- 1
- 2
- undefined_7
- Available hours
- Available hours_2
- undefined_8
- Available hours_3
- undefined_9
- Current address 1
- Neither
- Available hours_4
- Available hours_5
- undefined_10
- Available hours_6
- 1_2
- 2_2
- undefined_11
- Available hours_7
- Available hours_8
- undefined_12
- Available hours_9
- FHA Case No include any suffix
- Mortgagee Case No
- Mortgagee ID
- Sponsor ID
- Agent ID
- Name and Address of Sponsor Name and Address of Agent
- Borrowers Name Present Address include ZIP Code Property Address
- include name of subdivision lot block no ZIP Code
- Name of ThirdParty Originator
- NMLS ID of ThirdParty Originator
- s application
- ty Number
- ty Number_2
- Date Signed_2
- Date Mortgage Approved
- Date Approval Expires
- Printed Name
- Title 1
- DEs ID Number
- DEs ID Number_2
- Mortgagee
- Name of Mortgagees Representative
- Title of Mortgagees Representative
- Signature of the Mortgagees Representative
- Date_2
- Applicant names 1
- Applicant names 2
- Applicant names 3
- Loan number_2
- Date_3
- Applicant printed name
- Social Security number
- Date_4
- Applicant printed name_2
- Social Security number_2
- Date_5
- Applicant printed name_3
- Social Security number_3
- Date_6
- Applicant printed name_4
- Social Security number_4
- 1a Name shown on tax return if a joint return enter the name shown first
- 1b First social security number on tax return individual taxpayer identification number or employer identification number see instructions
- 2a If a joint return enter spouses name shown on tax return
- 2b Second social security number or individual taxpayer identification number if joint tax return
- 4 Previous address shown on the last return filed if different from line 3 see instructions
- 5a IVES participant name address and SOR mailbox ID
- Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing see instructions
- Signature see instructions
- Date_7
- Phone number of taxpayer on line 1a or 2a
- PrintType name
- Here
- Spouses signature
- Date_8
- PrintType name_2
- Name
- Date of birth
- Service number
- Name_2
- Date of birth_2
- Service number_2
- Date_9
- Applicant printed name_5
- Date_10
- Applicant printed name_6
- Date_11
- Current Borrower printed name
- Date_12
- Current Borrower printed name_2
- Date_13
- Text3
- Text10
- undefined_13
- Text15
- undefined_14
- undefined_15
- undefined_16
- undefined_17
- undefined_18
- undefined_19
- undefined_20
- undefined_21
- undefined_23
- Reason for assumption Off
- Requestors relationship to owners Off
- Check one Off
- Check one1 Off
- Day1
- Evening
- Cell phone
- Check one2 Off
- Check one3 Off
- Check one4 Off
- Check one5 Off
- Text2-1
- Text2-2
- Text2-3
- Text2-4
- Text2-5
- Text2-6
- Text3-1
- Text3-2
- Text3-3
- Text3-4
- Text3-6
- Text3-7
- Text3-8
- Text3-9
- Text3-10
- Text3-11
- Text3-12
- Text3-13
- Text3-14
- Text3-15
- Text3-16
- Text3-17
- Text3-18
- Text3-19
- Text3-20
- Text3-21
- Text3-22
- Text3-23
- Text3-24
- Text3-25
- Text3-26
- Text3-27
- Text3-28
- Text3-29
- Text3-30
- Text3-31
- Text3-32
- Text3-33
- Text3-34
- Text3-35
- Text3-36
- Text3-37
- Text3-38
- Text3-39
- Text3-40
- Text3-41
- Text3-42
- Text3-43
- Text3-44
- Text3-45
- Text3-46
- Text3-47
- Text3-48
- Text3-49
- Text3-50
- Text3-51
- Text3-52
- Text3-53
- Text3-5
- Text3-54
- Text3-55
- Text3-56
- Citizenship Off
- Type of credit Off
- Marital Status Off
- Housing Off
- Housing1 Off
- ownership Off
- DNA1 Off
- DNA2 Off
- DNA3 Off
- family Off
- BO Off
- Total
- Text31
- Text32
- Text33
- Text34
- Text35
- Text36
- Text37
- Text38
- Text39
- Text310
- Text311
- Text312
- Text313
- Text314
- Text315
- Text316
- Text317
- Text318
- Text319
- ownership1 Off
- Total1
- Total1-2
- Check Box4-1 Off
- Text320
- Text321
- Text322
- Text323
- Text324
- Text325
- Text326
- Text327
- Text328
- Text329
- Check Box4-2 Off
- Check Box4-3 Off
- Check Box4-4 Off
- Check Box4-8 Off
- Check Box4-9 Off
- Text330
- Text331
- Text332
- Text333
- Text334
- Text335
- Text1-1
- Text1-2
- Text1-3
- Text1-4
- Text1-5
- Text1-6
- Text1-7
- Text1-8
- Text1-9
- Text1-10
- Text1-11
- Text1-12
- Text1-13
- Text1-14
- Text1-15
- Text1-16
- Text1-17
- Text1-18
- Text1-19
- Text1-20
- Text1-21
- Text1-22
- Text1-23
- Text1-24
- Text1-25
- Text1-26
- Text1-27
- Text1-28
- Text1-29
- Text1-30
- Text1-31
- Text1-32
- Text1-33
- Text1-34
- Text1-35
- Check Box3-2 Off
- Check Box2-1 Off
- Check Box2-2 Off
- Check Box2-3 Off
- Check Box2-4 Off
- Check Box2-5 Off
- Text1-36
- Text1-37
- Text1-38
- Text1-39
- Text1-40
- Text1-41
- Text1-42
- Text1-43
- Text1-44
- Text1-45
- Text1-46
- Text1-47
- Text1-48
- Text1-49
- Text1-50
- Text1-51
- Text1-52
- Text1-53
- Text1-54
- Text1-55
- Text1-56
- Text1-57
- Text1-58
- Text1-59
- Text1-60
- Text1-61
- Check Box3-11 Off
- A1
- A2
- A3
- A4
- A5
- A6
- A7
- A8
- A9
- A10
- A11
- A12
- Check Box3-1 Off
- Check Box30-1 Off
- Check Box30-2 Off
- Check Box30-4 Off
- Check Box30-5 Off
- Check Box30-7 Off
- Check Box30-8 Off
- Check Box30-9 Off
- Check Box30-10 Off
- Check Box30-11 Off
- Check Box30-12 Off
- A13
- A14
- A15
- A16
- A17 Off
- A18
- A19
- A20
- A21
- A22
- A23
- A24
- A25
- A26
- A27
- A28
- A29
- A30
- A31
- A32
- A33
- A34
- A35
- A36
- A37
- A38 Off
- A39
- A40
- A41
- A42
- A43
- A44
- A45
- A46
- A47
- A48
- A49
- A50
- A51
- A52
- A53
- A54
- A55
- A56
- A57
- A58
- A59
- A60
- A61
- A62
- A63
- A64
- A65
- A66
- A67
- A68
- A69
- A70
- A71
- A72
- A73
- A74
- Loan Purpose Off
- occupancy1 Off
- lien type Off
- lientype Off
- mixed use Off
- manufactured home Off
- deposit1 Off
- deposit2 Off
- B1
- B2
- B3
- B4
- B5
- B6
- B7
- B8
- B9
- B10
- fha Off
- Check Box51 Off
- B11
- B12
- B13
- B14
- B15
- B16
- B17
- B18
- B19 Off
- B20
- B21
- B22 Off
- B23
- B24
- B25
- B26
- B27
- B28
- A
-
- Will you occupy the property as your primary residence Off
- Will you occupy the property as your primary residence1 Off
-
- If yes have you had an ownership interest in another property in the last three years Off
- Text9-2
- B
-
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property Off
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property1 Off
-
- 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 Off
- 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 application1 Off
-
- 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 Off
- 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 application1 Off
-
- new credit Off
- 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) Off
- the Property Assessed Clean Energy Program)1 Off
-
- F
-
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application Off
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application1 Off
-
- G
-
- Are there any outstanding judgments against you Off
- Are there any outstanding judgments against you1 Off
-
- H
-
- Are you currently delinquent or in default on a Federal debt Off
- Are you currently delinquent or in default on a Federal debt1 Off
-
- I
-
- Are you a party to a lawsuit in which you potentially have any personal financial liability Off
- Are you a party to a lawsuit in which you potentially have any personal financial liability1 Off
-
- J
-
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years Off
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years1 Off
-
- 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 Off
- 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 due1 Off
-
- L
-
- Have you had property foreclosed upon in the last 7 years Off
- Have you had property foreclosed upon in the last 7 years1 Off
-
- M
-
- Have you declared bankruptcy within the past 7 years Off
- Have you declared bankruptcy within the past 7 years1 Off
-
- Check Box8-2 Off
- Check Box8-3 Off
- Check Box8-4 Off
- Text9-3
- Text9-5
- Text9-6
- Text97
- military Off
- ethnicity Off
- sex Off
- race Off
- demo Off
- Text12-1
- Check Box11-1 Off
- Check Box11-2 Off
- Check Box11-3 Off
- Check Box11-4 Off
- Check Box11-5 Off
- Check Box11-6 Off
- Check Box11-7 Off
- Check Box11-8 Off
- Check Box11-9 Off
- Text12-2
- Check Box11-10 Off
- Check Box11-11 Off
- Check Box11-12 Off
- Check Box11-13 Off
- Check Box11-14 Off
- Check Box11-15 Off
- Text12-3
- Check Box11-16 Off
- Check Box11-17 Off
- Check Box11-18 Off
- Check Box11-19 Off
- Check Box11-20 Off
- Check Box11-21 Off
- Check Box11-22 Off
- Check Box11-23 Off
- Text12-4
- Check Box11-24 Off
- Check Box11-25 Off
- Check Box11-26 Off
- Check Box11-27 Off
- Check Box11-28 Off
- Check Box11-29 Off
- Text12-5
- Check Box11-30 Off
- Check Box11-31 Off
- citizen Off
- credit Off
- marital status1 Off
- housing-1 Off
- housing-2 Off
- own Off
- C1
- C2
- C3
- C6
- C7
- C8
- C9
- C10
- C11
- C12
- C13
- C14
- C15
- C16
- C17
- C18
- C19
- C20
- C21
- C22
- C23
- C24
- C25
- C26
- C27
- C28
- C29
- C30
- C31
- C32
- C33
- C34
- C35
- Check Box-2 Off
- C36
- C37
- C38
- C39
- C4
- C40
- C41
- C42
- C43
- C44
- C45
- C46
- C47
- Check Box-3 Off
- Check Box-4 Off
- C48
- C49
- C5
- C50
- C51
- C52
- C53
- C54
- C55
- Check Box-1-1 Off
- own1 Off
- Check Box-1 Off
- D1 Off
- D2
- D3
- D4
- D5
- D6
- D7
- D8
- D9
- D10
- D11
- D12
- D13
- D14 Off
- D15 Off
- D16
- D17
- D18
- D19
- D20
- D21
- D22
- D23
- D24 Off
- D25
- D26
- D27
- D28
- D29
- D30
- D31
- D32
- D33
- D34
- D35 Off
- D36
- D37 Off
- D38
- D39
- D40
- D41
- D42
- D43
- D44
- D45
- D46
- D47
- If yes have you had an ownership interest in another property in the last three years1 Off
- new credit1 Off
- Check Box8-1 Off
- Check Box8-1-2 Off
- Check Box8-1-1 Off
- Check Box8-1-3 Off
- Check Box8-1-4 Off
- Military Service mdash Did you (or your deceased spouse) ever serve or are you currently serving in the United States Armed Forces 1 Off
- Check1 Off
- Text9-1-1
- Check2 Off
- Check3 Off
- Check4 Off
- Text9-1
- E1
- E2
- E3
- Was the ethnicity of the Borrower collected on the basis of visual observation or surname1 Off
- Was the sex of the Borrower collected on the basis of visual observation or surname1 Off
- Was the race of the Borrower collected on the basis of visual observation or surname1 Off
- The Demographic Information was provided through1 Off
- F1 Off
- F2 Off
- F3 Off
- F4 Off
- F5 Off
- F6
- F7 Off
- F8 Off
- F9 Off
- F10 Off
- F11 Off
- F12 Off
- F13
- F14 Off
- F15 Off
- F16 Off
- F17 Off
- F18 Off
- F19 Off
- F20 Off
- F21 Off
- F22
- F23 Off
- F24 Off
- F25 Off
- F26 Off
- F27 Off
- F28 Off
- F29
- F30 Off
- F31 Off
- undefined_13-1
- undefined_13-2
- undefined_14-1
- undefined_15-1
- undefined_16-1
- undefined_17-1
- undefined_18-1
- undefined_19-1
- undefined_21-1
- undefined_20-1
- undefined_23-1
- undefined_13_1
- Single-Two Off
- Refi type Off
- refi program Off
- Estate Off
- Title held Off
- Trust Information Off
- Indian Country Land Tenure Off
- Mortgage Type Applied For Off
- Mortgage Lien Type Off
- Amortization Type Off
- G1 Off
- G2 Off
- G3 Off
- G4 Off
- G5 Off
- G6
- G7
- G8
- G9
- G10 Off
- G11 Off
- G12 Off
- G13 Off
- G14 Off
- G15 Off
- G16
- G17
- G18
- G19
- G20
- G21
- G22
- G23 Off
- G24
- G25 Off
- G26
- G27 Off
- G28 Off
- G29
- G30 Off
- G31
- G32 Off
- G33
- G34
- G35
- G36
- G37
- G38
- G39
- G40
- G41
- G42
- Property Held
- refi
- Text18-1
- Text18-2
- Text18-3
- Text18-4
- Text18-5
- Text18-6
- Text18-7
- Text18-8
- Text18-9
- Text18-10
- Text18-11
- Text18-12
- Text18-13
- Text18-14
- Text18-15
- Text18-16
- Text18-17
- Text18-18
- Text18-19
- Lender
- case no
- If you selected ldquoUnmarriedrdquo in Section 1 is there a person who is not your legal spouse but who currently has real property rights similar to those of a legal spouse Off
- Relationship and State Off
- Other-5
- Text19-1
- BName
- Additional Information
- ABN
- Additional Information1
- BSign
- BSDate
- ABSign
- ABDate
- MortageeNameAddress
- NAmeAddress
- Bname1
- DOB1
- DOB2
- SignOfBorr1
- SignOfBorr
- Date Signed
- SignOfBorr2
- SignOfBorr3
- Date Signed3
- Date Signed4
- MortgageeRepSign
- DirectSign
- DirectSign1
- Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union Off
- AppSign
- AppSign1
- AppSign2
- AppSign3
- Nopage38 Off
- Yespage38 Off
- Yes1 Off
- No1 Off
- Yes2 Off
- Yes3 Off
- Yes4 Off
- Yes5 Off
- Yes6 Off
- Yes7 Off
- Yes8 Off
- Yes9 Off
- Yes10 Off
- No2 Off
- No3 Off
- No4 Off
- No5 Off
- No6 Off
- No7 Off
- No8 Off
- No9 Off
- No10 Off
- BorrowerNo Off
- BorrowerYes Off
- AppSignature
- AppSignature1
- CurrentSign
- CurrentSign1
- InterviewSign
- Yes_1 Off
- No_1 Off
- Yes_2 Off
- No_2 Off
- Mail Off
- Phone Off
HUD Addendum to Uniform Residential Loan Application OMB Approval No HUD 2502-0059 (exp )
Part I - Identifying Information HUDFHA Application for Insurance under the National Housing Act and Borrower Certification
FHA Case No (include any suffix) Mortgagee Case No
Mortgagee ID Sponsor ID Agent ID
Mortgagee Name Address (include ZIP Code) and Telephone Number
Type or print all entries clearly
Name and Address of Sponsor Name and Address of Agent
Borrowers Name amp Present Address (include ZIP Code) Property Address (include name of subdivision lot amp block no amp ZIP Code)
Sponsored Originations
Name of Third-Party Originator NMLS ID of Third-Party Originator
Part II - Borrower Consent for Social Security Administration to Verify Social Security Number I authorize the Social Security Administration (SSA) to verify my Social Security Number (SSN) to the Mortgagee and HUDFHA I authorize SSA to provide explanatory
information to HUDFHA in the event of a discrepancy This consent is valid for 180 days from the date signed unless indicated otherwise by the individual(s) named in this
loan application
Signature(s) of Borrower(s) - Read consent carefully Review accuracy of Social Security Number(s) provided on this application
Borrowerrsquos NameDate of BirthSocial Security Number
Co-Borrowerrsquos Name Date of BirthSocial Security Number
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
Part III - Borrower Notices Information and Acknowledgment Public Reporting Burden
Public reporting burden for this collection of information is estimated to average 10 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 conduct or sponsor and a person is not
required to respond to a collection of information unless that collection displays a valid OMB control number which can be located on the OMB Internet page at
httpwwwreginfogovpublicdoPRAMain
Privacy Act Information
The information requested on the Uniform Residential Loan Application and this Addendum is authorized by the National Housing Act of 1934 12 USC sect 1701 et seq The Debt
Collection Act of 1982 Pub L 97-365 and HUDrsquos Housing and Community Development Act of 1987 42 USC sect 3543 require persons applying for a federally insured loan to
furnish their SSN You must provide all the requested information including your SSN HUD may conduct a computer match to verify the information you provide HUD may
disclose certain information to Federal State and local agencies when relevant to civil criminal or regulatory investigations and prosecutions It will not otherwise be disclosed or
released outside of HUD except as required and permitted by law The information will be used to determine whether you qualify as a mortgagor Failure to provide any of the
requested information including SSN may result in disapproval of your loan application This is notice to you as required by the Right to Financial Privacy Act of 1978 that
HUDFHA has a right of access to financial records held by financial institutions in connection with the consideration or administration of assistance to you Financial records
involving your transaction will be available to HUDFHA without further notice or authorization but will not be disclosed or released by the institution to another Government Agency
or Department without your consent except as required or permitted by law
WARNING This warning applies to all certifications made in this document Anyone who knowingly submits a false claim or makes false statements is subject to criminal and civil penalties including confinement for up to 5 years fines and civil penalties 18 USC sectsect 287 1001 and 31 USC sect 3729
orm HUD-92900-A ( ) Page 1
Borrower Name ____________________________ FHA Case No __________________
Caution Delinquencies Defaults Foreclosures and Abuses Delinquencies defaults foreclosures and abuses of mortgage loans involving programs of the Federal Government can be costly and detrimental to your credit now and in the future The Mortgagee in this transaction its agents and assigns as well as the Federal Government its agencies agents and assigns are authorized to take any and all of the following actions in the event loan payments become delinquent on the mortgage loan described in the attached application (1) Report your name and account information to a credit bureau (2) Assess additional interest and penalty charges for the period of time that payment is not made (3) Assess charges to cover additional administrative costs incurred by the Federal Government to service your account (4) Offset amounts owed to you
under other Federal programs (5) Refer your account to a private attorney collection agency or mortgage servicing agency to collect the amount due foreclose
the mortgage sell the property and seek judgment against you for any deficiency (6) Refer your account to the Department of Justice (DOJ) for litigation in the
courts (7) If you are a current or retired Federal employee take action to offset your salary or civil service retirement benefits (8) Refer your debt to the Internal
Revenue Service for offset against any amount owed to you as an income tax refund and (9) Report any resulting written off debt of yours to the Internal Revenue Service as your taxable income All of these actions may be used to recover any debts owed when it is determined to be in the interest of the Mortgagee or Federal Government or both
As a mortgage loan borrower you will be legally obligated to make the mortgage payments called for by your mortgage loan contract The fact that you dispose of your property after the loan has been made will not relieve you of liability for making these payments Payment of the loan in full is ordinarily the way liability on a mortgage note is ended Some home buyers have the mistaken impression that if they sell their homes when they move to another locality or dispose of it for any other reasons they are no longer liable for the mortgage payments and that liability for these payments is solely that of the new owners Even though the new owners may agree in writing to assume liability for your mortgage payments this assumption agreement will not relieve you from liability to the holder of the note which you signed when you obtained the loan to buy the property Unless you are able to sell the property to a buyer who is acceptable to HUDFHA who will assume the payment of your obligation to the lender you will not be relieved from liability to repay any claim which HUDFHA may be required to pay your lender on account of default in your loan payments The amount of any such claim payment may be a debt owed by you to the Federal Government and subject to established collection procedures
Fair Housing Act I and anyone acting on my behalf are and will remain in compliance with the Fair Housing Act 42 USC sect 3604 et seq with respect to the dwelling or property covered by the loan and in the provision of services or facilities in connection therewith I recognize that any restrictive covenant on this property related to race color religion sex disability familial status or national origin is unlawful under the Fair Housing Act and unenforceable I further recognize that in addition to administrative action by HUD a civil action may be brought by the DOJ in any appropriate US court against any person responsible for a violation of the
applicable law
Certification and Acknowledgment All information in this application is given for the purpose of obtaining a loan to be insured under the National Housing Act and the information in the Uniform Residential Loan Application and this Addendum is true and complete to the best of my knowledge and belief Verification may be obtained from any source named herein I have read and understand the foregoing concerning my liability on the loan and Part III Borrower Notices Information and Acknowledgment
Signature(s) of Borrower(s) - Do not sign unless this application is fully completed Read the certification carefully and review accuracy of this application
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
orm HUD-92900-A ( Page 2
___________________________________
______________________________________________________
______________________________________________________________
- - - - - - - - - - - - - - - - - - - - - - -
Borrower Name ____________________________ FHA Case No __________________
Part IV - Direct Endorsement Approval for a HUD FHA-Insured Mortgage A Underwriting the Borrower
Date Mortgage Approved ______________________________ Date Approval Expires ______________________
For mortgages rated as an ldquoacceptrdquo or ldquoapproverdquo by FHAs TOTAL Mortgage Scorecard
The information submitted to TOTAL was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA4e Final Underwriting Decision (TOTAL) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee Representative Signature
Printed Name
Title
OR
For mortgages rated as a ldquoreferrdquo by FHAs TOTAL Mortgage Scorecard or manually underwritten by a Direct Endorsement underwriter I have personally reviewed and underwritten the borrowerrsquos credit application The information used to underwrite the borrower was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA5d Final Underwriting Decision (Manual) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
B Underwriting the Property
For all mortgages where FHA requires an appraisal I have personally reviewed and underwritten the appraisal according to FHA requirements I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
orm HUD-92900-A ( ) Page 3
Borrower Name ____________________________ FHA Case No __________________
Part V Mortgagees Certification
I have personally reviewed the mortgage documents and the application for insurance endorsement and This mortgage complies with SF Handbook 40001 Section IIA7 Post-Closing and Endorsement to the extent that no defect exists that would have changed the decision to endorse or submit the mortgage for insurance
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee
Name of Mortgageersquos Representative
Title of Mortgageersquos Representative
Signature of the Mortgageersquos Representative Date
orm HUD-92900-A ( ) Page 4
GENERAL AUTHORIZATION FOR A MORTGAGE LOAN ASSUMPTION
Applicant name(s)
Loan number
NOTICES AND DISCLOSURES
Non-discriminatory underwriting guidelines Anyone who inquires about the availability of credit from us has the right to receive a copy of our non-discriminatory underwriting guidelines To request a copy of these guidelines contact your Loan Processor
Attorney note Itrsquos the responsibility of our attorneys to protect our interest You may at your expense request an attorney to represent your interest
Notice to HUDFHA applicants As required by the Right to Financial Privacy Act of 1978 this notice is to inform you that the US Department of Housing and Urban Development (HUD)Federal Housing Administration (FHA) has a right of access to financial records held by financial institutions related to a request for assistance Financial records involving your assumption will be available to HUDFHA without further notice or authorization but wonrsquot be disclosed or released by us to another government agency or department without your consent except as required or permitted by law
Borrower consent to the use of tax return information I understand acknowledge and agree that the Lender and Other Loan Participants can obtain use and share tax return information for purposes of (i) providing an offer (ii) originating maintaining managing monitoring servicing selling insuring and securitizing a loan (iii) marketing or (iv) as otherwise permitted by applicable laws including state and federal privacy and data security laws The Lender includes the Lenderrsquos affiliates agents service providers and any of aforementioned partiesrsquo successors and assigns The Other Loan Participants includes any actual or potential owners of a loan resulting from your loan application or acquirers of any beneficial or other interest in the loan and mortgage insurer guarantor any servicers or service providers for these parties and any of aforementioned partiesrsquo successors and assigns
CERTIFICATION AND AUTHORIZATION
Environmental certification By signing below I represent and warrant that Irsquom not aware of any substances materials or products that may be an environmental hazard such as but not limited to asbestos formaldehyde radon gas lead-based paint fuel or chemical storage tanks (above or below ground) and contaminated soil or water on the property I acknowledge that Chase is relying on this representation and warranty as a material part of its loan application process I also am not aware of any landfill on any portion of the property
Exceptions to the above I further acknowledge (1) receipt of applicable disclosures from the seller in purchase transactions (2) that lead-based paint may exist in housing constructed prior to 1978 (3) that Chase performs no environmental investigation on my behalf and isnrsquot responsible for identifying lead-based paint or any other environmental conditions that might impact the property or its residents and (4) that it is my sole obligation to investigate for potential impact to the property from environmental conditions
Certifications I certify by signing below that (1) all of the loan application information provided is true and complete (2) I understand any intentional or negligent misrepresentation(s) of the information provided in conjunction with my application may result in civil liability andor 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 Chase its agents successors and assigns insurers and any other person who may suffer any loss due to reliance upon any misrepresentation that I have made on the application and (3) any significant change from the information provided at the time of application until the final loan application is signed may have a bearing on the approval of my application for a home loan
Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union
This question is asked because of state laws that extend the same or similar rights benefits and protections of spouses in a marriage to persons who are members of a partnership or union recognized under state law You should consult with your own legal advisor for advice regarding the rights protections benefits responsibilities obligations and duties of those who are registered domestic partners civil union partners or members of other unions recognized under applicable law
CREDIT AUTHORIZATION RELEASE
By signing below I authorize Chase andor my mortgage insurer (if any) to verify my past and present employment earnings records (including information contained in income tax returns that have been filed with the IRS) bank accounts stock holdings and any other information that it finds necessary to process my mortgage loan application or to review it for quality-control purposes I understand that a credit report will be ordered from a credit reporting agency for verification prior to loan closing as part of the application process and may be ordered after closing as part of the Lenderrsquos quality-control program A credit report may also be completed as part of the Lenderrsquos servicing or collection of the loan or in consideration of any other product or service that the Lender may consider offering me in the future and at any time throughout the life of the loan I understand that use of a photocopy of this form may be necessary to verify one or more of my credit references I understand that a photocopy or fax copy of this form will also serve as authorization
By signing below each applicant acknowledges (1) making the above certifications and authorizations and (2) that each applicant has received and understands the above notices and disclosures
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
You do not have to give us this information but if you donrsquot your application for approval as a borrower may be delayed or rejected The information requested in this form is authorized by Title 38 USC Chapter 37 (if VA) by 12 USC Section 1701 et seq (if HUDFHA) by 42 USC Section 1452b (if HUDCPD) and Title 42 USC 1471 et seq or 7 USC 1921 et seq (if USDA FHA)
Updated December 2021 99177-GA-0215
1b
2b
Form 4506-C (September 2020)
Department of the Treasury - Internal Revenue Service
IVES Request for Transcript of Tax Return OMB Number
1545-1872
Do not sign this form unless all applicable lines have been completed Request may be rejected if the form is incomplete or illegible
For more information about Form 4506-C visit wwwirsgov and search IVES
1a Name shown on tax return (if a joint return enter the name shown first)
First social security number on tax return individual taxpayer identification number or employer identification number (see instructions)
2a If a joint return enter spousersquos name shown on tax return Second social security number or individual taxpayer identification number if joint tax return
3 Current name address (including apt room or suite no) city state and ZIP code (see instructions)
4 Previous address shown on the last return filed if different from line 3 (see instructions)
5a IVES participant name address and SOR mailbox ID
DataVerify 875 Greentree Rd 8 Parkway Center Pittsburgh PA 15220
5b Customer file number (if applicable) (see instructions)
Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing (see instructions)
6 Transcript requested Enter the tax form number here (1040 1065 1120 etc) and check the appropriate box below Enter only one tax form number per request 1040
a Return Transcript which includes most of the line items of a tax return as filed with the IRS A tax return transcript does not reflect changes made to the account after the return is processed Transcripts are only available for the following returns Form 1040 series Form 1065 Form 1120 Form 1120-A Form 1120-H Form 1120-L and Form 1120S Return transcripts are available for the current year and returns processed during the prior 3 processing years
b Account Transcript which contains information on the financial status of the account such as payments made on the account penalty assessments and adjustments made by you or the IRS after the return was filed Return information is limited to items such as tax liability and estimated tax payments Account transcripts are available for most returns
c Record of Account which provides the most detailed information as it is a combination of the Return Transcript and the Account Transcript Available for current year and 3 prior tax years
7 Form W-2 Form 1099 series Form 1098 series or Form 5498 series transcript The IRS can provide a transcript that includes data from these information returns State or local information is not included with the Form W-2 information The IRS may be able to provide this transcript information for up to 10 years Information for the current year is generally not available until the year after it is filed with the IRS For example W-2 information for 2016 filed in 2017 will likely not be available from the IRS until 2018 If you need W-2 information for retirement purposes you should contact the Social Security Administration at 1-800-772-1213
Caution If you need a copy of Form W-2 or Form 1099 you should first contact the payer To get a copy of the Form W-2 or Form 1099 filed with your return you must use Form 4506 and request a copy of your return which includes all attachments
8 Year or period requested Enter the ending date of the tax year or period using the mmddyyyy format (see instructions)
12 31 2020 12 31 2019 12 31 2018 Caution Do not sign this form unless all applicable lines have been completed
Signature of taxpayer(s) I declare that I am either the taxpayer whose name is shown on line 1a or 2a or a person authorized to obtain the tax information requested If the request applies to a joint return at least one spouse must sign If signed by a corporate officer 1 percent or more shareholder partner managing member guardian tax matters partner executor receiver administrator trustee or party other than the taxpayer I certify that I have the authority to execute Form 4506-C on behalf of the taxpayer Note This form must be received by IRS within 120 days of the signature date
Signatory attests that heshe has read the attestation clause and upon so reading declares that heshe has the authority to sign the Form 4506-C See instructions
Sign Here
Signature (see instructions) Date Phone number of taxpayer on line 1a or 2a
PrintType name
Title (if line 1a above is a corporation partnership estate or trust)
Spousersquos signature Date
PrintType name
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020) For Privacy Act and Paperwork Reduction Act Notice see page 2
Instructions for Form 4506-C IVES Request for Transcript of Tax Return
Section references are to the Internal Revenue Code unless otherwise noted
Future Developments
For the latest information about Form 4506-C and its instructions go to wwwirsgov and search IVES Information about any recent developments affecting Form 4506-C (such as legislation enacted after we released it) will be posted on that page
Whats New Form 4506-C was created to be utilized by authorized IVES participants to order tax transcripts with the consent of the taxpayer
General Instructions
Caution Do not sign this form unless all applicable lines have been completed
Designated Recipient Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information received pursuant to the taxpayerrsquos consent and holds the recipient subject to penalties for any unauthorized access other use or redisclosure without the taxpayerrsquos express permission or request
Taxpayer Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information provided pursuant to your consent and holds the recipient subject to penalties brought by private right of action for any unauthorized access other use or redisclosure without your express permission or request
Purpose of form Use Form 4506-C to request tax return information through an authorized IVES participant You will designate an IVES participant to receive the information on line 5a
Note If you are unsure of which type of transcript you need check with the party requesting your tax information
Where to file The IVES participant will fax Form 4506-C with the approved IVES cover sheet to their assigned Service Center
Chart for ordering transcripts
If your assigned Service Center is
Fax the requests with the approved coversheet to
Austin Submission Processing Center
Austin IVES Team
844-249-6238
Fresno Submission Processing Center
Fresno IVES Team
844-249-6239
Kansas City Submission Processing Center
Kansas City IVES Team
844-249-8128
Ogden Submission Processing Center
Ogden IVES Team
844-249-8129
Specific Instructions
Line 1b Enter the social security number (SSN) or individual taxpayer identification number (ITIN) for the individual listed on line 1a or enter the employer identification number (EIN) for the business listed on line 1a
Line 3 Enter your current address If you use a PO box include it on this line
Line 4 Enter the address shown on the last return filed if different from the address entered on line 3
Note If the addresses on lines 3 and 4 are different and you have not changed your address with the IRS file Form 8822 Change of Address or Form 8822-BChange of Address or Responsible Party mdash Business with Form 4506-C
Line 5b Enter up to 10 numeric characters to create a unique customer file number that will appear on the transcript The customer file number cannot contain an SSN ITIN or EIN Completion of this line is not required
Note If you use an SSN name or combination of both we will not input the information and the customer file number will reflect a generic entry of 9999999999 on the transcript
Line 8 Enter the end date of the tax year or period requested in mmddyyyy format This may be a calendar year fiscal year or quarter Enter each quarter requested for quarterly returns Example Enter 12312018 for a calendar year 2018 Form 1040 transcript
Signature and date Form 4506-C must be signed and dated by the taxpayer listed on line 1a or 2a The IRS must receive Form 4506-C within 120 days of the date signed by the taxpayer or it will be rejected Ensure that all applicable lines including lines 5a through 8 are completed before signing
You must check the box in the signature area to acknowledge you have the authority to sign and request the information The form will not be processed if unchecked
Individuals Transcripts listed on on line 6 may be furnished to either spouse if jointly filed Only one signature is required Sign Form 4506-C exactly as your name appeared on the original return If you changed your name also sign your current name
Corporations Generally Form 4506-C can be signed by
(1) an officer having legal authority to bind the corporation (2) any person designated by the board of directors or other governing body or (3) any officer or employee on written request by any principal officer and attested to by the secretary or other officer A bona fide shareholder of record owning 1 percent or more of the outstanding stock of the corporation may submit a Form 4506-C but must provide documentation to support the requesters right to receive the information
Partnerships Generally Form 4506-C can be signed by any person who was a member of the partnership during any part of the tax period requested on line 8
All others See section 6103(e) if the taxpayer has died is insolvent is a dissolved corporation or if a trustee guardian executor receiver or administrator is acting for the taxpayer
Note If you are Heir at law Next of kin or Beneficiary you must be able to establish a material interest in the estate or trust
Documentation For entities other than individuals you must attach the authorization document For example this could be the letter from the principal officer authorizing an employee of the corporation or the letters testamentary authorizing an individual to act for an estate
Signature by a representative A representative can sign Form 4506-C for a taxpayer only if the taxpayer has specifically delegated this authority to the representative on Form 2848 line 5 The representative must attach Form 2848 showing the delegation to sign Form 4506-C
Privacy Act and Paperwork Reduction Act Notice We ask for the information on this form to establish your right to gain access to the requested tax information under the Internal Revenue Code We need this information to properly identify the tax information and respond to your request You are not required to request any transcript if you do request a transcript sections 6103 and 6109 and their regulations require you to provide this information including your SSN or EIN If you do not provide this information we may not be able to process your request Providing false or fraudulent information may subject you to penalties
Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and cities states the District of Columbia and US commonwealths and possessions for use in administering their tax laws We may also disclose this information to other countries under a tax treaty to federal and state agencies to enforce federal nontax criminal laws or to federal law enforcement and intelligence agencies to combat terrorism
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law Generally tax returns and return information are confidential as required by section 6103
The time needed to complete and file Form 4506-C will vary depending on individual circumstances The estimated average time is
Learning about the law or the form 10 min Preparing the form 12 min Copying assembling and sending the form to the IRS 20 min
If you have comments concerning the accuracy of these time estimates or suggestions for making Form 4506-C simpler we would be happy to hear from you You can write to
Internal Revenue Service Tax Forms and Publications Division 1111 Constitution Ave NW IR-6526 Washington DC 20224
Do not send the form to this address Instead see Where to file on this page
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020)
Rev April 2021 CHASEO Facts What does Chase do with your personal information
Why Financial companies choose how they share your personal information Federal law gives consumers the right to limit some but not all sharing Federal law also requires us to tell you how we collect share and protect your personal information Please read this notice carefully to understand what we do
What The types of personal information we collect and share depend on the product or service you have with us This information can include bull Social Security number and income bull account balances and transaction history bull credit history and payment history
How All financial companies need to share customers personal information to run their everyday business In the section below we list the reasons financial companies can share their customers personal information the reasons Chase chooses to share and whether you can limit this sharing
Reasons we can share your personal information Does Chase share
Can you limit this sharing
For our everyday business purposes - such as to process your transactions maintain your account(s) respond to court orders and legal investigations or report to credit bureaus
Yes No
For our marketing purposes - to offer our products and services to you
Yes No
For joint marketing with other financial companies Yes No
For our affiliates everyday business purposes - information about your transactions and experiences
Yes No
For our affiliates everyday business purposes - information about your creditworthiness
Yes Yes
For our affiliates to market to you Yes Yes
For nonaffiliates to market to you Yes Yes
a
0
To limit our sharing
bull Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
bull Visit us online chasecomprivacypreferences
Please note If you are a new customer we can begin sharing your information 30 days from the date we sent this notice When you are no longer our customer we continue to share your information as described in this notice However you can contact us at any time to limit our sharing
Questions
Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
PAGE 2
Who we are
Who is providing this notice The US consumer financial companies within the JPMorgan Chase amp Co family including JPMorgan Chase Bank NA Chase Insurance Agency Inc and JP Morgan Securities LLC
What we do
How does Chase protect my To protect your personal information from unauthorized access and use we personal information use security measures that comply with federal law These measures include
computer safeguards and secured files and buildings We authorize our employees to get your information only when they need it to do their work and we require companies that work for us to protect your information
How does Chase collect my We collect your personal information for example when you personal information bull open an account or make deposits or withdrawals from your account
bull pay your bills or apply for a loan bull use your credit or debit card We also collect your personal information from others such as credit bureaus affiliates or other companies
Why cant I limit all sharing Federal law gives you the right to limit only bull sharing for affiliates everyday business purposes - information about your
creditworthiness bull affiliates from using your information to market to you bull sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing See below for more on your rights under state law
What happens when I limit sharing for an account I hold jointly with someone else
Your choices will apply to everyone on your account
Definitions
Affiliates Companies related by common ownership or control They can be financial and non financial companies bull Our affiliates include companies with a Chase or JP Morgan name and financial companies such asjP Morgan Securities LLC
Nonaffiliates Companies not related by common ownership or control They can be financial and non financial companies bull Nonaffiliates we share with can include companies such as retailers auto dealers auto makers and membership clubs
Joint marketing A formal agreement between nonaffiliated financial companies that together market financial products or services to you bull Our joint marketing partners include categories of companies such as insurance companies
Other important information
VT Accounts with a Vermont mailing address are automatically treated as if they have limited the sharing as described on page 1 For joint marketing we will only disclose your name contact information and information about your transactions
NV We are providing you this notice pursuant to Nevada law If you prefer not to receive marketing calls from us you may be placed on our Internal Do Not Call List by calling 1-800-945-9470 or by writing to us at PO Box 734007 Dallas TX 75373-4007
For more information contact us at the address above or email PrivacylnfoJPMChasecom with Nevada Annual Notice in the subject line You may also contact the Nevada Attorney Generals office Bureau of Consumer Protection Office of the Nevada Attorney General 555 E Washington St Suite 3900 Las Vegas NV 89101 telephone number 1-702-486-3132 email BCPINFOagstatenvus
CA Accounts with a California mailing address are automatically treated as if they have limited the sharing with nonaffiliates as described on page 1 CA residents are provided a CA notice for additional choices
CHASE O
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
The following disclosure is required by the USA PATRIOT Act
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 opens an account
What this means to you When you 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 drivers
license or other identifying documents
99177-PAT-0215
VETERAN STATEMENT When this loan was opened the US Department of Veterans Affairs (VA) used the veteran borrowerrsquos entitlement which is a set amount the VA promises to repay a lender if the borrower defaults on the mortgage An assumption will modify who is obligated to pay the existing mortgage loan but all loan termsmdashincluding the entitlementmdashwill remain the same If the veteran borrower is being removed from the loan the entitlement would remain with whoever is assuming the loan because the loan will continue to be serviced by the VA If the applicant is also a veteran and can substitute his or her entitlement for the current entitlement then the current borrowerrsquos entitlement can be released
Please review the following questions and answer as appropriate This form requires completion by both the applicant(s) and current borrower(s)
1 Applicant to Complete
Are you (the applicant) currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the reverse side)
Yes (If yes please provide the information requested below answer the question in section 3 and sign and date this form at the bottom of the reverse side)
Name of applicant(s) who answered ldquoyesrdquo to the above question
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Are you receiving VA disability benefts
Applicant
Yes
No
Co-Applicant
Yes
No
Are you entitled to receive VA disability benefts Yes No Yes No
Have you received VA disability benefts in the past Yes No Yes No
Are you a surviving spouse of a veteran who died on active duty or as the result of a service-related disability
Yes No Yes No
Do you have any VA loans Yes No Yes No
2 Current Borrower to Complete
Is the current borrowerco-borrower currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the page)
Yes (If yes please answer the question in section 3 and sign and date this form at the bottom of the page)
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
________________________________________________________________________________________________
3 Applicant and Current Borrower to Complete
If the answer to the questions in section 1 and 2 are both yes please answer the following question After yoursquove reviewed and completed this entire form please sign and date at the bottom
Applicant Current Borrower
Do you want to apply for a substitution of entitlement Yes Yes No No
In order to complete a substitution of entitlement the veteran applicant must have suffcient entitlement to substitute for that of the current borrower Contact the VA Offce of Jurisdiction for your area for more information Also before the veteran applicant can substitute entitlement on a VA loan heshe must certify that the property securing the loan will be occupied as hisher primary residence Both the applicantrsquos and current borrowerrsquos original certifcate of eligibility will be required If your sales contract is contingent upon the restoration of entitlement please contact your VA Offce of Jurisdiction for complete procedures Otherwise the substitution will be completed after the loan has been approved and closed
Date Applicant printed name Applicant signature
Date Applicant printed name Applicant signature
Date Current Borrower printed name Current Borrower signature
Date Current Borrower printed name Current Borrower signature
Forms completed by Mail Phone
For Chase use only
Interviewer signature Date
99177-VS-0215
- Assumption Application Package_41521-noscannedpages-update-4pdf
-
- 1 FM203 Cover Pagepdf
- 2 FM202 Mortgage Assumption Application Package pagepdf
- 3 The Documents Youll need to Send Uspdf
- 4 FM201 FAQpdf
- 5 FM142 CIWpdf
- 6 FM126 URLApdf
- 7 FM130 URLA Instpdf
-
- Blank Page
-
- 8 92900a Addednum to Loan Applicationpdf
- 9 FM462 Gen Authpdf
- 10 FM220 4506-Cpdf
- 11 FM153 Chase Federal Privacy Noticepdf
- 12 FM144 Info on Opening a New Accountpdf
- 13 FM152 Veteran Statementpdf
-
- Date
- Loan number
- Applicant name
- Phone1
- Loan number 1
- Loan number 2
- Other
- Other_2
- 1
- 2
- undefined_7
- Available hours
- Available hours_2
- undefined_8
- Available hours_3
- undefined_9
- Current address 1
- Neither
- Available hours_4
- Available hours_5
- undefined_10
- Available hours_6
- 1_2
- 2_2
- undefined_11
- Available hours_7
- Available hours_8
- undefined_12
- Available hours_9
- FHA Case No include any suffix
- Mortgagee Case No
- Mortgagee ID
- Sponsor ID
- Agent ID
- Name and Address of Sponsor Name and Address of Agent
- Borrowers Name Present Address include ZIP Code Property Address
- include name of subdivision lot block no ZIP Code
- Name of ThirdParty Originator
- NMLS ID of ThirdParty Originator
- s application
- ty Number
- ty Number_2
- Date Signed_2
- Date Mortgage Approved
- Date Approval Expires
- Printed Name
- Title 1
- DEs ID Number
- DEs ID Number_2
- Mortgagee
- Name of Mortgagees Representative
- Title of Mortgagees Representative
- Signature of the Mortgagees Representative
- Date_2
- Applicant names 1
- Applicant names 2
- Applicant names 3
- Loan number_2
- Date_3
- Applicant printed name
- Social Security number
- Date_4
- Applicant printed name_2
- Social Security number_2
- Date_5
- Applicant printed name_3
- Social Security number_3
- Date_6
- Applicant printed name_4
- Social Security number_4
- 1a Name shown on tax return if a joint return enter the name shown first
- 1b First social security number on tax return individual taxpayer identification number or employer identification number see instructions
- 2a If a joint return enter spouses name shown on tax return
- 2b Second social security number or individual taxpayer identification number if joint tax return
- 4 Previous address shown on the last return filed if different from line 3 see instructions
- 5a IVES participant name address and SOR mailbox ID
- Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing see instructions
- Signature see instructions
- Date_7
- Phone number of taxpayer on line 1a or 2a
- PrintType name
- Here
- Spouses signature
- Date_8
- PrintType name_2
- Name
- Date of birth
- Service number
- Name_2
- Date of birth_2
- Service number_2
- Date_9
- Applicant printed name_5
- Date_10
- Applicant printed name_6
- Date_11
- Current Borrower printed name
- Date_12
- Current Borrower printed name_2
- Date_13
- Text3
- Text10
- undefined_13
- Text15
- undefined_14
- undefined_15
- undefined_16
- undefined_17
- undefined_18
- undefined_19
- undefined_20
- undefined_21
- undefined_23
- Reason for assumption Off
- Requestors relationship to owners Off
- Check one Off
- Check one1 Off
- Day1
- Evening
- Cell phone
- Check one2 Off
- Check one3 Off
- Check one4 Off
- Check one5 Off
- Text2-1
- Text2-2
- Text2-3
- Text2-4
- Text2-5
- Text2-6
- Text3-1
- Text3-2
- Text3-3
- Text3-4
- Text3-6
- Text3-7
- Text3-8
- Text3-9
- Text3-10
- Text3-11
- Text3-12
- Text3-13
- Text3-14
- Text3-15
- Text3-16
- Text3-17
- Text3-18
- Text3-19
- Text3-20
- Text3-21
- Text3-22
- Text3-23
- Text3-24
- Text3-25
- Text3-26
- Text3-27
- Text3-28
- Text3-29
- Text3-30
- Text3-31
- Text3-32
- Text3-33
- Text3-34
- Text3-35
- Text3-36
- Text3-37
- Text3-38
- Text3-39
- Text3-40
- Text3-41
- Text3-42
- Text3-43
- Text3-44
- Text3-45
- Text3-46
- Text3-47
- Text3-48
- Text3-49
- Text3-50
- Text3-51
- Text3-52
- Text3-53
- Text3-5
- Text3-54
- Text3-55
- Text3-56
- Citizenship Off
- Type of credit Off
- Marital Status Off
- Housing Off
- Housing1 Off
- ownership Off
- DNA1 Off
- DNA2 Off
- DNA3 Off
- family Off
- BO Off
- Total
- Text31
- Text32
- Text33
- Text34
- Text35
- Text36
- Text37
- Text38
- Text39
- Text310
- Text311
- Text312
- Text313
- Text314
- Text315
- Text316
- Text317
- Text318
- Text319
- ownership1 Off
- Total1
- Total1-2
- Check Box4-1 Off
- Text320
- Text321
- Text322
- Text323
- Text324
- Text325
- Text326
- Text327
- Text328
- Text329
- Check Box4-2 Off
- Check Box4-3 Off
- Check Box4-4 Off
- Check Box4-8 Off
- Check Box4-9 Off
- Text330
- Text331
- Text332
- Text333
- Text334
- Text335
- Text1-1
- Text1-2
- Text1-3
- Text1-4
- Text1-5
- Text1-6
- Text1-7
- Text1-8
- Text1-9
- Text1-10
- Text1-11
- Text1-12
- Text1-13
- Text1-14
- Text1-15
- Text1-16
- Text1-17
- Text1-18
- Text1-19
- Text1-20
- Text1-21
- Text1-22
- Text1-23
- Text1-24
- Text1-25
- Text1-26
- Text1-27
- Text1-28
- Text1-29
- Text1-30
- Text1-31
- Text1-32
- Text1-33
- Text1-34
- Text1-35
- Check Box3-2 Off
- Check Box2-1 Off
- Check Box2-2 Off
- Check Box2-3 Off
- Check Box2-4 Off
- Check Box2-5 Off
- Text1-36
- Text1-37
- Text1-38
- Text1-39
- Text1-40
- Text1-41
- Text1-42
- Text1-43
- Text1-44
- Text1-45
- Text1-46
- Text1-47
- Text1-48
- Text1-49
- Text1-50
- Text1-51
- Text1-52
- Text1-53
- Text1-54
- Text1-55
- Text1-56
- Text1-57
- Text1-58
- Text1-59
- Text1-60
- Text1-61
- Check Box3-11 Off
- A1
- A2
- A3
- A4
- A5
- A6
- A7
- A8
- A9
- A10
- A11
- A12
- Check Box3-1 Off
- Check Box30-1 Off
- Check Box30-2 Off
- Check Box30-4 Off
- Check Box30-5 Off
- Check Box30-7 Off
- Check Box30-8 Off
- Check Box30-9 Off
- Check Box30-10 Off
- Check Box30-11 Off
- Check Box30-12 Off
- A13
- A14
- A15
- A16
- A17 Off
- A18
- A19
- A20
- A21
- A22
- A23
- A24
- A25
- A26
- A27
- A28
- A29
- A30
- A31
- A32
- A33
- A34
- A35
- A36
- A37
- A38 Off
- A39
- A40
- A41
- A42
- A43
- A44
- A45
- A46
- A47
- A48
- A49
- A50
- A51
- A52
- A53
- A54
- A55
- A56
- A57
- A58
- A59
- A60
- A61
- A62
- A63
- A64
- A65
- A66
- A67
- A68
- A69
- A70
- A71
- A72
- A73
- A74
- Loan Purpose Off
- occupancy1 Off
- lien type Off
- lientype Off
- mixed use Off
- manufactured home Off
- deposit1 Off
- deposit2 Off
- B1
- B2
- B3
- B4
- B5
- B6
- B7
- B8
- B9
- B10
- fha Off
- Check Box51 Off
- B11
- B12
- B13
- B14
- B15
- B16
- B17
- B18
- B19 Off
- B20
- B21
- B22 Off
- B23
- B24
- B25
- B26
- B27
- B28
- A
-
- Will you occupy the property as your primary residence Off
- Will you occupy the property as your primary residence1 Off
-
- If yes have you had an ownership interest in another property in the last three years Off
- Text9-2
- B
-
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property Off
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property1 Off
-
- 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 Off
- 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 application1 Off
-
- 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 Off
- 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 application1 Off
-
- new credit Off
- 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) Off
- the Property Assessed Clean Energy Program)1 Off
-
- F
-
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application Off
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application1 Off
-
- G
-
- Are there any outstanding judgments against you Off
- Are there any outstanding judgments against you1 Off
-
- H
-
- Are you currently delinquent or in default on a Federal debt Off
- Are you currently delinquent or in default on a Federal debt1 Off
-
- I
-
- Are you a party to a lawsuit in which you potentially have any personal financial liability Off
- Are you a party to a lawsuit in which you potentially have any personal financial liability1 Off
-
- J
-
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years Off
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years1 Off
-
- 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 Off
- 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 due1 Off
-
- L
-
- Have you had property foreclosed upon in the last 7 years Off
- Have you had property foreclosed upon in the last 7 years1 Off
-
- M
-
- Have you declared bankruptcy within the past 7 years Off
- Have you declared bankruptcy within the past 7 years1 Off
-
- Check Box8-2 Off
- Check Box8-3 Off
- Check Box8-4 Off
- Text9-3
- Text9-5
- Text9-6
- Text97
- military Off
- ethnicity Off
- sex Off
- race Off
- demo Off
- Text12-1
- Check Box11-1 Off
- Check Box11-2 Off
- Check Box11-3 Off
- Check Box11-4 Off
- Check Box11-5 Off
- Check Box11-6 Off
- Check Box11-7 Off
- Check Box11-8 Off
- Check Box11-9 Off
- Text12-2
- Check Box11-10 Off
- Check Box11-11 Off
- Check Box11-12 Off
- Check Box11-13 Off
- Check Box11-14 Off
- Check Box11-15 Off
- Text12-3
- Check Box11-16 Off
- Check Box11-17 Off
- Check Box11-18 Off
- Check Box11-19 Off
- Check Box11-20 Off
- Check Box11-21 Off
- Check Box11-22 Off
- Check Box11-23 Off
- Text12-4
- Check Box11-24 Off
- Check Box11-25 Off
- Check Box11-26 Off
- Check Box11-27 Off
- Check Box11-28 Off
- Check Box11-29 Off
- Text12-5
- Check Box11-30 Off
- Check Box11-31 Off
- citizen Off
- credit Off
- marital status1 Off
- housing-1 Off
- housing-2 Off
- own Off
- C1
- C2
- C3
- C6
- C7
- C8
- C9
- C10
- C11
- C12
- C13
- C14
- C15
- C16
- C17
- C18
- C19
- C20
- C21
- C22
- C23
- C24
- C25
- C26
- C27
- C28
- C29
- C30
- C31
- C32
- C33
- C34
- C35
- Check Box-2 Off
- C36
- C37
- C38
- C39
- C4
- C40
- C41
- C42
- C43
- C44
- C45
- C46
- C47
- Check Box-3 Off
- Check Box-4 Off
- C48
- C49
- C5
- C50
- C51
- C52
- C53
- C54
- C55
- Check Box-1-1 Off
- own1 Off
- Check Box-1 Off
- D1 Off
- D2
- D3
- D4
- D5
- D6
- D7
- D8
- D9
- D10
- D11
- D12
- D13
- D14 Off
- D15 Off
- D16
- D17
- D18
- D19
- D20
- D21
- D22
- D23
- D24 Off
- D25
- D26
- D27
- D28
- D29
- D30
- D31
- D32
- D33
- D34
- D35 Off
- D36
- D37 Off
- D38
- D39
- D40
- D41
- D42
- D43
- D44
- D45
- D46
- D47
- If yes have you had an ownership interest in another property in the last three years1 Off
- new credit1 Off
- Check Box8-1 Off
- Check Box8-1-2 Off
- Check Box8-1-1 Off
- Check Box8-1-3 Off
- Check Box8-1-4 Off
- Military Service mdash Did you (or your deceased spouse) ever serve or are you currently serving in the United States Armed Forces 1 Off
- Check1 Off
- Text9-1-1
- Check2 Off
- Check3 Off
- Check4 Off
- Text9-1
- E1
- E2
- E3
- Was the ethnicity of the Borrower collected on the basis of visual observation or surname1 Off
- Was the sex of the Borrower collected on the basis of visual observation or surname1 Off
- Was the race of the Borrower collected on the basis of visual observation or surname1 Off
- The Demographic Information was provided through1 Off
- F1 Off
- F2 Off
- F3 Off
- F4 Off
- F5 Off
- F6
- F7 Off
- F8 Off
- F9 Off
- F10 Off
- F11 Off
- F12 Off
- F13
- F14 Off
- F15 Off
- F16 Off
- F17 Off
- F18 Off
- F19 Off
- F20 Off
- F21 Off
- F22
- F23 Off
- F24 Off
- F25 Off
- F26 Off
- F27 Off
- F28 Off
- F29
- F30 Off
- F31 Off
- undefined_13-1
- undefined_13-2
- undefined_14-1
- undefined_15-1
- undefined_16-1
- undefined_17-1
- undefined_18-1
- undefined_19-1
- undefined_21-1
- undefined_20-1
- undefined_23-1
- undefined_13_1
- Single-Two Off
- Refi type Off
- refi program Off
- Estate Off
- Title held Off
- Trust Information Off
- Indian Country Land Tenure Off
- Mortgage Type Applied For Off
- Mortgage Lien Type Off
- Amortization Type Off
- G1 Off
- G2 Off
- G3 Off
- G4 Off
- G5 Off
- G6
- G7
- G8
- G9
- G10 Off
- G11 Off
- G12 Off
- G13 Off
- G14 Off
- G15 Off
- G16
- G17
- G18
- G19
- G20
- G21
- G22
- G23 Off
- G24
- G25 Off
- G26
- G27 Off
- G28 Off
- G29
- G30 Off
- G31
- G32 Off
- G33
- G34
- G35
- G36
- G37
- G38
- G39
- G40
- G41
- G42
- Property Held
- refi
- Text18-1
- Text18-2
- Text18-3
- Text18-4
- Text18-5
- Text18-6
- Text18-7
- Text18-8
- Text18-9
- Text18-10
- Text18-11
- Text18-12
- Text18-13
- Text18-14
- Text18-15
- Text18-16
- Text18-17
- Text18-18
- Text18-19
- Lender
- case no
- If you selected ldquoUnmarriedrdquo in Section 1 is there a person who is not your legal spouse but who currently has real property rights similar to those of a legal spouse Off
- Relationship and State Off
- Other-5
- Text19-1
- BName
- Additional Information
- ABN
- Additional Information1
- BSign
- BSDate
- ABSign
- ABDate
- MortageeNameAddress
- NAmeAddress
- Bname1
- DOB1
- DOB2
- SignOfBorr1
- SignOfBorr
- Date Signed
- SignOfBorr2
- SignOfBorr3
- Date Signed3
- Date Signed4
- MortgageeRepSign
- DirectSign
- DirectSign1
- Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union Off
- AppSign
- AppSign1
- AppSign2
- AppSign3
- Nopage38 Off
- Yespage38 Off
- Yes1 Off
- No1 Off
- Yes2 Off
- Yes3 Off
- Yes4 Off
- Yes5 Off
- Yes6 Off
- Yes7 Off
- Yes8 Off
- Yes9 Off
- Yes10 Off
- No2 Off
- No3 Off
- No4 Off
- No5 Off
- No6 Off
- No7 Off
- No8 Off
- No9 Off
- No10 Off
- BorrowerNo Off
- BorrowerYes Off
- AppSignature
- AppSignature1
- CurrentSign
- CurrentSign1
- InterviewSign
- Yes_1 Off
- No_1 Off
- Yes_2 Off
- No_2 Off
- Mail Off
- Phone Off
Borrower Name ____________________________ FHA Case No __________________
Caution Delinquencies Defaults Foreclosures and Abuses Delinquencies defaults foreclosures and abuses of mortgage loans involving programs of the Federal Government can be costly and detrimental to your credit now and in the future The Mortgagee in this transaction its agents and assigns as well as the Federal Government its agencies agents and assigns are authorized to take any and all of the following actions in the event loan payments become delinquent on the mortgage loan described in the attached application (1) Report your name and account information to a credit bureau (2) Assess additional interest and penalty charges for the period of time that payment is not made (3) Assess charges to cover additional administrative costs incurred by the Federal Government to service your account (4) Offset amounts owed to you
under other Federal programs (5) Refer your account to a private attorney collection agency or mortgage servicing agency to collect the amount due foreclose
the mortgage sell the property and seek judgment against you for any deficiency (6) Refer your account to the Department of Justice (DOJ) for litigation in the
courts (7) If you are a current or retired Federal employee take action to offset your salary or civil service retirement benefits (8) Refer your debt to the Internal
Revenue Service for offset against any amount owed to you as an income tax refund and (9) Report any resulting written off debt of yours to the Internal Revenue Service as your taxable income All of these actions may be used to recover any debts owed when it is determined to be in the interest of the Mortgagee or Federal Government or both
As a mortgage loan borrower you will be legally obligated to make the mortgage payments called for by your mortgage loan contract The fact that you dispose of your property after the loan has been made will not relieve you of liability for making these payments Payment of the loan in full is ordinarily the way liability on a mortgage note is ended Some home buyers have the mistaken impression that if they sell their homes when they move to another locality or dispose of it for any other reasons they are no longer liable for the mortgage payments and that liability for these payments is solely that of the new owners Even though the new owners may agree in writing to assume liability for your mortgage payments this assumption agreement will not relieve you from liability to the holder of the note which you signed when you obtained the loan to buy the property Unless you are able to sell the property to a buyer who is acceptable to HUDFHA who will assume the payment of your obligation to the lender you will not be relieved from liability to repay any claim which HUDFHA may be required to pay your lender on account of default in your loan payments The amount of any such claim payment may be a debt owed by you to the Federal Government and subject to established collection procedures
Fair Housing Act I and anyone acting on my behalf are and will remain in compliance with the Fair Housing Act 42 USC sect 3604 et seq with respect to the dwelling or property covered by the loan and in the provision of services or facilities in connection therewith I recognize that any restrictive covenant on this property related to race color religion sex disability familial status or national origin is unlawful under the Fair Housing Act and unenforceable I further recognize that in addition to administrative action by HUD a civil action may be brought by the DOJ in any appropriate US court against any person responsible for a violation of the
applicable law
Certification and Acknowledgment All information in this application is given for the purpose of obtaining a loan to be insured under the National Housing Act and the information in the Uniform Residential Loan Application and this Addendum is true and complete to the best of my knowledge and belief Verification may be obtained from any source named herein I have read and understand the foregoing concerning my liability on the loan and Part III Borrower Notices Information and Acknowledgment
Signature(s) of Borrower(s) - Do not sign unless this application is fully completed Read the certification carefully and review accuracy of this application
Signature(s) of Borrower(s) Date Signed Signature(s) of Co-Borrower(s) Date Signed
orm HUD-92900-A ( Page 2
___________________________________
______________________________________________________
______________________________________________________________
- - - - - - - - - - - - - - - - - - - - - - -
Borrower Name ____________________________ FHA Case No __________________
Part IV - Direct Endorsement Approval for a HUD FHA-Insured Mortgage A Underwriting the Borrower
Date Mortgage Approved ______________________________ Date Approval Expires ______________________
For mortgages rated as an ldquoacceptrdquo or ldquoapproverdquo by FHAs TOTAL Mortgage Scorecard
The information submitted to TOTAL was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA4e Final Underwriting Decision (TOTAL) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee Representative Signature
Printed Name
Title
OR
For mortgages rated as a ldquoreferrdquo by FHAs TOTAL Mortgage Scorecard or manually underwritten by a Direct Endorsement underwriter I have personally reviewed and underwritten the borrowerrsquos credit application The information used to underwrite the borrower was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA5d Final Underwriting Decision (Manual) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
B Underwriting the Property
For all mortgages where FHA requires an appraisal I have personally reviewed and underwritten the appraisal according to FHA requirements I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
orm HUD-92900-A ( ) Page 3
Borrower Name ____________________________ FHA Case No __________________
Part V Mortgagees Certification
I have personally reviewed the mortgage documents and the application for insurance endorsement and This mortgage complies with SF Handbook 40001 Section IIA7 Post-Closing and Endorsement to the extent that no defect exists that would have changed the decision to endorse or submit the mortgage for insurance
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee
Name of Mortgageersquos Representative
Title of Mortgageersquos Representative
Signature of the Mortgageersquos Representative Date
orm HUD-92900-A ( ) Page 4
GENERAL AUTHORIZATION FOR A MORTGAGE LOAN ASSUMPTION
Applicant name(s)
Loan number
NOTICES AND DISCLOSURES
Non-discriminatory underwriting guidelines Anyone who inquires about the availability of credit from us has the right to receive a copy of our non-discriminatory underwriting guidelines To request a copy of these guidelines contact your Loan Processor
Attorney note Itrsquos the responsibility of our attorneys to protect our interest You may at your expense request an attorney to represent your interest
Notice to HUDFHA applicants As required by the Right to Financial Privacy Act of 1978 this notice is to inform you that the US Department of Housing and Urban Development (HUD)Federal Housing Administration (FHA) has a right of access to financial records held by financial institutions related to a request for assistance Financial records involving your assumption will be available to HUDFHA without further notice or authorization but wonrsquot be disclosed or released by us to another government agency or department without your consent except as required or permitted by law
Borrower consent to the use of tax return information I understand acknowledge and agree that the Lender and Other Loan Participants can obtain use and share tax return information for purposes of (i) providing an offer (ii) originating maintaining managing monitoring servicing selling insuring and securitizing a loan (iii) marketing or (iv) as otherwise permitted by applicable laws including state and federal privacy and data security laws The Lender includes the Lenderrsquos affiliates agents service providers and any of aforementioned partiesrsquo successors and assigns The Other Loan Participants includes any actual or potential owners of a loan resulting from your loan application or acquirers of any beneficial or other interest in the loan and mortgage insurer guarantor any servicers or service providers for these parties and any of aforementioned partiesrsquo successors and assigns
CERTIFICATION AND AUTHORIZATION
Environmental certification By signing below I represent and warrant that Irsquom not aware of any substances materials or products that may be an environmental hazard such as but not limited to asbestos formaldehyde radon gas lead-based paint fuel or chemical storage tanks (above or below ground) and contaminated soil or water on the property I acknowledge that Chase is relying on this representation and warranty as a material part of its loan application process I also am not aware of any landfill on any portion of the property
Exceptions to the above I further acknowledge (1) receipt of applicable disclosures from the seller in purchase transactions (2) that lead-based paint may exist in housing constructed prior to 1978 (3) that Chase performs no environmental investigation on my behalf and isnrsquot responsible for identifying lead-based paint or any other environmental conditions that might impact the property or its residents and (4) that it is my sole obligation to investigate for potential impact to the property from environmental conditions
Certifications I certify by signing below that (1) all of the loan application information provided is true and complete (2) I understand any intentional or negligent misrepresentation(s) of the information provided in conjunction with my application may result in civil liability andor 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 Chase its agents successors and assigns insurers and any other person who may suffer any loss due to reliance upon any misrepresentation that I have made on the application and (3) any significant change from the information provided at the time of application until the final loan application is signed may have a bearing on the approval of my application for a home loan
Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union
This question is asked because of state laws that extend the same or similar rights benefits and protections of spouses in a marriage to persons who are members of a partnership or union recognized under state law You should consult with your own legal advisor for advice regarding the rights protections benefits responsibilities obligations and duties of those who are registered domestic partners civil union partners or members of other unions recognized under applicable law
CREDIT AUTHORIZATION RELEASE
By signing below I authorize Chase andor my mortgage insurer (if any) to verify my past and present employment earnings records (including information contained in income tax returns that have been filed with the IRS) bank accounts stock holdings and any other information that it finds necessary to process my mortgage loan application or to review it for quality-control purposes I understand that a credit report will be ordered from a credit reporting agency for verification prior to loan closing as part of the application process and may be ordered after closing as part of the Lenderrsquos quality-control program A credit report may also be completed as part of the Lenderrsquos servicing or collection of the loan or in consideration of any other product or service that the Lender may consider offering me in the future and at any time throughout the life of the loan I understand that use of a photocopy of this form may be necessary to verify one or more of my credit references I understand that a photocopy or fax copy of this form will also serve as authorization
By signing below each applicant acknowledges (1) making the above certifications and authorizations and (2) that each applicant has received and understands the above notices and disclosures
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
You do not have to give us this information but if you donrsquot your application for approval as a borrower may be delayed or rejected The information requested in this form is authorized by Title 38 USC Chapter 37 (if VA) by 12 USC Section 1701 et seq (if HUDFHA) by 42 USC Section 1452b (if HUDCPD) and Title 42 USC 1471 et seq or 7 USC 1921 et seq (if USDA FHA)
Updated December 2021 99177-GA-0215
1b
2b
Form 4506-C (September 2020)
Department of the Treasury - Internal Revenue Service
IVES Request for Transcript of Tax Return OMB Number
1545-1872
Do not sign this form unless all applicable lines have been completed Request may be rejected if the form is incomplete or illegible
For more information about Form 4506-C visit wwwirsgov and search IVES
1a Name shown on tax return (if a joint return enter the name shown first)
First social security number on tax return individual taxpayer identification number or employer identification number (see instructions)
2a If a joint return enter spousersquos name shown on tax return Second social security number or individual taxpayer identification number if joint tax return
3 Current name address (including apt room or suite no) city state and ZIP code (see instructions)
4 Previous address shown on the last return filed if different from line 3 (see instructions)
5a IVES participant name address and SOR mailbox ID
DataVerify 875 Greentree Rd 8 Parkway Center Pittsburgh PA 15220
5b Customer file number (if applicable) (see instructions)
Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing (see instructions)
6 Transcript requested Enter the tax form number here (1040 1065 1120 etc) and check the appropriate box below Enter only one tax form number per request 1040
a Return Transcript which includes most of the line items of a tax return as filed with the IRS A tax return transcript does not reflect changes made to the account after the return is processed Transcripts are only available for the following returns Form 1040 series Form 1065 Form 1120 Form 1120-A Form 1120-H Form 1120-L and Form 1120S Return transcripts are available for the current year and returns processed during the prior 3 processing years
b Account Transcript which contains information on the financial status of the account such as payments made on the account penalty assessments and adjustments made by you or the IRS after the return was filed Return information is limited to items such as tax liability and estimated tax payments Account transcripts are available for most returns
c Record of Account which provides the most detailed information as it is a combination of the Return Transcript and the Account Transcript Available for current year and 3 prior tax years
7 Form W-2 Form 1099 series Form 1098 series or Form 5498 series transcript The IRS can provide a transcript that includes data from these information returns State or local information is not included with the Form W-2 information The IRS may be able to provide this transcript information for up to 10 years Information for the current year is generally not available until the year after it is filed with the IRS For example W-2 information for 2016 filed in 2017 will likely not be available from the IRS until 2018 If you need W-2 information for retirement purposes you should contact the Social Security Administration at 1-800-772-1213
Caution If you need a copy of Form W-2 or Form 1099 you should first contact the payer To get a copy of the Form W-2 or Form 1099 filed with your return you must use Form 4506 and request a copy of your return which includes all attachments
8 Year or period requested Enter the ending date of the tax year or period using the mmddyyyy format (see instructions)
12 31 2020 12 31 2019 12 31 2018 Caution Do not sign this form unless all applicable lines have been completed
Signature of taxpayer(s) I declare that I am either the taxpayer whose name is shown on line 1a or 2a or a person authorized to obtain the tax information requested If the request applies to a joint return at least one spouse must sign If signed by a corporate officer 1 percent or more shareholder partner managing member guardian tax matters partner executor receiver administrator trustee or party other than the taxpayer I certify that I have the authority to execute Form 4506-C on behalf of the taxpayer Note This form must be received by IRS within 120 days of the signature date
Signatory attests that heshe has read the attestation clause and upon so reading declares that heshe has the authority to sign the Form 4506-C See instructions
Sign Here
Signature (see instructions) Date Phone number of taxpayer on line 1a or 2a
PrintType name
Title (if line 1a above is a corporation partnership estate or trust)
Spousersquos signature Date
PrintType name
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020) For Privacy Act and Paperwork Reduction Act Notice see page 2
Instructions for Form 4506-C IVES Request for Transcript of Tax Return
Section references are to the Internal Revenue Code unless otherwise noted
Future Developments
For the latest information about Form 4506-C and its instructions go to wwwirsgov and search IVES Information about any recent developments affecting Form 4506-C (such as legislation enacted after we released it) will be posted on that page
Whats New Form 4506-C was created to be utilized by authorized IVES participants to order tax transcripts with the consent of the taxpayer
General Instructions
Caution Do not sign this form unless all applicable lines have been completed
Designated Recipient Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information received pursuant to the taxpayerrsquos consent and holds the recipient subject to penalties for any unauthorized access other use or redisclosure without the taxpayerrsquos express permission or request
Taxpayer Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information provided pursuant to your consent and holds the recipient subject to penalties brought by private right of action for any unauthorized access other use or redisclosure without your express permission or request
Purpose of form Use Form 4506-C to request tax return information through an authorized IVES participant You will designate an IVES participant to receive the information on line 5a
Note If you are unsure of which type of transcript you need check with the party requesting your tax information
Where to file The IVES participant will fax Form 4506-C with the approved IVES cover sheet to their assigned Service Center
Chart for ordering transcripts
If your assigned Service Center is
Fax the requests with the approved coversheet to
Austin Submission Processing Center
Austin IVES Team
844-249-6238
Fresno Submission Processing Center
Fresno IVES Team
844-249-6239
Kansas City Submission Processing Center
Kansas City IVES Team
844-249-8128
Ogden Submission Processing Center
Ogden IVES Team
844-249-8129
Specific Instructions
Line 1b Enter the social security number (SSN) or individual taxpayer identification number (ITIN) for the individual listed on line 1a or enter the employer identification number (EIN) for the business listed on line 1a
Line 3 Enter your current address If you use a PO box include it on this line
Line 4 Enter the address shown on the last return filed if different from the address entered on line 3
Note If the addresses on lines 3 and 4 are different and you have not changed your address with the IRS file Form 8822 Change of Address or Form 8822-BChange of Address or Responsible Party mdash Business with Form 4506-C
Line 5b Enter up to 10 numeric characters to create a unique customer file number that will appear on the transcript The customer file number cannot contain an SSN ITIN or EIN Completion of this line is not required
Note If you use an SSN name or combination of both we will not input the information and the customer file number will reflect a generic entry of 9999999999 on the transcript
Line 8 Enter the end date of the tax year or period requested in mmddyyyy format This may be a calendar year fiscal year or quarter Enter each quarter requested for quarterly returns Example Enter 12312018 for a calendar year 2018 Form 1040 transcript
Signature and date Form 4506-C must be signed and dated by the taxpayer listed on line 1a or 2a The IRS must receive Form 4506-C within 120 days of the date signed by the taxpayer or it will be rejected Ensure that all applicable lines including lines 5a through 8 are completed before signing
You must check the box in the signature area to acknowledge you have the authority to sign and request the information The form will not be processed if unchecked
Individuals Transcripts listed on on line 6 may be furnished to either spouse if jointly filed Only one signature is required Sign Form 4506-C exactly as your name appeared on the original return If you changed your name also sign your current name
Corporations Generally Form 4506-C can be signed by
(1) an officer having legal authority to bind the corporation (2) any person designated by the board of directors or other governing body or (3) any officer or employee on written request by any principal officer and attested to by the secretary or other officer A bona fide shareholder of record owning 1 percent or more of the outstanding stock of the corporation may submit a Form 4506-C but must provide documentation to support the requesters right to receive the information
Partnerships Generally Form 4506-C can be signed by any person who was a member of the partnership during any part of the tax period requested on line 8
All others See section 6103(e) if the taxpayer has died is insolvent is a dissolved corporation or if a trustee guardian executor receiver or administrator is acting for the taxpayer
Note If you are Heir at law Next of kin or Beneficiary you must be able to establish a material interest in the estate or trust
Documentation For entities other than individuals you must attach the authorization document For example this could be the letter from the principal officer authorizing an employee of the corporation or the letters testamentary authorizing an individual to act for an estate
Signature by a representative A representative can sign Form 4506-C for a taxpayer only if the taxpayer has specifically delegated this authority to the representative on Form 2848 line 5 The representative must attach Form 2848 showing the delegation to sign Form 4506-C
Privacy Act and Paperwork Reduction Act Notice We ask for the information on this form to establish your right to gain access to the requested tax information under the Internal Revenue Code We need this information to properly identify the tax information and respond to your request You are not required to request any transcript if you do request a transcript sections 6103 and 6109 and their regulations require you to provide this information including your SSN or EIN If you do not provide this information we may not be able to process your request Providing false or fraudulent information may subject you to penalties
Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and cities states the District of Columbia and US commonwealths and possessions for use in administering their tax laws We may also disclose this information to other countries under a tax treaty to federal and state agencies to enforce federal nontax criminal laws or to federal law enforcement and intelligence agencies to combat terrorism
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law Generally tax returns and return information are confidential as required by section 6103
The time needed to complete and file Form 4506-C will vary depending on individual circumstances The estimated average time is
Learning about the law or the form 10 min Preparing the form 12 min Copying assembling and sending the form to the IRS 20 min
If you have comments concerning the accuracy of these time estimates or suggestions for making Form 4506-C simpler we would be happy to hear from you You can write to
Internal Revenue Service Tax Forms and Publications Division 1111 Constitution Ave NW IR-6526 Washington DC 20224
Do not send the form to this address Instead see Where to file on this page
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020)
Rev April 2021 CHASEO Facts What does Chase do with your personal information
Why Financial companies choose how they share your personal information Federal law gives consumers the right to limit some but not all sharing Federal law also requires us to tell you how we collect share and protect your personal information Please read this notice carefully to understand what we do
What The types of personal information we collect and share depend on the product or service you have with us This information can include bull Social Security number and income bull account balances and transaction history bull credit history and payment history
How All financial companies need to share customers personal information to run their everyday business In the section below we list the reasons financial companies can share their customers personal information the reasons Chase chooses to share and whether you can limit this sharing
Reasons we can share your personal information Does Chase share
Can you limit this sharing
For our everyday business purposes - such as to process your transactions maintain your account(s) respond to court orders and legal investigations or report to credit bureaus
Yes No
For our marketing purposes - to offer our products and services to you
Yes No
For joint marketing with other financial companies Yes No
For our affiliates everyday business purposes - information about your transactions and experiences
Yes No
For our affiliates everyday business purposes - information about your creditworthiness
Yes Yes
For our affiliates to market to you Yes Yes
For nonaffiliates to market to you Yes Yes
a
0
To limit our sharing
bull Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
bull Visit us online chasecomprivacypreferences
Please note If you are a new customer we can begin sharing your information 30 days from the date we sent this notice When you are no longer our customer we continue to share your information as described in this notice However you can contact us at any time to limit our sharing
Questions
Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
PAGE 2
Who we are
Who is providing this notice The US consumer financial companies within the JPMorgan Chase amp Co family including JPMorgan Chase Bank NA Chase Insurance Agency Inc and JP Morgan Securities LLC
What we do
How does Chase protect my To protect your personal information from unauthorized access and use we personal information use security measures that comply with federal law These measures include
computer safeguards and secured files and buildings We authorize our employees to get your information only when they need it to do their work and we require companies that work for us to protect your information
How does Chase collect my We collect your personal information for example when you personal information bull open an account or make deposits or withdrawals from your account
bull pay your bills or apply for a loan bull use your credit or debit card We also collect your personal information from others such as credit bureaus affiliates or other companies
Why cant I limit all sharing Federal law gives you the right to limit only bull sharing for affiliates everyday business purposes - information about your
creditworthiness bull affiliates from using your information to market to you bull sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing See below for more on your rights under state law
What happens when I limit sharing for an account I hold jointly with someone else
Your choices will apply to everyone on your account
Definitions
Affiliates Companies related by common ownership or control They can be financial and non financial companies bull Our affiliates include companies with a Chase or JP Morgan name and financial companies such asjP Morgan Securities LLC
Nonaffiliates Companies not related by common ownership or control They can be financial and non financial companies bull Nonaffiliates we share with can include companies such as retailers auto dealers auto makers and membership clubs
Joint marketing A formal agreement between nonaffiliated financial companies that together market financial products or services to you bull Our joint marketing partners include categories of companies such as insurance companies
Other important information
VT Accounts with a Vermont mailing address are automatically treated as if they have limited the sharing as described on page 1 For joint marketing we will only disclose your name contact information and information about your transactions
NV We are providing you this notice pursuant to Nevada law If you prefer not to receive marketing calls from us you may be placed on our Internal Do Not Call List by calling 1-800-945-9470 or by writing to us at PO Box 734007 Dallas TX 75373-4007
For more information contact us at the address above or email PrivacylnfoJPMChasecom with Nevada Annual Notice in the subject line You may also contact the Nevada Attorney Generals office Bureau of Consumer Protection Office of the Nevada Attorney General 555 E Washington St Suite 3900 Las Vegas NV 89101 telephone number 1-702-486-3132 email BCPINFOagstatenvus
CA Accounts with a California mailing address are automatically treated as if they have limited the sharing with nonaffiliates as described on page 1 CA residents are provided a CA notice for additional choices
CHASE O
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
The following disclosure is required by the USA PATRIOT Act
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 opens an account
What this means to you When you 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 drivers
license or other identifying documents
99177-PAT-0215
VETERAN STATEMENT When this loan was opened the US Department of Veterans Affairs (VA) used the veteran borrowerrsquos entitlement which is a set amount the VA promises to repay a lender if the borrower defaults on the mortgage An assumption will modify who is obligated to pay the existing mortgage loan but all loan termsmdashincluding the entitlementmdashwill remain the same If the veteran borrower is being removed from the loan the entitlement would remain with whoever is assuming the loan because the loan will continue to be serviced by the VA If the applicant is also a veteran and can substitute his or her entitlement for the current entitlement then the current borrowerrsquos entitlement can be released
Please review the following questions and answer as appropriate This form requires completion by both the applicant(s) and current borrower(s)
1 Applicant to Complete
Are you (the applicant) currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the reverse side)
Yes (If yes please provide the information requested below answer the question in section 3 and sign and date this form at the bottom of the reverse side)
Name of applicant(s) who answered ldquoyesrdquo to the above question
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Are you receiving VA disability benefts
Applicant
Yes
No
Co-Applicant
Yes
No
Are you entitled to receive VA disability benefts Yes No Yes No
Have you received VA disability benefts in the past Yes No Yes No
Are you a surviving spouse of a veteran who died on active duty or as the result of a service-related disability
Yes No Yes No
Do you have any VA loans Yes No Yes No
2 Current Borrower to Complete
Is the current borrowerco-borrower currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the page)
Yes (If yes please answer the question in section 3 and sign and date this form at the bottom of the page)
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
________________________________________________________________________________________________
3 Applicant and Current Borrower to Complete
If the answer to the questions in section 1 and 2 are both yes please answer the following question After yoursquove reviewed and completed this entire form please sign and date at the bottom
Applicant Current Borrower
Do you want to apply for a substitution of entitlement Yes Yes No No
In order to complete a substitution of entitlement the veteran applicant must have suffcient entitlement to substitute for that of the current borrower Contact the VA Offce of Jurisdiction for your area for more information Also before the veteran applicant can substitute entitlement on a VA loan heshe must certify that the property securing the loan will be occupied as hisher primary residence Both the applicantrsquos and current borrowerrsquos original certifcate of eligibility will be required If your sales contract is contingent upon the restoration of entitlement please contact your VA Offce of Jurisdiction for complete procedures Otherwise the substitution will be completed after the loan has been approved and closed
Date Applicant printed name Applicant signature
Date Applicant printed name Applicant signature
Date Current Borrower printed name Current Borrower signature
Date Current Borrower printed name Current Borrower signature
Forms completed by Mail Phone
For Chase use only
Interviewer signature Date
99177-VS-0215
- Assumption Application Package_41521-noscannedpages-update-4pdf
-
- 1 FM203 Cover Pagepdf
- 2 FM202 Mortgage Assumption Application Package pagepdf
- 3 The Documents Youll need to Send Uspdf
- 4 FM201 FAQpdf
- 5 FM142 CIWpdf
- 6 FM126 URLApdf
- 7 FM130 URLA Instpdf
-
- Blank Page
-
- 8 92900a Addednum to Loan Applicationpdf
- 9 FM462 Gen Authpdf
- 10 FM220 4506-Cpdf
- 11 FM153 Chase Federal Privacy Noticepdf
- 12 FM144 Info on Opening a New Accountpdf
- 13 FM152 Veteran Statementpdf
-
- Date
- Loan number
- Applicant name
- Phone1
- Loan number 1
- Loan number 2
- Other
- Other_2
- 1
- 2
- undefined_7
- Available hours
- Available hours_2
- undefined_8
- Available hours_3
- undefined_9
- Current address 1
- Neither
- Available hours_4
- Available hours_5
- undefined_10
- Available hours_6
- 1_2
- 2_2
- undefined_11
- Available hours_7
- Available hours_8
- undefined_12
- Available hours_9
- FHA Case No include any suffix
- Mortgagee Case No
- Mortgagee ID
- Sponsor ID
- Agent ID
- Name and Address of Sponsor Name and Address of Agent
- Borrowers Name Present Address include ZIP Code Property Address
- include name of subdivision lot block no ZIP Code
- Name of ThirdParty Originator
- NMLS ID of ThirdParty Originator
- s application
- ty Number
- ty Number_2
- Date Signed_2
- Date Mortgage Approved
- Date Approval Expires
- Printed Name
- Title 1
- DEs ID Number
- DEs ID Number_2
- Mortgagee
- Name of Mortgagees Representative
- Title of Mortgagees Representative
- Signature of the Mortgagees Representative
- Date_2
- Applicant names 1
- Applicant names 2
- Applicant names 3
- Loan number_2
- Date_3
- Applicant printed name
- Social Security number
- Date_4
- Applicant printed name_2
- Social Security number_2
- Date_5
- Applicant printed name_3
- Social Security number_3
- Date_6
- Applicant printed name_4
- Social Security number_4
- 1a Name shown on tax return if a joint return enter the name shown first
- 1b First social security number on tax return individual taxpayer identification number or employer identification number see instructions
- 2a If a joint return enter spouses name shown on tax return
- 2b Second social security number or individual taxpayer identification number if joint tax return
- 4 Previous address shown on the last return filed if different from line 3 see instructions
- 5a IVES participant name address and SOR mailbox ID
- Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing see instructions
- Signature see instructions
- Date_7
- Phone number of taxpayer on line 1a or 2a
- PrintType name
- Here
- Spouses signature
- Date_8
- PrintType name_2
- Name
- Date of birth
- Service number
- Name_2
- Date of birth_2
- Service number_2
- Date_9
- Applicant printed name_5
- Date_10
- Applicant printed name_6
- Date_11
- Current Borrower printed name
- Date_12
- Current Borrower printed name_2
- Date_13
- Text3
- Text10
- undefined_13
- Text15
- undefined_14
- undefined_15
- undefined_16
- undefined_17
- undefined_18
- undefined_19
- undefined_20
- undefined_21
- undefined_23
- Reason for assumption Off
- Requestors relationship to owners Off
- Check one Off
- Check one1 Off
- Day1
- Evening
- Cell phone
- Check one2 Off
- Check one3 Off
- Check one4 Off
- Check one5 Off
- Text2-1
- Text2-2
- Text2-3
- Text2-4
- Text2-5
- Text2-6
- Text3-1
- Text3-2
- Text3-3
- Text3-4
- Text3-6
- Text3-7
- Text3-8
- Text3-9
- Text3-10
- Text3-11
- Text3-12
- Text3-13
- Text3-14
- Text3-15
- Text3-16
- Text3-17
- Text3-18
- Text3-19
- Text3-20
- Text3-21
- Text3-22
- Text3-23
- Text3-24
- Text3-25
- Text3-26
- Text3-27
- Text3-28
- Text3-29
- Text3-30
- Text3-31
- Text3-32
- Text3-33
- Text3-34
- Text3-35
- Text3-36
- Text3-37
- Text3-38
- Text3-39
- Text3-40
- Text3-41
- Text3-42
- Text3-43
- Text3-44
- Text3-45
- Text3-46
- Text3-47
- Text3-48
- Text3-49
- Text3-50
- Text3-51
- Text3-52
- Text3-53
- Text3-5
- Text3-54
- Text3-55
- Text3-56
- Citizenship Off
- Type of credit Off
- Marital Status Off
- Housing Off
- Housing1 Off
- ownership Off
- DNA1 Off
- DNA2 Off
- DNA3 Off
- family Off
- BO Off
- Total
- Text31
- Text32
- Text33
- Text34
- Text35
- Text36
- Text37
- Text38
- Text39
- Text310
- Text311
- Text312
- Text313
- Text314
- Text315
- Text316
- Text317
- Text318
- Text319
- ownership1 Off
- Total1
- Total1-2
- Check Box4-1 Off
- Text320
- Text321
- Text322
- Text323
- Text324
- Text325
- Text326
- Text327
- Text328
- Text329
- Check Box4-2 Off
- Check Box4-3 Off
- Check Box4-4 Off
- Check Box4-8 Off
- Check Box4-9 Off
- Text330
- Text331
- Text332
- Text333
- Text334
- Text335
- Text1-1
- Text1-2
- Text1-3
- Text1-4
- Text1-5
- Text1-6
- Text1-7
- Text1-8
- Text1-9
- Text1-10
- Text1-11
- Text1-12
- Text1-13
- Text1-14
- Text1-15
- Text1-16
- Text1-17
- Text1-18
- Text1-19
- Text1-20
- Text1-21
- Text1-22
- Text1-23
- Text1-24
- Text1-25
- Text1-26
- Text1-27
- Text1-28
- Text1-29
- Text1-30
- Text1-31
- Text1-32
- Text1-33
- Text1-34
- Text1-35
- Check Box3-2 Off
- Check Box2-1 Off
- Check Box2-2 Off
- Check Box2-3 Off
- Check Box2-4 Off
- Check Box2-5 Off
- Text1-36
- Text1-37
- Text1-38
- Text1-39
- Text1-40
- Text1-41
- Text1-42
- Text1-43
- Text1-44
- Text1-45
- Text1-46
- Text1-47
- Text1-48
- Text1-49
- Text1-50
- Text1-51
- Text1-52
- Text1-53
- Text1-54
- Text1-55
- Text1-56
- Text1-57
- Text1-58
- Text1-59
- Text1-60
- Text1-61
- Check Box3-11 Off
- A1
- A2
- A3
- A4
- A5
- A6
- A7
- A8
- A9
- A10
- A11
- A12
- Check Box3-1 Off
- Check Box30-1 Off
- Check Box30-2 Off
- Check Box30-4 Off
- Check Box30-5 Off
- Check Box30-7 Off
- Check Box30-8 Off
- Check Box30-9 Off
- Check Box30-10 Off
- Check Box30-11 Off
- Check Box30-12 Off
- A13
- A14
- A15
- A16
- A17 Off
- A18
- A19
- A20
- A21
- A22
- A23
- A24
- A25
- A26
- A27
- A28
- A29
- A30
- A31
- A32
- A33
- A34
- A35
- A36
- A37
- A38 Off
- A39
- A40
- A41
- A42
- A43
- A44
- A45
- A46
- A47
- A48
- A49
- A50
- A51
- A52
- A53
- A54
- A55
- A56
- A57
- A58
- A59
- A60
- A61
- A62
- A63
- A64
- A65
- A66
- A67
- A68
- A69
- A70
- A71
- A72
- A73
- A74
- Loan Purpose Off
- occupancy1 Off
- lien type Off
- lientype Off
- mixed use Off
- manufactured home Off
- deposit1 Off
- deposit2 Off
- B1
- B2
- B3
- B4
- B5
- B6
- B7
- B8
- B9
- B10
- fha Off
- Check Box51 Off
- B11
- B12
- B13
- B14
- B15
- B16
- B17
- B18
- B19 Off
- B20
- B21
- B22 Off
- B23
- B24
- B25
- B26
- B27
- B28
- A
-
- Will you occupy the property as your primary residence Off
- Will you occupy the property as your primary residence1 Off
-
- If yes have you had an ownership interest in another property in the last three years Off
- Text9-2
- B
-
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property Off
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property1 Off
-
- 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 Off
- 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 application1 Off
-
- 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 Off
- 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 application1 Off
-
- new credit Off
- 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) Off
- the Property Assessed Clean Energy Program)1 Off
-
- F
-
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application Off
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application1 Off
-
- G
-
- Are there any outstanding judgments against you Off
- Are there any outstanding judgments against you1 Off
-
- H
-
- Are you currently delinquent or in default on a Federal debt Off
- Are you currently delinquent or in default on a Federal debt1 Off
-
- I
-
- Are you a party to a lawsuit in which you potentially have any personal financial liability Off
- Are you a party to a lawsuit in which you potentially have any personal financial liability1 Off
-
- J
-
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years Off
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years1 Off
-
- 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 Off
- 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 due1 Off
-
- L
-
- Have you had property foreclosed upon in the last 7 years Off
- Have you had property foreclosed upon in the last 7 years1 Off
-
- M
-
- Have you declared bankruptcy within the past 7 years Off
- Have you declared bankruptcy within the past 7 years1 Off
-
- Check Box8-2 Off
- Check Box8-3 Off
- Check Box8-4 Off
- Text9-3
- Text9-5
- Text9-6
- Text97
- military Off
- ethnicity Off
- sex Off
- race Off
- demo Off
- Text12-1
- Check Box11-1 Off
- Check Box11-2 Off
- Check Box11-3 Off
- Check Box11-4 Off
- Check Box11-5 Off
- Check Box11-6 Off
- Check Box11-7 Off
- Check Box11-8 Off
- Check Box11-9 Off
- Text12-2
- Check Box11-10 Off
- Check Box11-11 Off
- Check Box11-12 Off
- Check Box11-13 Off
- Check Box11-14 Off
- Check Box11-15 Off
- Text12-3
- Check Box11-16 Off
- Check Box11-17 Off
- Check Box11-18 Off
- Check Box11-19 Off
- Check Box11-20 Off
- Check Box11-21 Off
- Check Box11-22 Off
- Check Box11-23 Off
- Text12-4
- Check Box11-24 Off
- Check Box11-25 Off
- Check Box11-26 Off
- Check Box11-27 Off
- Check Box11-28 Off
- Check Box11-29 Off
- Text12-5
- Check Box11-30 Off
- Check Box11-31 Off
- citizen Off
- credit Off
- marital status1 Off
- housing-1 Off
- housing-2 Off
- own Off
- C1
- C2
- C3
- C6
- C7
- C8
- C9
- C10
- C11
- C12
- C13
- C14
- C15
- C16
- C17
- C18
- C19
- C20
- C21
- C22
- C23
- C24
- C25
- C26
- C27
- C28
- C29
- C30
- C31
- C32
- C33
- C34
- C35
- Check Box-2 Off
- C36
- C37
- C38
- C39
- C4
- C40
- C41
- C42
- C43
- C44
- C45
- C46
- C47
- Check Box-3 Off
- Check Box-4 Off
- C48
- C49
- C5
- C50
- C51
- C52
- C53
- C54
- C55
- Check Box-1-1 Off
- own1 Off
- Check Box-1 Off
- D1 Off
- D2
- D3
- D4
- D5
- D6
- D7
- D8
- D9
- D10
- D11
- D12
- D13
- D14 Off
- D15 Off
- D16
- D17
- D18
- D19
- D20
- D21
- D22
- D23
- D24 Off
- D25
- D26
- D27
- D28
- D29
- D30
- D31
- D32
- D33
- D34
- D35 Off
- D36
- D37 Off
- D38
- D39
- D40
- D41
- D42
- D43
- D44
- D45
- D46
- D47
- If yes have you had an ownership interest in another property in the last three years1 Off
- new credit1 Off
- Check Box8-1 Off
- Check Box8-1-2 Off
- Check Box8-1-1 Off
- Check Box8-1-3 Off
- Check Box8-1-4 Off
- Military Service mdash Did you (or your deceased spouse) ever serve or are you currently serving in the United States Armed Forces 1 Off
- Check1 Off
- Text9-1-1
- Check2 Off
- Check3 Off
- Check4 Off
- Text9-1
- E1
- E2
- E3
- Was the ethnicity of the Borrower collected on the basis of visual observation or surname1 Off
- Was the sex of the Borrower collected on the basis of visual observation or surname1 Off
- Was the race of the Borrower collected on the basis of visual observation or surname1 Off
- The Demographic Information was provided through1 Off
- F1 Off
- F2 Off
- F3 Off
- F4 Off
- F5 Off
- F6
- F7 Off
- F8 Off
- F9 Off
- F10 Off
- F11 Off
- F12 Off
- F13
- F14 Off
- F15 Off
- F16 Off
- F17 Off
- F18 Off
- F19 Off
- F20 Off
- F21 Off
- F22
- F23 Off
- F24 Off
- F25 Off
- F26 Off
- F27 Off
- F28 Off
- F29
- F30 Off
- F31 Off
- undefined_13-1
- undefined_13-2
- undefined_14-1
- undefined_15-1
- undefined_16-1
- undefined_17-1
- undefined_18-1
- undefined_19-1
- undefined_21-1
- undefined_20-1
- undefined_23-1
- undefined_13_1
- Single-Two Off
- Refi type Off
- refi program Off
- Estate Off
- Title held Off
- Trust Information Off
- Indian Country Land Tenure Off
- Mortgage Type Applied For Off
- Mortgage Lien Type Off
- Amortization Type Off
- G1 Off
- G2 Off
- G3 Off
- G4 Off
- G5 Off
- G6
- G7
- G8
- G9
- G10 Off
- G11 Off
- G12 Off
- G13 Off
- G14 Off
- G15 Off
- G16
- G17
- G18
- G19
- G20
- G21
- G22
- G23 Off
- G24
- G25 Off
- G26
- G27 Off
- G28 Off
- G29
- G30 Off
- G31
- G32 Off
- G33
- G34
- G35
- G36
- G37
- G38
- G39
- G40
- G41
- G42
- Property Held
- refi
- Text18-1
- Text18-2
- Text18-3
- Text18-4
- Text18-5
- Text18-6
- Text18-7
- Text18-8
- Text18-9
- Text18-10
- Text18-11
- Text18-12
- Text18-13
- Text18-14
- Text18-15
- Text18-16
- Text18-17
- Text18-18
- Text18-19
- Lender
- case no
- If you selected ldquoUnmarriedrdquo in Section 1 is there a person who is not your legal spouse but who currently has real property rights similar to those of a legal spouse Off
- Relationship and State Off
- Other-5
- Text19-1
- BName
- Additional Information
- ABN
- Additional Information1
- BSign
- BSDate
- ABSign
- ABDate
- MortageeNameAddress
- NAmeAddress
- Bname1
- DOB1
- DOB2
- SignOfBorr1
- SignOfBorr
- Date Signed
- SignOfBorr2
- SignOfBorr3
- Date Signed3
- Date Signed4
- MortgageeRepSign
- DirectSign
- DirectSign1
- Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union Off
- AppSign
- AppSign1
- AppSign2
- AppSign3
- Nopage38 Off
- Yespage38 Off
- Yes1 Off
- No1 Off
- Yes2 Off
- Yes3 Off
- Yes4 Off
- Yes5 Off
- Yes6 Off
- Yes7 Off
- Yes8 Off
- Yes9 Off
- Yes10 Off
- No2 Off
- No3 Off
- No4 Off
- No5 Off
- No6 Off
- No7 Off
- No8 Off
- No9 Off
- No10 Off
- BorrowerNo Off
- BorrowerYes Off
- AppSignature
- AppSignature1
- CurrentSign
- CurrentSign1
- InterviewSign
- Yes_1 Off
- No_1 Off
- Yes_2 Off
- No_2 Off
- Mail Off
- Phone Off
___________________________________
______________________________________________________
______________________________________________________________
- - - - - - - - - - - - - - - - - - - - - - -
Borrower Name ____________________________ FHA Case No __________________
Part IV - Direct Endorsement Approval for a HUD FHA-Insured Mortgage A Underwriting the Borrower
Date Mortgage Approved ______________________________ Date Approval Expires ______________________
For mortgages rated as an ldquoacceptrdquo or ldquoapproverdquo by FHAs TOTAL Mortgage Scorecard
The information submitted to TOTAL was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA4e Final Underwriting Decision (TOTAL) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee Representative Signature
Printed Name
Title
OR
For mortgages rated as a ldquoreferrdquo by FHAs TOTAL Mortgage Scorecard or manually underwritten by a Direct Endorsement underwriter I have personally reviewed and underwritten the borrowerrsquos credit application The information used to underwrite the borrower was documented in accordance with Single Family Housing Policy Handbook 40001 (SF Handbook) and accurately represents the final information obtained by the mortgagee and This mortgage complies with SF Handbook 40001 Section IIA5d Final Underwriting Decision (Manual) to the extent that no defect exists in connection with the underwriting of this mortgage such that it should not have been approved in accordance with FHA requirements
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
B Underwriting the Property
For all mortgages where FHA requires an appraisal I have personally reviewed and underwritten the appraisal according to FHA requirements I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Direct Endorsement Underwriter Signature __________________________ DErsquos ID Number _____________________
orm HUD-92900-A ( ) Page 3
Borrower Name ____________________________ FHA Case No __________________
Part V Mortgagees Certification
I have personally reviewed the mortgage documents and the application for insurance endorsement and This mortgage complies with SF Handbook 40001 Section IIA7 Post-Closing and Endorsement to the extent that no defect exists that would have changed the decision to endorse or submit the mortgage for insurance
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee
Name of Mortgageersquos Representative
Title of Mortgageersquos Representative
Signature of the Mortgageersquos Representative Date
orm HUD-92900-A ( ) Page 4
GENERAL AUTHORIZATION FOR A MORTGAGE LOAN ASSUMPTION
Applicant name(s)
Loan number
NOTICES AND DISCLOSURES
Non-discriminatory underwriting guidelines Anyone who inquires about the availability of credit from us has the right to receive a copy of our non-discriminatory underwriting guidelines To request a copy of these guidelines contact your Loan Processor
Attorney note Itrsquos the responsibility of our attorneys to protect our interest You may at your expense request an attorney to represent your interest
Notice to HUDFHA applicants As required by the Right to Financial Privacy Act of 1978 this notice is to inform you that the US Department of Housing and Urban Development (HUD)Federal Housing Administration (FHA) has a right of access to financial records held by financial institutions related to a request for assistance Financial records involving your assumption will be available to HUDFHA without further notice or authorization but wonrsquot be disclosed or released by us to another government agency or department without your consent except as required or permitted by law
Borrower consent to the use of tax return information I understand acknowledge and agree that the Lender and Other Loan Participants can obtain use and share tax return information for purposes of (i) providing an offer (ii) originating maintaining managing monitoring servicing selling insuring and securitizing a loan (iii) marketing or (iv) as otherwise permitted by applicable laws including state and federal privacy and data security laws The Lender includes the Lenderrsquos affiliates agents service providers and any of aforementioned partiesrsquo successors and assigns The Other Loan Participants includes any actual or potential owners of a loan resulting from your loan application or acquirers of any beneficial or other interest in the loan and mortgage insurer guarantor any servicers or service providers for these parties and any of aforementioned partiesrsquo successors and assigns
CERTIFICATION AND AUTHORIZATION
Environmental certification By signing below I represent and warrant that Irsquom not aware of any substances materials or products that may be an environmental hazard such as but not limited to asbestos formaldehyde radon gas lead-based paint fuel or chemical storage tanks (above or below ground) and contaminated soil or water on the property I acknowledge that Chase is relying on this representation and warranty as a material part of its loan application process I also am not aware of any landfill on any portion of the property
Exceptions to the above I further acknowledge (1) receipt of applicable disclosures from the seller in purchase transactions (2) that lead-based paint may exist in housing constructed prior to 1978 (3) that Chase performs no environmental investigation on my behalf and isnrsquot responsible for identifying lead-based paint or any other environmental conditions that might impact the property or its residents and (4) that it is my sole obligation to investigate for potential impact to the property from environmental conditions
Certifications I certify by signing below that (1) all of the loan application information provided is true and complete (2) I understand any intentional or negligent misrepresentation(s) of the information provided in conjunction with my application may result in civil liability andor 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 Chase its agents successors and assigns insurers and any other person who may suffer any loss due to reliance upon any misrepresentation that I have made on the application and (3) any significant change from the information provided at the time of application until the final loan application is signed may have a bearing on the approval of my application for a home loan
Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union
This question is asked because of state laws that extend the same or similar rights benefits and protections of spouses in a marriage to persons who are members of a partnership or union recognized under state law You should consult with your own legal advisor for advice regarding the rights protections benefits responsibilities obligations and duties of those who are registered domestic partners civil union partners or members of other unions recognized under applicable law
CREDIT AUTHORIZATION RELEASE
By signing below I authorize Chase andor my mortgage insurer (if any) to verify my past and present employment earnings records (including information contained in income tax returns that have been filed with the IRS) bank accounts stock holdings and any other information that it finds necessary to process my mortgage loan application or to review it for quality-control purposes I understand that a credit report will be ordered from a credit reporting agency for verification prior to loan closing as part of the application process and may be ordered after closing as part of the Lenderrsquos quality-control program A credit report may also be completed as part of the Lenderrsquos servicing or collection of the loan or in consideration of any other product or service that the Lender may consider offering me in the future and at any time throughout the life of the loan I understand that use of a photocopy of this form may be necessary to verify one or more of my credit references I understand that a photocopy or fax copy of this form will also serve as authorization
By signing below each applicant acknowledges (1) making the above certifications and authorizations and (2) that each applicant has received and understands the above notices and disclosures
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
You do not have to give us this information but if you donrsquot your application for approval as a borrower may be delayed or rejected The information requested in this form is authorized by Title 38 USC Chapter 37 (if VA) by 12 USC Section 1701 et seq (if HUDFHA) by 42 USC Section 1452b (if HUDCPD) and Title 42 USC 1471 et seq or 7 USC 1921 et seq (if USDA FHA)
Updated December 2021 99177-GA-0215
1b
2b
Form 4506-C (September 2020)
Department of the Treasury - Internal Revenue Service
IVES Request for Transcript of Tax Return OMB Number
1545-1872
Do not sign this form unless all applicable lines have been completed Request may be rejected if the form is incomplete or illegible
For more information about Form 4506-C visit wwwirsgov and search IVES
1a Name shown on tax return (if a joint return enter the name shown first)
First social security number on tax return individual taxpayer identification number or employer identification number (see instructions)
2a If a joint return enter spousersquos name shown on tax return Second social security number or individual taxpayer identification number if joint tax return
3 Current name address (including apt room or suite no) city state and ZIP code (see instructions)
4 Previous address shown on the last return filed if different from line 3 (see instructions)
5a IVES participant name address and SOR mailbox ID
DataVerify 875 Greentree Rd 8 Parkway Center Pittsburgh PA 15220
5b Customer file number (if applicable) (see instructions)
Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing (see instructions)
6 Transcript requested Enter the tax form number here (1040 1065 1120 etc) and check the appropriate box below Enter only one tax form number per request 1040
a Return Transcript which includes most of the line items of a tax return as filed with the IRS A tax return transcript does not reflect changes made to the account after the return is processed Transcripts are only available for the following returns Form 1040 series Form 1065 Form 1120 Form 1120-A Form 1120-H Form 1120-L and Form 1120S Return transcripts are available for the current year and returns processed during the prior 3 processing years
b Account Transcript which contains information on the financial status of the account such as payments made on the account penalty assessments and adjustments made by you or the IRS after the return was filed Return information is limited to items such as tax liability and estimated tax payments Account transcripts are available for most returns
c Record of Account which provides the most detailed information as it is a combination of the Return Transcript and the Account Transcript Available for current year and 3 prior tax years
7 Form W-2 Form 1099 series Form 1098 series or Form 5498 series transcript The IRS can provide a transcript that includes data from these information returns State or local information is not included with the Form W-2 information The IRS may be able to provide this transcript information for up to 10 years Information for the current year is generally not available until the year after it is filed with the IRS For example W-2 information for 2016 filed in 2017 will likely not be available from the IRS until 2018 If you need W-2 information for retirement purposes you should contact the Social Security Administration at 1-800-772-1213
Caution If you need a copy of Form W-2 or Form 1099 you should first contact the payer To get a copy of the Form W-2 or Form 1099 filed with your return you must use Form 4506 and request a copy of your return which includes all attachments
8 Year or period requested Enter the ending date of the tax year or period using the mmddyyyy format (see instructions)
12 31 2020 12 31 2019 12 31 2018 Caution Do not sign this form unless all applicable lines have been completed
Signature of taxpayer(s) I declare that I am either the taxpayer whose name is shown on line 1a or 2a or a person authorized to obtain the tax information requested If the request applies to a joint return at least one spouse must sign If signed by a corporate officer 1 percent or more shareholder partner managing member guardian tax matters partner executor receiver administrator trustee or party other than the taxpayer I certify that I have the authority to execute Form 4506-C on behalf of the taxpayer Note This form must be received by IRS within 120 days of the signature date
Signatory attests that heshe has read the attestation clause and upon so reading declares that heshe has the authority to sign the Form 4506-C See instructions
Sign Here
Signature (see instructions) Date Phone number of taxpayer on line 1a or 2a
PrintType name
Title (if line 1a above is a corporation partnership estate or trust)
Spousersquos signature Date
PrintType name
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020) For Privacy Act and Paperwork Reduction Act Notice see page 2
Instructions for Form 4506-C IVES Request for Transcript of Tax Return
Section references are to the Internal Revenue Code unless otherwise noted
Future Developments
For the latest information about Form 4506-C and its instructions go to wwwirsgov and search IVES Information about any recent developments affecting Form 4506-C (such as legislation enacted after we released it) will be posted on that page
Whats New Form 4506-C was created to be utilized by authorized IVES participants to order tax transcripts with the consent of the taxpayer
General Instructions
Caution Do not sign this form unless all applicable lines have been completed
Designated Recipient Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information received pursuant to the taxpayerrsquos consent and holds the recipient subject to penalties for any unauthorized access other use or redisclosure without the taxpayerrsquos express permission or request
Taxpayer Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information provided pursuant to your consent and holds the recipient subject to penalties brought by private right of action for any unauthorized access other use or redisclosure without your express permission or request
Purpose of form Use Form 4506-C to request tax return information through an authorized IVES participant You will designate an IVES participant to receive the information on line 5a
Note If you are unsure of which type of transcript you need check with the party requesting your tax information
Where to file The IVES participant will fax Form 4506-C with the approved IVES cover sheet to their assigned Service Center
Chart for ordering transcripts
If your assigned Service Center is
Fax the requests with the approved coversheet to
Austin Submission Processing Center
Austin IVES Team
844-249-6238
Fresno Submission Processing Center
Fresno IVES Team
844-249-6239
Kansas City Submission Processing Center
Kansas City IVES Team
844-249-8128
Ogden Submission Processing Center
Ogden IVES Team
844-249-8129
Specific Instructions
Line 1b Enter the social security number (SSN) or individual taxpayer identification number (ITIN) for the individual listed on line 1a or enter the employer identification number (EIN) for the business listed on line 1a
Line 3 Enter your current address If you use a PO box include it on this line
Line 4 Enter the address shown on the last return filed if different from the address entered on line 3
Note If the addresses on lines 3 and 4 are different and you have not changed your address with the IRS file Form 8822 Change of Address or Form 8822-BChange of Address or Responsible Party mdash Business with Form 4506-C
Line 5b Enter up to 10 numeric characters to create a unique customer file number that will appear on the transcript The customer file number cannot contain an SSN ITIN or EIN Completion of this line is not required
Note If you use an SSN name or combination of both we will not input the information and the customer file number will reflect a generic entry of 9999999999 on the transcript
Line 8 Enter the end date of the tax year or period requested in mmddyyyy format This may be a calendar year fiscal year or quarter Enter each quarter requested for quarterly returns Example Enter 12312018 for a calendar year 2018 Form 1040 transcript
Signature and date Form 4506-C must be signed and dated by the taxpayer listed on line 1a or 2a The IRS must receive Form 4506-C within 120 days of the date signed by the taxpayer or it will be rejected Ensure that all applicable lines including lines 5a through 8 are completed before signing
You must check the box in the signature area to acknowledge you have the authority to sign and request the information The form will not be processed if unchecked
Individuals Transcripts listed on on line 6 may be furnished to either spouse if jointly filed Only one signature is required Sign Form 4506-C exactly as your name appeared on the original return If you changed your name also sign your current name
Corporations Generally Form 4506-C can be signed by
(1) an officer having legal authority to bind the corporation (2) any person designated by the board of directors or other governing body or (3) any officer or employee on written request by any principal officer and attested to by the secretary or other officer A bona fide shareholder of record owning 1 percent or more of the outstanding stock of the corporation may submit a Form 4506-C but must provide documentation to support the requesters right to receive the information
Partnerships Generally Form 4506-C can be signed by any person who was a member of the partnership during any part of the tax period requested on line 8
All others See section 6103(e) if the taxpayer has died is insolvent is a dissolved corporation or if a trustee guardian executor receiver or administrator is acting for the taxpayer
Note If you are Heir at law Next of kin or Beneficiary you must be able to establish a material interest in the estate or trust
Documentation For entities other than individuals you must attach the authorization document For example this could be the letter from the principal officer authorizing an employee of the corporation or the letters testamentary authorizing an individual to act for an estate
Signature by a representative A representative can sign Form 4506-C for a taxpayer only if the taxpayer has specifically delegated this authority to the representative on Form 2848 line 5 The representative must attach Form 2848 showing the delegation to sign Form 4506-C
Privacy Act and Paperwork Reduction Act Notice We ask for the information on this form to establish your right to gain access to the requested tax information under the Internal Revenue Code We need this information to properly identify the tax information and respond to your request You are not required to request any transcript if you do request a transcript sections 6103 and 6109 and their regulations require you to provide this information including your SSN or EIN If you do not provide this information we may not be able to process your request Providing false or fraudulent information may subject you to penalties
Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and cities states the District of Columbia and US commonwealths and possessions for use in administering their tax laws We may also disclose this information to other countries under a tax treaty to federal and state agencies to enforce federal nontax criminal laws or to federal law enforcement and intelligence agencies to combat terrorism
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law Generally tax returns and return information are confidential as required by section 6103
The time needed to complete and file Form 4506-C will vary depending on individual circumstances The estimated average time is
Learning about the law or the form 10 min Preparing the form 12 min Copying assembling and sending the form to the IRS 20 min
If you have comments concerning the accuracy of these time estimates or suggestions for making Form 4506-C simpler we would be happy to hear from you You can write to
Internal Revenue Service Tax Forms and Publications Division 1111 Constitution Ave NW IR-6526 Washington DC 20224
Do not send the form to this address Instead see Where to file on this page
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020)
Rev April 2021 CHASEO Facts What does Chase do with your personal information
Why Financial companies choose how they share your personal information Federal law gives consumers the right to limit some but not all sharing Federal law also requires us to tell you how we collect share and protect your personal information Please read this notice carefully to understand what we do
What The types of personal information we collect and share depend on the product or service you have with us This information can include bull Social Security number and income bull account balances and transaction history bull credit history and payment history
How All financial companies need to share customers personal information to run their everyday business In the section below we list the reasons financial companies can share their customers personal information the reasons Chase chooses to share and whether you can limit this sharing
Reasons we can share your personal information Does Chase share
Can you limit this sharing
For our everyday business purposes - such as to process your transactions maintain your account(s) respond to court orders and legal investigations or report to credit bureaus
Yes No
For our marketing purposes - to offer our products and services to you
Yes No
For joint marketing with other financial companies Yes No
For our affiliates everyday business purposes - information about your transactions and experiences
Yes No
For our affiliates everyday business purposes - information about your creditworthiness
Yes Yes
For our affiliates to market to you Yes Yes
For nonaffiliates to market to you Yes Yes
a
0
To limit our sharing
bull Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
bull Visit us online chasecomprivacypreferences
Please note If you are a new customer we can begin sharing your information 30 days from the date we sent this notice When you are no longer our customer we continue to share your information as described in this notice However you can contact us at any time to limit our sharing
Questions
Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
PAGE 2
Who we are
Who is providing this notice The US consumer financial companies within the JPMorgan Chase amp Co family including JPMorgan Chase Bank NA Chase Insurance Agency Inc and JP Morgan Securities LLC
What we do
How does Chase protect my To protect your personal information from unauthorized access and use we personal information use security measures that comply with federal law These measures include
computer safeguards and secured files and buildings We authorize our employees to get your information only when they need it to do their work and we require companies that work for us to protect your information
How does Chase collect my We collect your personal information for example when you personal information bull open an account or make deposits or withdrawals from your account
bull pay your bills or apply for a loan bull use your credit or debit card We also collect your personal information from others such as credit bureaus affiliates or other companies
Why cant I limit all sharing Federal law gives you the right to limit only bull sharing for affiliates everyday business purposes - information about your
creditworthiness bull affiliates from using your information to market to you bull sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing See below for more on your rights under state law
What happens when I limit sharing for an account I hold jointly with someone else
Your choices will apply to everyone on your account
Definitions
Affiliates Companies related by common ownership or control They can be financial and non financial companies bull Our affiliates include companies with a Chase or JP Morgan name and financial companies such asjP Morgan Securities LLC
Nonaffiliates Companies not related by common ownership or control They can be financial and non financial companies bull Nonaffiliates we share with can include companies such as retailers auto dealers auto makers and membership clubs
Joint marketing A formal agreement between nonaffiliated financial companies that together market financial products or services to you bull Our joint marketing partners include categories of companies such as insurance companies
Other important information
VT Accounts with a Vermont mailing address are automatically treated as if they have limited the sharing as described on page 1 For joint marketing we will only disclose your name contact information and information about your transactions
NV We are providing you this notice pursuant to Nevada law If you prefer not to receive marketing calls from us you may be placed on our Internal Do Not Call List by calling 1-800-945-9470 or by writing to us at PO Box 734007 Dallas TX 75373-4007
For more information contact us at the address above or email PrivacylnfoJPMChasecom with Nevada Annual Notice in the subject line You may also contact the Nevada Attorney Generals office Bureau of Consumer Protection Office of the Nevada Attorney General 555 E Washington St Suite 3900 Las Vegas NV 89101 telephone number 1-702-486-3132 email BCPINFOagstatenvus
CA Accounts with a California mailing address are automatically treated as if they have limited the sharing with nonaffiliates as described on page 1 CA residents are provided a CA notice for additional choices
CHASE O
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
The following disclosure is required by the USA PATRIOT Act
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 opens an account
What this means to you When you 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 drivers
license or other identifying documents
99177-PAT-0215
VETERAN STATEMENT When this loan was opened the US Department of Veterans Affairs (VA) used the veteran borrowerrsquos entitlement which is a set amount the VA promises to repay a lender if the borrower defaults on the mortgage An assumption will modify who is obligated to pay the existing mortgage loan but all loan termsmdashincluding the entitlementmdashwill remain the same If the veteran borrower is being removed from the loan the entitlement would remain with whoever is assuming the loan because the loan will continue to be serviced by the VA If the applicant is also a veteran and can substitute his or her entitlement for the current entitlement then the current borrowerrsquos entitlement can be released
Please review the following questions and answer as appropriate This form requires completion by both the applicant(s) and current borrower(s)
1 Applicant to Complete
Are you (the applicant) currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the reverse side)
Yes (If yes please provide the information requested below answer the question in section 3 and sign and date this form at the bottom of the reverse side)
Name of applicant(s) who answered ldquoyesrdquo to the above question
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Are you receiving VA disability benefts
Applicant
Yes
No
Co-Applicant
Yes
No
Are you entitled to receive VA disability benefts Yes No Yes No
Have you received VA disability benefts in the past Yes No Yes No
Are you a surviving spouse of a veteran who died on active duty or as the result of a service-related disability
Yes No Yes No
Do you have any VA loans Yes No Yes No
2 Current Borrower to Complete
Is the current borrowerco-borrower currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the page)
Yes (If yes please answer the question in section 3 and sign and date this form at the bottom of the page)
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
________________________________________________________________________________________________
3 Applicant and Current Borrower to Complete
If the answer to the questions in section 1 and 2 are both yes please answer the following question After yoursquove reviewed and completed this entire form please sign and date at the bottom
Applicant Current Borrower
Do you want to apply for a substitution of entitlement Yes Yes No No
In order to complete a substitution of entitlement the veteran applicant must have suffcient entitlement to substitute for that of the current borrower Contact the VA Offce of Jurisdiction for your area for more information Also before the veteran applicant can substitute entitlement on a VA loan heshe must certify that the property securing the loan will be occupied as hisher primary residence Both the applicantrsquos and current borrowerrsquos original certifcate of eligibility will be required If your sales contract is contingent upon the restoration of entitlement please contact your VA Offce of Jurisdiction for complete procedures Otherwise the substitution will be completed after the loan has been approved and closed
Date Applicant printed name Applicant signature
Date Applicant printed name Applicant signature
Date Current Borrower printed name Current Borrower signature
Date Current Borrower printed name Current Borrower signature
Forms completed by Mail Phone
For Chase use only
Interviewer signature Date
99177-VS-0215
- Assumption Application Package_41521-noscannedpages-update-4pdf
-
- 1 FM203 Cover Pagepdf
- 2 FM202 Mortgage Assumption Application Package pagepdf
- 3 The Documents Youll need to Send Uspdf
- 4 FM201 FAQpdf
- 5 FM142 CIWpdf
- 6 FM126 URLApdf
- 7 FM130 URLA Instpdf
-
- Blank Page
-
- 8 92900a Addednum to Loan Applicationpdf
- 9 FM462 Gen Authpdf
- 10 FM220 4506-Cpdf
- 11 FM153 Chase Federal Privacy Noticepdf
- 12 FM144 Info on Opening a New Accountpdf
- 13 FM152 Veteran Statementpdf
-
- Date
- Loan number
- Applicant name
- Phone1
- Loan number 1
- Loan number 2
- Other
- Other_2
- 1
- 2
- undefined_7
- Available hours
- Available hours_2
- undefined_8
- Available hours_3
- undefined_9
- Current address 1
- Neither
- Available hours_4
- Available hours_5
- undefined_10
- Available hours_6
- 1_2
- 2_2
- undefined_11
- Available hours_7
- Available hours_8
- undefined_12
- Available hours_9
- FHA Case No include any suffix
- Mortgagee Case No
- Mortgagee ID
- Sponsor ID
- Agent ID
- Name and Address of Sponsor Name and Address of Agent
- Borrowers Name Present Address include ZIP Code Property Address
- include name of subdivision lot block no ZIP Code
- Name of ThirdParty Originator
- NMLS ID of ThirdParty Originator
- s application
- ty Number
- ty Number_2
- Date Signed_2
- Date Mortgage Approved
- Date Approval Expires
- Printed Name
- Title 1
- DEs ID Number
- DEs ID Number_2
- Mortgagee
- Name of Mortgagees Representative
- Title of Mortgagees Representative
- Signature of the Mortgagees Representative
- Date_2
- Applicant names 1
- Applicant names 2
- Applicant names 3
- Loan number_2
- Date_3
- Applicant printed name
- Social Security number
- Date_4
- Applicant printed name_2
- Social Security number_2
- Date_5
- Applicant printed name_3
- Social Security number_3
- Date_6
- Applicant printed name_4
- Social Security number_4
- 1a Name shown on tax return if a joint return enter the name shown first
- 1b First social security number on tax return individual taxpayer identification number or employer identification number see instructions
- 2a If a joint return enter spouses name shown on tax return
- 2b Second social security number or individual taxpayer identification number if joint tax return
- 4 Previous address shown on the last return filed if different from line 3 see instructions
- 5a IVES participant name address and SOR mailbox ID
- Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing see instructions
- Signature see instructions
- Date_7
- Phone number of taxpayer on line 1a or 2a
- PrintType name
- Here
- Spouses signature
- Date_8
- PrintType name_2
- Name
- Date of birth
- Service number
- Name_2
- Date of birth_2
- Service number_2
- Date_9
- Applicant printed name_5
- Date_10
- Applicant printed name_6
- Date_11
- Current Borrower printed name
- Date_12
- Current Borrower printed name_2
- Date_13
- Text3
- Text10
- undefined_13
- Text15
- undefined_14
- undefined_15
- undefined_16
- undefined_17
- undefined_18
- undefined_19
- undefined_20
- undefined_21
- undefined_23
- Reason for assumption Off
- Requestors relationship to owners Off
- Check one Off
- Check one1 Off
- Day1
- Evening
- Cell phone
- Check one2 Off
- Check one3 Off
- Check one4 Off
- Check one5 Off
- Text2-1
- Text2-2
- Text2-3
- Text2-4
- Text2-5
- Text2-6
- Text3-1
- Text3-2
- Text3-3
- Text3-4
- Text3-6
- Text3-7
- Text3-8
- Text3-9
- Text3-10
- Text3-11
- Text3-12
- Text3-13
- Text3-14
- Text3-15
- Text3-16
- Text3-17
- Text3-18
- Text3-19
- Text3-20
- Text3-21
- Text3-22
- Text3-23
- Text3-24
- Text3-25
- Text3-26
- Text3-27
- Text3-28
- Text3-29
- Text3-30
- Text3-31
- Text3-32
- Text3-33
- Text3-34
- Text3-35
- Text3-36
- Text3-37
- Text3-38
- Text3-39
- Text3-40
- Text3-41
- Text3-42
- Text3-43
- Text3-44
- Text3-45
- Text3-46
- Text3-47
- Text3-48
- Text3-49
- Text3-50
- Text3-51
- Text3-52
- Text3-53
- Text3-5
- Text3-54
- Text3-55
- Text3-56
- Citizenship Off
- Type of credit Off
- Marital Status Off
- Housing Off
- Housing1 Off
- ownership Off
- DNA1 Off
- DNA2 Off
- DNA3 Off
- family Off
- BO Off
- Total
- Text31
- Text32
- Text33
- Text34
- Text35
- Text36
- Text37
- Text38
- Text39
- Text310
- Text311
- Text312
- Text313
- Text314
- Text315
- Text316
- Text317
- Text318
- Text319
- ownership1 Off
- Total1
- Total1-2
- Check Box4-1 Off
- Text320
- Text321
- Text322
- Text323
- Text324
- Text325
- Text326
- Text327
- Text328
- Text329
- Check Box4-2 Off
- Check Box4-3 Off
- Check Box4-4 Off
- Check Box4-8 Off
- Check Box4-9 Off
- Text330
- Text331
- Text332
- Text333
- Text334
- Text335
- Text1-1
- Text1-2
- Text1-3
- Text1-4
- Text1-5
- Text1-6
- Text1-7
- Text1-8
- Text1-9
- Text1-10
- Text1-11
- Text1-12
- Text1-13
- Text1-14
- Text1-15
- Text1-16
- Text1-17
- Text1-18
- Text1-19
- Text1-20
- Text1-21
- Text1-22
- Text1-23
- Text1-24
- Text1-25
- Text1-26
- Text1-27
- Text1-28
- Text1-29
- Text1-30
- Text1-31
- Text1-32
- Text1-33
- Text1-34
- Text1-35
- Check Box3-2 Off
- Check Box2-1 Off
- Check Box2-2 Off
- Check Box2-3 Off
- Check Box2-4 Off
- Check Box2-5 Off
- Text1-36
- Text1-37
- Text1-38
- Text1-39
- Text1-40
- Text1-41
- Text1-42
- Text1-43
- Text1-44
- Text1-45
- Text1-46
- Text1-47
- Text1-48
- Text1-49
- Text1-50
- Text1-51
- Text1-52
- Text1-53
- Text1-54
- Text1-55
- Text1-56
- Text1-57
- Text1-58
- Text1-59
- Text1-60
- Text1-61
- Check Box3-11 Off
- A1
- A2
- A3
- A4
- A5
- A6
- A7
- A8
- A9
- A10
- A11
- A12
- Check Box3-1 Off
- Check Box30-1 Off
- Check Box30-2 Off
- Check Box30-4 Off
- Check Box30-5 Off
- Check Box30-7 Off
- Check Box30-8 Off
- Check Box30-9 Off
- Check Box30-10 Off
- Check Box30-11 Off
- Check Box30-12 Off
- A13
- A14
- A15
- A16
- A17 Off
- A18
- A19
- A20
- A21
- A22
- A23
- A24
- A25
- A26
- A27
- A28
- A29
- A30
- A31
- A32
- A33
- A34
- A35
- A36
- A37
- A38 Off
- A39
- A40
- A41
- A42
- A43
- A44
- A45
- A46
- A47
- A48
- A49
- A50
- A51
- A52
- A53
- A54
- A55
- A56
- A57
- A58
- A59
- A60
- A61
- A62
- A63
- A64
- A65
- A66
- A67
- A68
- A69
- A70
- A71
- A72
- A73
- A74
- Loan Purpose Off
- occupancy1 Off
- lien type Off
- lientype Off
- mixed use Off
- manufactured home Off
- deposit1 Off
- deposit2 Off
- B1
- B2
- B3
- B4
- B5
- B6
- B7
- B8
- B9
- B10
- fha Off
- Check Box51 Off
- B11
- B12
- B13
- B14
- B15
- B16
- B17
- B18
- B19 Off
- B20
- B21
- B22 Off
- B23
- B24
- B25
- B26
- B27
- B28
- A
-
- Will you occupy the property as your primary residence Off
- Will you occupy the property as your primary residence1 Off
-
- If yes have you had an ownership interest in another property in the last three years Off
- Text9-2
- B
-
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property Off
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property1 Off
-
- 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 Off
- 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 application1 Off
-
- 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 Off
- 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 application1 Off
-
- new credit Off
- 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) Off
- the Property Assessed Clean Energy Program)1 Off
-
- F
-
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application Off
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application1 Off
-
- G
-
- Are there any outstanding judgments against you Off
- Are there any outstanding judgments against you1 Off
-
- H
-
- Are you currently delinquent or in default on a Federal debt Off
- Are you currently delinquent or in default on a Federal debt1 Off
-
- I
-
- Are you a party to a lawsuit in which you potentially have any personal financial liability Off
- Are you a party to a lawsuit in which you potentially have any personal financial liability1 Off
-
- J
-
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years Off
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years1 Off
-
- 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 Off
- 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 due1 Off
-
- L
-
- Have you had property foreclosed upon in the last 7 years Off
- Have you had property foreclosed upon in the last 7 years1 Off
-
- M
-
- Have you declared bankruptcy within the past 7 years Off
- Have you declared bankruptcy within the past 7 years1 Off
-
- Check Box8-2 Off
- Check Box8-3 Off
- Check Box8-4 Off
- Text9-3
- Text9-5
- Text9-6
- Text97
- military Off
- ethnicity Off
- sex Off
- race Off
- demo Off
- Text12-1
- Check Box11-1 Off
- Check Box11-2 Off
- Check Box11-3 Off
- Check Box11-4 Off
- Check Box11-5 Off
- Check Box11-6 Off
- Check Box11-7 Off
- Check Box11-8 Off
- Check Box11-9 Off
- Text12-2
- Check Box11-10 Off
- Check Box11-11 Off
- Check Box11-12 Off
- Check Box11-13 Off
- Check Box11-14 Off
- Check Box11-15 Off
- Text12-3
- Check Box11-16 Off
- Check Box11-17 Off
- Check Box11-18 Off
- Check Box11-19 Off
- Check Box11-20 Off
- Check Box11-21 Off
- Check Box11-22 Off
- Check Box11-23 Off
- Text12-4
- Check Box11-24 Off
- Check Box11-25 Off
- Check Box11-26 Off
- Check Box11-27 Off
- Check Box11-28 Off
- Check Box11-29 Off
- Text12-5
- Check Box11-30 Off
- Check Box11-31 Off
- citizen Off
- credit Off
- marital status1 Off
- housing-1 Off
- housing-2 Off
- own Off
- C1
- C2
- C3
- C6
- C7
- C8
- C9
- C10
- C11
- C12
- C13
- C14
- C15
- C16
- C17
- C18
- C19
- C20
- C21
- C22
- C23
- C24
- C25
- C26
- C27
- C28
- C29
- C30
- C31
- C32
- C33
- C34
- C35
- Check Box-2 Off
- C36
- C37
- C38
- C39
- C4
- C40
- C41
- C42
- C43
- C44
- C45
- C46
- C47
- Check Box-3 Off
- Check Box-4 Off
- C48
- C49
- C5
- C50
- C51
- C52
- C53
- C54
- C55
- Check Box-1-1 Off
- own1 Off
- Check Box-1 Off
- D1 Off
- D2
- D3
- D4
- D5
- D6
- D7
- D8
- D9
- D10
- D11
- D12
- D13
- D14 Off
- D15 Off
- D16
- D17
- D18
- D19
- D20
- D21
- D22
- D23
- D24 Off
- D25
- D26
- D27
- D28
- D29
- D30
- D31
- D32
- D33
- D34
- D35 Off
- D36
- D37 Off
- D38
- D39
- D40
- D41
- D42
- D43
- D44
- D45
- D46
- D47
- If yes have you had an ownership interest in another property in the last three years1 Off
- new credit1 Off
- Check Box8-1 Off
- Check Box8-1-2 Off
- Check Box8-1-1 Off
- Check Box8-1-3 Off
- Check Box8-1-4 Off
- Military Service mdash Did you (or your deceased spouse) ever serve or are you currently serving in the United States Armed Forces 1 Off
- Check1 Off
- Text9-1-1
- Check2 Off
- Check3 Off
- Check4 Off
- Text9-1
- E1
- E2
- E3
- Was the ethnicity of the Borrower collected on the basis of visual observation or surname1 Off
- Was the sex of the Borrower collected on the basis of visual observation or surname1 Off
- Was the race of the Borrower collected on the basis of visual observation or surname1 Off
- The Demographic Information was provided through1 Off
- F1 Off
- F2 Off
- F3 Off
- F4 Off
- F5 Off
- F6
- F7 Off
- F8 Off
- F9 Off
- F10 Off
- F11 Off
- F12 Off
- F13
- F14 Off
- F15 Off
- F16 Off
- F17 Off
- F18 Off
- F19 Off
- F20 Off
- F21 Off
- F22
- F23 Off
- F24 Off
- F25 Off
- F26 Off
- F27 Off
- F28 Off
- F29
- F30 Off
- F31 Off
- undefined_13-1
- undefined_13-2
- undefined_14-1
- undefined_15-1
- undefined_16-1
- undefined_17-1
- undefined_18-1
- undefined_19-1
- undefined_21-1
- undefined_20-1
- undefined_23-1
- undefined_13_1
- Single-Two Off
- Refi type Off
- refi program Off
- Estate Off
- Title held Off
- Trust Information Off
- Indian Country Land Tenure Off
- Mortgage Type Applied For Off
- Mortgage Lien Type Off
- Amortization Type Off
- G1 Off
- G2 Off
- G3 Off
- G4 Off
- G5 Off
- G6
- G7
- G8
- G9
- G10 Off
- G11 Off
- G12 Off
- G13 Off
- G14 Off
- G15 Off
- G16
- G17
- G18
- G19
- G20
- G21
- G22
- G23 Off
- G24
- G25 Off
- G26
- G27 Off
- G28 Off
- G29
- G30 Off
- G31
- G32 Off
- G33
- G34
- G35
- G36
- G37
- G38
- G39
- G40
- G41
- G42
- Property Held
- refi
- Text18-1
- Text18-2
- Text18-3
- Text18-4
- Text18-5
- Text18-6
- Text18-7
- Text18-8
- Text18-9
- Text18-10
- Text18-11
- Text18-12
- Text18-13
- Text18-14
- Text18-15
- Text18-16
- Text18-17
- Text18-18
- Text18-19
- Lender
- case no
- If you selected ldquoUnmarriedrdquo in Section 1 is there a person who is not your legal spouse but who currently has real property rights similar to those of a legal spouse Off
- Relationship and State Off
- Other-5
- Text19-1
- BName
- Additional Information
- ABN
- Additional Information1
- BSign
- BSDate
- ABSign
- ABDate
- MortageeNameAddress
- NAmeAddress
- Bname1
- DOB1
- DOB2
- SignOfBorr1
- SignOfBorr
- Date Signed
- SignOfBorr2
- SignOfBorr3
- Date Signed3
- Date Signed4
- MortgageeRepSign
- DirectSign
- DirectSign1
- Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union Off
- AppSign
- AppSign1
- AppSign2
- AppSign3
- Nopage38 Off
- Yespage38 Off
- Yes1 Off
- No1 Off
- Yes2 Off
- Yes3 Off
- Yes4 Off
- Yes5 Off
- Yes6 Off
- Yes7 Off
- Yes8 Off
- Yes9 Off
- Yes10 Off
- No2 Off
- No3 Off
- No4 Off
- No5 Off
- No6 Off
- No7 Off
- No8 Off
- No9 Off
- No10 Off
- BorrowerNo Off
- BorrowerYes Off
- AppSignature
- AppSignature1
- CurrentSign
- CurrentSign1
- InterviewSign
- Yes_1 Off
- No_1 Off
- Yes_2 Off
- No_2 Off
- Mail Off
- Phone Off
Borrower Name ____________________________ FHA Case No __________________
Part V Mortgagees Certification
I have personally reviewed the mortgage documents and the application for insurance endorsement and This mortgage complies with SF Handbook 40001 Section IIA7 Post-Closing and Endorsement to the extent that no defect exists that would have changed the decision to endorse or submit the mortgage for insurance
I certify that the statements above are materially correct with the understanding that in the event HUD elects to pursue a claim arising out of or relating to any inaccuracy of this certification HUD will interpret the severity of such inaccuracy in a manner that is consistent with the HUD Defect Taxonomy in effect as of the date this mortgage is endorsed for insurance
Mortgagee
Name of Mortgageersquos Representative
Title of Mortgageersquos Representative
Signature of the Mortgageersquos Representative Date
orm HUD-92900-A ( ) Page 4
GENERAL AUTHORIZATION FOR A MORTGAGE LOAN ASSUMPTION
Applicant name(s)
Loan number
NOTICES AND DISCLOSURES
Non-discriminatory underwriting guidelines Anyone who inquires about the availability of credit from us has the right to receive a copy of our non-discriminatory underwriting guidelines To request a copy of these guidelines contact your Loan Processor
Attorney note Itrsquos the responsibility of our attorneys to protect our interest You may at your expense request an attorney to represent your interest
Notice to HUDFHA applicants As required by the Right to Financial Privacy Act of 1978 this notice is to inform you that the US Department of Housing and Urban Development (HUD)Federal Housing Administration (FHA) has a right of access to financial records held by financial institutions related to a request for assistance Financial records involving your assumption will be available to HUDFHA without further notice or authorization but wonrsquot be disclosed or released by us to another government agency or department without your consent except as required or permitted by law
Borrower consent to the use of tax return information I understand acknowledge and agree that the Lender and Other Loan Participants can obtain use and share tax return information for purposes of (i) providing an offer (ii) originating maintaining managing monitoring servicing selling insuring and securitizing a loan (iii) marketing or (iv) as otherwise permitted by applicable laws including state and federal privacy and data security laws The Lender includes the Lenderrsquos affiliates agents service providers and any of aforementioned partiesrsquo successors and assigns The Other Loan Participants includes any actual or potential owners of a loan resulting from your loan application or acquirers of any beneficial or other interest in the loan and mortgage insurer guarantor any servicers or service providers for these parties and any of aforementioned partiesrsquo successors and assigns
CERTIFICATION AND AUTHORIZATION
Environmental certification By signing below I represent and warrant that Irsquom not aware of any substances materials or products that may be an environmental hazard such as but not limited to asbestos formaldehyde radon gas lead-based paint fuel or chemical storage tanks (above or below ground) and contaminated soil or water on the property I acknowledge that Chase is relying on this representation and warranty as a material part of its loan application process I also am not aware of any landfill on any portion of the property
Exceptions to the above I further acknowledge (1) receipt of applicable disclosures from the seller in purchase transactions (2) that lead-based paint may exist in housing constructed prior to 1978 (3) that Chase performs no environmental investigation on my behalf and isnrsquot responsible for identifying lead-based paint or any other environmental conditions that might impact the property or its residents and (4) that it is my sole obligation to investigate for potential impact to the property from environmental conditions
Certifications I certify by signing below that (1) all of the loan application information provided is true and complete (2) I understand any intentional or negligent misrepresentation(s) of the information provided in conjunction with my application may result in civil liability andor 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 Chase its agents successors and assigns insurers and any other person who may suffer any loss due to reliance upon any misrepresentation that I have made on the application and (3) any significant change from the information provided at the time of application until the final loan application is signed may have a bearing on the approval of my application for a home loan
Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union
This question is asked because of state laws that extend the same or similar rights benefits and protections of spouses in a marriage to persons who are members of a partnership or union recognized under state law You should consult with your own legal advisor for advice regarding the rights protections benefits responsibilities obligations and duties of those who are registered domestic partners civil union partners or members of other unions recognized under applicable law
CREDIT AUTHORIZATION RELEASE
By signing below I authorize Chase andor my mortgage insurer (if any) to verify my past and present employment earnings records (including information contained in income tax returns that have been filed with the IRS) bank accounts stock holdings and any other information that it finds necessary to process my mortgage loan application or to review it for quality-control purposes I understand that a credit report will be ordered from a credit reporting agency for verification prior to loan closing as part of the application process and may be ordered after closing as part of the Lenderrsquos quality-control program A credit report may also be completed as part of the Lenderrsquos servicing or collection of the loan or in consideration of any other product or service that the Lender may consider offering me in the future and at any time throughout the life of the loan I understand that use of a photocopy of this form may be necessary to verify one or more of my credit references I understand that a photocopy or fax copy of this form will also serve as authorization
By signing below each applicant acknowledges (1) making the above certifications and authorizations and (2) that each applicant has received and understands the above notices and disclosures
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
You do not have to give us this information but if you donrsquot your application for approval as a borrower may be delayed or rejected The information requested in this form is authorized by Title 38 USC Chapter 37 (if VA) by 12 USC Section 1701 et seq (if HUDFHA) by 42 USC Section 1452b (if HUDCPD) and Title 42 USC 1471 et seq or 7 USC 1921 et seq (if USDA FHA)
Updated December 2021 99177-GA-0215
1b
2b
Form 4506-C (September 2020)
Department of the Treasury - Internal Revenue Service
IVES Request for Transcript of Tax Return OMB Number
1545-1872
Do not sign this form unless all applicable lines have been completed Request may be rejected if the form is incomplete or illegible
For more information about Form 4506-C visit wwwirsgov and search IVES
1a Name shown on tax return (if a joint return enter the name shown first)
First social security number on tax return individual taxpayer identification number or employer identification number (see instructions)
2a If a joint return enter spousersquos name shown on tax return Second social security number or individual taxpayer identification number if joint tax return
3 Current name address (including apt room or suite no) city state and ZIP code (see instructions)
4 Previous address shown on the last return filed if different from line 3 (see instructions)
5a IVES participant name address and SOR mailbox ID
DataVerify 875 Greentree Rd 8 Parkway Center Pittsburgh PA 15220
5b Customer file number (if applicable) (see instructions)
Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing (see instructions)
6 Transcript requested Enter the tax form number here (1040 1065 1120 etc) and check the appropriate box below Enter only one tax form number per request 1040
a Return Transcript which includes most of the line items of a tax return as filed with the IRS A tax return transcript does not reflect changes made to the account after the return is processed Transcripts are only available for the following returns Form 1040 series Form 1065 Form 1120 Form 1120-A Form 1120-H Form 1120-L and Form 1120S Return transcripts are available for the current year and returns processed during the prior 3 processing years
b Account Transcript which contains information on the financial status of the account such as payments made on the account penalty assessments and adjustments made by you or the IRS after the return was filed Return information is limited to items such as tax liability and estimated tax payments Account transcripts are available for most returns
c Record of Account which provides the most detailed information as it is a combination of the Return Transcript and the Account Transcript Available for current year and 3 prior tax years
7 Form W-2 Form 1099 series Form 1098 series or Form 5498 series transcript The IRS can provide a transcript that includes data from these information returns State or local information is not included with the Form W-2 information The IRS may be able to provide this transcript information for up to 10 years Information for the current year is generally not available until the year after it is filed with the IRS For example W-2 information for 2016 filed in 2017 will likely not be available from the IRS until 2018 If you need W-2 information for retirement purposes you should contact the Social Security Administration at 1-800-772-1213
Caution If you need a copy of Form W-2 or Form 1099 you should first contact the payer To get a copy of the Form W-2 or Form 1099 filed with your return you must use Form 4506 and request a copy of your return which includes all attachments
8 Year or period requested Enter the ending date of the tax year or period using the mmddyyyy format (see instructions)
12 31 2020 12 31 2019 12 31 2018 Caution Do not sign this form unless all applicable lines have been completed
Signature of taxpayer(s) I declare that I am either the taxpayer whose name is shown on line 1a or 2a or a person authorized to obtain the tax information requested If the request applies to a joint return at least one spouse must sign If signed by a corporate officer 1 percent or more shareholder partner managing member guardian tax matters partner executor receiver administrator trustee or party other than the taxpayer I certify that I have the authority to execute Form 4506-C on behalf of the taxpayer Note This form must be received by IRS within 120 days of the signature date
Signatory attests that heshe has read the attestation clause and upon so reading declares that heshe has the authority to sign the Form 4506-C See instructions
Sign Here
Signature (see instructions) Date Phone number of taxpayer on line 1a or 2a
PrintType name
Title (if line 1a above is a corporation partnership estate or trust)
Spousersquos signature Date
PrintType name
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020) For Privacy Act and Paperwork Reduction Act Notice see page 2
Instructions for Form 4506-C IVES Request for Transcript of Tax Return
Section references are to the Internal Revenue Code unless otherwise noted
Future Developments
For the latest information about Form 4506-C and its instructions go to wwwirsgov and search IVES Information about any recent developments affecting Form 4506-C (such as legislation enacted after we released it) will be posted on that page
Whats New Form 4506-C was created to be utilized by authorized IVES participants to order tax transcripts with the consent of the taxpayer
General Instructions
Caution Do not sign this form unless all applicable lines have been completed
Designated Recipient Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information received pursuant to the taxpayerrsquos consent and holds the recipient subject to penalties for any unauthorized access other use or redisclosure without the taxpayerrsquos express permission or request
Taxpayer Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information provided pursuant to your consent and holds the recipient subject to penalties brought by private right of action for any unauthorized access other use or redisclosure without your express permission or request
Purpose of form Use Form 4506-C to request tax return information through an authorized IVES participant You will designate an IVES participant to receive the information on line 5a
Note If you are unsure of which type of transcript you need check with the party requesting your tax information
Where to file The IVES participant will fax Form 4506-C with the approved IVES cover sheet to their assigned Service Center
Chart for ordering transcripts
If your assigned Service Center is
Fax the requests with the approved coversheet to
Austin Submission Processing Center
Austin IVES Team
844-249-6238
Fresno Submission Processing Center
Fresno IVES Team
844-249-6239
Kansas City Submission Processing Center
Kansas City IVES Team
844-249-8128
Ogden Submission Processing Center
Ogden IVES Team
844-249-8129
Specific Instructions
Line 1b Enter the social security number (SSN) or individual taxpayer identification number (ITIN) for the individual listed on line 1a or enter the employer identification number (EIN) for the business listed on line 1a
Line 3 Enter your current address If you use a PO box include it on this line
Line 4 Enter the address shown on the last return filed if different from the address entered on line 3
Note If the addresses on lines 3 and 4 are different and you have not changed your address with the IRS file Form 8822 Change of Address or Form 8822-BChange of Address or Responsible Party mdash Business with Form 4506-C
Line 5b Enter up to 10 numeric characters to create a unique customer file number that will appear on the transcript The customer file number cannot contain an SSN ITIN or EIN Completion of this line is not required
Note If you use an SSN name or combination of both we will not input the information and the customer file number will reflect a generic entry of 9999999999 on the transcript
Line 8 Enter the end date of the tax year or period requested in mmddyyyy format This may be a calendar year fiscal year or quarter Enter each quarter requested for quarterly returns Example Enter 12312018 for a calendar year 2018 Form 1040 transcript
Signature and date Form 4506-C must be signed and dated by the taxpayer listed on line 1a or 2a The IRS must receive Form 4506-C within 120 days of the date signed by the taxpayer or it will be rejected Ensure that all applicable lines including lines 5a through 8 are completed before signing
You must check the box in the signature area to acknowledge you have the authority to sign and request the information The form will not be processed if unchecked
Individuals Transcripts listed on on line 6 may be furnished to either spouse if jointly filed Only one signature is required Sign Form 4506-C exactly as your name appeared on the original return If you changed your name also sign your current name
Corporations Generally Form 4506-C can be signed by
(1) an officer having legal authority to bind the corporation (2) any person designated by the board of directors or other governing body or (3) any officer or employee on written request by any principal officer and attested to by the secretary or other officer A bona fide shareholder of record owning 1 percent or more of the outstanding stock of the corporation may submit a Form 4506-C but must provide documentation to support the requesters right to receive the information
Partnerships Generally Form 4506-C can be signed by any person who was a member of the partnership during any part of the tax period requested on line 8
All others See section 6103(e) if the taxpayer has died is insolvent is a dissolved corporation or if a trustee guardian executor receiver or administrator is acting for the taxpayer
Note If you are Heir at law Next of kin or Beneficiary you must be able to establish a material interest in the estate or trust
Documentation For entities other than individuals you must attach the authorization document For example this could be the letter from the principal officer authorizing an employee of the corporation or the letters testamentary authorizing an individual to act for an estate
Signature by a representative A representative can sign Form 4506-C for a taxpayer only if the taxpayer has specifically delegated this authority to the representative on Form 2848 line 5 The representative must attach Form 2848 showing the delegation to sign Form 4506-C
Privacy Act and Paperwork Reduction Act Notice We ask for the information on this form to establish your right to gain access to the requested tax information under the Internal Revenue Code We need this information to properly identify the tax information and respond to your request You are not required to request any transcript if you do request a transcript sections 6103 and 6109 and their regulations require you to provide this information including your SSN or EIN If you do not provide this information we may not be able to process your request Providing false or fraudulent information may subject you to penalties
Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and cities states the District of Columbia and US commonwealths and possessions for use in administering their tax laws We may also disclose this information to other countries under a tax treaty to federal and state agencies to enforce federal nontax criminal laws or to federal law enforcement and intelligence agencies to combat terrorism
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law Generally tax returns and return information are confidential as required by section 6103
The time needed to complete and file Form 4506-C will vary depending on individual circumstances The estimated average time is
Learning about the law or the form 10 min Preparing the form 12 min Copying assembling and sending the form to the IRS 20 min
If you have comments concerning the accuracy of these time estimates or suggestions for making Form 4506-C simpler we would be happy to hear from you You can write to
Internal Revenue Service Tax Forms and Publications Division 1111 Constitution Ave NW IR-6526 Washington DC 20224
Do not send the form to this address Instead see Where to file on this page
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020)
Rev April 2021 CHASEO Facts What does Chase do with your personal information
Why Financial companies choose how they share your personal information Federal law gives consumers the right to limit some but not all sharing Federal law also requires us to tell you how we collect share and protect your personal information Please read this notice carefully to understand what we do
What The types of personal information we collect and share depend on the product or service you have with us This information can include bull Social Security number and income bull account balances and transaction history bull credit history and payment history
How All financial companies need to share customers personal information to run their everyday business In the section below we list the reasons financial companies can share their customers personal information the reasons Chase chooses to share and whether you can limit this sharing
Reasons we can share your personal information Does Chase share
Can you limit this sharing
For our everyday business purposes - such as to process your transactions maintain your account(s) respond to court orders and legal investigations or report to credit bureaus
Yes No
For our marketing purposes - to offer our products and services to you
Yes No
For joint marketing with other financial companies Yes No
For our affiliates everyday business purposes - information about your transactions and experiences
Yes No
For our affiliates everyday business purposes - information about your creditworthiness
Yes Yes
For our affiliates to market to you Yes Yes
For nonaffiliates to market to you Yes Yes
a
0
To limit our sharing
bull Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
bull Visit us online chasecomprivacypreferences
Please note If you are a new customer we can begin sharing your information 30 days from the date we sent this notice When you are no longer our customer we continue to share your information as described in this notice However you can contact us at any time to limit our sharing
Questions
Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
PAGE 2
Who we are
Who is providing this notice The US consumer financial companies within the JPMorgan Chase amp Co family including JPMorgan Chase Bank NA Chase Insurance Agency Inc and JP Morgan Securities LLC
What we do
How does Chase protect my To protect your personal information from unauthorized access and use we personal information use security measures that comply with federal law These measures include
computer safeguards and secured files and buildings We authorize our employees to get your information only when they need it to do their work and we require companies that work for us to protect your information
How does Chase collect my We collect your personal information for example when you personal information bull open an account or make deposits or withdrawals from your account
bull pay your bills or apply for a loan bull use your credit or debit card We also collect your personal information from others such as credit bureaus affiliates or other companies
Why cant I limit all sharing Federal law gives you the right to limit only bull sharing for affiliates everyday business purposes - information about your
creditworthiness bull affiliates from using your information to market to you bull sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing See below for more on your rights under state law
What happens when I limit sharing for an account I hold jointly with someone else
Your choices will apply to everyone on your account
Definitions
Affiliates Companies related by common ownership or control They can be financial and non financial companies bull Our affiliates include companies with a Chase or JP Morgan name and financial companies such asjP Morgan Securities LLC
Nonaffiliates Companies not related by common ownership or control They can be financial and non financial companies bull Nonaffiliates we share with can include companies such as retailers auto dealers auto makers and membership clubs
Joint marketing A formal agreement between nonaffiliated financial companies that together market financial products or services to you bull Our joint marketing partners include categories of companies such as insurance companies
Other important information
VT Accounts with a Vermont mailing address are automatically treated as if they have limited the sharing as described on page 1 For joint marketing we will only disclose your name contact information and information about your transactions
NV We are providing you this notice pursuant to Nevada law If you prefer not to receive marketing calls from us you may be placed on our Internal Do Not Call List by calling 1-800-945-9470 or by writing to us at PO Box 734007 Dallas TX 75373-4007
For more information contact us at the address above or email PrivacylnfoJPMChasecom with Nevada Annual Notice in the subject line You may also contact the Nevada Attorney Generals office Bureau of Consumer Protection Office of the Nevada Attorney General 555 E Washington St Suite 3900 Las Vegas NV 89101 telephone number 1-702-486-3132 email BCPINFOagstatenvus
CA Accounts with a California mailing address are automatically treated as if they have limited the sharing with nonaffiliates as described on page 1 CA residents are provided a CA notice for additional choices
CHASE O
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
The following disclosure is required by the USA PATRIOT Act
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 opens an account
What this means to you When you 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 drivers
license or other identifying documents
99177-PAT-0215
VETERAN STATEMENT When this loan was opened the US Department of Veterans Affairs (VA) used the veteran borrowerrsquos entitlement which is a set amount the VA promises to repay a lender if the borrower defaults on the mortgage An assumption will modify who is obligated to pay the existing mortgage loan but all loan termsmdashincluding the entitlementmdashwill remain the same If the veteran borrower is being removed from the loan the entitlement would remain with whoever is assuming the loan because the loan will continue to be serviced by the VA If the applicant is also a veteran and can substitute his or her entitlement for the current entitlement then the current borrowerrsquos entitlement can be released
Please review the following questions and answer as appropriate This form requires completion by both the applicant(s) and current borrower(s)
1 Applicant to Complete
Are you (the applicant) currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the reverse side)
Yes (If yes please provide the information requested below answer the question in section 3 and sign and date this form at the bottom of the reverse side)
Name of applicant(s) who answered ldquoyesrdquo to the above question
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Are you receiving VA disability benefts
Applicant
Yes
No
Co-Applicant
Yes
No
Are you entitled to receive VA disability benefts Yes No Yes No
Have you received VA disability benefts in the past Yes No Yes No
Are you a surviving spouse of a veteran who died on active duty or as the result of a service-related disability
Yes No Yes No
Do you have any VA loans Yes No Yes No
2 Current Borrower to Complete
Is the current borrowerco-borrower currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the page)
Yes (If yes please answer the question in section 3 and sign and date this form at the bottom of the page)
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
________________________________________________________________________________________________
3 Applicant and Current Borrower to Complete
If the answer to the questions in section 1 and 2 are both yes please answer the following question After yoursquove reviewed and completed this entire form please sign and date at the bottom
Applicant Current Borrower
Do you want to apply for a substitution of entitlement Yes Yes No No
In order to complete a substitution of entitlement the veteran applicant must have suffcient entitlement to substitute for that of the current borrower Contact the VA Offce of Jurisdiction for your area for more information Also before the veteran applicant can substitute entitlement on a VA loan heshe must certify that the property securing the loan will be occupied as hisher primary residence Both the applicantrsquos and current borrowerrsquos original certifcate of eligibility will be required If your sales contract is contingent upon the restoration of entitlement please contact your VA Offce of Jurisdiction for complete procedures Otherwise the substitution will be completed after the loan has been approved and closed
Date Applicant printed name Applicant signature
Date Applicant printed name Applicant signature
Date Current Borrower printed name Current Borrower signature
Date Current Borrower printed name Current Borrower signature
Forms completed by Mail Phone
For Chase use only
Interviewer signature Date
99177-VS-0215
- Assumption Application Package_41521-noscannedpages-update-4pdf
-
- 1 FM203 Cover Pagepdf
- 2 FM202 Mortgage Assumption Application Package pagepdf
- 3 The Documents Youll need to Send Uspdf
- 4 FM201 FAQpdf
- 5 FM142 CIWpdf
- 6 FM126 URLApdf
- 7 FM130 URLA Instpdf
-
- Blank Page
-
- 8 92900a Addednum to Loan Applicationpdf
- 9 FM462 Gen Authpdf
- 10 FM220 4506-Cpdf
- 11 FM153 Chase Federal Privacy Noticepdf
- 12 FM144 Info on Opening a New Accountpdf
- 13 FM152 Veteran Statementpdf
-
- Date
- Loan number
- Applicant name
- Phone1
- Loan number 1
- Loan number 2
- Other
- Other_2
- 1
- 2
- undefined_7
- Available hours
- Available hours_2
- undefined_8
- Available hours_3
- undefined_9
- Current address 1
- Neither
- Available hours_4
- Available hours_5
- undefined_10
- Available hours_6
- 1_2
- 2_2
- undefined_11
- Available hours_7
- Available hours_8
- undefined_12
- Available hours_9
- FHA Case No include any suffix
- Mortgagee Case No
- Mortgagee ID
- Sponsor ID
- Agent ID
- Name and Address of Sponsor Name and Address of Agent
- Borrowers Name Present Address include ZIP Code Property Address
- include name of subdivision lot block no ZIP Code
- Name of ThirdParty Originator
- NMLS ID of ThirdParty Originator
- s application
- ty Number
- ty Number_2
- Date Signed_2
- Date Mortgage Approved
- Date Approval Expires
- Printed Name
- Title 1
- DEs ID Number
- DEs ID Number_2
- Mortgagee
- Name of Mortgagees Representative
- Title of Mortgagees Representative
- Signature of the Mortgagees Representative
- Date_2
- Applicant names 1
- Applicant names 2
- Applicant names 3
- Loan number_2
- Date_3
- Applicant printed name
- Social Security number
- Date_4
- Applicant printed name_2
- Social Security number_2
- Date_5
- Applicant printed name_3
- Social Security number_3
- Date_6
- Applicant printed name_4
- Social Security number_4
- 1a Name shown on tax return if a joint return enter the name shown first
- 1b First social security number on tax return individual taxpayer identification number or employer identification number see instructions
- 2a If a joint return enter spouses name shown on tax return
- 2b Second social security number or individual taxpayer identification number if joint tax return
- 4 Previous address shown on the last return filed if different from line 3 see instructions
- 5a IVES participant name address and SOR mailbox ID
- Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing see instructions
- Signature see instructions
- Date_7
- Phone number of taxpayer on line 1a or 2a
- PrintType name
- Here
- Spouses signature
- Date_8
- PrintType name_2
- Name
- Date of birth
- Service number
- Name_2
- Date of birth_2
- Service number_2
- Date_9
- Applicant printed name_5
- Date_10
- Applicant printed name_6
- Date_11
- Current Borrower printed name
- Date_12
- Current Borrower printed name_2
- Date_13
- Text3
- Text10
- undefined_13
- Text15
- undefined_14
- undefined_15
- undefined_16
- undefined_17
- undefined_18
- undefined_19
- undefined_20
- undefined_21
- undefined_23
- Reason for assumption Off
- Requestors relationship to owners Off
- Check one Off
- Check one1 Off
- Day1
- Evening
- Cell phone
- Check one2 Off
- Check one3 Off
- Check one4 Off
- Check one5 Off
- Text2-1
- Text2-2
- Text2-3
- Text2-4
- Text2-5
- Text2-6
- Text3-1
- Text3-2
- Text3-3
- Text3-4
- Text3-6
- Text3-7
- Text3-8
- Text3-9
- Text3-10
- Text3-11
- Text3-12
- Text3-13
- Text3-14
- Text3-15
- Text3-16
- Text3-17
- Text3-18
- Text3-19
- Text3-20
- Text3-21
- Text3-22
- Text3-23
- Text3-24
- Text3-25
- Text3-26
- Text3-27
- Text3-28
- Text3-29
- Text3-30
- Text3-31
- Text3-32
- Text3-33
- Text3-34
- Text3-35
- Text3-36
- Text3-37
- Text3-38
- Text3-39
- Text3-40
- Text3-41
- Text3-42
- Text3-43
- Text3-44
- Text3-45
- Text3-46
- Text3-47
- Text3-48
- Text3-49
- Text3-50
- Text3-51
- Text3-52
- Text3-53
- Text3-5
- Text3-54
- Text3-55
- Text3-56
- Citizenship Off
- Type of credit Off
- Marital Status Off
- Housing Off
- Housing1 Off
- ownership Off
- DNA1 Off
- DNA2 Off
- DNA3 Off
- family Off
- BO Off
- Total
- Text31
- Text32
- Text33
- Text34
- Text35
- Text36
- Text37
- Text38
- Text39
- Text310
- Text311
- Text312
- Text313
- Text314
- Text315
- Text316
- Text317
- Text318
- Text319
- ownership1 Off
- Total1
- Total1-2
- Check Box4-1 Off
- Text320
- Text321
- Text322
- Text323
- Text324
- Text325
- Text326
- Text327
- Text328
- Text329
- Check Box4-2 Off
- Check Box4-3 Off
- Check Box4-4 Off
- Check Box4-8 Off
- Check Box4-9 Off
- Text330
- Text331
- Text332
- Text333
- Text334
- Text335
- Text1-1
- Text1-2
- Text1-3
- Text1-4
- Text1-5
- Text1-6
- Text1-7
- Text1-8
- Text1-9
- Text1-10
- Text1-11
- Text1-12
- Text1-13
- Text1-14
- Text1-15
- Text1-16
- Text1-17
- Text1-18
- Text1-19
- Text1-20
- Text1-21
- Text1-22
- Text1-23
- Text1-24
- Text1-25
- Text1-26
- Text1-27
- Text1-28
- Text1-29
- Text1-30
- Text1-31
- Text1-32
- Text1-33
- Text1-34
- Text1-35
- Check Box3-2 Off
- Check Box2-1 Off
- Check Box2-2 Off
- Check Box2-3 Off
- Check Box2-4 Off
- Check Box2-5 Off
- Text1-36
- Text1-37
- Text1-38
- Text1-39
- Text1-40
- Text1-41
- Text1-42
- Text1-43
- Text1-44
- Text1-45
- Text1-46
- Text1-47
- Text1-48
- Text1-49
- Text1-50
- Text1-51
- Text1-52
- Text1-53
- Text1-54
- Text1-55
- Text1-56
- Text1-57
- Text1-58
- Text1-59
- Text1-60
- Text1-61
- Check Box3-11 Off
- A1
- A2
- A3
- A4
- A5
- A6
- A7
- A8
- A9
- A10
- A11
- A12
- Check Box3-1 Off
- Check Box30-1 Off
- Check Box30-2 Off
- Check Box30-4 Off
- Check Box30-5 Off
- Check Box30-7 Off
- Check Box30-8 Off
- Check Box30-9 Off
- Check Box30-10 Off
- Check Box30-11 Off
- Check Box30-12 Off
- A13
- A14
- A15
- A16
- A17 Off
- A18
- A19
- A20
- A21
- A22
- A23
- A24
- A25
- A26
- A27
- A28
- A29
- A30
- A31
- A32
- A33
- A34
- A35
- A36
- A37
- A38 Off
- A39
- A40
- A41
- A42
- A43
- A44
- A45
- A46
- A47
- A48
- A49
- A50
- A51
- A52
- A53
- A54
- A55
- A56
- A57
- A58
- A59
- A60
- A61
- A62
- A63
- A64
- A65
- A66
- A67
- A68
- A69
- A70
- A71
- A72
- A73
- A74
- Loan Purpose Off
- occupancy1 Off
- lien type Off
- lientype Off
- mixed use Off
- manufactured home Off
- deposit1 Off
- deposit2 Off
- B1
- B2
- B3
- B4
- B5
- B6
- B7
- B8
- B9
- B10
- fha Off
- Check Box51 Off
- B11
- B12
- B13
- B14
- B15
- B16
- B17
- B18
- B19 Off
- B20
- B21
- B22 Off
- B23
- B24
- B25
- B26
- B27
- B28
- A
-
- Will you occupy the property as your primary residence Off
- Will you occupy the property as your primary residence1 Off
-
- If yes have you had an ownership interest in another property in the last three years Off
- Text9-2
- B
-
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property Off
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property1 Off
-
- 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 Off
- 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 application1 Off
-
- 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 Off
- 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 application1 Off
-
- new credit Off
- 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) Off
- the Property Assessed Clean Energy Program)1 Off
-
- F
-
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application Off
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application1 Off
-
- G
-
- Are there any outstanding judgments against you Off
- Are there any outstanding judgments against you1 Off
-
- H
-
- Are you currently delinquent or in default on a Federal debt Off
- Are you currently delinquent or in default on a Federal debt1 Off
-
- I
-
- Are you a party to a lawsuit in which you potentially have any personal financial liability Off
- Are you a party to a lawsuit in which you potentially have any personal financial liability1 Off
-
- J
-
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years Off
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years1 Off
-
- 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 Off
- 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 due1 Off
-
- L
-
- Have you had property foreclosed upon in the last 7 years Off
- Have you had property foreclosed upon in the last 7 years1 Off
-
- M
-
- Have you declared bankruptcy within the past 7 years Off
- Have you declared bankruptcy within the past 7 years1 Off
-
- Check Box8-2 Off
- Check Box8-3 Off
- Check Box8-4 Off
- Text9-3
- Text9-5
- Text9-6
- Text97
- military Off
- ethnicity Off
- sex Off
- race Off
- demo Off
- Text12-1
- Check Box11-1 Off
- Check Box11-2 Off
- Check Box11-3 Off
- Check Box11-4 Off
- Check Box11-5 Off
- Check Box11-6 Off
- Check Box11-7 Off
- Check Box11-8 Off
- Check Box11-9 Off
- Text12-2
- Check Box11-10 Off
- Check Box11-11 Off
- Check Box11-12 Off
- Check Box11-13 Off
- Check Box11-14 Off
- Check Box11-15 Off
- Text12-3
- Check Box11-16 Off
- Check Box11-17 Off
- Check Box11-18 Off
- Check Box11-19 Off
- Check Box11-20 Off
- Check Box11-21 Off
- Check Box11-22 Off
- Check Box11-23 Off
- Text12-4
- Check Box11-24 Off
- Check Box11-25 Off
- Check Box11-26 Off
- Check Box11-27 Off
- Check Box11-28 Off
- Check Box11-29 Off
- Text12-5
- Check Box11-30 Off
- Check Box11-31 Off
- citizen Off
- credit Off
- marital status1 Off
- housing-1 Off
- housing-2 Off
- own Off
- C1
- C2
- C3
- C6
- C7
- C8
- C9
- C10
- C11
- C12
- C13
- C14
- C15
- C16
- C17
- C18
- C19
- C20
- C21
- C22
- C23
- C24
- C25
- C26
- C27
- C28
- C29
- C30
- C31
- C32
- C33
- C34
- C35
- Check Box-2 Off
- C36
- C37
- C38
- C39
- C4
- C40
- C41
- C42
- C43
- C44
- C45
- C46
- C47
- Check Box-3 Off
- Check Box-4 Off
- C48
- C49
- C5
- C50
- C51
- C52
- C53
- C54
- C55
- Check Box-1-1 Off
- own1 Off
- Check Box-1 Off
- D1 Off
- D2
- D3
- D4
- D5
- D6
- D7
- D8
- D9
- D10
- D11
- D12
- D13
- D14 Off
- D15 Off
- D16
- D17
- D18
- D19
- D20
- D21
- D22
- D23
- D24 Off
- D25
- D26
- D27
- D28
- D29
- D30
- D31
- D32
- D33
- D34
- D35 Off
- D36
- D37 Off
- D38
- D39
- D40
- D41
- D42
- D43
- D44
- D45
- D46
- D47
- If yes have you had an ownership interest in another property in the last three years1 Off
- new credit1 Off
- Check Box8-1 Off
- Check Box8-1-2 Off
- Check Box8-1-1 Off
- Check Box8-1-3 Off
- Check Box8-1-4 Off
- Military Service mdash Did you (or your deceased spouse) ever serve or are you currently serving in the United States Armed Forces 1 Off
- Check1 Off
- Text9-1-1
- Check2 Off
- Check3 Off
- Check4 Off
- Text9-1
- E1
- E2
- E3
- Was the ethnicity of the Borrower collected on the basis of visual observation or surname1 Off
- Was the sex of the Borrower collected on the basis of visual observation or surname1 Off
- Was the race of the Borrower collected on the basis of visual observation or surname1 Off
- The Demographic Information was provided through1 Off
- F1 Off
- F2 Off
- F3 Off
- F4 Off
- F5 Off
- F6
- F7 Off
- F8 Off
- F9 Off
- F10 Off
- F11 Off
- F12 Off
- F13
- F14 Off
- F15 Off
- F16 Off
- F17 Off
- F18 Off
- F19 Off
- F20 Off
- F21 Off
- F22
- F23 Off
- F24 Off
- F25 Off
- F26 Off
- F27 Off
- F28 Off
- F29
- F30 Off
- F31 Off
- undefined_13-1
- undefined_13-2
- undefined_14-1
- undefined_15-1
- undefined_16-1
- undefined_17-1
- undefined_18-1
- undefined_19-1
- undefined_21-1
- undefined_20-1
- undefined_23-1
- undefined_13_1
- Single-Two Off
- Refi type Off
- refi program Off
- Estate Off
- Title held Off
- Trust Information Off
- Indian Country Land Tenure Off
- Mortgage Type Applied For Off
- Mortgage Lien Type Off
- Amortization Type Off
- G1 Off
- G2 Off
- G3 Off
- G4 Off
- G5 Off
- G6
- G7
- G8
- G9
- G10 Off
- G11 Off
- G12 Off
- G13 Off
- G14 Off
- G15 Off
- G16
- G17
- G18
- G19
- G20
- G21
- G22
- G23 Off
- G24
- G25 Off
- G26
- G27 Off
- G28 Off
- G29
- G30 Off
- G31
- G32 Off
- G33
- G34
- G35
- G36
- G37
- G38
- G39
- G40
- G41
- G42
- Property Held
- refi
- Text18-1
- Text18-2
- Text18-3
- Text18-4
- Text18-5
- Text18-6
- Text18-7
- Text18-8
- Text18-9
- Text18-10
- Text18-11
- Text18-12
- Text18-13
- Text18-14
- Text18-15
- Text18-16
- Text18-17
- Text18-18
- Text18-19
- Lender
- case no
- If you selected ldquoUnmarriedrdquo in Section 1 is there a person who is not your legal spouse but who currently has real property rights similar to those of a legal spouse Off
- Relationship and State Off
- Other-5
- Text19-1
- BName
- Additional Information
- ABN
- Additional Information1
- BSign
- BSDate
- ABSign
- ABDate
- MortageeNameAddress
- NAmeAddress
- Bname1
- DOB1
- DOB2
- SignOfBorr1
- SignOfBorr
- Date Signed
- SignOfBorr2
- SignOfBorr3
- Date Signed3
- Date Signed4
- MortgageeRepSign
- DirectSign
- DirectSign1
- Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union Off
- AppSign
- AppSign1
- AppSign2
- AppSign3
- Nopage38 Off
- Yespage38 Off
- Yes1 Off
- No1 Off
- Yes2 Off
- Yes3 Off
- Yes4 Off
- Yes5 Off
- Yes6 Off
- Yes7 Off
- Yes8 Off
- Yes9 Off
- Yes10 Off
- No2 Off
- No3 Off
- No4 Off
- No5 Off
- No6 Off
- No7 Off
- No8 Off
- No9 Off
- No10 Off
- BorrowerNo Off
- BorrowerYes Off
- AppSignature
- AppSignature1
- CurrentSign
- CurrentSign1
- InterviewSign
- Yes_1 Off
- No_1 Off
- Yes_2 Off
- No_2 Off
- Mail Off
- Phone Off
GENERAL AUTHORIZATION FOR A MORTGAGE LOAN ASSUMPTION
Applicant name(s)
Loan number
NOTICES AND DISCLOSURES
Non-discriminatory underwriting guidelines Anyone who inquires about the availability of credit from us has the right to receive a copy of our non-discriminatory underwriting guidelines To request a copy of these guidelines contact your Loan Processor
Attorney note Itrsquos the responsibility of our attorneys to protect our interest You may at your expense request an attorney to represent your interest
Notice to HUDFHA applicants As required by the Right to Financial Privacy Act of 1978 this notice is to inform you that the US Department of Housing and Urban Development (HUD)Federal Housing Administration (FHA) has a right of access to financial records held by financial institutions related to a request for assistance Financial records involving your assumption will be available to HUDFHA without further notice or authorization but wonrsquot be disclosed or released by us to another government agency or department without your consent except as required or permitted by law
Borrower consent to the use of tax return information I understand acknowledge and agree that the Lender and Other Loan Participants can obtain use and share tax return information for purposes of (i) providing an offer (ii) originating maintaining managing monitoring servicing selling insuring and securitizing a loan (iii) marketing or (iv) as otherwise permitted by applicable laws including state and federal privacy and data security laws The Lender includes the Lenderrsquos affiliates agents service providers and any of aforementioned partiesrsquo successors and assigns The Other Loan Participants includes any actual or potential owners of a loan resulting from your loan application or acquirers of any beneficial or other interest in the loan and mortgage insurer guarantor any servicers or service providers for these parties and any of aforementioned partiesrsquo successors and assigns
CERTIFICATION AND AUTHORIZATION
Environmental certification By signing below I represent and warrant that Irsquom not aware of any substances materials or products that may be an environmental hazard such as but not limited to asbestos formaldehyde radon gas lead-based paint fuel or chemical storage tanks (above or below ground) and contaminated soil or water on the property I acknowledge that Chase is relying on this representation and warranty as a material part of its loan application process I also am not aware of any landfill on any portion of the property
Exceptions to the above I further acknowledge (1) receipt of applicable disclosures from the seller in purchase transactions (2) that lead-based paint may exist in housing constructed prior to 1978 (3) that Chase performs no environmental investigation on my behalf and isnrsquot responsible for identifying lead-based paint or any other environmental conditions that might impact the property or its residents and (4) that it is my sole obligation to investigate for potential impact to the property from environmental conditions
Certifications I certify by signing below that (1) all of the loan application information provided is true and complete (2) I understand any intentional or negligent misrepresentation(s) of the information provided in conjunction with my application may result in civil liability andor 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 Chase its agents successors and assigns insurers and any other person who may suffer any loss due to reliance upon any misrepresentation that I have made on the application and (3) any significant change from the information provided at the time of application until the final loan application is signed may have a bearing on the approval of my application for a home loan
Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union
This question is asked because of state laws that extend the same or similar rights benefits and protections of spouses in a marriage to persons who are members of a partnership or union recognized under state law You should consult with your own legal advisor for advice regarding the rights protections benefits responsibilities obligations and duties of those who are registered domestic partners civil union partners or members of other unions recognized under applicable law
CREDIT AUTHORIZATION RELEASE
By signing below I authorize Chase andor my mortgage insurer (if any) to verify my past and present employment earnings records (including information contained in income tax returns that have been filed with the IRS) bank accounts stock holdings and any other information that it finds necessary to process my mortgage loan application or to review it for quality-control purposes I understand that a credit report will be ordered from a credit reporting agency for verification prior to loan closing as part of the application process and may be ordered after closing as part of the Lenderrsquos quality-control program A credit report may also be completed as part of the Lenderrsquos servicing or collection of the loan or in consideration of any other product or service that the Lender may consider offering me in the future and at any time throughout the life of the loan I understand that use of a photocopy of this form may be necessary to verify one or more of my credit references I understand that a photocopy or fax copy of this form will also serve as authorization
By signing below each applicant acknowledges (1) making the above certifications and authorizations and (2) that each applicant has received and understands the above notices and disclosures
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
You do not have to give us this information but if you donrsquot your application for approval as a borrower may be delayed or rejected The information requested in this form is authorized by Title 38 USC Chapter 37 (if VA) by 12 USC Section 1701 et seq (if HUDFHA) by 42 USC Section 1452b (if HUDCPD) and Title 42 USC 1471 et seq or 7 USC 1921 et seq (if USDA FHA)
Updated December 2021 99177-GA-0215
1b
2b
Form 4506-C (September 2020)
Department of the Treasury - Internal Revenue Service
IVES Request for Transcript of Tax Return OMB Number
1545-1872
Do not sign this form unless all applicable lines have been completed Request may be rejected if the form is incomplete or illegible
For more information about Form 4506-C visit wwwirsgov and search IVES
1a Name shown on tax return (if a joint return enter the name shown first)
First social security number on tax return individual taxpayer identification number or employer identification number (see instructions)
2a If a joint return enter spousersquos name shown on tax return Second social security number or individual taxpayer identification number if joint tax return
3 Current name address (including apt room or suite no) city state and ZIP code (see instructions)
4 Previous address shown on the last return filed if different from line 3 (see instructions)
5a IVES participant name address and SOR mailbox ID
DataVerify 875 Greentree Rd 8 Parkway Center Pittsburgh PA 15220
5b Customer file number (if applicable) (see instructions)
Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing (see instructions)
6 Transcript requested Enter the tax form number here (1040 1065 1120 etc) and check the appropriate box below Enter only one tax form number per request 1040
a Return Transcript which includes most of the line items of a tax return as filed with the IRS A tax return transcript does not reflect changes made to the account after the return is processed Transcripts are only available for the following returns Form 1040 series Form 1065 Form 1120 Form 1120-A Form 1120-H Form 1120-L and Form 1120S Return transcripts are available for the current year and returns processed during the prior 3 processing years
b Account Transcript which contains information on the financial status of the account such as payments made on the account penalty assessments and adjustments made by you or the IRS after the return was filed Return information is limited to items such as tax liability and estimated tax payments Account transcripts are available for most returns
c Record of Account which provides the most detailed information as it is a combination of the Return Transcript and the Account Transcript Available for current year and 3 prior tax years
7 Form W-2 Form 1099 series Form 1098 series or Form 5498 series transcript The IRS can provide a transcript that includes data from these information returns State or local information is not included with the Form W-2 information The IRS may be able to provide this transcript information for up to 10 years Information for the current year is generally not available until the year after it is filed with the IRS For example W-2 information for 2016 filed in 2017 will likely not be available from the IRS until 2018 If you need W-2 information for retirement purposes you should contact the Social Security Administration at 1-800-772-1213
Caution If you need a copy of Form W-2 or Form 1099 you should first contact the payer To get a copy of the Form W-2 or Form 1099 filed with your return you must use Form 4506 and request a copy of your return which includes all attachments
8 Year or period requested Enter the ending date of the tax year or period using the mmddyyyy format (see instructions)
12 31 2020 12 31 2019 12 31 2018 Caution Do not sign this form unless all applicable lines have been completed
Signature of taxpayer(s) I declare that I am either the taxpayer whose name is shown on line 1a or 2a or a person authorized to obtain the tax information requested If the request applies to a joint return at least one spouse must sign If signed by a corporate officer 1 percent or more shareholder partner managing member guardian tax matters partner executor receiver administrator trustee or party other than the taxpayer I certify that I have the authority to execute Form 4506-C on behalf of the taxpayer Note This form must be received by IRS within 120 days of the signature date
Signatory attests that heshe has read the attestation clause and upon so reading declares that heshe has the authority to sign the Form 4506-C See instructions
Sign Here
Signature (see instructions) Date Phone number of taxpayer on line 1a or 2a
PrintType name
Title (if line 1a above is a corporation partnership estate or trust)
Spousersquos signature Date
PrintType name
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020) For Privacy Act and Paperwork Reduction Act Notice see page 2
Instructions for Form 4506-C IVES Request for Transcript of Tax Return
Section references are to the Internal Revenue Code unless otherwise noted
Future Developments
For the latest information about Form 4506-C and its instructions go to wwwirsgov and search IVES Information about any recent developments affecting Form 4506-C (such as legislation enacted after we released it) will be posted on that page
Whats New Form 4506-C was created to be utilized by authorized IVES participants to order tax transcripts with the consent of the taxpayer
General Instructions
Caution Do not sign this form unless all applicable lines have been completed
Designated Recipient Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information received pursuant to the taxpayerrsquos consent and holds the recipient subject to penalties for any unauthorized access other use or redisclosure without the taxpayerrsquos express permission or request
Taxpayer Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information provided pursuant to your consent and holds the recipient subject to penalties brought by private right of action for any unauthorized access other use or redisclosure without your express permission or request
Purpose of form Use Form 4506-C to request tax return information through an authorized IVES participant You will designate an IVES participant to receive the information on line 5a
Note If you are unsure of which type of transcript you need check with the party requesting your tax information
Where to file The IVES participant will fax Form 4506-C with the approved IVES cover sheet to their assigned Service Center
Chart for ordering transcripts
If your assigned Service Center is
Fax the requests with the approved coversheet to
Austin Submission Processing Center
Austin IVES Team
844-249-6238
Fresno Submission Processing Center
Fresno IVES Team
844-249-6239
Kansas City Submission Processing Center
Kansas City IVES Team
844-249-8128
Ogden Submission Processing Center
Ogden IVES Team
844-249-8129
Specific Instructions
Line 1b Enter the social security number (SSN) or individual taxpayer identification number (ITIN) for the individual listed on line 1a or enter the employer identification number (EIN) for the business listed on line 1a
Line 3 Enter your current address If you use a PO box include it on this line
Line 4 Enter the address shown on the last return filed if different from the address entered on line 3
Note If the addresses on lines 3 and 4 are different and you have not changed your address with the IRS file Form 8822 Change of Address or Form 8822-BChange of Address or Responsible Party mdash Business with Form 4506-C
Line 5b Enter up to 10 numeric characters to create a unique customer file number that will appear on the transcript The customer file number cannot contain an SSN ITIN or EIN Completion of this line is not required
Note If you use an SSN name or combination of both we will not input the information and the customer file number will reflect a generic entry of 9999999999 on the transcript
Line 8 Enter the end date of the tax year or period requested in mmddyyyy format This may be a calendar year fiscal year or quarter Enter each quarter requested for quarterly returns Example Enter 12312018 for a calendar year 2018 Form 1040 transcript
Signature and date Form 4506-C must be signed and dated by the taxpayer listed on line 1a or 2a The IRS must receive Form 4506-C within 120 days of the date signed by the taxpayer or it will be rejected Ensure that all applicable lines including lines 5a through 8 are completed before signing
You must check the box in the signature area to acknowledge you have the authority to sign and request the information The form will not be processed if unchecked
Individuals Transcripts listed on on line 6 may be furnished to either spouse if jointly filed Only one signature is required Sign Form 4506-C exactly as your name appeared on the original return If you changed your name also sign your current name
Corporations Generally Form 4506-C can be signed by
(1) an officer having legal authority to bind the corporation (2) any person designated by the board of directors or other governing body or (3) any officer or employee on written request by any principal officer and attested to by the secretary or other officer A bona fide shareholder of record owning 1 percent or more of the outstanding stock of the corporation may submit a Form 4506-C but must provide documentation to support the requesters right to receive the information
Partnerships Generally Form 4506-C can be signed by any person who was a member of the partnership during any part of the tax period requested on line 8
All others See section 6103(e) if the taxpayer has died is insolvent is a dissolved corporation or if a trustee guardian executor receiver or administrator is acting for the taxpayer
Note If you are Heir at law Next of kin or Beneficiary you must be able to establish a material interest in the estate or trust
Documentation For entities other than individuals you must attach the authorization document For example this could be the letter from the principal officer authorizing an employee of the corporation or the letters testamentary authorizing an individual to act for an estate
Signature by a representative A representative can sign Form 4506-C for a taxpayer only if the taxpayer has specifically delegated this authority to the representative on Form 2848 line 5 The representative must attach Form 2848 showing the delegation to sign Form 4506-C
Privacy Act and Paperwork Reduction Act Notice We ask for the information on this form to establish your right to gain access to the requested tax information under the Internal Revenue Code We need this information to properly identify the tax information and respond to your request You are not required to request any transcript if you do request a transcript sections 6103 and 6109 and their regulations require you to provide this information including your SSN or EIN If you do not provide this information we may not be able to process your request Providing false or fraudulent information may subject you to penalties
Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and cities states the District of Columbia and US commonwealths and possessions for use in administering their tax laws We may also disclose this information to other countries under a tax treaty to federal and state agencies to enforce federal nontax criminal laws or to federal law enforcement and intelligence agencies to combat terrorism
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law Generally tax returns and return information are confidential as required by section 6103
The time needed to complete and file Form 4506-C will vary depending on individual circumstances The estimated average time is
Learning about the law or the form 10 min Preparing the form 12 min Copying assembling and sending the form to the IRS 20 min
If you have comments concerning the accuracy of these time estimates or suggestions for making Form 4506-C simpler we would be happy to hear from you You can write to
Internal Revenue Service Tax Forms and Publications Division 1111 Constitution Ave NW IR-6526 Washington DC 20224
Do not send the form to this address Instead see Where to file on this page
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020)
Rev April 2021 CHASEO Facts What does Chase do with your personal information
Why Financial companies choose how they share your personal information Federal law gives consumers the right to limit some but not all sharing Federal law also requires us to tell you how we collect share and protect your personal information Please read this notice carefully to understand what we do
What The types of personal information we collect and share depend on the product or service you have with us This information can include bull Social Security number and income bull account balances and transaction history bull credit history and payment history
How All financial companies need to share customers personal information to run their everyday business In the section below we list the reasons financial companies can share their customers personal information the reasons Chase chooses to share and whether you can limit this sharing
Reasons we can share your personal information Does Chase share
Can you limit this sharing
For our everyday business purposes - such as to process your transactions maintain your account(s) respond to court orders and legal investigations or report to credit bureaus
Yes No
For our marketing purposes - to offer our products and services to you
Yes No
For joint marketing with other financial companies Yes No
For our affiliates everyday business purposes - information about your transactions and experiences
Yes No
For our affiliates everyday business purposes - information about your creditworthiness
Yes Yes
For our affiliates to market to you Yes Yes
For nonaffiliates to market to you Yes Yes
a
0
To limit our sharing
bull Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
bull Visit us online chasecomprivacypreferences
Please note If you are a new customer we can begin sharing your information 30 days from the date we sent this notice When you are no longer our customer we continue to share your information as described in this notice However you can contact us at any time to limit our sharing
Questions
Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
PAGE 2
Who we are
Who is providing this notice The US consumer financial companies within the JPMorgan Chase amp Co family including JPMorgan Chase Bank NA Chase Insurance Agency Inc and JP Morgan Securities LLC
What we do
How does Chase protect my To protect your personal information from unauthorized access and use we personal information use security measures that comply with federal law These measures include
computer safeguards and secured files and buildings We authorize our employees to get your information only when they need it to do their work and we require companies that work for us to protect your information
How does Chase collect my We collect your personal information for example when you personal information bull open an account or make deposits or withdrawals from your account
bull pay your bills or apply for a loan bull use your credit or debit card We also collect your personal information from others such as credit bureaus affiliates or other companies
Why cant I limit all sharing Federal law gives you the right to limit only bull sharing for affiliates everyday business purposes - information about your
creditworthiness bull affiliates from using your information to market to you bull sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing See below for more on your rights under state law
What happens when I limit sharing for an account I hold jointly with someone else
Your choices will apply to everyone on your account
Definitions
Affiliates Companies related by common ownership or control They can be financial and non financial companies bull Our affiliates include companies with a Chase or JP Morgan name and financial companies such asjP Morgan Securities LLC
Nonaffiliates Companies not related by common ownership or control They can be financial and non financial companies bull Nonaffiliates we share with can include companies such as retailers auto dealers auto makers and membership clubs
Joint marketing A formal agreement between nonaffiliated financial companies that together market financial products or services to you bull Our joint marketing partners include categories of companies such as insurance companies
Other important information
VT Accounts with a Vermont mailing address are automatically treated as if they have limited the sharing as described on page 1 For joint marketing we will only disclose your name contact information and information about your transactions
NV We are providing you this notice pursuant to Nevada law If you prefer not to receive marketing calls from us you may be placed on our Internal Do Not Call List by calling 1-800-945-9470 or by writing to us at PO Box 734007 Dallas TX 75373-4007
For more information contact us at the address above or email PrivacylnfoJPMChasecom with Nevada Annual Notice in the subject line You may also contact the Nevada Attorney Generals office Bureau of Consumer Protection Office of the Nevada Attorney General 555 E Washington St Suite 3900 Las Vegas NV 89101 telephone number 1-702-486-3132 email BCPINFOagstatenvus
CA Accounts with a California mailing address are automatically treated as if they have limited the sharing with nonaffiliates as described on page 1 CA residents are provided a CA notice for additional choices
CHASE O
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
The following disclosure is required by the USA PATRIOT Act
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 opens an account
What this means to you When you 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 drivers
license or other identifying documents
99177-PAT-0215
VETERAN STATEMENT When this loan was opened the US Department of Veterans Affairs (VA) used the veteran borrowerrsquos entitlement which is a set amount the VA promises to repay a lender if the borrower defaults on the mortgage An assumption will modify who is obligated to pay the existing mortgage loan but all loan termsmdashincluding the entitlementmdashwill remain the same If the veteran borrower is being removed from the loan the entitlement would remain with whoever is assuming the loan because the loan will continue to be serviced by the VA If the applicant is also a veteran and can substitute his or her entitlement for the current entitlement then the current borrowerrsquos entitlement can be released
Please review the following questions and answer as appropriate This form requires completion by both the applicant(s) and current borrower(s)
1 Applicant to Complete
Are you (the applicant) currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the reverse side)
Yes (If yes please provide the information requested below answer the question in section 3 and sign and date this form at the bottom of the reverse side)
Name of applicant(s) who answered ldquoyesrdquo to the above question
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Are you receiving VA disability benefts
Applicant
Yes
No
Co-Applicant
Yes
No
Are you entitled to receive VA disability benefts Yes No Yes No
Have you received VA disability benefts in the past Yes No Yes No
Are you a surviving spouse of a veteran who died on active duty or as the result of a service-related disability
Yes No Yes No
Do you have any VA loans Yes No Yes No
2 Current Borrower to Complete
Is the current borrowerco-borrower currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the page)
Yes (If yes please answer the question in section 3 and sign and date this form at the bottom of the page)
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
________________________________________________________________________________________________
3 Applicant and Current Borrower to Complete
If the answer to the questions in section 1 and 2 are both yes please answer the following question After yoursquove reviewed and completed this entire form please sign and date at the bottom
Applicant Current Borrower
Do you want to apply for a substitution of entitlement Yes Yes No No
In order to complete a substitution of entitlement the veteran applicant must have suffcient entitlement to substitute for that of the current borrower Contact the VA Offce of Jurisdiction for your area for more information Also before the veteran applicant can substitute entitlement on a VA loan heshe must certify that the property securing the loan will be occupied as hisher primary residence Both the applicantrsquos and current borrowerrsquos original certifcate of eligibility will be required If your sales contract is contingent upon the restoration of entitlement please contact your VA Offce of Jurisdiction for complete procedures Otherwise the substitution will be completed after the loan has been approved and closed
Date Applicant printed name Applicant signature
Date Applicant printed name Applicant signature
Date Current Borrower printed name Current Borrower signature
Date Current Borrower printed name Current Borrower signature
Forms completed by Mail Phone
For Chase use only
Interviewer signature Date
99177-VS-0215
- Assumption Application Package_41521-noscannedpages-update-4pdf
-
- 1 FM203 Cover Pagepdf
- 2 FM202 Mortgage Assumption Application Package pagepdf
- 3 The Documents Youll need to Send Uspdf
- 4 FM201 FAQpdf
- 5 FM142 CIWpdf
- 6 FM126 URLApdf
- 7 FM130 URLA Instpdf
-
- Blank Page
-
- 8 92900a Addednum to Loan Applicationpdf
- 9 FM462 Gen Authpdf
- 10 FM220 4506-Cpdf
- 11 FM153 Chase Federal Privacy Noticepdf
- 12 FM144 Info on Opening a New Accountpdf
- 13 FM152 Veteran Statementpdf
-
- Date
- Loan number
- Applicant name
- Phone1
- Loan number 1
- Loan number 2
- Other
- Other_2
- 1
- 2
- undefined_7
- Available hours
- Available hours_2
- undefined_8
- Available hours_3
- undefined_9
- Current address 1
- Neither
- Available hours_4
- Available hours_5
- undefined_10
- Available hours_6
- 1_2
- 2_2
- undefined_11
- Available hours_7
- Available hours_8
- undefined_12
- Available hours_9
- FHA Case No include any suffix
- Mortgagee Case No
- Mortgagee ID
- Sponsor ID
- Agent ID
- Name and Address of Sponsor Name and Address of Agent
- Borrowers Name Present Address include ZIP Code Property Address
- include name of subdivision lot block no ZIP Code
- Name of ThirdParty Originator
- NMLS ID of ThirdParty Originator
- s application
- ty Number
- ty Number_2
- Date Signed_2
- Date Mortgage Approved
- Date Approval Expires
- Printed Name
- Title 1
- DEs ID Number
- DEs ID Number_2
- Mortgagee
- Name of Mortgagees Representative
- Title of Mortgagees Representative
- Signature of the Mortgagees Representative
- Date_2
- Applicant names 1
- Applicant names 2
- Applicant names 3
- Loan number_2
- Date_3
- Applicant printed name
- Social Security number
- Date_4
- Applicant printed name_2
- Social Security number_2
- Date_5
- Applicant printed name_3
- Social Security number_3
- Date_6
- Applicant printed name_4
- Social Security number_4
- 1a Name shown on tax return if a joint return enter the name shown first
- 1b First social security number on tax return individual taxpayer identification number or employer identification number see instructions
- 2a If a joint return enter spouses name shown on tax return
- 2b Second social security number or individual taxpayer identification number if joint tax return
- 4 Previous address shown on the last return filed if different from line 3 see instructions
- 5a IVES participant name address and SOR mailbox ID
- Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing see instructions
- Signature see instructions
- Date_7
- Phone number of taxpayer on line 1a or 2a
- PrintType name
- Here
- Spouses signature
- Date_8
- PrintType name_2
- Name
- Date of birth
- Service number
- Name_2
- Date of birth_2
- Service number_2
- Date_9
- Applicant printed name_5
- Date_10
- Applicant printed name_6
- Date_11
- Current Borrower printed name
- Date_12
- Current Borrower printed name_2
- Date_13
- Text3
- Text10
- undefined_13
- Text15
- undefined_14
- undefined_15
- undefined_16
- undefined_17
- undefined_18
- undefined_19
- undefined_20
- undefined_21
- undefined_23
- Reason for assumption Off
- Requestors relationship to owners Off
- Check one Off
- Check one1 Off
- Day1
- Evening
- Cell phone
- Check one2 Off
- Check one3 Off
- Check one4 Off
- Check one5 Off
- Text2-1
- Text2-2
- Text2-3
- Text2-4
- Text2-5
- Text2-6
- Text3-1
- Text3-2
- Text3-3
- Text3-4
- Text3-6
- Text3-7
- Text3-8
- Text3-9
- Text3-10
- Text3-11
- Text3-12
- Text3-13
- Text3-14
- Text3-15
- Text3-16
- Text3-17
- Text3-18
- Text3-19
- Text3-20
- Text3-21
- Text3-22
- Text3-23
- Text3-24
- Text3-25
- Text3-26
- Text3-27
- Text3-28
- Text3-29
- Text3-30
- Text3-31
- Text3-32
- Text3-33
- Text3-34
- Text3-35
- Text3-36
- Text3-37
- Text3-38
- Text3-39
- Text3-40
- Text3-41
- Text3-42
- Text3-43
- Text3-44
- Text3-45
- Text3-46
- Text3-47
- Text3-48
- Text3-49
- Text3-50
- Text3-51
- Text3-52
- Text3-53
- Text3-5
- Text3-54
- Text3-55
- Text3-56
- Citizenship Off
- Type of credit Off
- Marital Status Off
- Housing Off
- Housing1 Off
- ownership Off
- DNA1 Off
- DNA2 Off
- DNA3 Off
- family Off
- BO Off
- Total
- Text31
- Text32
- Text33
- Text34
- Text35
- Text36
- Text37
- Text38
- Text39
- Text310
- Text311
- Text312
- Text313
- Text314
- Text315
- Text316
- Text317
- Text318
- Text319
- ownership1 Off
- Total1
- Total1-2
- Check Box4-1 Off
- Text320
- Text321
- Text322
- Text323
- Text324
- Text325
- Text326
- Text327
- Text328
- Text329
- Check Box4-2 Off
- Check Box4-3 Off
- Check Box4-4 Off
- Check Box4-8 Off
- Check Box4-9 Off
- Text330
- Text331
- Text332
- Text333
- Text334
- Text335
- Text1-1
- Text1-2
- Text1-3
- Text1-4
- Text1-5
- Text1-6
- Text1-7
- Text1-8
- Text1-9
- Text1-10
- Text1-11
- Text1-12
- Text1-13
- Text1-14
- Text1-15
- Text1-16
- Text1-17
- Text1-18
- Text1-19
- Text1-20
- Text1-21
- Text1-22
- Text1-23
- Text1-24
- Text1-25
- Text1-26
- Text1-27
- Text1-28
- Text1-29
- Text1-30
- Text1-31
- Text1-32
- Text1-33
- Text1-34
- Text1-35
- Check Box3-2 Off
- Check Box2-1 Off
- Check Box2-2 Off
- Check Box2-3 Off
- Check Box2-4 Off
- Check Box2-5 Off
- Text1-36
- Text1-37
- Text1-38
- Text1-39
- Text1-40
- Text1-41
- Text1-42
- Text1-43
- Text1-44
- Text1-45
- Text1-46
- Text1-47
- Text1-48
- Text1-49
- Text1-50
- Text1-51
- Text1-52
- Text1-53
- Text1-54
- Text1-55
- Text1-56
- Text1-57
- Text1-58
- Text1-59
- Text1-60
- Text1-61
- Check Box3-11 Off
- A1
- A2
- A3
- A4
- A5
- A6
- A7
- A8
- A9
- A10
- A11
- A12
- Check Box3-1 Off
- Check Box30-1 Off
- Check Box30-2 Off
- Check Box30-4 Off
- Check Box30-5 Off
- Check Box30-7 Off
- Check Box30-8 Off
- Check Box30-9 Off
- Check Box30-10 Off
- Check Box30-11 Off
- Check Box30-12 Off
- A13
- A14
- A15
- A16
- A17 Off
- A18
- A19
- A20
- A21
- A22
- A23
- A24
- A25
- A26
- A27
- A28
- A29
- A30
- A31
- A32
- A33
- A34
- A35
- A36
- A37
- A38 Off
- A39
- A40
- A41
- A42
- A43
- A44
- A45
- A46
- A47
- A48
- A49
- A50
- A51
- A52
- A53
- A54
- A55
- A56
- A57
- A58
- A59
- A60
- A61
- A62
- A63
- A64
- A65
- A66
- A67
- A68
- A69
- A70
- A71
- A72
- A73
- A74
- Loan Purpose Off
- occupancy1 Off
- lien type Off
- lientype Off
- mixed use Off
- manufactured home Off
- deposit1 Off
- deposit2 Off
- B1
- B2
- B3
- B4
- B5
- B6
- B7
- B8
- B9
- B10
- fha Off
- Check Box51 Off
- B11
- B12
- B13
- B14
- B15
- B16
- B17
- B18
- B19 Off
- B20
- B21
- B22 Off
- B23
- B24
- B25
- B26
- B27
- B28
- A
-
- Will you occupy the property as your primary residence Off
- Will you occupy the property as your primary residence1 Off
-
- If yes have you had an ownership interest in another property in the last three years Off
- Text9-2
- B
-
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property Off
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property1 Off
-
- 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 Off
- 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 application1 Off
-
- 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 Off
- 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 application1 Off
-
- new credit Off
- 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) Off
- the Property Assessed Clean Energy Program)1 Off
-
- F
-
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application Off
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application1 Off
-
- G
-
- Are there any outstanding judgments against you Off
- Are there any outstanding judgments against you1 Off
-
- H
-
- Are you currently delinquent or in default on a Federal debt Off
- Are you currently delinquent or in default on a Federal debt1 Off
-
- I
-
- Are you a party to a lawsuit in which you potentially have any personal financial liability Off
- Are you a party to a lawsuit in which you potentially have any personal financial liability1 Off
-
- J
-
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years Off
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years1 Off
-
- 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 Off
- 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 due1 Off
-
- L
-
- Have you had property foreclosed upon in the last 7 years Off
- Have you had property foreclosed upon in the last 7 years1 Off
-
- M
-
- Have you declared bankruptcy within the past 7 years Off
- Have you declared bankruptcy within the past 7 years1 Off
-
- Check Box8-2 Off
- Check Box8-3 Off
- Check Box8-4 Off
- Text9-3
- Text9-5
- Text9-6
- Text97
- military Off
- ethnicity Off
- sex Off
- race Off
- demo Off
- Text12-1
- Check Box11-1 Off
- Check Box11-2 Off
- Check Box11-3 Off
- Check Box11-4 Off
- Check Box11-5 Off
- Check Box11-6 Off
- Check Box11-7 Off
- Check Box11-8 Off
- Check Box11-9 Off
- Text12-2
- Check Box11-10 Off
- Check Box11-11 Off
- Check Box11-12 Off
- Check Box11-13 Off
- Check Box11-14 Off
- Check Box11-15 Off
- Text12-3
- Check Box11-16 Off
- Check Box11-17 Off
- Check Box11-18 Off
- Check Box11-19 Off
- Check Box11-20 Off
- Check Box11-21 Off
- Check Box11-22 Off
- Check Box11-23 Off
- Text12-4
- Check Box11-24 Off
- Check Box11-25 Off
- Check Box11-26 Off
- Check Box11-27 Off
- Check Box11-28 Off
- Check Box11-29 Off
- Text12-5
- Check Box11-30 Off
- Check Box11-31 Off
- citizen Off
- credit Off
- marital status1 Off
- housing-1 Off
- housing-2 Off
- own Off
- C1
- C2
- C3
- C6
- C7
- C8
- C9
- C10
- C11
- C12
- C13
- C14
- C15
- C16
- C17
- C18
- C19
- C20
- C21
- C22
- C23
- C24
- C25
- C26
- C27
- C28
- C29
- C30
- C31
- C32
- C33
- C34
- C35
- Check Box-2 Off
- C36
- C37
- C38
- C39
- C4
- C40
- C41
- C42
- C43
- C44
- C45
- C46
- C47
- Check Box-3 Off
- Check Box-4 Off
- C48
- C49
- C5
- C50
- C51
- C52
- C53
- C54
- C55
- Check Box-1-1 Off
- own1 Off
- Check Box-1 Off
- D1 Off
- D2
- D3
- D4
- D5
- D6
- D7
- D8
- D9
- D10
- D11
- D12
- D13
- D14 Off
- D15 Off
- D16
- D17
- D18
- D19
- D20
- D21
- D22
- D23
- D24 Off
- D25
- D26
- D27
- D28
- D29
- D30
- D31
- D32
- D33
- D34
- D35 Off
- D36
- D37 Off
- D38
- D39
- D40
- D41
- D42
- D43
- D44
- D45
- D46
- D47
- If yes have you had an ownership interest in another property in the last three years1 Off
- new credit1 Off
- Check Box8-1 Off
- Check Box8-1-2 Off
- Check Box8-1-1 Off
- Check Box8-1-3 Off
- Check Box8-1-4 Off
- Military Service mdash Did you (or your deceased spouse) ever serve or are you currently serving in the United States Armed Forces 1 Off
- Check1 Off
- Text9-1-1
- Check2 Off
- Check3 Off
- Check4 Off
- Text9-1
- E1
- E2
- E3
- Was the ethnicity of the Borrower collected on the basis of visual observation or surname1 Off
- Was the sex of the Borrower collected on the basis of visual observation or surname1 Off
- Was the race of the Borrower collected on the basis of visual observation or surname1 Off
- The Demographic Information was provided through1 Off
- F1 Off
- F2 Off
- F3 Off
- F4 Off
- F5 Off
- F6
- F7 Off
- F8 Off
- F9 Off
- F10 Off
- F11 Off
- F12 Off
- F13
- F14 Off
- F15 Off
- F16 Off
- F17 Off
- F18 Off
- F19 Off
- F20 Off
- F21 Off
- F22
- F23 Off
- F24 Off
- F25 Off
- F26 Off
- F27 Off
- F28 Off
- F29
- F30 Off
- F31 Off
- undefined_13-1
- undefined_13-2
- undefined_14-1
- undefined_15-1
- undefined_16-1
- undefined_17-1
- undefined_18-1
- undefined_19-1
- undefined_21-1
- undefined_20-1
- undefined_23-1
- undefined_13_1
- Single-Two Off
- Refi type Off
- refi program Off
- Estate Off
- Title held Off
- Trust Information Off
- Indian Country Land Tenure Off
- Mortgage Type Applied For Off
- Mortgage Lien Type Off
- Amortization Type Off
- G1 Off
- G2 Off
- G3 Off
- G4 Off
- G5 Off
- G6
- G7
- G8
- G9
- G10 Off
- G11 Off
- G12 Off
- G13 Off
- G14 Off
- G15 Off
- G16
- G17
- G18
- G19
- G20
- G21
- G22
- G23 Off
- G24
- G25 Off
- G26
- G27 Off
- G28 Off
- G29
- G30 Off
- G31
- G32 Off
- G33
- G34
- G35
- G36
- G37
- G38
- G39
- G40
- G41
- G42
- Property Held
- refi
- Text18-1
- Text18-2
- Text18-3
- Text18-4
- Text18-5
- Text18-6
- Text18-7
- Text18-8
- Text18-9
- Text18-10
- Text18-11
- Text18-12
- Text18-13
- Text18-14
- Text18-15
- Text18-16
- Text18-17
- Text18-18
- Text18-19
- Lender
- case no
- If you selected ldquoUnmarriedrdquo in Section 1 is there a person who is not your legal spouse but who currently has real property rights similar to those of a legal spouse Off
- Relationship and State Off
- Other-5
- Text19-1
- BName
- Additional Information
- ABN
- Additional Information1
- BSign
- BSDate
- ABSign
- ABDate
- MortageeNameAddress
- NAmeAddress
- Bname1
- DOB1
- DOB2
- SignOfBorr1
- SignOfBorr
- Date Signed
- SignOfBorr2
- SignOfBorr3
- Date Signed3
- Date Signed4
- MortgageeRepSign
- DirectSign
- DirectSign1
- Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union Off
- AppSign
- AppSign1
- AppSign2
- AppSign3
- Nopage38 Off
- Yespage38 Off
- Yes1 Off
- No1 Off
- Yes2 Off
- Yes3 Off
- Yes4 Off
- Yes5 Off
- Yes6 Off
- Yes7 Off
- Yes8 Off
- Yes9 Off
- Yes10 Off
- No2 Off
- No3 Off
- No4 Off
- No5 Off
- No6 Off
- No7 Off
- No8 Off
- No9 Off
- No10 Off
- BorrowerNo Off
- BorrowerYes Off
- AppSignature
- AppSignature1
- CurrentSign
- CurrentSign1
- InterviewSign
- Yes_1 Off
- No_1 Off
- Yes_2 Off
- No_2 Off
- Mail Off
- Phone Off
Certifications I certify by signing below that (1) all of the loan application information provided is true and complete (2) I understand any intentional or negligent misrepresentation(s) of the information provided in conjunction with my application may result in civil liability andor 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 Chase its agents successors and assigns insurers and any other person who may suffer any loss due to reliance upon any misrepresentation that I have made on the application and (3) any significant change from the information provided at the time of application until the final loan application is signed may have a bearing on the approval of my application for a home loan
Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union
This question is asked because of state laws that extend the same or similar rights benefits and protections of spouses in a marriage to persons who are members of a partnership or union recognized under state law You should consult with your own legal advisor for advice regarding the rights protections benefits responsibilities obligations and duties of those who are registered domestic partners civil union partners or members of other unions recognized under applicable law
CREDIT AUTHORIZATION RELEASE
By signing below I authorize Chase andor my mortgage insurer (if any) to verify my past and present employment earnings records (including information contained in income tax returns that have been filed with the IRS) bank accounts stock holdings and any other information that it finds necessary to process my mortgage loan application or to review it for quality-control purposes I understand that a credit report will be ordered from a credit reporting agency for verification prior to loan closing as part of the application process and may be ordered after closing as part of the Lenderrsquos quality-control program A credit report may also be completed as part of the Lenderrsquos servicing or collection of the loan or in consideration of any other product or service that the Lender may consider offering me in the future and at any time throughout the life of the loan I understand that use of a photocopy of this form may be necessary to verify one or more of my credit references I understand that a photocopy or fax copy of this form will also serve as authorization
By signing below each applicant acknowledges (1) making the above certifications and authorizations and (2) that each applicant has received and understands the above notices and disclosures
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
Date Applicant printed name Applicant signature Social Security number
You do not have to give us this information but if you donrsquot your application for approval as a borrower may be delayed or rejected The information requested in this form is authorized by Title 38 USC Chapter 37 (if VA) by 12 USC Section 1701 et seq (if HUDFHA) by 42 USC Section 1452b (if HUDCPD) and Title 42 USC 1471 et seq or 7 USC 1921 et seq (if USDA FHA)
Updated December 2021 99177-GA-0215
1b
2b
Form 4506-C (September 2020)
Department of the Treasury - Internal Revenue Service
IVES Request for Transcript of Tax Return OMB Number
1545-1872
Do not sign this form unless all applicable lines have been completed Request may be rejected if the form is incomplete or illegible
For more information about Form 4506-C visit wwwirsgov and search IVES
1a Name shown on tax return (if a joint return enter the name shown first)
First social security number on tax return individual taxpayer identification number or employer identification number (see instructions)
2a If a joint return enter spousersquos name shown on tax return Second social security number or individual taxpayer identification number if joint tax return
3 Current name address (including apt room or suite no) city state and ZIP code (see instructions)
4 Previous address shown on the last return filed if different from line 3 (see instructions)
5a IVES participant name address and SOR mailbox ID
DataVerify 875 Greentree Rd 8 Parkway Center Pittsburgh PA 15220
5b Customer file number (if applicable) (see instructions)
Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing (see instructions)
6 Transcript requested Enter the tax form number here (1040 1065 1120 etc) and check the appropriate box below Enter only one tax form number per request 1040
a Return Transcript which includes most of the line items of a tax return as filed with the IRS A tax return transcript does not reflect changes made to the account after the return is processed Transcripts are only available for the following returns Form 1040 series Form 1065 Form 1120 Form 1120-A Form 1120-H Form 1120-L and Form 1120S Return transcripts are available for the current year and returns processed during the prior 3 processing years
b Account Transcript which contains information on the financial status of the account such as payments made on the account penalty assessments and adjustments made by you or the IRS after the return was filed Return information is limited to items such as tax liability and estimated tax payments Account transcripts are available for most returns
c Record of Account which provides the most detailed information as it is a combination of the Return Transcript and the Account Transcript Available for current year and 3 prior tax years
7 Form W-2 Form 1099 series Form 1098 series or Form 5498 series transcript The IRS can provide a transcript that includes data from these information returns State or local information is not included with the Form W-2 information The IRS may be able to provide this transcript information for up to 10 years Information for the current year is generally not available until the year after it is filed with the IRS For example W-2 information for 2016 filed in 2017 will likely not be available from the IRS until 2018 If you need W-2 information for retirement purposes you should contact the Social Security Administration at 1-800-772-1213
Caution If you need a copy of Form W-2 or Form 1099 you should first contact the payer To get a copy of the Form W-2 or Form 1099 filed with your return you must use Form 4506 and request a copy of your return which includes all attachments
8 Year or period requested Enter the ending date of the tax year or period using the mmddyyyy format (see instructions)
12 31 2020 12 31 2019 12 31 2018 Caution Do not sign this form unless all applicable lines have been completed
Signature of taxpayer(s) I declare that I am either the taxpayer whose name is shown on line 1a or 2a or a person authorized to obtain the tax information requested If the request applies to a joint return at least one spouse must sign If signed by a corporate officer 1 percent or more shareholder partner managing member guardian tax matters partner executor receiver administrator trustee or party other than the taxpayer I certify that I have the authority to execute Form 4506-C on behalf of the taxpayer Note This form must be received by IRS within 120 days of the signature date
Signatory attests that heshe has read the attestation clause and upon so reading declares that heshe has the authority to sign the Form 4506-C See instructions
Sign Here
Signature (see instructions) Date Phone number of taxpayer on line 1a or 2a
PrintType name
Title (if line 1a above is a corporation partnership estate or trust)
Spousersquos signature Date
PrintType name
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020) For Privacy Act and Paperwork Reduction Act Notice see page 2
Instructions for Form 4506-C IVES Request for Transcript of Tax Return
Section references are to the Internal Revenue Code unless otherwise noted
Future Developments
For the latest information about Form 4506-C and its instructions go to wwwirsgov and search IVES Information about any recent developments affecting Form 4506-C (such as legislation enacted after we released it) will be posted on that page
Whats New Form 4506-C was created to be utilized by authorized IVES participants to order tax transcripts with the consent of the taxpayer
General Instructions
Caution Do not sign this form unless all applicable lines have been completed
Designated Recipient Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information received pursuant to the taxpayerrsquos consent and holds the recipient subject to penalties for any unauthorized access other use or redisclosure without the taxpayerrsquos express permission or request
Taxpayer Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information provided pursuant to your consent and holds the recipient subject to penalties brought by private right of action for any unauthorized access other use or redisclosure without your express permission or request
Purpose of form Use Form 4506-C to request tax return information through an authorized IVES participant You will designate an IVES participant to receive the information on line 5a
Note If you are unsure of which type of transcript you need check with the party requesting your tax information
Where to file The IVES participant will fax Form 4506-C with the approved IVES cover sheet to their assigned Service Center
Chart for ordering transcripts
If your assigned Service Center is
Fax the requests with the approved coversheet to
Austin Submission Processing Center
Austin IVES Team
844-249-6238
Fresno Submission Processing Center
Fresno IVES Team
844-249-6239
Kansas City Submission Processing Center
Kansas City IVES Team
844-249-8128
Ogden Submission Processing Center
Ogden IVES Team
844-249-8129
Specific Instructions
Line 1b Enter the social security number (SSN) or individual taxpayer identification number (ITIN) for the individual listed on line 1a or enter the employer identification number (EIN) for the business listed on line 1a
Line 3 Enter your current address If you use a PO box include it on this line
Line 4 Enter the address shown on the last return filed if different from the address entered on line 3
Note If the addresses on lines 3 and 4 are different and you have not changed your address with the IRS file Form 8822 Change of Address or Form 8822-BChange of Address or Responsible Party mdash Business with Form 4506-C
Line 5b Enter up to 10 numeric characters to create a unique customer file number that will appear on the transcript The customer file number cannot contain an SSN ITIN or EIN Completion of this line is not required
Note If you use an SSN name or combination of both we will not input the information and the customer file number will reflect a generic entry of 9999999999 on the transcript
Line 8 Enter the end date of the tax year or period requested in mmddyyyy format This may be a calendar year fiscal year or quarter Enter each quarter requested for quarterly returns Example Enter 12312018 for a calendar year 2018 Form 1040 transcript
Signature and date Form 4506-C must be signed and dated by the taxpayer listed on line 1a or 2a The IRS must receive Form 4506-C within 120 days of the date signed by the taxpayer or it will be rejected Ensure that all applicable lines including lines 5a through 8 are completed before signing
You must check the box in the signature area to acknowledge you have the authority to sign and request the information The form will not be processed if unchecked
Individuals Transcripts listed on on line 6 may be furnished to either spouse if jointly filed Only one signature is required Sign Form 4506-C exactly as your name appeared on the original return If you changed your name also sign your current name
Corporations Generally Form 4506-C can be signed by
(1) an officer having legal authority to bind the corporation (2) any person designated by the board of directors or other governing body or (3) any officer or employee on written request by any principal officer and attested to by the secretary or other officer A bona fide shareholder of record owning 1 percent or more of the outstanding stock of the corporation may submit a Form 4506-C but must provide documentation to support the requesters right to receive the information
Partnerships Generally Form 4506-C can be signed by any person who was a member of the partnership during any part of the tax period requested on line 8
All others See section 6103(e) if the taxpayer has died is insolvent is a dissolved corporation or if a trustee guardian executor receiver or administrator is acting for the taxpayer
Note If you are Heir at law Next of kin or Beneficiary you must be able to establish a material interest in the estate or trust
Documentation For entities other than individuals you must attach the authorization document For example this could be the letter from the principal officer authorizing an employee of the corporation or the letters testamentary authorizing an individual to act for an estate
Signature by a representative A representative can sign Form 4506-C for a taxpayer only if the taxpayer has specifically delegated this authority to the representative on Form 2848 line 5 The representative must attach Form 2848 showing the delegation to sign Form 4506-C
Privacy Act and Paperwork Reduction Act Notice We ask for the information on this form to establish your right to gain access to the requested tax information under the Internal Revenue Code We need this information to properly identify the tax information and respond to your request You are not required to request any transcript if you do request a transcript sections 6103 and 6109 and their regulations require you to provide this information including your SSN or EIN If you do not provide this information we may not be able to process your request Providing false or fraudulent information may subject you to penalties
Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and cities states the District of Columbia and US commonwealths and possessions for use in administering their tax laws We may also disclose this information to other countries under a tax treaty to federal and state agencies to enforce federal nontax criminal laws or to federal law enforcement and intelligence agencies to combat terrorism
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law Generally tax returns and return information are confidential as required by section 6103
The time needed to complete and file Form 4506-C will vary depending on individual circumstances The estimated average time is
Learning about the law or the form 10 min Preparing the form 12 min Copying assembling and sending the form to the IRS 20 min
If you have comments concerning the accuracy of these time estimates or suggestions for making Form 4506-C simpler we would be happy to hear from you You can write to
Internal Revenue Service Tax Forms and Publications Division 1111 Constitution Ave NW IR-6526 Washington DC 20224
Do not send the form to this address Instead see Where to file on this page
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020)
Rev April 2021 CHASEO Facts What does Chase do with your personal information
Why Financial companies choose how they share your personal information Federal law gives consumers the right to limit some but not all sharing Federal law also requires us to tell you how we collect share and protect your personal information Please read this notice carefully to understand what we do
What The types of personal information we collect and share depend on the product or service you have with us This information can include bull Social Security number and income bull account balances and transaction history bull credit history and payment history
How All financial companies need to share customers personal information to run their everyday business In the section below we list the reasons financial companies can share their customers personal information the reasons Chase chooses to share and whether you can limit this sharing
Reasons we can share your personal information Does Chase share
Can you limit this sharing
For our everyday business purposes - such as to process your transactions maintain your account(s) respond to court orders and legal investigations or report to credit bureaus
Yes No
For our marketing purposes - to offer our products and services to you
Yes No
For joint marketing with other financial companies Yes No
For our affiliates everyday business purposes - information about your transactions and experiences
Yes No
For our affiliates everyday business purposes - information about your creditworthiness
Yes Yes
For our affiliates to market to you Yes Yes
For nonaffiliates to market to you Yes Yes
a
0
To limit our sharing
bull Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
bull Visit us online chasecomprivacypreferences
Please note If you are a new customer we can begin sharing your information 30 days from the date we sent this notice When you are no longer our customer we continue to share your information as described in this notice However you can contact us at any time to limit our sharing
Questions
Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
PAGE 2
Who we are
Who is providing this notice The US consumer financial companies within the JPMorgan Chase amp Co family including JPMorgan Chase Bank NA Chase Insurance Agency Inc and JP Morgan Securities LLC
What we do
How does Chase protect my To protect your personal information from unauthorized access and use we personal information use security measures that comply with federal law These measures include
computer safeguards and secured files and buildings We authorize our employees to get your information only when they need it to do their work and we require companies that work for us to protect your information
How does Chase collect my We collect your personal information for example when you personal information bull open an account or make deposits or withdrawals from your account
bull pay your bills or apply for a loan bull use your credit or debit card We also collect your personal information from others such as credit bureaus affiliates or other companies
Why cant I limit all sharing Federal law gives you the right to limit only bull sharing for affiliates everyday business purposes - information about your
creditworthiness bull affiliates from using your information to market to you bull sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing See below for more on your rights under state law
What happens when I limit sharing for an account I hold jointly with someone else
Your choices will apply to everyone on your account
Definitions
Affiliates Companies related by common ownership or control They can be financial and non financial companies bull Our affiliates include companies with a Chase or JP Morgan name and financial companies such asjP Morgan Securities LLC
Nonaffiliates Companies not related by common ownership or control They can be financial and non financial companies bull Nonaffiliates we share with can include companies such as retailers auto dealers auto makers and membership clubs
Joint marketing A formal agreement between nonaffiliated financial companies that together market financial products or services to you bull Our joint marketing partners include categories of companies such as insurance companies
Other important information
VT Accounts with a Vermont mailing address are automatically treated as if they have limited the sharing as described on page 1 For joint marketing we will only disclose your name contact information and information about your transactions
NV We are providing you this notice pursuant to Nevada law If you prefer not to receive marketing calls from us you may be placed on our Internal Do Not Call List by calling 1-800-945-9470 or by writing to us at PO Box 734007 Dallas TX 75373-4007
For more information contact us at the address above or email PrivacylnfoJPMChasecom with Nevada Annual Notice in the subject line You may also contact the Nevada Attorney Generals office Bureau of Consumer Protection Office of the Nevada Attorney General 555 E Washington St Suite 3900 Las Vegas NV 89101 telephone number 1-702-486-3132 email BCPINFOagstatenvus
CA Accounts with a California mailing address are automatically treated as if they have limited the sharing with nonaffiliates as described on page 1 CA residents are provided a CA notice for additional choices
CHASE O
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
The following disclosure is required by the USA PATRIOT Act
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 opens an account
What this means to you When you 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 drivers
license or other identifying documents
99177-PAT-0215
VETERAN STATEMENT When this loan was opened the US Department of Veterans Affairs (VA) used the veteran borrowerrsquos entitlement which is a set amount the VA promises to repay a lender if the borrower defaults on the mortgage An assumption will modify who is obligated to pay the existing mortgage loan but all loan termsmdashincluding the entitlementmdashwill remain the same If the veteran borrower is being removed from the loan the entitlement would remain with whoever is assuming the loan because the loan will continue to be serviced by the VA If the applicant is also a veteran and can substitute his or her entitlement for the current entitlement then the current borrowerrsquos entitlement can be released
Please review the following questions and answer as appropriate This form requires completion by both the applicant(s) and current borrower(s)
1 Applicant to Complete
Are you (the applicant) currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the reverse side)
Yes (If yes please provide the information requested below answer the question in section 3 and sign and date this form at the bottom of the reverse side)
Name of applicant(s) who answered ldquoyesrdquo to the above question
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Are you receiving VA disability benefts
Applicant
Yes
No
Co-Applicant
Yes
No
Are you entitled to receive VA disability benefts Yes No Yes No
Have you received VA disability benefts in the past Yes No Yes No
Are you a surviving spouse of a veteran who died on active duty or as the result of a service-related disability
Yes No Yes No
Do you have any VA loans Yes No Yes No
2 Current Borrower to Complete
Is the current borrowerco-borrower currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the page)
Yes (If yes please answer the question in section 3 and sign and date this form at the bottom of the page)
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
________________________________________________________________________________________________
3 Applicant and Current Borrower to Complete
If the answer to the questions in section 1 and 2 are both yes please answer the following question After yoursquove reviewed and completed this entire form please sign and date at the bottom
Applicant Current Borrower
Do you want to apply for a substitution of entitlement Yes Yes No No
In order to complete a substitution of entitlement the veteran applicant must have suffcient entitlement to substitute for that of the current borrower Contact the VA Offce of Jurisdiction for your area for more information Also before the veteran applicant can substitute entitlement on a VA loan heshe must certify that the property securing the loan will be occupied as hisher primary residence Both the applicantrsquos and current borrowerrsquos original certifcate of eligibility will be required If your sales contract is contingent upon the restoration of entitlement please contact your VA Offce of Jurisdiction for complete procedures Otherwise the substitution will be completed after the loan has been approved and closed
Date Applicant printed name Applicant signature
Date Applicant printed name Applicant signature
Date Current Borrower printed name Current Borrower signature
Date Current Borrower printed name Current Borrower signature
Forms completed by Mail Phone
For Chase use only
Interviewer signature Date
99177-VS-0215
- Assumption Application Package_41521-noscannedpages-update-4pdf
-
- 1 FM203 Cover Pagepdf
- 2 FM202 Mortgage Assumption Application Package pagepdf
- 3 The Documents Youll need to Send Uspdf
- 4 FM201 FAQpdf
- 5 FM142 CIWpdf
- 6 FM126 URLApdf
- 7 FM130 URLA Instpdf
-
- Blank Page
-
- 8 92900a Addednum to Loan Applicationpdf
- 9 FM462 Gen Authpdf
- 10 FM220 4506-Cpdf
- 11 FM153 Chase Federal Privacy Noticepdf
- 12 FM144 Info on Opening a New Accountpdf
- 13 FM152 Veteran Statementpdf
-
- Date
- Loan number
- Applicant name
- Phone1
- Loan number 1
- Loan number 2
- Other
- Other_2
- 1
- 2
- undefined_7
- Available hours
- Available hours_2
- undefined_8
- Available hours_3
- undefined_9
- Current address 1
- Neither
- Available hours_4
- Available hours_5
- undefined_10
- Available hours_6
- 1_2
- 2_2
- undefined_11
- Available hours_7
- Available hours_8
- undefined_12
- Available hours_9
- FHA Case No include any suffix
- Mortgagee Case No
- Mortgagee ID
- Sponsor ID
- Agent ID
- Name and Address of Sponsor Name and Address of Agent
- Borrowers Name Present Address include ZIP Code Property Address
- include name of subdivision lot block no ZIP Code
- Name of ThirdParty Originator
- NMLS ID of ThirdParty Originator
- s application
- ty Number
- ty Number_2
- Date Signed_2
- Date Mortgage Approved
- Date Approval Expires
- Printed Name
- Title 1
- DEs ID Number
- DEs ID Number_2
- Mortgagee
- Name of Mortgagees Representative
- Title of Mortgagees Representative
- Signature of the Mortgagees Representative
- Date_2
- Applicant names 1
- Applicant names 2
- Applicant names 3
- Loan number_2
- Date_3
- Applicant printed name
- Social Security number
- Date_4
- Applicant printed name_2
- Social Security number_2
- Date_5
- Applicant printed name_3
- Social Security number_3
- Date_6
- Applicant printed name_4
- Social Security number_4
- 1a Name shown on tax return if a joint return enter the name shown first
- 1b First social security number on tax return individual taxpayer identification number or employer identification number see instructions
- 2a If a joint return enter spouses name shown on tax return
- 2b Second social security number or individual taxpayer identification number if joint tax return
- 4 Previous address shown on the last return filed if different from line 3 see instructions
- 5a IVES participant name address and SOR mailbox ID
- Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing see instructions
- Signature see instructions
- Date_7
- Phone number of taxpayer on line 1a or 2a
- PrintType name
- Here
- Spouses signature
- Date_8
- PrintType name_2
- Name
- Date of birth
- Service number
- Name_2
- Date of birth_2
- Service number_2
- Date_9
- Applicant printed name_5
- Date_10
- Applicant printed name_6
- Date_11
- Current Borrower printed name
- Date_12
- Current Borrower printed name_2
- Date_13
- Text3
- Text10
- undefined_13
- Text15
- undefined_14
- undefined_15
- undefined_16
- undefined_17
- undefined_18
- undefined_19
- undefined_20
- undefined_21
- undefined_23
- Reason for assumption Off
- Requestors relationship to owners Off
- Check one Off
- Check one1 Off
- Day1
- Evening
- Cell phone
- Check one2 Off
- Check one3 Off
- Check one4 Off
- Check one5 Off
- Text2-1
- Text2-2
- Text2-3
- Text2-4
- Text2-5
- Text2-6
- Text3-1
- Text3-2
- Text3-3
- Text3-4
- Text3-6
- Text3-7
- Text3-8
- Text3-9
- Text3-10
- Text3-11
- Text3-12
- Text3-13
- Text3-14
- Text3-15
- Text3-16
- Text3-17
- Text3-18
- Text3-19
- Text3-20
- Text3-21
- Text3-22
- Text3-23
- Text3-24
- Text3-25
- Text3-26
- Text3-27
- Text3-28
- Text3-29
- Text3-30
- Text3-31
- Text3-32
- Text3-33
- Text3-34
- Text3-35
- Text3-36
- Text3-37
- Text3-38
- Text3-39
- Text3-40
- Text3-41
- Text3-42
- Text3-43
- Text3-44
- Text3-45
- Text3-46
- Text3-47
- Text3-48
- Text3-49
- Text3-50
- Text3-51
- Text3-52
- Text3-53
- Text3-5
- Text3-54
- Text3-55
- Text3-56
- Citizenship Off
- Type of credit Off
- Marital Status Off
- Housing Off
- Housing1 Off
- ownership Off
- DNA1 Off
- DNA2 Off
- DNA3 Off
- family Off
- BO Off
- Total
- Text31
- Text32
- Text33
- Text34
- Text35
- Text36
- Text37
- Text38
- Text39
- Text310
- Text311
- Text312
- Text313
- Text314
- Text315
- Text316
- Text317
- Text318
- Text319
- ownership1 Off
- Total1
- Total1-2
- Check Box4-1 Off
- Text320
- Text321
- Text322
- Text323
- Text324
- Text325
- Text326
- Text327
- Text328
- Text329
- Check Box4-2 Off
- Check Box4-3 Off
- Check Box4-4 Off
- Check Box4-8 Off
- Check Box4-9 Off
- Text330
- Text331
- Text332
- Text333
- Text334
- Text335
- Text1-1
- Text1-2
- Text1-3
- Text1-4
- Text1-5
- Text1-6
- Text1-7
- Text1-8
- Text1-9
- Text1-10
- Text1-11
- Text1-12
- Text1-13
- Text1-14
- Text1-15
- Text1-16
- Text1-17
- Text1-18
- Text1-19
- Text1-20
- Text1-21
- Text1-22
- Text1-23
- Text1-24
- Text1-25
- Text1-26
- Text1-27
- Text1-28
- Text1-29
- Text1-30
- Text1-31
- Text1-32
- Text1-33
- Text1-34
- Text1-35
- Check Box3-2 Off
- Check Box2-1 Off
- Check Box2-2 Off
- Check Box2-3 Off
- Check Box2-4 Off
- Check Box2-5 Off
- Text1-36
- Text1-37
- Text1-38
- Text1-39
- Text1-40
- Text1-41
- Text1-42
- Text1-43
- Text1-44
- Text1-45
- Text1-46
- Text1-47
- Text1-48
- Text1-49
- Text1-50
- Text1-51
- Text1-52
- Text1-53
- Text1-54
- Text1-55
- Text1-56
- Text1-57
- Text1-58
- Text1-59
- Text1-60
- Text1-61
- Check Box3-11 Off
- A1
- A2
- A3
- A4
- A5
- A6
- A7
- A8
- A9
- A10
- A11
- A12
- Check Box3-1 Off
- Check Box30-1 Off
- Check Box30-2 Off
- Check Box30-4 Off
- Check Box30-5 Off
- Check Box30-7 Off
- Check Box30-8 Off
- Check Box30-9 Off
- Check Box30-10 Off
- Check Box30-11 Off
- Check Box30-12 Off
- A13
- A14
- A15
- A16
- A17 Off
- A18
- A19
- A20
- A21
- A22
- A23
- A24
- A25
- A26
- A27
- A28
- A29
- A30
- A31
- A32
- A33
- A34
- A35
- A36
- A37
- A38 Off
- A39
- A40
- A41
- A42
- A43
- A44
- A45
- A46
- A47
- A48
- A49
- A50
- A51
- A52
- A53
- A54
- A55
- A56
- A57
- A58
- A59
- A60
- A61
- A62
- A63
- A64
- A65
- A66
- A67
- A68
- A69
- A70
- A71
- A72
- A73
- A74
- Loan Purpose Off
- occupancy1 Off
- lien type Off
- lientype Off
- mixed use Off
- manufactured home Off
- deposit1 Off
- deposit2 Off
- B1
- B2
- B3
- B4
- B5
- B6
- B7
- B8
- B9
- B10
- fha Off
- Check Box51 Off
- B11
- B12
- B13
- B14
- B15
- B16
- B17
- B18
- B19 Off
- B20
- B21
- B22 Off
- B23
- B24
- B25
- B26
- B27
- B28
- A
-
- Will you occupy the property as your primary residence Off
- Will you occupy the property as your primary residence1 Off
-
- If yes have you had an ownership interest in another property in the last three years Off
- Text9-2
- B
-
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property Off
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property1 Off
-
- 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 Off
- 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 application1 Off
-
- 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 Off
- 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 application1 Off
-
- new credit Off
- 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) Off
- the Property Assessed Clean Energy Program)1 Off
-
- F
-
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application Off
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application1 Off
-
- G
-
- Are there any outstanding judgments against you Off
- Are there any outstanding judgments against you1 Off
-
- H
-
- Are you currently delinquent or in default on a Federal debt Off
- Are you currently delinquent or in default on a Federal debt1 Off
-
- I
-
- Are you a party to a lawsuit in which you potentially have any personal financial liability Off
- Are you a party to a lawsuit in which you potentially have any personal financial liability1 Off
-
- J
-
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years Off
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years1 Off
-
- 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 Off
- 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 due1 Off
-
- L
-
- Have you had property foreclosed upon in the last 7 years Off
- Have you had property foreclosed upon in the last 7 years1 Off
-
- M
-
- Have you declared bankruptcy within the past 7 years Off
- Have you declared bankruptcy within the past 7 years1 Off
-
- Check Box8-2 Off
- Check Box8-3 Off
- Check Box8-4 Off
- Text9-3
- Text9-5
- Text9-6
- Text97
- military Off
- ethnicity Off
- sex Off
- race Off
- demo Off
- Text12-1
- Check Box11-1 Off
- Check Box11-2 Off
- Check Box11-3 Off
- Check Box11-4 Off
- Check Box11-5 Off
- Check Box11-6 Off
- Check Box11-7 Off
- Check Box11-8 Off
- Check Box11-9 Off
- Text12-2
- Check Box11-10 Off
- Check Box11-11 Off
- Check Box11-12 Off
- Check Box11-13 Off
- Check Box11-14 Off
- Check Box11-15 Off
- Text12-3
- Check Box11-16 Off
- Check Box11-17 Off
- Check Box11-18 Off
- Check Box11-19 Off
- Check Box11-20 Off
- Check Box11-21 Off
- Check Box11-22 Off
- Check Box11-23 Off
- Text12-4
- Check Box11-24 Off
- Check Box11-25 Off
- Check Box11-26 Off
- Check Box11-27 Off
- Check Box11-28 Off
- Check Box11-29 Off
- Text12-5
- Check Box11-30 Off
- Check Box11-31 Off
- citizen Off
- credit Off
- marital status1 Off
- housing-1 Off
- housing-2 Off
- own Off
- C1
- C2
- C3
- C6
- C7
- C8
- C9
- C10
- C11
- C12
- C13
- C14
- C15
- C16
- C17
- C18
- C19
- C20
- C21
- C22
- C23
- C24
- C25
- C26
- C27
- C28
- C29
- C30
- C31
- C32
- C33
- C34
- C35
- Check Box-2 Off
- C36
- C37
- C38
- C39
- C4
- C40
- C41
- C42
- C43
- C44
- C45
- C46
- C47
- Check Box-3 Off
- Check Box-4 Off
- C48
- C49
- C5
- C50
- C51
- C52
- C53
- C54
- C55
- Check Box-1-1 Off
- own1 Off
- Check Box-1 Off
- D1 Off
- D2
- D3
- D4
- D5
- D6
- D7
- D8
- D9
- D10
- D11
- D12
- D13
- D14 Off
- D15 Off
- D16
- D17
- D18
- D19
- D20
- D21
- D22
- D23
- D24 Off
- D25
- D26
- D27
- D28
- D29
- D30
- D31
- D32
- D33
- D34
- D35 Off
- D36
- D37 Off
- D38
- D39
- D40
- D41
- D42
- D43
- D44
- D45
- D46
- D47
- If yes have you had an ownership interest in another property in the last three years1 Off
- new credit1 Off
- Check Box8-1 Off
- Check Box8-1-2 Off
- Check Box8-1-1 Off
- Check Box8-1-3 Off
- Check Box8-1-4 Off
- Military Service mdash Did you (or your deceased spouse) ever serve or are you currently serving in the United States Armed Forces 1 Off
- Check1 Off
- Text9-1-1
- Check2 Off
- Check3 Off
- Check4 Off
- Text9-1
- E1
- E2
- E3
- Was the ethnicity of the Borrower collected on the basis of visual observation or surname1 Off
- Was the sex of the Borrower collected on the basis of visual observation or surname1 Off
- Was the race of the Borrower collected on the basis of visual observation or surname1 Off
- The Demographic Information was provided through1 Off
- F1 Off
- F2 Off
- F3 Off
- F4 Off
- F5 Off
- F6
- F7 Off
- F8 Off
- F9 Off
- F10 Off
- F11 Off
- F12 Off
- F13
- F14 Off
- F15 Off
- F16 Off
- F17 Off
- F18 Off
- F19 Off
- F20 Off
- F21 Off
- F22
- F23 Off
- F24 Off
- F25 Off
- F26 Off
- F27 Off
- F28 Off
- F29
- F30 Off
- F31 Off
- undefined_13-1
- undefined_13-2
- undefined_14-1
- undefined_15-1
- undefined_16-1
- undefined_17-1
- undefined_18-1
- undefined_19-1
- undefined_21-1
- undefined_20-1
- undefined_23-1
- undefined_13_1
- Single-Two Off
- Refi type Off
- refi program Off
- Estate Off
- Title held Off
- Trust Information Off
- Indian Country Land Tenure Off
- Mortgage Type Applied For Off
- Mortgage Lien Type Off
- Amortization Type Off
- G1 Off
- G2 Off
- G3 Off
- G4 Off
- G5 Off
- G6
- G7
- G8
- G9
- G10 Off
- G11 Off
- G12 Off
- G13 Off
- G14 Off
- G15 Off
- G16
- G17
- G18
- G19
- G20
- G21
- G22
- G23 Off
- G24
- G25 Off
- G26
- G27 Off
- G28 Off
- G29
- G30 Off
- G31
- G32 Off
- G33
- G34
- G35
- G36
- G37
- G38
- G39
- G40
- G41
- G42
- Property Held
- refi
- Text18-1
- Text18-2
- Text18-3
- Text18-4
- Text18-5
- Text18-6
- Text18-7
- Text18-8
- Text18-9
- Text18-10
- Text18-11
- Text18-12
- Text18-13
- Text18-14
- Text18-15
- Text18-16
- Text18-17
- Text18-18
- Text18-19
- Lender
- case no
- If you selected ldquoUnmarriedrdquo in Section 1 is there a person who is not your legal spouse but who currently has real property rights similar to those of a legal spouse Off
- Relationship and State Off
- Other-5
- Text19-1
- BName
- Additional Information
- ABN
- Additional Information1
- BSign
- BSDate
- ABSign
- ABDate
- MortageeNameAddress
- NAmeAddress
- Bname1
- DOB1
- DOB2
- SignOfBorr1
- SignOfBorr
- Date Signed
- SignOfBorr2
- SignOfBorr3
- Date Signed3
- Date Signed4
- MortgageeRepSign
- DirectSign
- DirectSign1
- Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union Off
- AppSign
- AppSign1
- AppSign2
- AppSign3
- Nopage38 Off
- Yespage38 Off
- Yes1 Off
- No1 Off
- Yes2 Off
- Yes3 Off
- Yes4 Off
- Yes5 Off
- Yes6 Off
- Yes7 Off
- Yes8 Off
- Yes9 Off
- Yes10 Off
- No2 Off
- No3 Off
- No4 Off
- No5 Off
- No6 Off
- No7 Off
- No8 Off
- No9 Off
- No10 Off
- BorrowerNo Off
- BorrowerYes Off
- AppSignature
- AppSignature1
- CurrentSign
- CurrentSign1
- InterviewSign
- Yes_1 Off
- No_1 Off
- Yes_2 Off
- No_2 Off
- Mail Off
- Phone Off
1b
2b
Form 4506-C (September 2020)
Department of the Treasury - Internal Revenue Service
IVES Request for Transcript of Tax Return OMB Number
1545-1872
Do not sign this form unless all applicable lines have been completed Request may be rejected if the form is incomplete or illegible
For more information about Form 4506-C visit wwwirsgov and search IVES
1a Name shown on tax return (if a joint return enter the name shown first)
First social security number on tax return individual taxpayer identification number or employer identification number (see instructions)
2a If a joint return enter spousersquos name shown on tax return Second social security number or individual taxpayer identification number if joint tax return
3 Current name address (including apt room or suite no) city state and ZIP code (see instructions)
4 Previous address shown on the last return filed if different from line 3 (see instructions)
5a IVES participant name address and SOR mailbox ID
DataVerify 875 Greentree Rd 8 Parkway Center Pittsburgh PA 15220
5b Customer file number (if applicable) (see instructions)
Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing (see instructions)
6 Transcript requested Enter the tax form number here (1040 1065 1120 etc) and check the appropriate box below Enter only one tax form number per request 1040
a Return Transcript which includes most of the line items of a tax return as filed with the IRS A tax return transcript does not reflect changes made to the account after the return is processed Transcripts are only available for the following returns Form 1040 series Form 1065 Form 1120 Form 1120-A Form 1120-H Form 1120-L and Form 1120S Return transcripts are available for the current year and returns processed during the prior 3 processing years
b Account Transcript which contains information on the financial status of the account such as payments made on the account penalty assessments and adjustments made by you or the IRS after the return was filed Return information is limited to items such as tax liability and estimated tax payments Account transcripts are available for most returns
c Record of Account which provides the most detailed information as it is a combination of the Return Transcript and the Account Transcript Available for current year and 3 prior tax years
7 Form W-2 Form 1099 series Form 1098 series or Form 5498 series transcript The IRS can provide a transcript that includes data from these information returns State or local information is not included with the Form W-2 information The IRS may be able to provide this transcript information for up to 10 years Information for the current year is generally not available until the year after it is filed with the IRS For example W-2 information for 2016 filed in 2017 will likely not be available from the IRS until 2018 If you need W-2 information for retirement purposes you should contact the Social Security Administration at 1-800-772-1213
Caution If you need a copy of Form W-2 or Form 1099 you should first contact the payer To get a copy of the Form W-2 or Form 1099 filed with your return you must use Form 4506 and request a copy of your return which includes all attachments
8 Year or period requested Enter the ending date of the tax year or period using the mmddyyyy format (see instructions)
12 31 2020 12 31 2019 12 31 2018 Caution Do not sign this form unless all applicable lines have been completed
Signature of taxpayer(s) I declare that I am either the taxpayer whose name is shown on line 1a or 2a or a person authorized to obtain the tax information requested If the request applies to a joint return at least one spouse must sign If signed by a corporate officer 1 percent or more shareholder partner managing member guardian tax matters partner executor receiver administrator trustee or party other than the taxpayer I certify that I have the authority to execute Form 4506-C on behalf of the taxpayer Note This form must be received by IRS within 120 days of the signature date
Signatory attests that heshe has read the attestation clause and upon so reading declares that heshe has the authority to sign the Form 4506-C See instructions
Sign Here
Signature (see instructions) Date Phone number of taxpayer on line 1a or 2a
PrintType name
Title (if line 1a above is a corporation partnership estate or trust)
Spousersquos signature Date
PrintType name
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020) For Privacy Act and Paperwork Reduction Act Notice see page 2
Instructions for Form 4506-C IVES Request for Transcript of Tax Return
Section references are to the Internal Revenue Code unless otherwise noted
Future Developments
For the latest information about Form 4506-C and its instructions go to wwwirsgov and search IVES Information about any recent developments affecting Form 4506-C (such as legislation enacted after we released it) will be posted on that page
Whats New Form 4506-C was created to be utilized by authorized IVES participants to order tax transcripts with the consent of the taxpayer
General Instructions
Caution Do not sign this form unless all applicable lines have been completed
Designated Recipient Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information received pursuant to the taxpayerrsquos consent and holds the recipient subject to penalties for any unauthorized access other use or redisclosure without the taxpayerrsquos express permission or request
Taxpayer Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information provided pursuant to your consent and holds the recipient subject to penalties brought by private right of action for any unauthorized access other use or redisclosure without your express permission or request
Purpose of form Use Form 4506-C to request tax return information through an authorized IVES participant You will designate an IVES participant to receive the information on line 5a
Note If you are unsure of which type of transcript you need check with the party requesting your tax information
Where to file The IVES participant will fax Form 4506-C with the approved IVES cover sheet to their assigned Service Center
Chart for ordering transcripts
If your assigned Service Center is
Fax the requests with the approved coversheet to
Austin Submission Processing Center
Austin IVES Team
844-249-6238
Fresno Submission Processing Center
Fresno IVES Team
844-249-6239
Kansas City Submission Processing Center
Kansas City IVES Team
844-249-8128
Ogden Submission Processing Center
Ogden IVES Team
844-249-8129
Specific Instructions
Line 1b Enter the social security number (SSN) or individual taxpayer identification number (ITIN) for the individual listed on line 1a or enter the employer identification number (EIN) for the business listed on line 1a
Line 3 Enter your current address If you use a PO box include it on this line
Line 4 Enter the address shown on the last return filed if different from the address entered on line 3
Note If the addresses on lines 3 and 4 are different and you have not changed your address with the IRS file Form 8822 Change of Address or Form 8822-BChange of Address or Responsible Party mdash Business with Form 4506-C
Line 5b Enter up to 10 numeric characters to create a unique customer file number that will appear on the transcript The customer file number cannot contain an SSN ITIN or EIN Completion of this line is not required
Note If you use an SSN name or combination of both we will not input the information and the customer file number will reflect a generic entry of 9999999999 on the transcript
Line 8 Enter the end date of the tax year or period requested in mmddyyyy format This may be a calendar year fiscal year or quarter Enter each quarter requested for quarterly returns Example Enter 12312018 for a calendar year 2018 Form 1040 transcript
Signature and date Form 4506-C must be signed and dated by the taxpayer listed on line 1a or 2a The IRS must receive Form 4506-C within 120 days of the date signed by the taxpayer or it will be rejected Ensure that all applicable lines including lines 5a through 8 are completed before signing
You must check the box in the signature area to acknowledge you have the authority to sign and request the information The form will not be processed if unchecked
Individuals Transcripts listed on on line 6 may be furnished to either spouse if jointly filed Only one signature is required Sign Form 4506-C exactly as your name appeared on the original return If you changed your name also sign your current name
Corporations Generally Form 4506-C can be signed by
(1) an officer having legal authority to bind the corporation (2) any person designated by the board of directors or other governing body or (3) any officer or employee on written request by any principal officer and attested to by the secretary or other officer A bona fide shareholder of record owning 1 percent or more of the outstanding stock of the corporation may submit a Form 4506-C but must provide documentation to support the requesters right to receive the information
Partnerships Generally Form 4506-C can be signed by any person who was a member of the partnership during any part of the tax period requested on line 8
All others See section 6103(e) if the taxpayer has died is insolvent is a dissolved corporation or if a trustee guardian executor receiver or administrator is acting for the taxpayer
Note If you are Heir at law Next of kin or Beneficiary you must be able to establish a material interest in the estate or trust
Documentation For entities other than individuals you must attach the authorization document For example this could be the letter from the principal officer authorizing an employee of the corporation or the letters testamentary authorizing an individual to act for an estate
Signature by a representative A representative can sign Form 4506-C for a taxpayer only if the taxpayer has specifically delegated this authority to the representative on Form 2848 line 5 The representative must attach Form 2848 showing the delegation to sign Form 4506-C
Privacy Act and Paperwork Reduction Act Notice We ask for the information on this form to establish your right to gain access to the requested tax information under the Internal Revenue Code We need this information to properly identify the tax information and respond to your request You are not required to request any transcript if you do request a transcript sections 6103 and 6109 and their regulations require you to provide this information including your SSN or EIN If you do not provide this information we may not be able to process your request Providing false or fraudulent information may subject you to penalties
Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and cities states the District of Columbia and US commonwealths and possessions for use in administering their tax laws We may also disclose this information to other countries under a tax treaty to federal and state agencies to enforce federal nontax criminal laws or to federal law enforcement and intelligence agencies to combat terrorism
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law Generally tax returns and return information are confidential as required by section 6103
The time needed to complete and file Form 4506-C will vary depending on individual circumstances The estimated average time is
Learning about the law or the form 10 min Preparing the form 12 min Copying assembling and sending the form to the IRS 20 min
If you have comments concerning the accuracy of these time estimates or suggestions for making Form 4506-C simpler we would be happy to hear from you You can write to
Internal Revenue Service Tax Forms and Publications Division 1111 Constitution Ave NW IR-6526 Washington DC 20224
Do not send the form to this address Instead see Where to file on this page
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020)
Rev April 2021 CHASEO Facts What does Chase do with your personal information
Why Financial companies choose how they share your personal information Federal law gives consumers the right to limit some but not all sharing Federal law also requires us to tell you how we collect share and protect your personal information Please read this notice carefully to understand what we do
What The types of personal information we collect and share depend on the product or service you have with us This information can include bull Social Security number and income bull account balances and transaction history bull credit history and payment history
How All financial companies need to share customers personal information to run their everyday business In the section below we list the reasons financial companies can share their customers personal information the reasons Chase chooses to share and whether you can limit this sharing
Reasons we can share your personal information Does Chase share
Can you limit this sharing
For our everyday business purposes - such as to process your transactions maintain your account(s) respond to court orders and legal investigations or report to credit bureaus
Yes No
For our marketing purposes - to offer our products and services to you
Yes No
For joint marketing with other financial companies Yes No
For our affiliates everyday business purposes - information about your transactions and experiences
Yes No
For our affiliates everyday business purposes - information about your creditworthiness
Yes Yes
For our affiliates to market to you Yes Yes
For nonaffiliates to market to you Yes Yes
a
0
To limit our sharing
bull Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
bull Visit us online chasecomprivacypreferences
Please note If you are a new customer we can begin sharing your information 30 days from the date we sent this notice When you are no longer our customer we continue to share your information as described in this notice However you can contact us at any time to limit our sharing
Questions
Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
PAGE 2
Who we are
Who is providing this notice The US consumer financial companies within the JPMorgan Chase amp Co family including JPMorgan Chase Bank NA Chase Insurance Agency Inc and JP Morgan Securities LLC
What we do
How does Chase protect my To protect your personal information from unauthorized access and use we personal information use security measures that comply with federal law These measures include
computer safeguards and secured files and buildings We authorize our employees to get your information only when they need it to do their work and we require companies that work for us to protect your information
How does Chase collect my We collect your personal information for example when you personal information bull open an account or make deposits or withdrawals from your account
bull pay your bills or apply for a loan bull use your credit or debit card We also collect your personal information from others such as credit bureaus affiliates or other companies
Why cant I limit all sharing Federal law gives you the right to limit only bull sharing for affiliates everyday business purposes - information about your
creditworthiness bull affiliates from using your information to market to you bull sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing See below for more on your rights under state law
What happens when I limit sharing for an account I hold jointly with someone else
Your choices will apply to everyone on your account
Definitions
Affiliates Companies related by common ownership or control They can be financial and non financial companies bull Our affiliates include companies with a Chase or JP Morgan name and financial companies such asjP Morgan Securities LLC
Nonaffiliates Companies not related by common ownership or control They can be financial and non financial companies bull Nonaffiliates we share with can include companies such as retailers auto dealers auto makers and membership clubs
Joint marketing A formal agreement between nonaffiliated financial companies that together market financial products or services to you bull Our joint marketing partners include categories of companies such as insurance companies
Other important information
VT Accounts with a Vermont mailing address are automatically treated as if they have limited the sharing as described on page 1 For joint marketing we will only disclose your name contact information and information about your transactions
NV We are providing you this notice pursuant to Nevada law If you prefer not to receive marketing calls from us you may be placed on our Internal Do Not Call List by calling 1-800-945-9470 or by writing to us at PO Box 734007 Dallas TX 75373-4007
For more information contact us at the address above or email PrivacylnfoJPMChasecom with Nevada Annual Notice in the subject line You may also contact the Nevada Attorney Generals office Bureau of Consumer Protection Office of the Nevada Attorney General 555 E Washington St Suite 3900 Las Vegas NV 89101 telephone number 1-702-486-3132 email BCPINFOagstatenvus
CA Accounts with a California mailing address are automatically treated as if they have limited the sharing with nonaffiliates as described on page 1 CA residents are provided a CA notice for additional choices
CHASE O
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
The following disclosure is required by the USA PATRIOT Act
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 opens an account
What this means to you When you 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 drivers
license or other identifying documents
99177-PAT-0215
VETERAN STATEMENT When this loan was opened the US Department of Veterans Affairs (VA) used the veteran borrowerrsquos entitlement which is a set amount the VA promises to repay a lender if the borrower defaults on the mortgage An assumption will modify who is obligated to pay the existing mortgage loan but all loan termsmdashincluding the entitlementmdashwill remain the same If the veteran borrower is being removed from the loan the entitlement would remain with whoever is assuming the loan because the loan will continue to be serviced by the VA If the applicant is also a veteran and can substitute his or her entitlement for the current entitlement then the current borrowerrsquos entitlement can be released
Please review the following questions and answer as appropriate This form requires completion by both the applicant(s) and current borrower(s)
1 Applicant to Complete
Are you (the applicant) currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the reverse side)
Yes (If yes please provide the information requested below answer the question in section 3 and sign and date this form at the bottom of the reverse side)
Name of applicant(s) who answered ldquoyesrdquo to the above question
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Are you receiving VA disability benefts
Applicant
Yes
No
Co-Applicant
Yes
No
Are you entitled to receive VA disability benefts Yes No Yes No
Have you received VA disability benefts in the past Yes No Yes No
Are you a surviving spouse of a veteran who died on active duty or as the result of a service-related disability
Yes No Yes No
Do you have any VA loans Yes No Yes No
2 Current Borrower to Complete
Is the current borrowerco-borrower currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the page)
Yes (If yes please answer the question in section 3 and sign and date this form at the bottom of the page)
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
________________________________________________________________________________________________
3 Applicant and Current Borrower to Complete
If the answer to the questions in section 1 and 2 are both yes please answer the following question After yoursquove reviewed and completed this entire form please sign and date at the bottom
Applicant Current Borrower
Do you want to apply for a substitution of entitlement Yes Yes No No
In order to complete a substitution of entitlement the veteran applicant must have suffcient entitlement to substitute for that of the current borrower Contact the VA Offce of Jurisdiction for your area for more information Also before the veteran applicant can substitute entitlement on a VA loan heshe must certify that the property securing the loan will be occupied as hisher primary residence Both the applicantrsquos and current borrowerrsquos original certifcate of eligibility will be required If your sales contract is contingent upon the restoration of entitlement please contact your VA Offce of Jurisdiction for complete procedures Otherwise the substitution will be completed after the loan has been approved and closed
Date Applicant printed name Applicant signature
Date Applicant printed name Applicant signature
Date Current Borrower printed name Current Borrower signature
Date Current Borrower printed name Current Borrower signature
Forms completed by Mail Phone
For Chase use only
Interviewer signature Date
99177-VS-0215
- Assumption Application Package_41521-noscannedpages-update-4pdf
-
- 1 FM203 Cover Pagepdf
- 2 FM202 Mortgage Assumption Application Package pagepdf
- 3 The Documents Youll need to Send Uspdf
- 4 FM201 FAQpdf
- 5 FM142 CIWpdf
- 6 FM126 URLApdf
- 7 FM130 URLA Instpdf
-
- Blank Page
-
- 8 92900a Addednum to Loan Applicationpdf
- 9 FM462 Gen Authpdf
- 10 FM220 4506-Cpdf
- 11 FM153 Chase Federal Privacy Noticepdf
- 12 FM144 Info on Opening a New Accountpdf
- 13 FM152 Veteran Statementpdf
-
- Date
- Loan number
- Applicant name
- Phone1
- Loan number 1
- Loan number 2
- Other
- Other_2
- 1
- 2
- undefined_7
- Available hours
- Available hours_2
- undefined_8
- Available hours_3
- undefined_9
- Current address 1
- Neither
- Available hours_4
- Available hours_5
- undefined_10
- Available hours_6
- 1_2
- 2_2
- undefined_11
- Available hours_7
- Available hours_8
- undefined_12
- Available hours_9
- FHA Case No include any suffix
- Mortgagee Case No
- Mortgagee ID
- Sponsor ID
- Agent ID
- Name and Address of Sponsor Name and Address of Agent
- Borrowers Name Present Address include ZIP Code Property Address
- include name of subdivision lot block no ZIP Code
- Name of ThirdParty Originator
- NMLS ID of ThirdParty Originator
- s application
- ty Number
- ty Number_2
- Date Signed_2
- Date Mortgage Approved
- Date Approval Expires
- Printed Name
- Title 1
- DEs ID Number
- DEs ID Number_2
- Mortgagee
- Name of Mortgagees Representative
- Title of Mortgagees Representative
- Signature of the Mortgagees Representative
- Date_2
- Applicant names 1
- Applicant names 2
- Applicant names 3
- Loan number_2
- Date_3
- Applicant printed name
- Social Security number
- Date_4
- Applicant printed name_2
- Social Security number_2
- Date_5
- Applicant printed name_3
- Social Security number_3
- Date_6
- Applicant printed name_4
- Social Security number_4
- 1a Name shown on tax return if a joint return enter the name shown first
- 1b First social security number on tax return individual taxpayer identification number or employer identification number see instructions
- 2a If a joint return enter spouses name shown on tax return
- 2b Second social security number or individual taxpayer identification number if joint tax return
- 4 Previous address shown on the last return filed if different from line 3 see instructions
- 5a IVES participant name address and SOR mailbox ID
- Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing see instructions
- Signature see instructions
- Date_7
- Phone number of taxpayer on line 1a or 2a
- PrintType name
- Here
- Spouses signature
- Date_8
- PrintType name_2
- Name
- Date of birth
- Service number
- Name_2
- Date of birth_2
- Service number_2
- Date_9
- Applicant printed name_5
- Date_10
- Applicant printed name_6
- Date_11
- Current Borrower printed name
- Date_12
- Current Borrower printed name_2
- Date_13
- Text3
- Text10
- undefined_13
- Text15
- undefined_14
- undefined_15
- undefined_16
- undefined_17
- undefined_18
- undefined_19
- undefined_20
- undefined_21
- undefined_23
- Reason for assumption Off
- Requestors relationship to owners Off
- Check one Off
- Check one1 Off
- Day1
- Evening
- Cell phone
- Check one2 Off
- Check one3 Off
- Check one4 Off
- Check one5 Off
- Text2-1
- Text2-2
- Text2-3
- Text2-4
- Text2-5
- Text2-6
- Text3-1
- Text3-2
- Text3-3
- Text3-4
- Text3-6
- Text3-7
- Text3-8
- Text3-9
- Text3-10
- Text3-11
- Text3-12
- Text3-13
- Text3-14
- Text3-15
- Text3-16
- Text3-17
- Text3-18
- Text3-19
- Text3-20
- Text3-21
- Text3-22
- Text3-23
- Text3-24
- Text3-25
- Text3-26
- Text3-27
- Text3-28
- Text3-29
- Text3-30
- Text3-31
- Text3-32
- Text3-33
- Text3-34
- Text3-35
- Text3-36
- Text3-37
- Text3-38
- Text3-39
- Text3-40
- Text3-41
- Text3-42
- Text3-43
- Text3-44
- Text3-45
- Text3-46
- Text3-47
- Text3-48
- Text3-49
- Text3-50
- Text3-51
- Text3-52
- Text3-53
- Text3-5
- Text3-54
- Text3-55
- Text3-56
- Citizenship Off
- Type of credit Off
- Marital Status Off
- Housing Off
- Housing1 Off
- ownership Off
- DNA1 Off
- DNA2 Off
- DNA3 Off
- family Off
- BO Off
- Total
- Text31
- Text32
- Text33
- Text34
- Text35
- Text36
- Text37
- Text38
- Text39
- Text310
- Text311
- Text312
- Text313
- Text314
- Text315
- Text316
- Text317
- Text318
- Text319
- ownership1 Off
- Total1
- Total1-2
- Check Box4-1 Off
- Text320
- Text321
- Text322
- Text323
- Text324
- Text325
- Text326
- Text327
- Text328
- Text329
- Check Box4-2 Off
- Check Box4-3 Off
- Check Box4-4 Off
- Check Box4-8 Off
- Check Box4-9 Off
- Text330
- Text331
- Text332
- Text333
- Text334
- Text335
- Text1-1
- Text1-2
- Text1-3
- Text1-4
- Text1-5
- Text1-6
- Text1-7
- Text1-8
- Text1-9
- Text1-10
- Text1-11
- Text1-12
- Text1-13
- Text1-14
- Text1-15
- Text1-16
- Text1-17
- Text1-18
- Text1-19
- Text1-20
- Text1-21
- Text1-22
- Text1-23
- Text1-24
- Text1-25
- Text1-26
- Text1-27
- Text1-28
- Text1-29
- Text1-30
- Text1-31
- Text1-32
- Text1-33
- Text1-34
- Text1-35
- Check Box3-2 Off
- Check Box2-1 Off
- Check Box2-2 Off
- Check Box2-3 Off
- Check Box2-4 Off
- Check Box2-5 Off
- Text1-36
- Text1-37
- Text1-38
- Text1-39
- Text1-40
- Text1-41
- Text1-42
- Text1-43
- Text1-44
- Text1-45
- Text1-46
- Text1-47
- Text1-48
- Text1-49
- Text1-50
- Text1-51
- Text1-52
- Text1-53
- Text1-54
- Text1-55
- Text1-56
- Text1-57
- Text1-58
- Text1-59
- Text1-60
- Text1-61
- Check Box3-11 Off
- A1
- A2
- A3
- A4
- A5
- A6
- A7
- A8
- A9
- A10
- A11
- A12
- Check Box3-1 Off
- Check Box30-1 Off
- Check Box30-2 Off
- Check Box30-4 Off
- Check Box30-5 Off
- Check Box30-7 Off
- Check Box30-8 Off
- Check Box30-9 Off
- Check Box30-10 Off
- Check Box30-11 Off
- Check Box30-12 Off
- A13
- A14
- A15
- A16
- A17 Off
- A18
- A19
- A20
- A21
- A22
- A23
- A24
- A25
- A26
- A27
- A28
- A29
- A30
- A31
- A32
- A33
- A34
- A35
- A36
- A37
- A38 Off
- A39
- A40
- A41
- A42
- A43
- A44
- A45
- A46
- A47
- A48
- A49
- A50
- A51
- A52
- A53
- A54
- A55
- A56
- A57
- A58
- A59
- A60
- A61
- A62
- A63
- A64
- A65
- A66
- A67
- A68
- A69
- A70
- A71
- A72
- A73
- A74
- Loan Purpose Off
- occupancy1 Off
- lien type Off
- lientype Off
- mixed use Off
- manufactured home Off
- deposit1 Off
- deposit2 Off
- B1
- B2
- B3
- B4
- B5
- B6
- B7
- B8
- B9
- B10
- fha Off
- Check Box51 Off
- B11
- B12
- B13
- B14
- B15
- B16
- B17
- B18
- B19 Off
- B20
- B21
- B22 Off
- B23
- B24
- B25
- B26
- B27
- B28
- A
-
- Will you occupy the property as your primary residence Off
- Will you occupy the property as your primary residence1 Off
-
- If yes have you had an ownership interest in another property in the last three years Off
- Text9-2
- B
-
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property Off
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property1 Off
-
- 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 Off
- 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 application1 Off
-
- 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 Off
- 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 application1 Off
-
- new credit Off
- 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) Off
- the Property Assessed Clean Energy Program)1 Off
-
- F
-
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application Off
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application1 Off
-
- G
-
- Are there any outstanding judgments against you Off
- Are there any outstanding judgments against you1 Off
-
- H
-
- Are you currently delinquent or in default on a Federal debt Off
- Are you currently delinquent or in default on a Federal debt1 Off
-
- I
-
- Are you a party to a lawsuit in which you potentially have any personal financial liability Off
- Are you a party to a lawsuit in which you potentially have any personal financial liability1 Off
-
- J
-
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years Off
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years1 Off
-
- 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 Off
- 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 due1 Off
-
- L
-
- Have you had property foreclosed upon in the last 7 years Off
- Have you had property foreclosed upon in the last 7 years1 Off
-
- M
-
- Have you declared bankruptcy within the past 7 years Off
- Have you declared bankruptcy within the past 7 years1 Off
-
- Check Box8-2 Off
- Check Box8-3 Off
- Check Box8-4 Off
- Text9-3
- Text9-5
- Text9-6
- Text97
- military Off
- ethnicity Off
- sex Off
- race Off
- demo Off
- Text12-1
- Check Box11-1 Off
- Check Box11-2 Off
- Check Box11-3 Off
- Check Box11-4 Off
- Check Box11-5 Off
- Check Box11-6 Off
- Check Box11-7 Off
- Check Box11-8 Off
- Check Box11-9 Off
- Text12-2
- Check Box11-10 Off
- Check Box11-11 Off
- Check Box11-12 Off
- Check Box11-13 Off
- Check Box11-14 Off
- Check Box11-15 Off
- Text12-3
- Check Box11-16 Off
- Check Box11-17 Off
- Check Box11-18 Off
- Check Box11-19 Off
- Check Box11-20 Off
- Check Box11-21 Off
- Check Box11-22 Off
- Check Box11-23 Off
- Text12-4
- Check Box11-24 Off
- Check Box11-25 Off
- Check Box11-26 Off
- Check Box11-27 Off
- Check Box11-28 Off
- Check Box11-29 Off
- Text12-5
- Check Box11-30 Off
- Check Box11-31 Off
- citizen Off
- credit Off
- marital status1 Off
- housing-1 Off
- housing-2 Off
- own Off
- C1
- C2
- C3
- C6
- C7
- C8
- C9
- C10
- C11
- C12
- C13
- C14
- C15
- C16
- C17
- C18
- C19
- C20
- C21
- C22
- C23
- C24
- C25
- C26
- C27
- C28
- C29
- C30
- C31
- C32
- C33
- C34
- C35
- Check Box-2 Off
- C36
- C37
- C38
- C39
- C4
- C40
- C41
- C42
- C43
- C44
- C45
- C46
- C47
- Check Box-3 Off
- Check Box-4 Off
- C48
- C49
- C5
- C50
- C51
- C52
- C53
- C54
- C55
- Check Box-1-1 Off
- own1 Off
- Check Box-1 Off
- D1 Off
- D2
- D3
- D4
- D5
- D6
- D7
- D8
- D9
- D10
- D11
- D12
- D13
- D14 Off
- D15 Off
- D16
- D17
- D18
- D19
- D20
- D21
- D22
- D23
- D24 Off
- D25
- D26
- D27
- D28
- D29
- D30
- D31
- D32
- D33
- D34
- D35 Off
- D36
- D37 Off
- D38
- D39
- D40
- D41
- D42
- D43
- D44
- D45
- D46
- D47
- If yes have you had an ownership interest in another property in the last three years1 Off
- new credit1 Off
- Check Box8-1 Off
- Check Box8-1-2 Off
- Check Box8-1-1 Off
- Check Box8-1-3 Off
- Check Box8-1-4 Off
- Military Service mdash Did you (or your deceased spouse) ever serve or are you currently serving in the United States Armed Forces 1 Off
- Check1 Off
- Text9-1-1
- Check2 Off
- Check3 Off
- Check4 Off
- Text9-1
- E1
- E2
- E3
- Was the ethnicity of the Borrower collected on the basis of visual observation or surname1 Off
- Was the sex of the Borrower collected on the basis of visual observation or surname1 Off
- Was the race of the Borrower collected on the basis of visual observation or surname1 Off
- The Demographic Information was provided through1 Off
- F1 Off
- F2 Off
- F3 Off
- F4 Off
- F5 Off
- F6
- F7 Off
- F8 Off
- F9 Off
- F10 Off
- F11 Off
- F12 Off
- F13
- F14 Off
- F15 Off
- F16 Off
- F17 Off
- F18 Off
- F19 Off
- F20 Off
- F21 Off
- F22
- F23 Off
- F24 Off
- F25 Off
- F26 Off
- F27 Off
- F28 Off
- F29
- F30 Off
- F31 Off
- undefined_13-1
- undefined_13-2
- undefined_14-1
- undefined_15-1
- undefined_16-1
- undefined_17-1
- undefined_18-1
- undefined_19-1
- undefined_21-1
- undefined_20-1
- undefined_23-1
- undefined_13_1
- Single-Two Off
- Refi type Off
- refi program Off
- Estate Off
- Title held Off
- Trust Information Off
- Indian Country Land Tenure Off
- Mortgage Type Applied For Off
- Mortgage Lien Type Off
- Amortization Type Off
- G1 Off
- G2 Off
- G3 Off
- G4 Off
- G5 Off
- G6
- G7
- G8
- G9
- G10 Off
- G11 Off
- G12 Off
- G13 Off
- G14 Off
- G15 Off
- G16
- G17
- G18
- G19
- G20
- G21
- G22
- G23 Off
- G24
- G25 Off
- G26
- G27 Off
- G28 Off
- G29
- G30 Off
- G31
- G32 Off
- G33
- G34
- G35
- G36
- G37
- G38
- G39
- G40
- G41
- G42
- Property Held
- refi
- Text18-1
- Text18-2
- Text18-3
- Text18-4
- Text18-5
- Text18-6
- Text18-7
- Text18-8
- Text18-9
- Text18-10
- Text18-11
- Text18-12
- Text18-13
- Text18-14
- Text18-15
- Text18-16
- Text18-17
- Text18-18
- Text18-19
- Lender
- case no
- If you selected ldquoUnmarriedrdquo in Section 1 is there a person who is not your legal spouse but who currently has real property rights similar to those of a legal spouse Off
- Relationship and State Off
- Other-5
- Text19-1
- BName
- Additional Information
- ABN
- Additional Information1
- BSign
- BSDate
- ABSign
- ABDate
- MortageeNameAddress
- NAmeAddress
- Bname1
- DOB1
- DOB2
- SignOfBorr1
- SignOfBorr
- Date Signed
- SignOfBorr2
- SignOfBorr3
- Date Signed3
- Date Signed4
- MortgageeRepSign
- DirectSign
- DirectSign1
- Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union Off
- AppSign
- AppSign1
- AppSign2
- AppSign3
- Nopage38 Off
- Yespage38 Off
- Yes1 Off
- No1 Off
- Yes2 Off
- Yes3 Off
- Yes4 Off
- Yes5 Off
- Yes6 Off
- Yes7 Off
- Yes8 Off
- Yes9 Off
- Yes10 Off
- No2 Off
- No3 Off
- No4 Off
- No5 Off
- No6 Off
- No7 Off
- No8 Off
- No9 Off
- No10 Off
- BorrowerNo Off
- BorrowerYes Off
- AppSignature
- AppSignature1
- CurrentSign
- CurrentSign1
- InterviewSign
- Yes_1 Off
- No_1 Off
- Yes_2 Off
- No_2 Off
- Mail Off
- Phone Off
Instructions for Form 4506-C IVES Request for Transcript of Tax Return
Section references are to the Internal Revenue Code unless otherwise noted
Future Developments
For the latest information about Form 4506-C and its instructions go to wwwirsgov and search IVES Information about any recent developments affecting Form 4506-C (such as legislation enacted after we released it) will be posted on that page
Whats New Form 4506-C was created to be utilized by authorized IVES participants to order tax transcripts with the consent of the taxpayer
General Instructions
Caution Do not sign this form unless all applicable lines have been completed
Designated Recipient Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information received pursuant to the taxpayerrsquos consent and holds the recipient subject to penalties for any unauthorized access other use or redisclosure without the taxpayerrsquos express permission or request
Taxpayer Notification Internal Revenue Code Section 6103(c) limits disclosure and use of return information provided pursuant to your consent and holds the recipient subject to penalties brought by private right of action for any unauthorized access other use or redisclosure without your express permission or request
Purpose of form Use Form 4506-C to request tax return information through an authorized IVES participant You will designate an IVES participant to receive the information on line 5a
Note If you are unsure of which type of transcript you need check with the party requesting your tax information
Where to file The IVES participant will fax Form 4506-C with the approved IVES cover sheet to their assigned Service Center
Chart for ordering transcripts
If your assigned Service Center is
Fax the requests with the approved coversheet to
Austin Submission Processing Center
Austin IVES Team
844-249-6238
Fresno Submission Processing Center
Fresno IVES Team
844-249-6239
Kansas City Submission Processing Center
Kansas City IVES Team
844-249-8128
Ogden Submission Processing Center
Ogden IVES Team
844-249-8129
Specific Instructions
Line 1b Enter the social security number (SSN) or individual taxpayer identification number (ITIN) for the individual listed on line 1a or enter the employer identification number (EIN) for the business listed on line 1a
Line 3 Enter your current address If you use a PO box include it on this line
Line 4 Enter the address shown on the last return filed if different from the address entered on line 3
Note If the addresses on lines 3 and 4 are different and you have not changed your address with the IRS file Form 8822 Change of Address or Form 8822-BChange of Address or Responsible Party mdash Business with Form 4506-C
Line 5b Enter up to 10 numeric characters to create a unique customer file number that will appear on the transcript The customer file number cannot contain an SSN ITIN or EIN Completion of this line is not required
Note If you use an SSN name or combination of both we will not input the information and the customer file number will reflect a generic entry of 9999999999 on the transcript
Line 8 Enter the end date of the tax year or period requested in mmddyyyy format This may be a calendar year fiscal year or quarter Enter each quarter requested for quarterly returns Example Enter 12312018 for a calendar year 2018 Form 1040 transcript
Signature and date Form 4506-C must be signed and dated by the taxpayer listed on line 1a or 2a The IRS must receive Form 4506-C within 120 days of the date signed by the taxpayer or it will be rejected Ensure that all applicable lines including lines 5a through 8 are completed before signing
You must check the box in the signature area to acknowledge you have the authority to sign and request the information The form will not be processed if unchecked
Individuals Transcripts listed on on line 6 may be furnished to either spouse if jointly filed Only one signature is required Sign Form 4506-C exactly as your name appeared on the original return If you changed your name also sign your current name
Corporations Generally Form 4506-C can be signed by
(1) an officer having legal authority to bind the corporation (2) any person designated by the board of directors or other governing body or (3) any officer or employee on written request by any principal officer and attested to by the secretary or other officer A bona fide shareholder of record owning 1 percent or more of the outstanding stock of the corporation may submit a Form 4506-C but must provide documentation to support the requesters right to receive the information
Partnerships Generally Form 4506-C can be signed by any person who was a member of the partnership during any part of the tax period requested on line 8
All others See section 6103(e) if the taxpayer has died is insolvent is a dissolved corporation or if a trustee guardian executor receiver or administrator is acting for the taxpayer
Note If you are Heir at law Next of kin or Beneficiary you must be able to establish a material interest in the estate or trust
Documentation For entities other than individuals you must attach the authorization document For example this could be the letter from the principal officer authorizing an employee of the corporation or the letters testamentary authorizing an individual to act for an estate
Signature by a representative A representative can sign Form 4506-C for a taxpayer only if the taxpayer has specifically delegated this authority to the representative on Form 2848 line 5 The representative must attach Form 2848 showing the delegation to sign Form 4506-C
Privacy Act and Paperwork Reduction Act Notice We ask for the information on this form to establish your right to gain access to the requested tax information under the Internal Revenue Code We need this information to properly identify the tax information and respond to your request You are not required to request any transcript if you do request a transcript sections 6103 and 6109 and their regulations require you to provide this information including your SSN or EIN If you do not provide this information we may not be able to process your request Providing false or fraudulent information may subject you to penalties
Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and cities states the District of Columbia and US commonwealths and possessions for use in administering their tax laws We may also disclose this information to other countries under a tax treaty to federal and state agencies to enforce federal nontax criminal laws or to federal law enforcement and intelligence agencies to combat terrorism
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law Generally tax returns and return information are confidential as required by section 6103
The time needed to complete and file Form 4506-C will vary depending on individual circumstances The estimated average time is
Learning about the law or the form 10 min Preparing the form 12 min Copying assembling and sending the form to the IRS 20 min
If you have comments concerning the accuracy of these time estimates or suggestions for making Form 4506-C simpler we would be happy to hear from you You can write to
Internal Revenue Service Tax Forms and Publications Division 1111 Constitution Ave NW IR-6526 Washington DC 20224
Do not send the form to this address Instead see Where to file on this page
Catalog Number 72627P wwwirsgov Form 4506-C (9-2020)
Rev April 2021 CHASEO Facts What does Chase do with your personal information
Why Financial companies choose how they share your personal information Federal law gives consumers the right to limit some but not all sharing Federal law also requires us to tell you how we collect share and protect your personal information Please read this notice carefully to understand what we do
What The types of personal information we collect and share depend on the product or service you have with us This information can include bull Social Security number and income bull account balances and transaction history bull credit history and payment history
How All financial companies need to share customers personal information to run their everyday business In the section below we list the reasons financial companies can share their customers personal information the reasons Chase chooses to share and whether you can limit this sharing
Reasons we can share your personal information Does Chase share
Can you limit this sharing
For our everyday business purposes - such as to process your transactions maintain your account(s) respond to court orders and legal investigations or report to credit bureaus
Yes No
For our marketing purposes - to offer our products and services to you
Yes No
For joint marketing with other financial companies Yes No
For our affiliates everyday business purposes - information about your transactions and experiences
Yes No
For our affiliates everyday business purposes - information about your creditworthiness
Yes Yes
For our affiliates to market to you Yes Yes
For nonaffiliates to market to you Yes Yes
a
0
To limit our sharing
bull Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
bull Visit us online chasecomprivacypreferences
Please note If you are a new customer we can begin sharing your information 30 days from the date we sent this notice When you are no longer our customer we continue to share your information as described in this notice However you can contact us at any time to limit our sharing
Questions
Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
PAGE 2
Who we are
Who is providing this notice The US consumer financial companies within the JPMorgan Chase amp Co family including JPMorgan Chase Bank NA Chase Insurance Agency Inc and JP Morgan Securities LLC
What we do
How does Chase protect my To protect your personal information from unauthorized access and use we personal information use security measures that comply with federal law These measures include
computer safeguards and secured files and buildings We authorize our employees to get your information only when they need it to do their work and we require companies that work for us to protect your information
How does Chase collect my We collect your personal information for example when you personal information bull open an account or make deposits or withdrawals from your account
bull pay your bills or apply for a loan bull use your credit or debit card We also collect your personal information from others such as credit bureaus affiliates or other companies
Why cant I limit all sharing Federal law gives you the right to limit only bull sharing for affiliates everyday business purposes - information about your
creditworthiness bull affiliates from using your information to market to you bull sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing See below for more on your rights under state law
What happens when I limit sharing for an account I hold jointly with someone else
Your choices will apply to everyone on your account
Definitions
Affiliates Companies related by common ownership or control They can be financial and non financial companies bull Our affiliates include companies with a Chase or JP Morgan name and financial companies such asjP Morgan Securities LLC
Nonaffiliates Companies not related by common ownership or control They can be financial and non financial companies bull Nonaffiliates we share with can include companies such as retailers auto dealers auto makers and membership clubs
Joint marketing A formal agreement between nonaffiliated financial companies that together market financial products or services to you bull Our joint marketing partners include categories of companies such as insurance companies
Other important information
VT Accounts with a Vermont mailing address are automatically treated as if they have limited the sharing as described on page 1 For joint marketing we will only disclose your name contact information and information about your transactions
NV We are providing you this notice pursuant to Nevada law If you prefer not to receive marketing calls from us you may be placed on our Internal Do Not Call List by calling 1-800-945-9470 or by writing to us at PO Box 734007 Dallas TX 75373-4007
For more information contact us at the address above or email PrivacylnfoJPMChasecom with Nevada Annual Notice in the subject line You may also contact the Nevada Attorney Generals office Bureau of Consumer Protection Office of the Nevada Attorney General 555 E Washington St Suite 3900 Las Vegas NV 89101 telephone number 1-702-486-3132 email BCPINFOagstatenvus
CA Accounts with a California mailing address are automatically treated as if they have limited the sharing with nonaffiliates as described on page 1 CA residents are provided a CA notice for additional choices
CHASE O
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
The following disclosure is required by the USA PATRIOT Act
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 opens an account
What this means to you When you 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 drivers
license or other identifying documents
99177-PAT-0215
VETERAN STATEMENT When this loan was opened the US Department of Veterans Affairs (VA) used the veteran borrowerrsquos entitlement which is a set amount the VA promises to repay a lender if the borrower defaults on the mortgage An assumption will modify who is obligated to pay the existing mortgage loan but all loan termsmdashincluding the entitlementmdashwill remain the same If the veteran borrower is being removed from the loan the entitlement would remain with whoever is assuming the loan because the loan will continue to be serviced by the VA If the applicant is also a veteran and can substitute his or her entitlement for the current entitlement then the current borrowerrsquos entitlement can be released
Please review the following questions and answer as appropriate This form requires completion by both the applicant(s) and current borrower(s)
1 Applicant to Complete
Are you (the applicant) currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the reverse side)
Yes (If yes please provide the information requested below answer the question in section 3 and sign and date this form at the bottom of the reverse side)
Name of applicant(s) who answered ldquoyesrdquo to the above question
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Are you receiving VA disability benefts
Applicant
Yes
No
Co-Applicant
Yes
No
Are you entitled to receive VA disability benefts Yes No Yes No
Have you received VA disability benefts in the past Yes No Yes No
Are you a surviving spouse of a veteran who died on active duty or as the result of a service-related disability
Yes No Yes No
Do you have any VA loans Yes No Yes No
2 Current Borrower to Complete
Is the current borrowerco-borrower currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the page)
Yes (If yes please answer the question in section 3 and sign and date this form at the bottom of the page)
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
________________________________________________________________________________________________
3 Applicant and Current Borrower to Complete
If the answer to the questions in section 1 and 2 are both yes please answer the following question After yoursquove reviewed and completed this entire form please sign and date at the bottom
Applicant Current Borrower
Do you want to apply for a substitution of entitlement Yes Yes No No
In order to complete a substitution of entitlement the veteran applicant must have suffcient entitlement to substitute for that of the current borrower Contact the VA Offce of Jurisdiction for your area for more information Also before the veteran applicant can substitute entitlement on a VA loan heshe must certify that the property securing the loan will be occupied as hisher primary residence Both the applicantrsquos and current borrowerrsquos original certifcate of eligibility will be required If your sales contract is contingent upon the restoration of entitlement please contact your VA Offce of Jurisdiction for complete procedures Otherwise the substitution will be completed after the loan has been approved and closed
Date Applicant printed name Applicant signature
Date Applicant printed name Applicant signature
Date Current Borrower printed name Current Borrower signature
Date Current Borrower printed name Current Borrower signature
Forms completed by Mail Phone
For Chase use only
Interviewer signature Date
99177-VS-0215
- Assumption Application Package_41521-noscannedpages-update-4pdf
-
- 1 FM203 Cover Pagepdf
- 2 FM202 Mortgage Assumption Application Package pagepdf
- 3 The Documents Youll need to Send Uspdf
- 4 FM201 FAQpdf
- 5 FM142 CIWpdf
- 6 FM126 URLApdf
- 7 FM130 URLA Instpdf
-
- Blank Page
-
- 8 92900a Addednum to Loan Applicationpdf
- 9 FM462 Gen Authpdf
- 10 FM220 4506-Cpdf
- 11 FM153 Chase Federal Privacy Noticepdf
- 12 FM144 Info on Opening a New Accountpdf
- 13 FM152 Veteran Statementpdf
-
- Date
- Loan number
- Applicant name
- Phone1
- Loan number 1
- Loan number 2
- Other
- Other_2
- 1
- 2
- undefined_7
- Available hours
- Available hours_2
- undefined_8
- Available hours_3
- undefined_9
- Current address 1
- Neither
- Available hours_4
- Available hours_5
- undefined_10
- Available hours_6
- 1_2
- 2_2
- undefined_11
- Available hours_7
- Available hours_8
- undefined_12
- Available hours_9
- FHA Case No include any suffix
- Mortgagee Case No
- Mortgagee ID
- Sponsor ID
- Agent ID
- Name and Address of Sponsor Name and Address of Agent
- Borrowers Name Present Address include ZIP Code Property Address
- include name of subdivision lot block no ZIP Code
- Name of ThirdParty Originator
- NMLS ID of ThirdParty Originator
- s application
- ty Number
- ty Number_2
- Date Signed_2
- Date Mortgage Approved
- Date Approval Expires
- Printed Name
- Title 1
- DEs ID Number
- DEs ID Number_2
- Mortgagee
- Name of Mortgagees Representative
- Title of Mortgagees Representative
- Signature of the Mortgagees Representative
- Date_2
- Applicant names 1
- Applicant names 2
- Applicant names 3
- Loan number_2
- Date_3
- Applicant printed name
- Social Security number
- Date_4
- Applicant printed name_2
- Social Security number_2
- Date_5
- Applicant printed name_3
- Social Security number_3
- Date_6
- Applicant printed name_4
- Social Security number_4
- 1a Name shown on tax return if a joint return enter the name shown first
- 1b First social security number on tax return individual taxpayer identification number or employer identification number see instructions
- 2a If a joint return enter spouses name shown on tax return
- 2b Second social security number or individual taxpayer identification number if joint tax return
- 4 Previous address shown on the last return filed if different from line 3 see instructions
- 5a IVES participant name address and SOR mailbox ID
- Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing see instructions
- Signature see instructions
- Date_7
- Phone number of taxpayer on line 1a or 2a
- PrintType name
- Here
- Spouses signature
- Date_8
- PrintType name_2
- Name
- Date of birth
- Service number
- Name_2
- Date of birth_2
- Service number_2
- Date_9
- Applicant printed name_5
- Date_10
- Applicant printed name_6
- Date_11
- Current Borrower printed name
- Date_12
- Current Borrower printed name_2
- Date_13
- Text3
- Text10
- undefined_13
- Text15
- undefined_14
- undefined_15
- undefined_16
- undefined_17
- undefined_18
- undefined_19
- undefined_20
- undefined_21
- undefined_23
- Reason for assumption Off
- Requestors relationship to owners Off
- Check one Off
- Check one1 Off
- Day1
- Evening
- Cell phone
- Check one2 Off
- Check one3 Off
- Check one4 Off
- Check one5 Off
- Text2-1
- Text2-2
- Text2-3
- Text2-4
- Text2-5
- Text2-6
- Text3-1
- Text3-2
- Text3-3
- Text3-4
- Text3-6
- Text3-7
- Text3-8
- Text3-9
- Text3-10
- Text3-11
- Text3-12
- Text3-13
- Text3-14
- Text3-15
- Text3-16
- Text3-17
- Text3-18
- Text3-19
- Text3-20
- Text3-21
- Text3-22
- Text3-23
- Text3-24
- Text3-25
- Text3-26
- Text3-27
- Text3-28
- Text3-29
- Text3-30
- Text3-31
- Text3-32
- Text3-33
- Text3-34
- Text3-35
- Text3-36
- Text3-37
- Text3-38
- Text3-39
- Text3-40
- Text3-41
- Text3-42
- Text3-43
- Text3-44
- Text3-45
- Text3-46
- Text3-47
- Text3-48
- Text3-49
- Text3-50
- Text3-51
- Text3-52
- Text3-53
- Text3-5
- Text3-54
- Text3-55
- Text3-56
- Citizenship Off
- Type of credit Off
- Marital Status Off
- Housing Off
- Housing1 Off
- ownership Off
- DNA1 Off
- DNA2 Off
- DNA3 Off
- family Off
- BO Off
- Total
- Text31
- Text32
- Text33
- Text34
- Text35
- Text36
- Text37
- Text38
- Text39
- Text310
- Text311
- Text312
- Text313
- Text314
- Text315
- Text316
- Text317
- Text318
- Text319
- ownership1 Off
- Total1
- Total1-2
- Check Box4-1 Off
- Text320
- Text321
- Text322
- Text323
- Text324
- Text325
- Text326
- Text327
- Text328
- Text329
- Check Box4-2 Off
- Check Box4-3 Off
- Check Box4-4 Off
- Check Box4-8 Off
- Check Box4-9 Off
- Text330
- Text331
- Text332
- Text333
- Text334
- Text335
- Text1-1
- Text1-2
- Text1-3
- Text1-4
- Text1-5
- Text1-6
- Text1-7
- Text1-8
- Text1-9
- Text1-10
- Text1-11
- Text1-12
- Text1-13
- Text1-14
- Text1-15
- Text1-16
- Text1-17
- Text1-18
- Text1-19
- Text1-20
- Text1-21
- Text1-22
- Text1-23
- Text1-24
- Text1-25
- Text1-26
- Text1-27
- Text1-28
- Text1-29
- Text1-30
- Text1-31
- Text1-32
- Text1-33
- Text1-34
- Text1-35
- Check Box3-2 Off
- Check Box2-1 Off
- Check Box2-2 Off
- Check Box2-3 Off
- Check Box2-4 Off
- Check Box2-5 Off
- Text1-36
- Text1-37
- Text1-38
- Text1-39
- Text1-40
- Text1-41
- Text1-42
- Text1-43
- Text1-44
- Text1-45
- Text1-46
- Text1-47
- Text1-48
- Text1-49
- Text1-50
- Text1-51
- Text1-52
- Text1-53
- Text1-54
- Text1-55
- Text1-56
- Text1-57
- Text1-58
- Text1-59
- Text1-60
- Text1-61
- Check Box3-11 Off
- A1
- A2
- A3
- A4
- A5
- A6
- A7
- A8
- A9
- A10
- A11
- A12
- Check Box3-1 Off
- Check Box30-1 Off
- Check Box30-2 Off
- Check Box30-4 Off
- Check Box30-5 Off
- Check Box30-7 Off
- Check Box30-8 Off
- Check Box30-9 Off
- Check Box30-10 Off
- Check Box30-11 Off
- Check Box30-12 Off
- A13
- A14
- A15
- A16
- A17 Off
- A18
- A19
- A20
- A21
- A22
- A23
- A24
- A25
- A26
- A27
- A28
- A29
- A30
- A31
- A32
- A33
- A34
- A35
- A36
- A37
- A38 Off
- A39
- A40
- A41
- A42
- A43
- A44
- A45
- A46
- A47
- A48
- A49
- A50
- A51
- A52
- A53
- A54
- A55
- A56
- A57
- A58
- A59
- A60
- A61
- A62
- A63
- A64
- A65
- A66
- A67
- A68
- A69
- A70
- A71
- A72
- A73
- A74
- Loan Purpose Off
- occupancy1 Off
- lien type Off
- lientype Off
- mixed use Off
- manufactured home Off
- deposit1 Off
- deposit2 Off
- B1
- B2
- B3
- B4
- B5
- B6
- B7
- B8
- B9
- B10
- fha Off
- Check Box51 Off
- B11
- B12
- B13
- B14
- B15
- B16
- B17
- B18
- B19 Off
- B20
- B21
- B22 Off
- B23
- B24
- B25
- B26
- B27
- B28
- A
-
- Will you occupy the property as your primary residence Off
- Will you occupy the property as your primary residence1 Off
-
- If yes have you had an ownership interest in another property in the last three years Off
- Text9-2
- B
-
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property Off
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property1 Off
-
- 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 Off
- 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 application1 Off
-
- 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 Off
- 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 application1 Off
-
- new credit Off
- 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) Off
- the Property Assessed Clean Energy Program)1 Off
-
- F
-
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application Off
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application1 Off
-
- G
-
- Are there any outstanding judgments against you Off
- Are there any outstanding judgments against you1 Off
-
- H
-
- Are you currently delinquent or in default on a Federal debt Off
- Are you currently delinquent or in default on a Federal debt1 Off
-
- I
-
- Are you a party to a lawsuit in which you potentially have any personal financial liability Off
- Are you a party to a lawsuit in which you potentially have any personal financial liability1 Off
-
- J
-
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years Off
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years1 Off
-
- 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 Off
- 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 due1 Off
-
- L
-
- Have you had property foreclosed upon in the last 7 years Off
- Have you had property foreclosed upon in the last 7 years1 Off
-
- M
-
- Have you declared bankruptcy within the past 7 years Off
- Have you declared bankruptcy within the past 7 years1 Off
-
- Check Box8-2 Off
- Check Box8-3 Off
- Check Box8-4 Off
- Text9-3
- Text9-5
- Text9-6
- Text97
- military Off
- ethnicity Off
- sex Off
- race Off
- demo Off
- Text12-1
- Check Box11-1 Off
- Check Box11-2 Off
- Check Box11-3 Off
- Check Box11-4 Off
- Check Box11-5 Off
- Check Box11-6 Off
- Check Box11-7 Off
- Check Box11-8 Off
- Check Box11-9 Off
- Text12-2
- Check Box11-10 Off
- Check Box11-11 Off
- Check Box11-12 Off
- Check Box11-13 Off
- Check Box11-14 Off
- Check Box11-15 Off
- Text12-3
- Check Box11-16 Off
- Check Box11-17 Off
- Check Box11-18 Off
- Check Box11-19 Off
- Check Box11-20 Off
- Check Box11-21 Off
- Check Box11-22 Off
- Check Box11-23 Off
- Text12-4
- Check Box11-24 Off
- Check Box11-25 Off
- Check Box11-26 Off
- Check Box11-27 Off
- Check Box11-28 Off
- Check Box11-29 Off
- Text12-5
- Check Box11-30 Off
- Check Box11-31 Off
- citizen Off
- credit Off
- marital status1 Off
- housing-1 Off
- housing-2 Off
- own Off
- C1
- C2
- C3
- C6
- C7
- C8
- C9
- C10
- C11
- C12
- C13
- C14
- C15
- C16
- C17
- C18
- C19
- C20
- C21
- C22
- C23
- C24
- C25
- C26
- C27
- C28
- C29
- C30
- C31
- C32
- C33
- C34
- C35
- Check Box-2 Off
- C36
- C37
- C38
- C39
- C4
- C40
- C41
- C42
- C43
- C44
- C45
- C46
- C47
- Check Box-3 Off
- Check Box-4 Off
- C48
- C49
- C5
- C50
- C51
- C52
- C53
- C54
- C55
- Check Box-1-1 Off
- own1 Off
- Check Box-1 Off
- D1 Off
- D2
- D3
- D4
- D5
- D6
- D7
- D8
- D9
- D10
- D11
- D12
- D13
- D14 Off
- D15 Off
- D16
- D17
- D18
- D19
- D20
- D21
- D22
- D23
- D24 Off
- D25
- D26
- D27
- D28
- D29
- D30
- D31
- D32
- D33
- D34
- D35 Off
- D36
- D37 Off
- D38
- D39
- D40
- D41
- D42
- D43
- D44
- D45
- D46
- D47
- If yes have you had an ownership interest in another property in the last three years1 Off
- new credit1 Off
- Check Box8-1 Off
- Check Box8-1-2 Off
- Check Box8-1-1 Off
- Check Box8-1-3 Off
- Check Box8-1-4 Off
- Military Service mdash Did you (or your deceased spouse) ever serve or are you currently serving in the United States Armed Forces 1 Off
- Check1 Off
- Text9-1-1
- Check2 Off
- Check3 Off
- Check4 Off
- Text9-1
- E1
- E2
- E3
- Was the ethnicity of the Borrower collected on the basis of visual observation or surname1 Off
- Was the sex of the Borrower collected on the basis of visual observation or surname1 Off
- Was the race of the Borrower collected on the basis of visual observation or surname1 Off
- The Demographic Information was provided through1 Off
- F1 Off
- F2 Off
- F3 Off
- F4 Off
- F5 Off
- F6
- F7 Off
- F8 Off
- F9 Off
- F10 Off
- F11 Off
- F12 Off
- F13
- F14 Off
- F15 Off
- F16 Off
- F17 Off
- F18 Off
- F19 Off
- F20 Off
- F21 Off
- F22
- F23 Off
- F24 Off
- F25 Off
- F26 Off
- F27 Off
- F28 Off
- F29
- F30 Off
- F31 Off
- undefined_13-1
- undefined_13-2
- undefined_14-1
- undefined_15-1
- undefined_16-1
- undefined_17-1
- undefined_18-1
- undefined_19-1
- undefined_21-1
- undefined_20-1
- undefined_23-1
- undefined_13_1
- Single-Two Off
- Refi type Off
- refi program Off
- Estate Off
- Title held Off
- Trust Information Off
- Indian Country Land Tenure Off
- Mortgage Type Applied For Off
- Mortgage Lien Type Off
- Amortization Type Off
- G1 Off
- G2 Off
- G3 Off
- G4 Off
- G5 Off
- G6
- G7
- G8
- G9
- G10 Off
- G11 Off
- G12 Off
- G13 Off
- G14 Off
- G15 Off
- G16
- G17
- G18
- G19
- G20
- G21
- G22
- G23 Off
- G24
- G25 Off
- G26
- G27 Off
- G28 Off
- G29
- G30 Off
- G31
- G32 Off
- G33
- G34
- G35
- G36
- G37
- G38
- G39
- G40
- G41
- G42
- Property Held
- refi
- Text18-1
- Text18-2
- Text18-3
- Text18-4
- Text18-5
- Text18-6
- Text18-7
- Text18-8
- Text18-9
- Text18-10
- Text18-11
- Text18-12
- Text18-13
- Text18-14
- Text18-15
- Text18-16
- Text18-17
- Text18-18
- Text18-19
- Lender
- case no
- If you selected ldquoUnmarriedrdquo in Section 1 is there a person who is not your legal spouse but who currently has real property rights similar to those of a legal spouse Off
- Relationship and State Off
- Other-5
- Text19-1
- BName
- Additional Information
- ABN
- Additional Information1
- BSign
- BSDate
- ABSign
- ABDate
- MortageeNameAddress
- NAmeAddress
- Bname1
- DOB1
- DOB2
- SignOfBorr1
- SignOfBorr
- Date Signed
- SignOfBorr2
- SignOfBorr3
- Date Signed3
- Date Signed4
- MortgageeRepSign
- DirectSign
- DirectSign1
- Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union Off
- AppSign
- AppSign1
- AppSign2
- AppSign3
- Nopage38 Off
- Yespage38 Off
- Yes1 Off
- No1 Off
- Yes2 Off
- Yes3 Off
- Yes4 Off
- Yes5 Off
- Yes6 Off
- Yes7 Off
- Yes8 Off
- Yes9 Off
- Yes10 Off
- No2 Off
- No3 Off
- No4 Off
- No5 Off
- No6 Off
- No7 Off
- No8 Off
- No9 Off
- No10 Off
- BorrowerNo Off
- BorrowerYes Off
- AppSignature
- AppSignature1
- CurrentSign
- CurrentSign1
- InterviewSign
- Yes_1 Off
- No_1 Off
- Yes_2 Off
- No_2 Off
- Mail Off
- Phone Off
Rev April 2021 CHASEO Facts What does Chase do with your personal information
Why Financial companies choose how they share your personal information Federal law gives consumers the right to limit some but not all sharing Federal law also requires us to tell you how we collect share and protect your personal information Please read this notice carefully to understand what we do
What The types of personal information we collect and share depend on the product or service you have with us This information can include bull Social Security number and income bull account balances and transaction history bull credit history and payment history
How All financial companies need to share customers personal information to run their everyday business In the section below we list the reasons financial companies can share their customers personal information the reasons Chase chooses to share and whether you can limit this sharing
Reasons we can share your personal information Does Chase share
Can you limit this sharing
For our everyday business purposes - such as to process your transactions maintain your account(s) respond to court orders and legal investigations or report to credit bureaus
Yes No
For our marketing purposes - to offer our products and services to you
Yes No
For joint marketing with other financial companies Yes No
For our affiliates everyday business purposes - information about your transactions and experiences
Yes No
For our affiliates everyday business purposes - information about your creditworthiness
Yes Yes
For our affiliates to market to you Yes Yes
For nonaffiliates to market to you Yes Yes
a
0
To limit our sharing
bull Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
bull Visit us online chasecomprivacypreferences
Please note If you are a new customer we can begin sharing your information 30 days from the date we sent this notice When you are no longer our customer we continue to share your information as described in this notice However you can contact us at any time to limit our sharing
Questions
Call 1-888-868-8618 - our menu will prompt you through your choice(s) We accept operator relay calls
PAGE 2
Who we are
Who is providing this notice The US consumer financial companies within the JPMorgan Chase amp Co family including JPMorgan Chase Bank NA Chase Insurance Agency Inc and JP Morgan Securities LLC
What we do
How does Chase protect my To protect your personal information from unauthorized access and use we personal information use security measures that comply with federal law These measures include
computer safeguards and secured files and buildings We authorize our employees to get your information only when they need it to do their work and we require companies that work for us to protect your information
How does Chase collect my We collect your personal information for example when you personal information bull open an account or make deposits or withdrawals from your account
bull pay your bills or apply for a loan bull use your credit or debit card We also collect your personal information from others such as credit bureaus affiliates or other companies
Why cant I limit all sharing Federal law gives you the right to limit only bull sharing for affiliates everyday business purposes - information about your
creditworthiness bull affiliates from using your information to market to you bull sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing See below for more on your rights under state law
What happens when I limit sharing for an account I hold jointly with someone else
Your choices will apply to everyone on your account
Definitions
Affiliates Companies related by common ownership or control They can be financial and non financial companies bull Our affiliates include companies with a Chase or JP Morgan name and financial companies such asjP Morgan Securities LLC
Nonaffiliates Companies not related by common ownership or control They can be financial and non financial companies bull Nonaffiliates we share with can include companies such as retailers auto dealers auto makers and membership clubs
Joint marketing A formal agreement between nonaffiliated financial companies that together market financial products or services to you bull Our joint marketing partners include categories of companies such as insurance companies
Other important information
VT Accounts with a Vermont mailing address are automatically treated as if they have limited the sharing as described on page 1 For joint marketing we will only disclose your name contact information and information about your transactions
NV We are providing you this notice pursuant to Nevada law If you prefer not to receive marketing calls from us you may be placed on our Internal Do Not Call List by calling 1-800-945-9470 or by writing to us at PO Box 734007 Dallas TX 75373-4007
For more information contact us at the address above or email PrivacylnfoJPMChasecom with Nevada Annual Notice in the subject line You may also contact the Nevada Attorney Generals office Bureau of Consumer Protection Office of the Nevada Attorney General 555 E Washington St Suite 3900 Las Vegas NV 89101 telephone number 1-702-486-3132 email BCPINFOagstatenvus
CA Accounts with a California mailing address are automatically treated as if they have limited the sharing with nonaffiliates as described on page 1 CA residents are provided a CA notice for additional choices
CHASE O
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
The following disclosure is required by the USA PATRIOT Act
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 opens an account
What this means to you When you 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 drivers
license or other identifying documents
99177-PAT-0215
VETERAN STATEMENT When this loan was opened the US Department of Veterans Affairs (VA) used the veteran borrowerrsquos entitlement which is a set amount the VA promises to repay a lender if the borrower defaults on the mortgage An assumption will modify who is obligated to pay the existing mortgage loan but all loan termsmdashincluding the entitlementmdashwill remain the same If the veteran borrower is being removed from the loan the entitlement would remain with whoever is assuming the loan because the loan will continue to be serviced by the VA If the applicant is also a veteran and can substitute his or her entitlement for the current entitlement then the current borrowerrsquos entitlement can be released
Please review the following questions and answer as appropriate This form requires completion by both the applicant(s) and current borrower(s)
1 Applicant to Complete
Are you (the applicant) currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the reverse side)
Yes (If yes please provide the information requested below answer the question in section 3 and sign and date this form at the bottom of the reverse side)
Name of applicant(s) who answered ldquoyesrdquo to the above question
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Are you receiving VA disability benefts
Applicant
Yes
No
Co-Applicant
Yes
No
Are you entitled to receive VA disability benefts Yes No Yes No
Have you received VA disability benefts in the past Yes No Yes No
Are you a surviving spouse of a veteran who died on active duty or as the result of a service-related disability
Yes No Yes No
Do you have any VA loans Yes No Yes No
2 Current Borrower to Complete
Is the current borrowerco-borrower currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the page)
Yes (If yes please answer the question in section 3 and sign and date this form at the bottom of the page)
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
________________________________________________________________________________________________
3 Applicant and Current Borrower to Complete
If the answer to the questions in section 1 and 2 are both yes please answer the following question After yoursquove reviewed and completed this entire form please sign and date at the bottom
Applicant Current Borrower
Do you want to apply for a substitution of entitlement Yes Yes No No
In order to complete a substitution of entitlement the veteran applicant must have suffcient entitlement to substitute for that of the current borrower Contact the VA Offce of Jurisdiction for your area for more information Also before the veteran applicant can substitute entitlement on a VA loan heshe must certify that the property securing the loan will be occupied as hisher primary residence Both the applicantrsquos and current borrowerrsquos original certifcate of eligibility will be required If your sales contract is contingent upon the restoration of entitlement please contact your VA Offce of Jurisdiction for complete procedures Otherwise the substitution will be completed after the loan has been approved and closed
Date Applicant printed name Applicant signature
Date Applicant printed name Applicant signature
Date Current Borrower printed name Current Borrower signature
Date Current Borrower printed name Current Borrower signature
Forms completed by Mail Phone
For Chase use only
Interviewer signature Date
99177-VS-0215
- Assumption Application Package_41521-noscannedpages-update-4pdf
-
- 1 FM203 Cover Pagepdf
- 2 FM202 Mortgage Assumption Application Package pagepdf
- 3 The Documents Youll need to Send Uspdf
- 4 FM201 FAQpdf
- 5 FM142 CIWpdf
- 6 FM126 URLApdf
- 7 FM130 URLA Instpdf
-
- Blank Page
-
- 8 92900a Addednum to Loan Applicationpdf
- 9 FM462 Gen Authpdf
- 10 FM220 4506-Cpdf
- 11 FM153 Chase Federal Privacy Noticepdf
- 12 FM144 Info on Opening a New Accountpdf
- 13 FM152 Veteran Statementpdf
-
- Date
- Loan number
- Applicant name
- Phone1
- Loan number 1
- Loan number 2
- Other
- Other_2
- 1
- 2
- undefined_7
- Available hours
- Available hours_2
- undefined_8
- Available hours_3
- undefined_9
- Current address 1
- Neither
- Available hours_4
- Available hours_5
- undefined_10
- Available hours_6
- 1_2
- 2_2
- undefined_11
- Available hours_7
- Available hours_8
- undefined_12
- Available hours_9
- FHA Case No include any suffix
- Mortgagee Case No
- Mortgagee ID
- Sponsor ID
- Agent ID
- Name and Address of Sponsor Name and Address of Agent
- Borrowers Name Present Address include ZIP Code Property Address
- include name of subdivision lot block no ZIP Code
- Name of ThirdParty Originator
- NMLS ID of ThirdParty Originator
- s application
- ty Number
- ty Number_2
- Date Signed_2
- Date Mortgage Approved
- Date Approval Expires
- Printed Name
- Title 1
- DEs ID Number
- DEs ID Number_2
- Mortgagee
- Name of Mortgagees Representative
- Title of Mortgagees Representative
- Signature of the Mortgagees Representative
- Date_2
- Applicant names 1
- Applicant names 2
- Applicant names 3
- Loan number_2
- Date_3
- Applicant printed name
- Social Security number
- Date_4
- Applicant printed name_2
- Social Security number_2
- Date_5
- Applicant printed name_3
- Social Security number_3
- Date_6
- Applicant printed name_4
- Social Security number_4
- 1a Name shown on tax return if a joint return enter the name shown first
- 1b First social security number on tax return individual taxpayer identification number or employer identification number see instructions
- 2a If a joint return enter spouses name shown on tax return
- 2b Second social security number or individual taxpayer identification number if joint tax return
- 4 Previous address shown on the last return filed if different from line 3 see instructions
- 5a IVES participant name address and SOR mailbox ID
- Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing see instructions
- Signature see instructions
- Date_7
- Phone number of taxpayer on line 1a or 2a
- PrintType name
- Here
- Spouses signature
- Date_8
- PrintType name_2
- Name
- Date of birth
- Service number
- Name_2
- Date of birth_2
- Service number_2
- Date_9
- Applicant printed name_5
- Date_10
- Applicant printed name_6
- Date_11
- Current Borrower printed name
- Date_12
- Current Borrower printed name_2
- Date_13
- Text3
- Text10
- undefined_13
- Text15
- undefined_14
- undefined_15
- undefined_16
- undefined_17
- undefined_18
- undefined_19
- undefined_20
- undefined_21
- undefined_23
- Reason for assumption Off
- Requestors relationship to owners Off
- Check one Off
- Check one1 Off
- Day1
- Evening
- Cell phone
- Check one2 Off
- Check one3 Off
- Check one4 Off
- Check one5 Off
- Text2-1
- Text2-2
- Text2-3
- Text2-4
- Text2-5
- Text2-6
- Text3-1
- Text3-2
- Text3-3
- Text3-4
- Text3-6
- Text3-7
- Text3-8
- Text3-9
- Text3-10
- Text3-11
- Text3-12
- Text3-13
- Text3-14
- Text3-15
- Text3-16
- Text3-17
- Text3-18
- Text3-19
- Text3-20
- Text3-21
- Text3-22
- Text3-23
- Text3-24
- Text3-25
- Text3-26
- Text3-27
- Text3-28
- Text3-29
- Text3-30
- Text3-31
- Text3-32
- Text3-33
- Text3-34
- Text3-35
- Text3-36
- Text3-37
- Text3-38
- Text3-39
- Text3-40
- Text3-41
- Text3-42
- Text3-43
- Text3-44
- Text3-45
- Text3-46
- Text3-47
- Text3-48
- Text3-49
- Text3-50
- Text3-51
- Text3-52
- Text3-53
- Text3-5
- Text3-54
- Text3-55
- Text3-56
- Citizenship Off
- Type of credit Off
- Marital Status Off
- Housing Off
- Housing1 Off
- ownership Off
- DNA1 Off
- DNA2 Off
- DNA3 Off
- family Off
- BO Off
- Total
- Text31
- Text32
- Text33
- Text34
- Text35
- Text36
- Text37
- Text38
- Text39
- Text310
- Text311
- Text312
- Text313
- Text314
- Text315
- Text316
- Text317
- Text318
- Text319
- ownership1 Off
- Total1
- Total1-2
- Check Box4-1 Off
- Text320
- Text321
- Text322
- Text323
- Text324
- Text325
- Text326
- Text327
- Text328
- Text329
- Check Box4-2 Off
- Check Box4-3 Off
- Check Box4-4 Off
- Check Box4-8 Off
- Check Box4-9 Off
- Text330
- Text331
- Text332
- Text333
- Text334
- Text335
- Text1-1
- Text1-2
- Text1-3
- Text1-4
- Text1-5
- Text1-6
- Text1-7
- Text1-8
- Text1-9
- Text1-10
- Text1-11
- Text1-12
- Text1-13
- Text1-14
- Text1-15
- Text1-16
- Text1-17
- Text1-18
- Text1-19
- Text1-20
- Text1-21
- Text1-22
- Text1-23
- Text1-24
- Text1-25
- Text1-26
- Text1-27
- Text1-28
- Text1-29
- Text1-30
- Text1-31
- Text1-32
- Text1-33
- Text1-34
- Text1-35
- Check Box3-2 Off
- Check Box2-1 Off
- Check Box2-2 Off
- Check Box2-3 Off
- Check Box2-4 Off
- Check Box2-5 Off
- Text1-36
- Text1-37
- Text1-38
- Text1-39
- Text1-40
- Text1-41
- Text1-42
- Text1-43
- Text1-44
- Text1-45
- Text1-46
- Text1-47
- Text1-48
- Text1-49
- Text1-50
- Text1-51
- Text1-52
- Text1-53
- Text1-54
- Text1-55
- Text1-56
- Text1-57
- Text1-58
- Text1-59
- Text1-60
- Text1-61
- Check Box3-11 Off
- A1
- A2
- A3
- A4
- A5
- A6
- A7
- A8
- A9
- A10
- A11
- A12
- Check Box3-1 Off
- Check Box30-1 Off
- Check Box30-2 Off
- Check Box30-4 Off
- Check Box30-5 Off
- Check Box30-7 Off
- Check Box30-8 Off
- Check Box30-9 Off
- Check Box30-10 Off
- Check Box30-11 Off
- Check Box30-12 Off
- A13
- A14
- A15
- A16
- A17 Off
- A18
- A19
- A20
- A21
- A22
- A23
- A24
- A25
- A26
- A27
- A28
- A29
- A30
- A31
- A32
- A33
- A34
- A35
- A36
- A37
- A38 Off
- A39
- A40
- A41
- A42
- A43
- A44
- A45
- A46
- A47
- A48
- A49
- A50
- A51
- A52
- A53
- A54
- A55
- A56
- A57
- A58
- A59
- A60
- A61
- A62
- A63
- A64
- A65
- A66
- A67
- A68
- A69
- A70
- A71
- A72
- A73
- A74
- Loan Purpose Off
- occupancy1 Off
- lien type Off
- lientype Off
- mixed use Off
- manufactured home Off
- deposit1 Off
- deposit2 Off
- B1
- B2
- B3
- B4
- B5
- B6
- B7
- B8
- B9
- B10
- fha Off
- Check Box51 Off
- B11
- B12
- B13
- B14
- B15
- B16
- B17
- B18
- B19 Off
- B20
- B21
- B22 Off
- B23
- B24
- B25
- B26
- B27
- B28
- A
-
- Will you occupy the property as your primary residence Off
- Will you occupy the property as your primary residence1 Off
-
- If yes have you had an ownership interest in another property in the last three years Off
- Text9-2
- B
-
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property Off
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property1 Off
-
- 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 Off
- 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 application1 Off
-
- 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 Off
- 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 application1 Off
-
- new credit Off
- 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) Off
- the Property Assessed Clean Energy Program)1 Off
-
- F
-
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application Off
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application1 Off
-
- G
-
- Are there any outstanding judgments against you Off
- Are there any outstanding judgments against you1 Off
-
- H
-
- Are you currently delinquent or in default on a Federal debt Off
- Are you currently delinquent or in default on a Federal debt1 Off
-
- I
-
- Are you a party to a lawsuit in which you potentially have any personal financial liability Off
- Are you a party to a lawsuit in which you potentially have any personal financial liability1 Off
-
- J
-
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years Off
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years1 Off
-
- 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 Off
- 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 due1 Off
-
- L
-
- Have you had property foreclosed upon in the last 7 years Off
- Have you had property foreclosed upon in the last 7 years1 Off
-
- M
-
- Have you declared bankruptcy within the past 7 years Off
- Have you declared bankruptcy within the past 7 years1 Off
-
- Check Box8-2 Off
- Check Box8-3 Off
- Check Box8-4 Off
- Text9-3
- Text9-5
- Text9-6
- Text97
- military Off
- ethnicity Off
- sex Off
- race Off
- demo Off
- Text12-1
- Check Box11-1 Off
- Check Box11-2 Off
- Check Box11-3 Off
- Check Box11-4 Off
- Check Box11-5 Off
- Check Box11-6 Off
- Check Box11-7 Off
- Check Box11-8 Off
- Check Box11-9 Off
- Text12-2
- Check Box11-10 Off
- Check Box11-11 Off
- Check Box11-12 Off
- Check Box11-13 Off
- Check Box11-14 Off
- Check Box11-15 Off
- Text12-3
- Check Box11-16 Off
- Check Box11-17 Off
- Check Box11-18 Off
- Check Box11-19 Off
- Check Box11-20 Off
- Check Box11-21 Off
- Check Box11-22 Off
- Check Box11-23 Off
- Text12-4
- Check Box11-24 Off
- Check Box11-25 Off
- Check Box11-26 Off
- Check Box11-27 Off
- Check Box11-28 Off
- Check Box11-29 Off
- Text12-5
- Check Box11-30 Off
- Check Box11-31 Off
- citizen Off
- credit Off
- marital status1 Off
- housing-1 Off
- housing-2 Off
- own Off
- C1
- C2
- C3
- C6
- C7
- C8
- C9
- C10
- C11
- C12
- C13
- C14
- C15
- C16
- C17
- C18
- C19
- C20
- C21
- C22
- C23
- C24
- C25
- C26
- C27
- C28
- C29
- C30
- C31
- C32
- C33
- C34
- C35
- Check Box-2 Off
- C36
- C37
- C38
- C39
- C4
- C40
- C41
- C42
- C43
- C44
- C45
- C46
- C47
- Check Box-3 Off
- Check Box-4 Off
- C48
- C49
- C5
- C50
- C51
- C52
- C53
- C54
- C55
- Check Box-1-1 Off
- own1 Off
- Check Box-1 Off
- D1 Off
- D2
- D3
- D4
- D5
- D6
- D7
- D8
- D9
- D10
- D11
- D12
- D13
- D14 Off
- D15 Off
- D16
- D17
- D18
- D19
- D20
- D21
- D22
- D23
- D24 Off
- D25
- D26
- D27
- D28
- D29
- D30
- D31
- D32
- D33
- D34
- D35 Off
- D36
- D37 Off
- D38
- D39
- D40
- D41
- D42
- D43
- D44
- D45
- D46
- D47
- If yes have you had an ownership interest in another property in the last three years1 Off
- new credit1 Off
- Check Box8-1 Off
- Check Box8-1-2 Off
- Check Box8-1-1 Off
- Check Box8-1-3 Off
- Check Box8-1-4 Off
- Military Service mdash Did you (or your deceased spouse) ever serve or are you currently serving in the United States Armed Forces 1 Off
- Check1 Off
- Text9-1-1
- Check2 Off
- Check3 Off
- Check4 Off
- Text9-1
- E1
- E2
- E3
- Was the ethnicity of the Borrower collected on the basis of visual observation or surname1 Off
- Was the sex of the Borrower collected on the basis of visual observation or surname1 Off
- Was the race of the Borrower collected on the basis of visual observation or surname1 Off
- The Demographic Information was provided through1 Off
- F1 Off
- F2 Off
- F3 Off
- F4 Off
- F5 Off
- F6
- F7 Off
- F8 Off
- F9 Off
- F10 Off
- F11 Off
- F12 Off
- F13
- F14 Off
- F15 Off
- F16 Off
- F17 Off
- F18 Off
- F19 Off
- F20 Off
- F21 Off
- F22
- F23 Off
- F24 Off
- F25 Off
- F26 Off
- F27 Off
- F28 Off
- F29
- F30 Off
- F31 Off
- undefined_13-1
- undefined_13-2
- undefined_14-1
- undefined_15-1
- undefined_16-1
- undefined_17-1
- undefined_18-1
- undefined_19-1
- undefined_21-1
- undefined_20-1
- undefined_23-1
- undefined_13_1
- Single-Two Off
- Refi type Off
- refi program Off
- Estate Off
- Title held Off
- Trust Information Off
- Indian Country Land Tenure Off
- Mortgage Type Applied For Off
- Mortgage Lien Type Off
- Amortization Type Off
- G1 Off
- G2 Off
- G3 Off
- G4 Off
- G5 Off
- G6
- G7
- G8
- G9
- G10 Off
- G11 Off
- G12 Off
- G13 Off
- G14 Off
- G15 Off
- G16
- G17
- G18
- G19
- G20
- G21
- G22
- G23 Off
- G24
- G25 Off
- G26
- G27 Off
- G28 Off
- G29
- G30 Off
- G31
- G32 Off
- G33
- G34
- G35
- G36
- G37
- G38
- G39
- G40
- G41
- G42
- Property Held
- refi
- Text18-1
- Text18-2
- Text18-3
- Text18-4
- Text18-5
- Text18-6
- Text18-7
- Text18-8
- Text18-9
- Text18-10
- Text18-11
- Text18-12
- Text18-13
- Text18-14
- Text18-15
- Text18-16
- Text18-17
- Text18-18
- Text18-19
- Lender
- case no
- If you selected ldquoUnmarriedrdquo in Section 1 is there a person who is not your legal spouse but who currently has real property rights similar to those of a legal spouse Off
- Relationship and State Off
- Other-5
- Text19-1
- BName
- Additional Information
- ABN
- Additional Information1
- BSign
- BSDate
- ABSign
- ABDate
- MortageeNameAddress
- NAmeAddress
- Bname1
- DOB1
- DOB2
- SignOfBorr1
- SignOfBorr
- Date Signed
- SignOfBorr2
- SignOfBorr3
- Date Signed3
- Date Signed4
- MortgageeRepSign
- DirectSign
- DirectSign1
- Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union Off
- AppSign
- AppSign1
- AppSign2
- AppSign3
- Nopage38 Off
- Yespage38 Off
- Yes1 Off
- No1 Off
- Yes2 Off
- Yes3 Off
- Yes4 Off
- Yes5 Off
- Yes6 Off
- Yes7 Off
- Yes8 Off
- Yes9 Off
- Yes10 Off
- No2 Off
- No3 Off
- No4 Off
- No5 Off
- No6 Off
- No7 Off
- No8 Off
- No9 Off
- No10 Off
- BorrowerNo Off
- BorrowerYes Off
- AppSignature
- AppSignature1
- CurrentSign
- CurrentSign1
- InterviewSign
- Yes_1 Off
- No_1 Off
- Yes_2 Off
- No_2 Off
- Mail Off
- Phone Off
PAGE 2
Who we are
Who is providing this notice The US consumer financial companies within the JPMorgan Chase amp Co family including JPMorgan Chase Bank NA Chase Insurance Agency Inc and JP Morgan Securities LLC
What we do
How does Chase protect my To protect your personal information from unauthorized access and use we personal information use security measures that comply with federal law These measures include
computer safeguards and secured files and buildings We authorize our employees to get your information only when they need it to do their work and we require companies that work for us to protect your information
How does Chase collect my We collect your personal information for example when you personal information bull open an account or make deposits or withdrawals from your account
bull pay your bills or apply for a loan bull use your credit or debit card We also collect your personal information from others such as credit bureaus affiliates or other companies
Why cant I limit all sharing Federal law gives you the right to limit only bull sharing for affiliates everyday business purposes - information about your
creditworthiness bull affiliates from using your information to market to you bull sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing See below for more on your rights under state law
What happens when I limit sharing for an account I hold jointly with someone else
Your choices will apply to everyone on your account
Definitions
Affiliates Companies related by common ownership or control They can be financial and non financial companies bull Our affiliates include companies with a Chase or JP Morgan name and financial companies such asjP Morgan Securities LLC
Nonaffiliates Companies not related by common ownership or control They can be financial and non financial companies bull Nonaffiliates we share with can include companies such as retailers auto dealers auto makers and membership clubs
Joint marketing A formal agreement between nonaffiliated financial companies that together market financial products or services to you bull Our joint marketing partners include categories of companies such as insurance companies
Other important information
VT Accounts with a Vermont mailing address are automatically treated as if they have limited the sharing as described on page 1 For joint marketing we will only disclose your name contact information and information about your transactions
NV We are providing you this notice pursuant to Nevada law If you prefer not to receive marketing calls from us you may be placed on our Internal Do Not Call List by calling 1-800-945-9470 or by writing to us at PO Box 734007 Dallas TX 75373-4007
For more information contact us at the address above or email PrivacylnfoJPMChasecom with Nevada Annual Notice in the subject line You may also contact the Nevada Attorney Generals office Bureau of Consumer Protection Office of the Nevada Attorney General 555 E Washington St Suite 3900 Las Vegas NV 89101 telephone number 1-702-486-3132 email BCPINFOagstatenvus
CA Accounts with a California mailing address are automatically treated as if they have limited the sharing with nonaffiliates as described on page 1 CA residents are provided a CA notice for additional choices
CHASE O
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
The following disclosure is required by the USA PATRIOT Act
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 opens an account
What this means to you When you 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 drivers
license or other identifying documents
99177-PAT-0215
VETERAN STATEMENT When this loan was opened the US Department of Veterans Affairs (VA) used the veteran borrowerrsquos entitlement which is a set amount the VA promises to repay a lender if the borrower defaults on the mortgage An assumption will modify who is obligated to pay the existing mortgage loan but all loan termsmdashincluding the entitlementmdashwill remain the same If the veteran borrower is being removed from the loan the entitlement would remain with whoever is assuming the loan because the loan will continue to be serviced by the VA If the applicant is also a veteran and can substitute his or her entitlement for the current entitlement then the current borrowerrsquos entitlement can be released
Please review the following questions and answer as appropriate This form requires completion by both the applicant(s) and current borrower(s)
1 Applicant to Complete
Are you (the applicant) currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the reverse side)
Yes (If yes please provide the information requested below answer the question in section 3 and sign and date this form at the bottom of the reverse side)
Name of applicant(s) who answered ldquoyesrdquo to the above question
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Are you receiving VA disability benefts
Applicant
Yes
No
Co-Applicant
Yes
No
Are you entitled to receive VA disability benefts Yes No Yes No
Have you received VA disability benefts in the past Yes No Yes No
Are you a surviving spouse of a veteran who died on active duty or as the result of a service-related disability
Yes No Yes No
Do you have any VA loans Yes No Yes No
2 Current Borrower to Complete
Is the current borrowerco-borrower currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the page)
Yes (If yes please answer the question in section 3 and sign and date this form at the bottom of the page)
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
________________________________________________________________________________________________
3 Applicant and Current Borrower to Complete
If the answer to the questions in section 1 and 2 are both yes please answer the following question After yoursquove reviewed and completed this entire form please sign and date at the bottom
Applicant Current Borrower
Do you want to apply for a substitution of entitlement Yes Yes No No
In order to complete a substitution of entitlement the veteran applicant must have suffcient entitlement to substitute for that of the current borrower Contact the VA Offce of Jurisdiction for your area for more information Also before the veteran applicant can substitute entitlement on a VA loan heshe must certify that the property securing the loan will be occupied as hisher primary residence Both the applicantrsquos and current borrowerrsquos original certifcate of eligibility will be required If your sales contract is contingent upon the restoration of entitlement please contact your VA Offce of Jurisdiction for complete procedures Otherwise the substitution will be completed after the loan has been approved and closed
Date Applicant printed name Applicant signature
Date Applicant printed name Applicant signature
Date Current Borrower printed name Current Borrower signature
Date Current Borrower printed name Current Borrower signature
Forms completed by Mail Phone
For Chase use only
Interviewer signature Date
99177-VS-0215
- Assumption Application Package_41521-noscannedpages-update-4pdf
-
- 1 FM203 Cover Pagepdf
- 2 FM202 Mortgage Assumption Application Package pagepdf
- 3 The Documents Youll need to Send Uspdf
- 4 FM201 FAQpdf
- 5 FM142 CIWpdf
- 6 FM126 URLApdf
- 7 FM130 URLA Instpdf
-
- Blank Page
-
- 8 92900a Addednum to Loan Applicationpdf
- 9 FM462 Gen Authpdf
- 10 FM220 4506-Cpdf
- 11 FM153 Chase Federal Privacy Noticepdf
- 12 FM144 Info on Opening a New Accountpdf
- 13 FM152 Veteran Statementpdf
-
- Date
- Loan number
- Applicant name
- Phone1
- Loan number 1
- Loan number 2
- Other
- Other_2
- 1
- 2
- undefined_7
- Available hours
- Available hours_2
- undefined_8
- Available hours_3
- undefined_9
- Current address 1
- Neither
- Available hours_4
- Available hours_5
- undefined_10
- Available hours_6
- 1_2
- 2_2
- undefined_11
- Available hours_7
- Available hours_8
- undefined_12
- Available hours_9
- FHA Case No include any suffix
- Mortgagee Case No
- Mortgagee ID
- Sponsor ID
- Agent ID
- Name and Address of Sponsor Name and Address of Agent
- Borrowers Name Present Address include ZIP Code Property Address
- include name of subdivision lot block no ZIP Code
- Name of ThirdParty Originator
- NMLS ID of ThirdParty Originator
- s application
- ty Number
- ty Number_2
- Date Signed_2
- Date Mortgage Approved
- Date Approval Expires
- Printed Name
- Title 1
- DEs ID Number
- DEs ID Number_2
- Mortgagee
- Name of Mortgagees Representative
- Title of Mortgagees Representative
- Signature of the Mortgagees Representative
- Date_2
- Applicant names 1
- Applicant names 2
- Applicant names 3
- Loan number_2
- Date_3
- Applicant printed name
- Social Security number
- Date_4
- Applicant printed name_2
- Social Security number_2
- Date_5
- Applicant printed name_3
- Social Security number_3
- Date_6
- Applicant printed name_4
- Social Security number_4
- 1a Name shown on tax return if a joint return enter the name shown first
- 1b First social security number on tax return individual taxpayer identification number or employer identification number see instructions
- 2a If a joint return enter spouses name shown on tax return
- 2b Second social security number or individual taxpayer identification number if joint tax return
- 4 Previous address shown on the last return filed if different from line 3 see instructions
- 5a IVES participant name address and SOR mailbox ID
- Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing see instructions
- Signature see instructions
- Date_7
- Phone number of taxpayer on line 1a or 2a
- PrintType name
- Here
- Spouses signature
- Date_8
- PrintType name_2
- Name
- Date of birth
- Service number
- Name_2
- Date of birth_2
- Service number_2
- Date_9
- Applicant printed name_5
- Date_10
- Applicant printed name_6
- Date_11
- Current Borrower printed name
- Date_12
- Current Borrower printed name_2
- Date_13
- Text3
- Text10
- undefined_13
- Text15
- undefined_14
- undefined_15
- undefined_16
- undefined_17
- undefined_18
- undefined_19
- undefined_20
- undefined_21
- undefined_23
- Reason for assumption Off
- Requestors relationship to owners Off
- Check one Off
- Check one1 Off
- Day1
- Evening
- Cell phone
- Check one2 Off
- Check one3 Off
- Check one4 Off
- Check one5 Off
- Text2-1
- Text2-2
- Text2-3
- Text2-4
- Text2-5
- Text2-6
- Text3-1
- Text3-2
- Text3-3
- Text3-4
- Text3-6
- Text3-7
- Text3-8
- Text3-9
- Text3-10
- Text3-11
- Text3-12
- Text3-13
- Text3-14
- Text3-15
- Text3-16
- Text3-17
- Text3-18
- Text3-19
- Text3-20
- Text3-21
- Text3-22
- Text3-23
- Text3-24
- Text3-25
- Text3-26
- Text3-27
- Text3-28
- Text3-29
- Text3-30
- Text3-31
- Text3-32
- Text3-33
- Text3-34
- Text3-35
- Text3-36
- Text3-37
- Text3-38
- Text3-39
- Text3-40
- Text3-41
- Text3-42
- Text3-43
- Text3-44
- Text3-45
- Text3-46
- Text3-47
- Text3-48
- Text3-49
- Text3-50
- Text3-51
- Text3-52
- Text3-53
- Text3-5
- Text3-54
- Text3-55
- Text3-56
- Citizenship Off
- Type of credit Off
- Marital Status Off
- Housing Off
- Housing1 Off
- ownership Off
- DNA1 Off
- DNA2 Off
- DNA3 Off
- family Off
- BO Off
- Total
- Text31
- Text32
- Text33
- Text34
- Text35
- Text36
- Text37
- Text38
- Text39
- Text310
- Text311
- Text312
- Text313
- Text314
- Text315
- Text316
- Text317
- Text318
- Text319
- ownership1 Off
- Total1
- Total1-2
- Check Box4-1 Off
- Text320
- Text321
- Text322
- Text323
- Text324
- Text325
- Text326
- Text327
- Text328
- Text329
- Check Box4-2 Off
- Check Box4-3 Off
- Check Box4-4 Off
- Check Box4-8 Off
- Check Box4-9 Off
- Text330
- Text331
- Text332
- Text333
- Text334
- Text335
- Text1-1
- Text1-2
- Text1-3
- Text1-4
- Text1-5
- Text1-6
- Text1-7
- Text1-8
- Text1-9
- Text1-10
- Text1-11
- Text1-12
- Text1-13
- Text1-14
- Text1-15
- Text1-16
- Text1-17
- Text1-18
- Text1-19
- Text1-20
- Text1-21
- Text1-22
- Text1-23
- Text1-24
- Text1-25
- Text1-26
- Text1-27
- Text1-28
- Text1-29
- Text1-30
- Text1-31
- Text1-32
- Text1-33
- Text1-34
- Text1-35
- Check Box3-2 Off
- Check Box2-1 Off
- Check Box2-2 Off
- Check Box2-3 Off
- Check Box2-4 Off
- Check Box2-5 Off
- Text1-36
- Text1-37
- Text1-38
- Text1-39
- Text1-40
- Text1-41
- Text1-42
- Text1-43
- Text1-44
- Text1-45
- Text1-46
- Text1-47
- Text1-48
- Text1-49
- Text1-50
- Text1-51
- Text1-52
- Text1-53
- Text1-54
- Text1-55
- Text1-56
- Text1-57
- Text1-58
- Text1-59
- Text1-60
- Text1-61
- Check Box3-11 Off
- A1
- A2
- A3
- A4
- A5
- A6
- A7
- A8
- A9
- A10
- A11
- A12
- Check Box3-1 Off
- Check Box30-1 Off
- Check Box30-2 Off
- Check Box30-4 Off
- Check Box30-5 Off
- Check Box30-7 Off
- Check Box30-8 Off
- Check Box30-9 Off
- Check Box30-10 Off
- Check Box30-11 Off
- Check Box30-12 Off
- A13
- A14
- A15
- A16
- A17 Off
- A18
- A19
- A20
- A21
- A22
- A23
- A24
- A25
- A26
- A27
- A28
- A29
- A30
- A31
- A32
- A33
- A34
- A35
- A36
- A37
- A38 Off
- A39
- A40
- A41
- A42
- A43
- A44
- A45
- A46
- A47
- A48
- A49
- A50
- A51
- A52
- A53
- A54
- A55
- A56
- A57
- A58
- A59
- A60
- A61
- A62
- A63
- A64
- A65
- A66
- A67
- A68
- A69
- A70
- A71
- A72
- A73
- A74
- Loan Purpose Off
- occupancy1 Off
- lien type Off
- lientype Off
- mixed use Off
- manufactured home Off
- deposit1 Off
- deposit2 Off
- B1
- B2
- B3
- B4
- B5
- B6
- B7
- B8
- B9
- B10
- fha Off
- Check Box51 Off
- B11
- B12
- B13
- B14
- B15
- B16
- B17
- B18
- B19 Off
- B20
- B21
- B22 Off
- B23
- B24
- B25
- B26
- B27
- B28
- A
-
- Will you occupy the property as your primary residence Off
- Will you occupy the property as your primary residence1 Off
-
- If yes have you had an ownership interest in another property in the last three years Off
- Text9-2
- B
-
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property Off
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property1 Off
-
- 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 Off
- 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 application1 Off
-
- 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 Off
- 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 application1 Off
-
- new credit Off
- 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) Off
- the Property Assessed Clean Energy Program)1 Off
-
- F
-
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application Off
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application1 Off
-
- G
-
- Are there any outstanding judgments against you Off
- Are there any outstanding judgments against you1 Off
-
- H
-
- Are you currently delinquent or in default on a Federal debt Off
- Are you currently delinquent or in default on a Federal debt1 Off
-
- I
-
- Are you a party to a lawsuit in which you potentially have any personal financial liability Off
- Are you a party to a lawsuit in which you potentially have any personal financial liability1 Off
-
- J
-
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years Off
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years1 Off
-
- 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 Off
- 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 due1 Off
-
- L
-
- Have you had property foreclosed upon in the last 7 years Off
- Have you had property foreclosed upon in the last 7 years1 Off
-
- M
-
- Have you declared bankruptcy within the past 7 years Off
- Have you declared bankruptcy within the past 7 years1 Off
-
- Check Box8-2 Off
- Check Box8-3 Off
- Check Box8-4 Off
- Text9-3
- Text9-5
- Text9-6
- Text97
- military Off
- ethnicity Off
- sex Off
- race Off
- demo Off
- Text12-1
- Check Box11-1 Off
- Check Box11-2 Off
- Check Box11-3 Off
- Check Box11-4 Off
- Check Box11-5 Off
- Check Box11-6 Off
- Check Box11-7 Off
- Check Box11-8 Off
- Check Box11-9 Off
- Text12-2
- Check Box11-10 Off
- Check Box11-11 Off
- Check Box11-12 Off
- Check Box11-13 Off
- Check Box11-14 Off
- Check Box11-15 Off
- Text12-3
- Check Box11-16 Off
- Check Box11-17 Off
- Check Box11-18 Off
- Check Box11-19 Off
- Check Box11-20 Off
- Check Box11-21 Off
- Check Box11-22 Off
- Check Box11-23 Off
- Text12-4
- Check Box11-24 Off
- Check Box11-25 Off
- Check Box11-26 Off
- Check Box11-27 Off
- Check Box11-28 Off
- Check Box11-29 Off
- Text12-5
- Check Box11-30 Off
- Check Box11-31 Off
- citizen Off
- credit Off
- marital status1 Off
- housing-1 Off
- housing-2 Off
- own Off
- C1
- C2
- C3
- C6
- C7
- C8
- C9
- C10
- C11
- C12
- C13
- C14
- C15
- C16
- C17
- C18
- C19
- C20
- C21
- C22
- C23
- C24
- C25
- C26
- C27
- C28
- C29
- C30
- C31
- C32
- C33
- C34
- C35
- Check Box-2 Off
- C36
- C37
- C38
- C39
- C4
- C40
- C41
- C42
- C43
- C44
- C45
- C46
- C47
- Check Box-3 Off
- Check Box-4 Off
- C48
- C49
- C5
- C50
- C51
- C52
- C53
- C54
- C55
- Check Box-1-1 Off
- own1 Off
- Check Box-1 Off
- D1 Off
- D2
- D3
- D4
- D5
- D6
- D7
- D8
- D9
- D10
- D11
- D12
- D13
- D14 Off
- D15 Off
- D16
- D17
- D18
- D19
- D20
- D21
- D22
- D23
- D24 Off
- D25
- D26
- D27
- D28
- D29
- D30
- D31
- D32
- D33
- D34
- D35 Off
- D36
- D37 Off
- D38
- D39
- D40
- D41
- D42
- D43
- D44
- D45
- D46
- D47
- If yes have you had an ownership interest in another property in the last three years1 Off
- new credit1 Off
- Check Box8-1 Off
- Check Box8-1-2 Off
- Check Box8-1-1 Off
- Check Box8-1-3 Off
- Check Box8-1-4 Off
- Military Service mdash Did you (or your deceased spouse) ever serve or are you currently serving in the United States Armed Forces 1 Off
- Check1 Off
- Text9-1-1
- Check2 Off
- Check3 Off
- Check4 Off
- Text9-1
- E1
- E2
- E3
- Was the ethnicity of the Borrower collected on the basis of visual observation or surname1 Off
- Was the sex of the Borrower collected on the basis of visual observation or surname1 Off
- Was the race of the Borrower collected on the basis of visual observation or surname1 Off
- The Demographic Information was provided through1 Off
- F1 Off
- F2 Off
- F3 Off
- F4 Off
- F5 Off
- F6
- F7 Off
- F8 Off
- F9 Off
- F10 Off
- F11 Off
- F12 Off
- F13
- F14 Off
- F15 Off
- F16 Off
- F17 Off
- F18 Off
- F19 Off
- F20 Off
- F21 Off
- F22
- F23 Off
- F24 Off
- F25 Off
- F26 Off
- F27 Off
- F28 Off
- F29
- F30 Off
- F31 Off
- undefined_13-1
- undefined_13-2
- undefined_14-1
- undefined_15-1
- undefined_16-1
- undefined_17-1
- undefined_18-1
- undefined_19-1
- undefined_21-1
- undefined_20-1
- undefined_23-1
- undefined_13_1
- Single-Two Off
- Refi type Off
- refi program Off
- Estate Off
- Title held Off
- Trust Information Off
- Indian Country Land Tenure Off
- Mortgage Type Applied For Off
- Mortgage Lien Type Off
- Amortization Type Off
- G1 Off
- G2 Off
- G3 Off
- G4 Off
- G5 Off
- G6
- G7
- G8
- G9
- G10 Off
- G11 Off
- G12 Off
- G13 Off
- G14 Off
- G15 Off
- G16
- G17
- G18
- G19
- G20
- G21
- G22
- G23 Off
- G24
- G25 Off
- G26
- G27 Off
- G28 Off
- G29
- G30 Off
- G31
- G32 Off
- G33
- G34
- G35
- G36
- G37
- G38
- G39
- G40
- G41
- G42
- Property Held
- refi
- Text18-1
- Text18-2
- Text18-3
- Text18-4
- Text18-5
- Text18-6
- Text18-7
- Text18-8
- Text18-9
- Text18-10
- Text18-11
- Text18-12
- Text18-13
- Text18-14
- Text18-15
- Text18-16
- Text18-17
- Text18-18
- Text18-19
- Lender
- case no
- If you selected ldquoUnmarriedrdquo in Section 1 is there a person who is not your legal spouse but who currently has real property rights similar to those of a legal spouse Off
- Relationship and State Off
- Other-5
- Text19-1
- BName
- Additional Information
- ABN
- Additional Information1
- BSign
- BSDate
- ABSign
- ABDate
- MortageeNameAddress
- NAmeAddress
- Bname1
- DOB1
- DOB2
- SignOfBorr1
- SignOfBorr
- Date Signed
- SignOfBorr2
- SignOfBorr3
- Date Signed3
- Date Signed4
- MortgageeRepSign
- DirectSign
- DirectSign1
- Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union Off
- AppSign
- AppSign1
- AppSign2
- AppSign3
- Nopage38 Off
- Yespage38 Off
- Yes1 Off
- No1 Off
- Yes2 Off
- Yes3 Off
- Yes4 Off
- Yes5 Off
- Yes6 Off
- Yes7 Off
- Yes8 Off
- Yes9 Off
- Yes10 Off
- No2 Off
- No3 Off
- No4 Off
- No5 Off
- No6 Off
- No7 Off
- No8 Off
- No9 Off
- No10 Off
- BorrowerNo Off
- BorrowerYes Off
- AppSignature
- AppSignature1
- CurrentSign
- CurrentSign1
- InterviewSign
- Yes_1 Off
- No_1 Off
- Yes_2 Off
- No_2 Off
- Mail Off
- Phone Off
CHASE O
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
The following disclosure is required by the USA PATRIOT Act
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 opens an account
What this means to you When you 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 drivers
license or other identifying documents
99177-PAT-0215
VETERAN STATEMENT When this loan was opened the US Department of Veterans Affairs (VA) used the veteran borrowerrsquos entitlement which is a set amount the VA promises to repay a lender if the borrower defaults on the mortgage An assumption will modify who is obligated to pay the existing mortgage loan but all loan termsmdashincluding the entitlementmdashwill remain the same If the veteran borrower is being removed from the loan the entitlement would remain with whoever is assuming the loan because the loan will continue to be serviced by the VA If the applicant is also a veteran and can substitute his or her entitlement for the current entitlement then the current borrowerrsquos entitlement can be released
Please review the following questions and answer as appropriate This form requires completion by both the applicant(s) and current borrower(s)
1 Applicant to Complete
Are you (the applicant) currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the reverse side)
Yes (If yes please provide the information requested below answer the question in section 3 and sign and date this form at the bottom of the reverse side)
Name of applicant(s) who answered ldquoyesrdquo to the above question
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Are you receiving VA disability benefts
Applicant
Yes
No
Co-Applicant
Yes
No
Are you entitled to receive VA disability benefts Yes No Yes No
Have you received VA disability benefts in the past Yes No Yes No
Are you a surviving spouse of a veteran who died on active duty or as the result of a service-related disability
Yes No Yes No
Do you have any VA loans Yes No Yes No
2 Current Borrower to Complete
Is the current borrowerco-borrower currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the page)
Yes (If yes please answer the question in section 3 and sign and date this form at the bottom of the page)
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
________________________________________________________________________________________________
3 Applicant and Current Borrower to Complete
If the answer to the questions in section 1 and 2 are both yes please answer the following question After yoursquove reviewed and completed this entire form please sign and date at the bottom
Applicant Current Borrower
Do you want to apply for a substitution of entitlement Yes Yes No No
In order to complete a substitution of entitlement the veteran applicant must have suffcient entitlement to substitute for that of the current borrower Contact the VA Offce of Jurisdiction for your area for more information Also before the veteran applicant can substitute entitlement on a VA loan heshe must certify that the property securing the loan will be occupied as hisher primary residence Both the applicantrsquos and current borrowerrsquos original certifcate of eligibility will be required If your sales contract is contingent upon the restoration of entitlement please contact your VA Offce of Jurisdiction for complete procedures Otherwise the substitution will be completed after the loan has been approved and closed
Date Applicant printed name Applicant signature
Date Applicant printed name Applicant signature
Date Current Borrower printed name Current Borrower signature
Date Current Borrower printed name Current Borrower signature
Forms completed by Mail Phone
For Chase use only
Interviewer signature Date
99177-VS-0215
- Assumption Application Package_41521-noscannedpages-update-4pdf
-
- 1 FM203 Cover Pagepdf
- 2 FM202 Mortgage Assumption Application Package pagepdf
- 3 The Documents Youll need to Send Uspdf
- 4 FM201 FAQpdf
- 5 FM142 CIWpdf
- 6 FM126 URLApdf
- 7 FM130 URLA Instpdf
-
- Blank Page
-
- 8 92900a Addednum to Loan Applicationpdf
- 9 FM462 Gen Authpdf
- 10 FM220 4506-Cpdf
- 11 FM153 Chase Federal Privacy Noticepdf
- 12 FM144 Info on Opening a New Accountpdf
- 13 FM152 Veteran Statementpdf
-
- Date
- Loan number
- Applicant name
- Phone1
- Loan number 1
- Loan number 2
- Other
- Other_2
- 1
- 2
- undefined_7
- Available hours
- Available hours_2
- undefined_8
- Available hours_3
- undefined_9
- Current address 1
- Neither
- Available hours_4
- Available hours_5
- undefined_10
- Available hours_6
- 1_2
- 2_2
- undefined_11
- Available hours_7
- Available hours_8
- undefined_12
- Available hours_9
- FHA Case No include any suffix
- Mortgagee Case No
- Mortgagee ID
- Sponsor ID
- Agent ID
- Name and Address of Sponsor Name and Address of Agent
- Borrowers Name Present Address include ZIP Code Property Address
- include name of subdivision lot block no ZIP Code
- Name of ThirdParty Originator
- NMLS ID of ThirdParty Originator
- s application
- ty Number
- ty Number_2
- Date Signed_2
- Date Mortgage Approved
- Date Approval Expires
- Printed Name
- Title 1
- DEs ID Number
- DEs ID Number_2
- Mortgagee
- Name of Mortgagees Representative
- Title of Mortgagees Representative
- Signature of the Mortgagees Representative
- Date_2
- Applicant names 1
- Applicant names 2
- Applicant names 3
- Loan number_2
- Date_3
- Applicant printed name
- Social Security number
- Date_4
- Applicant printed name_2
- Social Security number_2
- Date_5
- Applicant printed name_3
- Social Security number_3
- Date_6
- Applicant printed name_4
- Social Security number_4
- 1a Name shown on tax return if a joint return enter the name shown first
- 1b First social security number on tax return individual taxpayer identification number or employer identification number see instructions
- 2a If a joint return enter spouses name shown on tax return
- 2b Second social security number or individual taxpayer identification number if joint tax return
- 4 Previous address shown on the last return filed if different from line 3 see instructions
- 5a IVES participant name address and SOR mailbox ID
- Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing see instructions
- Signature see instructions
- Date_7
- Phone number of taxpayer on line 1a or 2a
- PrintType name
- Here
- Spouses signature
- Date_8
- PrintType name_2
- Name
- Date of birth
- Service number
- Name_2
- Date of birth_2
- Service number_2
- Date_9
- Applicant printed name_5
- Date_10
- Applicant printed name_6
- Date_11
- Current Borrower printed name
- Date_12
- Current Borrower printed name_2
- Date_13
- Text3
- Text10
- undefined_13
- Text15
- undefined_14
- undefined_15
- undefined_16
- undefined_17
- undefined_18
- undefined_19
- undefined_20
- undefined_21
- undefined_23
- Reason for assumption Off
- Requestors relationship to owners Off
- Check one Off
- Check one1 Off
- Day1
- Evening
- Cell phone
- Check one2 Off
- Check one3 Off
- Check one4 Off
- Check one5 Off
- Text2-1
- Text2-2
- Text2-3
- Text2-4
- Text2-5
- Text2-6
- Text3-1
- Text3-2
- Text3-3
- Text3-4
- Text3-6
- Text3-7
- Text3-8
- Text3-9
- Text3-10
- Text3-11
- Text3-12
- Text3-13
- Text3-14
- Text3-15
- Text3-16
- Text3-17
- Text3-18
- Text3-19
- Text3-20
- Text3-21
- Text3-22
- Text3-23
- Text3-24
- Text3-25
- Text3-26
- Text3-27
- Text3-28
- Text3-29
- Text3-30
- Text3-31
- Text3-32
- Text3-33
- Text3-34
- Text3-35
- Text3-36
- Text3-37
- Text3-38
- Text3-39
- Text3-40
- Text3-41
- Text3-42
- Text3-43
- Text3-44
- Text3-45
- Text3-46
- Text3-47
- Text3-48
- Text3-49
- Text3-50
- Text3-51
- Text3-52
- Text3-53
- Text3-5
- Text3-54
- Text3-55
- Text3-56
- Citizenship Off
- Type of credit Off
- Marital Status Off
- Housing Off
- Housing1 Off
- ownership Off
- DNA1 Off
- DNA2 Off
- DNA3 Off
- family Off
- BO Off
- Total
- Text31
- Text32
- Text33
- Text34
- Text35
- Text36
- Text37
- Text38
- Text39
- Text310
- Text311
- Text312
- Text313
- Text314
- Text315
- Text316
- Text317
- Text318
- Text319
- ownership1 Off
- Total1
- Total1-2
- Check Box4-1 Off
- Text320
- Text321
- Text322
- Text323
- Text324
- Text325
- Text326
- Text327
- Text328
- Text329
- Check Box4-2 Off
- Check Box4-3 Off
- Check Box4-4 Off
- Check Box4-8 Off
- Check Box4-9 Off
- Text330
- Text331
- Text332
- Text333
- Text334
- Text335
- Text1-1
- Text1-2
- Text1-3
- Text1-4
- Text1-5
- Text1-6
- Text1-7
- Text1-8
- Text1-9
- Text1-10
- Text1-11
- Text1-12
- Text1-13
- Text1-14
- Text1-15
- Text1-16
- Text1-17
- Text1-18
- Text1-19
- Text1-20
- Text1-21
- Text1-22
- Text1-23
- Text1-24
- Text1-25
- Text1-26
- Text1-27
- Text1-28
- Text1-29
- Text1-30
- Text1-31
- Text1-32
- Text1-33
- Text1-34
- Text1-35
- Check Box3-2 Off
- Check Box2-1 Off
- Check Box2-2 Off
- Check Box2-3 Off
- Check Box2-4 Off
- Check Box2-5 Off
- Text1-36
- Text1-37
- Text1-38
- Text1-39
- Text1-40
- Text1-41
- Text1-42
- Text1-43
- Text1-44
- Text1-45
- Text1-46
- Text1-47
- Text1-48
- Text1-49
- Text1-50
- Text1-51
- Text1-52
- Text1-53
- Text1-54
- Text1-55
- Text1-56
- Text1-57
- Text1-58
- Text1-59
- Text1-60
- Text1-61
- Check Box3-11 Off
- A1
- A2
- A3
- A4
- A5
- A6
- A7
- A8
- A9
- A10
- A11
- A12
- Check Box3-1 Off
- Check Box30-1 Off
- Check Box30-2 Off
- Check Box30-4 Off
- Check Box30-5 Off
- Check Box30-7 Off
- Check Box30-8 Off
- Check Box30-9 Off
- Check Box30-10 Off
- Check Box30-11 Off
- Check Box30-12 Off
- A13
- A14
- A15
- A16
- A17 Off
- A18
- A19
- A20
- A21
- A22
- A23
- A24
- A25
- A26
- A27
- A28
- A29
- A30
- A31
- A32
- A33
- A34
- A35
- A36
- A37
- A38 Off
- A39
- A40
- A41
- A42
- A43
- A44
- A45
- A46
- A47
- A48
- A49
- A50
- A51
- A52
- A53
- A54
- A55
- A56
- A57
- A58
- A59
- A60
- A61
- A62
- A63
- A64
- A65
- A66
- A67
- A68
- A69
- A70
- A71
- A72
- A73
- A74
- Loan Purpose Off
- occupancy1 Off
- lien type Off
- lientype Off
- mixed use Off
- manufactured home Off
- deposit1 Off
- deposit2 Off
- B1
- B2
- B3
- B4
- B5
- B6
- B7
- B8
- B9
- B10
- fha Off
- Check Box51 Off
- B11
- B12
- B13
- B14
- B15
- B16
- B17
- B18
- B19 Off
- B20
- B21
- B22 Off
- B23
- B24
- B25
- B26
- B27
- B28
- A
-
- Will you occupy the property as your primary residence Off
- Will you occupy the property as your primary residence1 Off
-
- If yes have you had an ownership interest in another property in the last three years Off
- Text9-2
- B
-
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property Off
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property1 Off
-
- 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 Off
- 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 application1 Off
-
- 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 Off
- 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 application1 Off
-
- new credit Off
- 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) Off
- the Property Assessed Clean Energy Program)1 Off
-
- F
-
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application Off
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application1 Off
-
- G
-
- Are there any outstanding judgments against you Off
- Are there any outstanding judgments against you1 Off
-
- H
-
- Are you currently delinquent or in default on a Federal debt Off
- Are you currently delinquent or in default on a Federal debt1 Off
-
- I
-
- Are you a party to a lawsuit in which you potentially have any personal financial liability Off
- Are you a party to a lawsuit in which you potentially have any personal financial liability1 Off
-
- J
-
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years Off
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years1 Off
-
- 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 Off
- 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 due1 Off
-
- L
-
- Have you had property foreclosed upon in the last 7 years Off
- Have you had property foreclosed upon in the last 7 years1 Off
-
- M
-
- Have you declared bankruptcy within the past 7 years Off
- Have you declared bankruptcy within the past 7 years1 Off
-
- Check Box8-2 Off
- Check Box8-3 Off
- Check Box8-4 Off
- Text9-3
- Text9-5
- Text9-6
- Text97
- military Off
- ethnicity Off
- sex Off
- race Off
- demo Off
- Text12-1
- Check Box11-1 Off
- Check Box11-2 Off
- Check Box11-3 Off
- Check Box11-4 Off
- Check Box11-5 Off
- Check Box11-6 Off
- Check Box11-7 Off
- Check Box11-8 Off
- Check Box11-9 Off
- Text12-2
- Check Box11-10 Off
- Check Box11-11 Off
- Check Box11-12 Off
- Check Box11-13 Off
- Check Box11-14 Off
- Check Box11-15 Off
- Text12-3
- Check Box11-16 Off
- Check Box11-17 Off
- Check Box11-18 Off
- Check Box11-19 Off
- Check Box11-20 Off
- Check Box11-21 Off
- Check Box11-22 Off
- Check Box11-23 Off
- Text12-4
- Check Box11-24 Off
- Check Box11-25 Off
- Check Box11-26 Off
- Check Box11-27 Off
- Check Box11-28 Off
- Check Box11-29 Off
- Text12-5
- Check Box11-30 Off
- Check Box11-31 Off
- citizen Off
- credit Off
- marital status1 Off
- housing-1 Off
- housing-2 Off
- own Off
- C1
- C2
- C3
- C6
- C7
- C8
- C9
- C10
- C11
- C12
- C13
- C14
- C15
- C16
- C17
- C18
- C19
- C20
- C21
- C22
- C23
- C24
- C25
- C26
- C27
- C28
- C29
- C30
- C31
- C32
- C33
- C34
- C35
- Check Box-2 Off
- C36
- C37
- C38
- C39
- C4
- C40
- C41
- C42
- C43
- C44
- C45
- C46
- C47
- Check Box-3 Off
- Check Box-4 Off
- C48
- C49
- C5
- C50
- C51
- C52
- C53
- C54
- C55
- Check Box-1-1 Off
- own1 Off
- Check Box-1 Off
- D1 Off
- D2
- D3
- D4
- D5
- D6
- D7
- D8
- D9
- D10
- D11
- D12
- D13
- D14 Off
- D15 Off
- D16
- D17
- D18
- D19
- D20
- D21
- D22
- D23
- D24 Off
- D25
- D26
- D27
- D28
- D29
- D30
- D31
- D32
- D33
- D34
- D35 Off
- D36
- D37 Off
- D38
- D39
- D40
- D41
- D42
- D43
- D44
- D45
- D46
- D47
- If yes have you had an ownership interest in another property in the last three years1 Off
- new credit1 Off
- Check Box8-1 Off
- Check Box8-1-2 Off
- Check Box8-1-1 Off
- Check Box8-1-3 Off
- Check Box8-1-4 Off
- Military Service mdash Did you (or your deceased spouse) ever serve or are you currently serving in the United States Armed Forces 1 Off
- Check1 Off
- Text9-1-1
- Check2 Off
- Check3 Off
- Check4 Off
- Text9-1
- E1
- E2
- E3
- Was the ethnicity of the Borrower collected on the basis of visual observation or surname1 Off
- Was the sex of the Borrower collected on the basis of visual observation or surname1 Off
- Was the race of the Borrower collected on the basis of visual observation or surname1 Off
- The Demographic Information was provided through1 Off
- F1 Off
- F2 Off
- F3 Off
- F4 Off
- F5 Off
- F6
- F7 Off
- F8 Off
- F9 Off
- F10 Off
- F11 Off
- F12 Off
- F13
- F14 Off
- F15 Off
- F16 Off
- F17 Off
- F18 Off
- F19 Off
- F20 Off
- F21 Off
- F22
- F23 Off
- F24 Off
- F25 Off
- F26 Off
- F27 Off
- F28 Off
- F29
- F30 Off
- F31 Off
- undefined_13-1
- undefined_13-2
- undefined_14-1
- undefined_15-1
- undefined_16-1
- undefined_17-1
- undefined_18-1
- undefined_19-1
- undefined_21-1
- undefined_20-1
- undefined_23-1
- undefined_13_1
- Single-Two Off
- Refi type Off
- refi program Off
- Estate Off
- Title held Off
- Trust Information Off
- Indian Country Land Tenure Off
- Mortgage Type Applied For Off
- Mortgage Lien Type Off
- Amortization Type Off
- G1 Off
- G2 Off
- G3 Off
- G4 Off
- G5 Off
- G6
- G7
- G8
- G9
- G10 Off
- G11 Off
- G12 Off
- G13 Off
- G14 Off
- G15 Off
- G16
- G17
- G18
- G19
- G20
- G21
- G22
- G23 Off
- G24
- G25 Off
- G26
- G27 Off
- G28 Off
- G29
- G30 Off
- G31
- G32 Off
- G33
- G34
- G35
- G36
- G37
- G38
- G39
- G40
- G41
- G42
- Property Held
- refi
- Text18-1
- Text18-2
- Text18-3
- Text18-4
- Text18-5
- Text18-6
- Text18-7
- Text18-8
- Text18-9
- Text18-10
- Text18-11
- Text18-12
- Text18-13
- Text18-14
- Text18-15
- Text18-16
- Text18-17
- Text18-18
- Text18-19
- Lender
- case no
- If you selected ldquoUnmarriedrdquo in Section 1 is there a person who is not your legal spouse but who currently has real property rights similar to those of a legal spouse Off
- Relationship and State Off
- Other-5
- Text19-1
- BName
- Additional Information
- ABN
- Additional Information1
- BSign
- BSDate
- ABSign
- ABDate
- MortageeNameAddress
- NAmeAddress
- Bname1
- DOB1
- DOB2
- SignOfBorr1
- SignOfBorr
- Date Signed
- SignOfBorr2
- SignOfBorr3
- Date Signed3
- Date Signed4
- MortgageeRepSign
- DirectSign
- DirectSign1
- Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union Off
- AppSign
- AppSign1
- AppSign2
- AppSign3
- Nopage38 Off
- Yespage38 Off
- Yes1 Off
- No1 Off
- Yes2 Off
- Yes3 Off
- Yes4 Off
- Yes5 Off
- Yes6 Off
- Yes7 Off
- Yes8 Off
- Yes9 Off
- Yes10 Off
- No2 Off
- No3 Off
- No4 Off
- No5 Off
- No6 Off
- No7 Off
- No8 Off
- No9 Off
- No10 Off
- BorrowerNo Off
- BorrowerYes Off
- AppSignature
- AppSignature1
- CurrentSign
- CurrentSign1
- InterviewSign
- Yes_1 Off
- No_1 Off
- Yes_2 Off
- No_2 Off
- Mail Off
- Phone Off
VETERAN STATEMENT When this loan was opened the US Department of Veterans Affairs (VA) used the veteran borrowerrsquos entitlement which is a set amount the VA promises to repay a lender if the borrower defaults on the mortgage An assumption will modify who is obligated to pay the existing mortgage loan but all loan termsmdashincluding the entitlementmdashwill remain the same If the veteran borrower is being removed from the loan the entitlement would remain with whoever is assuming the loan because the loan will continue to be serviced by the VA If the applicant is also a veteran and can substitute his or her entitlement for the current entitlement then the current borrowerrsquos entitlement can be released
Please review the following questions and answer as appropriate This form requires completion by both the applicant(s) and current borrower(s)
1 Applicant to Complete
Are you (the applicant) currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the reverse side)
Yes (If yes please provide the information requested below answer the question in section 3 and sign and date this form at the bottom of the reverse side)
Name of applicant(s) who answered ldquoyesrdquo to the above question
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Name ______________________________________________________________________________________________
Date of birth ________________________________________________________________________________________
Service number ______________________________________________________________________________________
Are you receiving VA disability benefts
Applicant
Yes
No
Co-Applicant
Yes
No
Are you entitled to receive VA disability benefts Yes No Yes No
Have you received VA disability benefts in the past Yes No Yes No
Are you a surviving spouse of a veteran who died on active duty or as the result of a service-related disability
Yes No Yes No
Do you have any VA loans Yes No Yes No
2 Current Borrower to Complete
Is the current borrowerco-borrower currently serving on active duty in the US Military a US Military veteran or a surviving spouse of a US Military veteran who died on active duty or as the result of a service-related disability
No (If no please sign and date this form at the bottom of the page)
Yes (If yes please answer the question in section 3 and sign and date this form at the bottom of the page)
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
________________________________________________________________________________________________
3 Applicant and Current Borrower to Complete
If the answer to the questions in section 1 and 2 are both yes please answer the following question After yoursquove reviewed and completed this entire form please sign and date at the bottom
Applicant Current Borrower
Do you want to apply for a substitution of entitlement Yes Yes No No
In order to complete a substitution of entitlement the veteran applicant must have suffcient entitlement to substitute for that of the current borrower Contact the VA Offce of Jurisdiction for your area for more information Also before the veteran applicant can substitute entitlement on a VA loan heshe must certify that the property securing the loan will be occupied as hisher primary residence Both the applicantrsquos and current borrowerrsquos original certifcate of eligibility will be required If your sales contract is contingent upon the restoration of entitlement please contact your VA Offce of Jurisdiction for complete procedures Otherwise the substitution will be completed after the loan has been approved and closed
Date Applicant printed name Applicant signature
Date Applicant printed name Applicant signature
Date Current Borrower printed name Current Borrower signature
Date Current Borrower printed name Current Borrower signature
Forms completed by Mail Phone
For Chase use only
Interviewer signature Date
99177-VS-0215
- Assumption Application Package_41521-noscannedpages-update-4pdf
-
- 1 FM203 Cover Pagepdf
- 2 FM202 Mortgage Assumption Application Package pagepdf
- 3 The Documents Youll need to Send Uspdf
- 4 FM201 FAQpdf
- 5 FM142 CIWpdf
- 6 FM126 URLApdf
- 7 FM130 URLA Instpdf
-
- Blank Page
-
- 8 92900a Addednum to Loan Applicationpdf
- 9 FM462 Gen Authpdf
- 10 FM220 4506-Cpdf
- 11 FM153 Chase Federal Privacy Noticepdf
- 12 FM144 Info on Opening a New Accountpdf
- 13 FM152 Veteran Statementpdf
-
- Date
- Loan number
- Applicant name
- Phone1
- Loan number 1
- Loan number 2
- Other
- Other_2
- 1
- 2
- undefined_7
- Available hours
- Available hours_2
- undefined_8
- Available hours_3
- undefined_9
- Current address 1
- Neither
- Available hours_4
- Available hours_5
- undefined_10
- Available hours_6
- 1_2
- 2_2
- undefined_11
- Available hours_7
- Available hours_8
- undefined_12
- Available hours_9
- FHA Case No include any suffix
- Mortgagee Case No
- Mortgagee ID
- Sponsor ID
- Agent ID
- Name and Address of Sponsor Name and Address of Agent
- Borrowers Name Present Address include ZIP Code Property Address
- include name of subdivision lot block no ZIP Code
- Name of ThirdParty Originator
- NMLS ID of ThirdParty Originator
- s application
- ty Number
- ty Number_2
- Date Signed_2
- Date Mortgage Approved
- Date Approval Expires
- Printed Name
- Title 1
- DEs ID Number
- DEs ID Number_2
- Mortgagee
- Name of Mortgagees Representative
- Title of Mortgagees Representative
- Signature of the Mortgagees Representative
- Date_2
- Applicant names 1
- Applicant names 2
- Applicant names 3
- Loan number_2
- Date_3
- Applicant printed name
- Social Security number
- Date_4
- Applicant printed name_2
- Social Security number_2
- Date_5
- Applicant printed name_3
- Social Security number_3
- Date_6
- Applicant printed name_4
- Social Security number_4
- 1a Name shown on tax return if a joint return enter the name shown first
- 1b First social security number on tax return individual taxpayer identification number or employer identification number see instructions
- 2a If a joint return enter spouses name shown on tax return
- 2b Second social security number or individual taxpayer identification number if joint tax return
- 4 Previous address shown on the last return filed if different from line 3 see instructions
- 5a IVES participant name address and SOR mailbox ID
- Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing see instructions
- Signature see instructions
- Date_7
- Phone number of taxpayer on line 1a or 2a
- PrintType name
- Here
- Spouses signature
- Date_8
- PrintType name_2
- Name
- Date of birth
- Service number
- Name_2
- Date of birth_2
- Service number_2
- Date_9
- Applicant printed name_5
- Date_10
- Applicant printed name_6
- Date_11
- Current Borrower printed name
- Date_12
- Current Borrower printed name_2
- Date_13
- Text3
- Text10
- undefined_13
- Text15
- undefined_14
- undefined_15
- undefined_16
- undefined_17
- undefined_18
- undefined_19
- undefined_20
- undefined_21
- undefined_23
- Reason for assumption Off
- Requestors relationship to owners Off
- Check one Off
- Check one1 Off
- Day1
- Evening
- Cell phone
- Check one2 Off
- Check one3 Off
- Check one4 Off
- Check one5 Off
- Text2-1
- Text2-2
- Text2-3
- Text2-4
- Text2-5
- Text2-6
- Text3-1
- Text3-2
- Text3-3
- Text3-4
- Text3-6
- Text3-7
- Text3-8
- Text3-9
- Text3-10
- Text3-11
- Text3-12
- Text3-13
- Text3-14
- Text3-15
- Text3-16
- Text3-17
- Text3-18
- Text3-19
- Text3-20
- Text3-21
- Text3-22
- Text3-23
- Text3-24
- Text3-25
- Text3-26
- Text3-27
- Text3-28
- Text3-29
- Text3-30
- Text3-31
- Text3-32
- Text3-33
- Text3-34
- Text3-35
- Text3-36
- Text3-37
- Text3-38
- Text3-39
- Text3-40
- Text3-41
- Text3-42
- Text3-43
- Text3-44
- Text3-45
- Text3-46
- Text3-47
- Text3-48
- Text3-49
- Text3-50
- Text3-51
- Text3-52
- Text3-53
- Text3-5
- Text3-54
- Text3-55
- Text3-56
- Citizenship Off
- Type of credit Off
- Marital Status Off
- Housing Off
- Housing1 Off
- ownership Off
- DNA1 Off
- DNA2 Off
- DNA3 Off
- family Off
- BO Off
- Total
- Text31
- Text32
- Text33
- Text34
- Text35
- Text36
- Text37
- Text38
- Text39
- Text310
- Text311
- Text312
- Text313
- Text314
- Text315
- Text316
- Text317
- Text318
- Text319
- ownership1 Off
- Total1
- Total1-2
- Check Box4-1 Off
- Text320
- Text321
- Text322
- Text323
- Text324
- Text325
- Text326
- Text327
- Text328
- Text329
- Check Box4-2 Off
- Check Box4-3 Off
- Check Box4-4 Off
- Check Box4-8 Off
- Check Box4-9 Off
- Text330
- Text331
- Text332
- Text333
- Text334
- Text335
- Text1-1
- Text1-2
- Text1-3
- Text1-4
- Text1-5
- Text1-6
- Text1-7
- Text1-8
- Text1-9
- Text1-10
- Text1-11
- Text1-12
- Text1-13
- Text1-14
- Text1-15
- Text1-16
- Text1-17
- Text1-18
- Text1-19
- Text1-20
- Text1-21
- Text1-22
- Text1-23
- Text1-24
- Text1-25
- Text1-26
- Text1-27
- Text1-28
- Text1-29
- Text1-30
- Text1-31
- Text1-32
- Text1-33
- Text1-34
- Text1-35
- Check Box3-2 Off
- Check Box2-1 Off
- Check Box2-2 Off
- Check Box2-3 Off
- Check Box2-4 Off
- Check Box2-5 Off
- Text1-36
- Text1-37
- Text1-38
- Text1-39
- Text1-40
- Text1-41
- Text1-42
- Text1-43
- Text1-44
- Text1-45
- Text1-46
- Text1-47
- Text1-48
- Text1-49
- Text1-50
- Text1-51
- Text1-52
- Text1-53
- Text1-54
- Text1-55
- Text1-56
- Text1-57
- Text1-58
- Text1-59
- Text1-60
- Text1-61
- Check Box3-11 Off
- A1
- A2
- A3
- A4
- A5
- A6
- A7
- A8
- A9
- A10
- A11
- A12
- Check Box3-1 Off
- Check Box30-1 Off
- Check Box30-2 Off
- Check Box30-4 Off
- Check Box30-5 Off
- Check Box30-7 Off
- Check Box30-8 Off
- Check Box30-9 Off
- Check Box30-10 Off
- Check Box30-11 Off
- Check Box30-12 Off
- A13
- A14
- A15
- A16
- A17 Off
- A18
- A19
- A20
- A21
- A22
- A23
- A24
- A25
- A26
- A27
- A28
- A29
- A30
- A31
- A32
- A33
- A34
- A35
- A36
- A37
- A38 Off
- A39
- A40
- A41
- A42
- A43
- A44
- A45
- A46
- A47
- A48
- A49
- A50
- A51
- A52
- A53
- A54
- A55
- A56
- A57
- A58
- A59
- A60
- A61
- A62
- A63
- A64
- A65
- A66
- A67
- A68
- A69
- A70
- A71
- A72
- A73
- A74
- Loan Purpose Off
- occupancy1 Off
- lien type Off
- lientype Off
- mixed use Off
- manufactured home Off
- deposit1 Off
- deposit2 Off
- B1
- B2
- B3
- B4
- B5
- B6
- B7
- B8
- B9
- B10
- fha Off
- Check Box51 Off
- B11
- B12
- B13
- B14
- B15
- B16
- B17
- B18
- B19 Off
- B20
- B21
- B22 Off
- B23
- B24
- B25
- B26
- B27
- B28
- A
-
- Will you occupy the property as your primary residence Off
- Will you occupy the property as your primary residence1 Off
-
- If yes have you had an ownership interest in another property in the last three years Off
- Text9-2
- B
-
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property Off
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property1 Off
-
- 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 Off
- 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 application1 Off
-
- 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 Off
- 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 application1 Off
-
- new credit Off
- 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) Off
- the Property Assessed Clean Energy Program)1 Off
-
- F
-
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application Off
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application1 Off
-
- G
-
- Are there any outstanding judgments against you Off
- Are there any outstanding judgments against you1 Off
-
- H
-
- Are you currently delinquent or in default on a Federal debt Off
- Are you currently delinquent or in default on a Federal debt1 Off
-
- I
-
- Are you a party to a lawsuit in which you potentially have any personal financial liability Off
- Are you a party to a lawsuit in which you potentially have any personal financial liability1 Off
-
- J
-
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years Off
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years1 Off
-
- 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 Off
- 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 due1 Off
-
- L
-
- Have you had property foreclosed upon in the last 7 years Off
- Have you had property foreclosed upon in the last 7 years1 Off
-
- M
-
- Have you declared bankruptcy within the past 7 years Off
- Have you declared bankruptcy within the past 7 years1 Off
-
- Check Box8-2 Off
- Check Box8-3 Off
- Check Box8-4 Off
- Text9-3
- Text9-5
- Text9-6
- Text97
- military Off
- ethnicity Off
- sex Off
- race Off
- demo Off
- Text12-1
- Check Box11-1 Off
- Check Box11-2 Off
- Check Box11-3 Off
- Check Box11-4 Off
- Check Box11-5 Off
- Check Box11-6 Off
- Check Box11-7 Off
- Check Box11-8 Off
- Check Box11-9 Off
- Text12-2
- Check Box11-10 Off
- Check Box11-11 Off
- Check Box11-12 Off
- Check Box11-13 Off
- Check Box11-14 Off
- Check Box11-15 Off
- Text12-3
- Check Box11-16 Off
- Check Box11-17 Off
- Check Box11-18 Off
- Check Box11-19 Off
- Check Box11-20 Off
- Check Box11-21 Off
- Check Box11-22 Off
- Check Box11-23 Off
- Text12-4
- Check Box11-24 Off
- Check Box11-25 Off
- Check Box11-26 Off
- Check Box11-27 Off
- Check Box11-28 Off
- Check Box11-29 Off
- Text12-5
- Check Box11-30 Off
- Check Box11-31 Off
- citizen Off
- credit Off
- marital status1 Off
- housing-1 Off
- housing-2 Off
- own Off
- C1
- C2
- C3
- C6
- C7
- C8
- C9
- C10
- C11
- C12
- C13
- C14
- C15
- C16
- C17
- C18
- C19
- C20
- C21
- C22
- C23
- C24
- C25
- C26
- C27
- C28
- C29
- C30
- C31
- C32
- C33
- C34
- C35
- Check Box-2 Off
- C36
- C37
- C38
- C39
- C4
- C40
- C41
- C42
- C43
- C44
- C45
- C46
- C47
- Check Box-3 Off
- Check Box-4 Off
- C48
- C49
- C5
- C50
- C51
- C52
- C53
- C54
- C55
- Check Box-1-1 Off
- own1 Off
- Check Box-1 Off
- D1 Off
- D2
- D3
- D4
- D5
- D6
- D7
- D8
- D9
- D10
- D11
- D12
- D13
- D14 Off
- D15 Off
- D16
- D17
- D18
- D19
- D20
- D21
- D22
- D23
- D24 Off
- D25
- D26
- D27
- D28
- D29
- D30
- D31
- D32
- D33
- D34
- D35 Off
- D36
- D37 Off
- D38
- D39
- D40
- D41
- D42
- D43
- D44
- D45
- D46
- D47
- If yes have you had an ownership interest in another property in the last three years1 Off
- new credit1 Off
- Check Box8-1 Off
- Check Box8-1-2 Off
- Check Box8-1-1 Off
- Check Box8-1-3 Off
- Check Box8-1-4 Off
- Military Service mdash Did you (or your deceased spouse) ever serve or are you currently serving in the United States Armed Forces 1 Off
- Check1 Off
- Text9-1-1
- Check2 Off
- Check3 Off
- Check4 Off
- Text9-1
- E1
- E2
- E3
- Was the ethnicity of the Borrower collected on the basis of visual observation or surname1 Off
- Was the sex of the Borrower collected on the basis of visual observation or surname1 Off
- Was the race of the Borrower collected on the basis of visual observation or surname1 Off
- The Demographic Information was provided through1 Off
- F1 Off
- F2 Off
- F3 Off
- F4 Off
- F5 Off
- F6
- F7 Off
- F8 Off
- F9 Off
- F10 Off
- F11 Off
- F12 Off
- F13
- F14 Off
- F15 Off
- F16 Off
- F17 Off
- F18 Off
- F19 Off
- F20 Off
- F21 Off
- F22
- F23 Off
- F24 Off
- F25 Off
- F26 Off
- F27 Off
- F28 Off
- F29
- F30 Off
- F31 Off
- undefined_13-1
- undefined_13-2
- undefined_14-1
- undefined_15-1
- undefined_16-1
- undefined_17-1
- undefined_18-1
- undefined_19-1
- undefined_21-1
- undefined_20-1
- undefined_23-1
- undefined_13_1
- Single-Two Off
- Refi type Off
- refi program Off
- Estate Off
- Title held Off
- Trust Information Off
- Indian Country Land Tenure Off
- Mortgage Type Applied For Off
- Mortgage Lien Type Off
- Amortization Type Off
- G1 Off
- G2 Off
- G3 Off
- G4 Off
- G5 Off
- G6
- G7
- G8
- G9
- G10 Off
- G11 Off
- G12 Off
- G13 Off
- G14 Off
- G15 Off
- G16
- G17
- G18
- G19
- G20
- G21
- G22
- G23 Off
- G24
- G25 Off
- G26
- G27 Off
- G28 Off
- G29
- G30 Off
- G31
- G32 Off
- G33
- G34
- G35
- G36
- G37
- G38
- G39
- G40
- G41
- G42
- Property Held
- refi
- Text18-1
- Text18-2
- Text18-3
- Text18-4
- Text18-5
- Text18-6
- Text18-7
- Text18-8
- Text18-9
- Text18-10
- Text18-11
- Text18-12
- Text18-13
- Text18-14
- Text18-15
- Text18-16
- Text18-17
- Text18-18
- Text18-19
- Lender
- case no
- If you selected ldquoUnmarriedrdquo in Section 1 is there a person who is not your legal spouse but who currently has real property rights similar to those of a legal spouse Off
- Relationship and State Off
- Other-5
- Text19-1
- BName
- Additional Information
- ABN
- Additional Information1
- BSign
- BSDate
- ABSign
- ABDate
- MortageeNameAddress
- NAmeAddress
- Bname1
- DOB1
- DOB2
- SignOfBorr1
- SignOfBorr
- Date Signed
- SignOfBorr2
- SignOfBorr3
- Date Signed3
- Date Signed4
- MortgageeRepSign
- DirectSign
- DirectSign1
- Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union Off
- AppSign
- AppSign1
- AppSign2
- AppSign3
- Nopage38 Off
- Yespage38 Off
- Yes1 Off
- No1 Off
- Yes2 Off
- Yes3 Off
- Yes4 Off
- Yes5 Off
- Yes6 Off
- Yes7 Off
- Yes8 Off
- Yes9 Off
- Yes10 Off
- No2 Off
- No3 Off
- No4 Off
- No5 Off
- No6 Off
- No7 Off
- No8 Off
- No9 Off
- No10 Off
- BorrowerNo Off
- BorrowerYes Off
- AppSignature
- AppSignature1
- CurrentSign
- CurrentSign1
- InterviewSign
- Yes_1 Off
- No_1 Off
- Yes_2 Off
- No_2 Off
- Mail Off
- Phone Off
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
_____________ _________________________________________ __________________________________________
________________________________________________________________________________________________
3 Applicant and Current Borrower to Complete
If the answer to the questions in section 1 and 2 are both yes please answer the following question After yoursquove reviewed and completed this entire form please sign and date at the bottom
Applicant Current Borrower
Do you want to apply for a substitution of entitlement Yes Yes No No
In order to complete a substitution of entitlement the veteran applicant must have suffcient entitlement to substitute for that of the current borrower Contact the VA Offce of Jurisdiction for your area for more information Also before the veteran applicant can substitute entitlement on a VA loan heshe must certify that the property securing the loan will be occupied as hisher primary residence Both the applicantrsquos and current borrowerrsquos original certifcate of eligibility will be required If your sales contract is contingent upon the restoration of entitlement please contact your VA Offce of Jurisdiction for complete procedures Otherwise the substitution will be completed after the loan has been approved and closed
Date Applicant printed name Applicant signature
Date Applicant printed name Applicant signature
Date Current Borrower printed name Current Borrower signature
Date Current Borrower printed name Current Borrower signature
Forms completed by Mail Phone
For Chase use only
Interviewer signature Date
99177-VS-0215
- Assumption Application Package_41521-noscannedpages-update-4pdf
-
- 1 FM203 Cover Pagepdf
- 2 FM202 Mortgage Assumption Application Package pagepdf
- 3 The Documents Youll need to Send Uspdf
- 4 FM201 FAQpdf
- 5 FM142 CIWpdf
- 6 FM126 URLApdf
- 7 FM130 URLA Instpdf
-
- Blank Page
-
- 8 92900a Addednum to Loan Applicationpdf
- 9 FM462 Gen Authpdf
- 10 FM220 4506-Cpdf
- 11 FM153 Chase Federal Privacy Noticepdf
- 12 FM144 Info on Opening a New Accountpdf
- 13 FM152 Veteran Statementpdf
-
- Date
- Loan number
- Applicant name
- Phone1
- Loan number 1
- Loan number 2
- Other
- Other_2
- 1
- 2
- undefined_7
- Available hours
- Available hours_2
- undefined_8
- Available hours_3
- undefined_9
- Current address 1
- Neither
- Available hours_4
- Available hours_5
- undefined_10
- Available hours_6
- 1_2
- 2_2
- undefined_11
- Available hours_7
- Available hours_8
- undefined_12
- Available hours_9
- FHA Case No include any suffix
- Mortgagee Case No
- Mortgagee ID
- Sponsor ID
- Agent ID
- Name and Address of Sponsor Name and Address of Agent
- Borrowers Name Present Address include ZIP Code Property Address
- include name of subdivision lot block no ZIP Code
- Name of ThirdParty Originator
- NMLS ID of ThirdParty Originator
- s application
- ty Number
- ty Number_2
- Date Signed_2
- Date Mortgage Approved
- Date Approval Expires
- Printed Name
- Title 1
- DEs ID Number
- DEs ID Number_2
- Mortgagee
- Name of Mortgagees Representative
- Title of Mortgagees Representative
- Signature of the Mortgagees Representative
- Date_2
- Applicant names 1
- Applicant names 2
- Applicant names 3
- Loan number_2
- Date_3
- Applicant printed name
- Social Security number
- Date_4
- Applicant printed name_2
- Social Security number_2
- Date_5
- Applicant printed name_3
- Social Security number_3
- Date_6
- Applicant printed name_4
- Social Security number_4
- 1a Name shown on tax return if a joint return enter the name shown first
- 1b First social security number on tax return individual taxpayer identification number or employer identification number see instructions
- 2a If a joint return enter spouses name shown on tax return
- 2b Second social security number or individual taxpayer identification number if joint tax return
- 4 Previous address shown on the last return filed if different from line 3 see instructions
- 5a IVES participant name address and SOR mailbox ID
- Caution This tax transcript is being sent to the third party entered on Line 5a Ensure that lines 5 through 8 are completed before signing see instructions
- Signature see instructions
- Date_7
- Phone number of taxpayer on line 1a or 2a
- PrintType name
- Here
- Spouses signature
- Date_8
- PrintType name_2
- Name
- Date of birth
- Service number
- Name_2
- Date of birth_2
- Service number_2
- Date_9
- Applicant printed name_5
- Date_10
- Applicant printed name_6
- Date_11
- Current Borrower printed name
- Date_12
- Current Borrower printed name_2
- Date_13
- Text3
- Text10
- undefined_13
- Text15
- undefined_14
- undefined_15
- undefined_16
- undefined_17
- undefined_18
- undefined_19
- undefined_20
- undefined_21
- undefined_23
- Reason for assumption Off
- Requestors relationship to owners Off
- Check one Off
- Check one1 Off
- Day1
- Evening
- Cell phone
- Check one2 Off
- Check one3 Off
- Check one4 Off
- Check one5 Off
- Text2-1
- Text2-2
- Text2-3
- Text2-4
- Text2-5
- Text2-6
- Text3-1
- Text3-2
- Text3-3
- Text3-4
- Text3-6
- Text3-7
- Text3-8
- Text3-9
- Text3-10
- Text3-11
- Text3-12
- Text3-13
- Text3-14
- Text3-15
- Text3-16
- Text3-17
- Text3-18
- Text3-19
- Text3-20
- Text3-21
- Text3-22
- Text3-23
- Text3-24
- Text3-25
- Text3-26
- Text3-27
- Text3-28
- Text3-29
- Text3-30
- Text3-31
- Text3-32
- Text3-33
- Text3-34
- Text3-35
- Text3-36
- Text3-37
- Text3-38
- Text3-39
- Text3-40
- Text3-41
- Text3-42
- Text3-43
- Text3-44
- Text3-45
- Text3-46
- Text3-47
- Text3-48
- Text3-49
- Text3-50
- Text3-51
- Text3-52
- Text3-53
- Text3-5
- Text3-54
- Text3-55
- Text3-56
- Citizenship Off
- Type of credit Off
- Marital Status Off
- Housing Off
- Housing1 Off
- ownership Off
- DNA1 Off
- DNA2 Off
- DNA3 Off
- family Off
- BO Off
- Total
- Text31
- Text32
- Text33
- Text34
- Text35
- Text36
- Text37
- Text38
- Text39
- Text310
- Text311
- Text312
- Text313
- Text314
- Text315
- Text316
- Text317
- Text318
- Text319
- ownership1 Off
- Total1
- Total1-2
- Check Box4-1 Off
- Text320
- Text321
- Text322
- Text323
- Text324
- Text325
- Text326
- Text327
- Text328
- Text329
- Check Box4-2 Off
- Check Box4-3 Off
- Check Box4-4 Off
- Check Box4-8 Off
- Check Box4-9 Off
- Text330
- Text331
- Text332
- Text333
- Text334
- Text335
- Text1-1
- Text1-2
- Text1-3
- Text1-4
- Text1-5
- Text1-6
- Text1-7
- Text1-8
- Text1-9
- Text1-10
- Text1-11
- Text1-12
- Text1-13
- Text1-14
- Text1-15
- Text1-16
- Text1-17
- Text1-18
- Text1-19
- Text1-20
- Text1-21
- Text1-22
- Text1-23
- Text1-24
- Text1-25
- Text1-26
- Text1-27
- Text1-28
- Text1-29
- Text1-30
- Text1-31
- Text1-32
- Text1-33
- Text1-34
- Text1-35
- Check Box3-2 Off
- Check Box2-1 Off
- Check Box2-2 Off
- Check Box2-3 Off
- Check Box2-4 Off
- Check Box2-5 Off
- Text1-36
- Text1-37
- Text1-38
- Text1-39
- Text1-40
- Text1-41
- Text1-42
- Text1-43
- Text1-44
- Text1-45
- Text1-46
- Text1-47
- Text1-48
- Text1-49
- Text1-50
- Text1-51
- Text1-52
- Text1-53
- Text1-54
- Text1-55
- Text1-56
- Text1-57
- Text1-58
- Text1-59
- Text1-60
- Text1-61
- Check Box3-11 Off
- A1
- A2
- A3
- A4
- A5
- A6
- A7
- A8
- A9
- A10
- A11
- A12
- Check Box3-1 Off
- Check Box30-1 Off
- Check Box30-2 Off
- Check Box30-4 Off
- Check Box30-5 Off
- Check Box30-7 Off
- Check Box30-8 Off
- Check Box30-9 Off
- Check Box30-10 Off
- Check Box30-11 Off
- Check Box30-12 Off
- A13
- A14
- A15
- A16
- A17 Off
- A18
- A19
- A20
- A21
- A22
- A23
- A24
- A25
- A26
- A27
- A28
- A29
- A30
- A31
- A32
- A33
- A34
- A35
- A36
- A37
- A38 Off
- A39
- A40
- A41
- A42
- A43
- A44
- A45
- A46
- A47
- A48
- A49
- A50
- A51
- A52
- A53
- A54
- A55
- A56
- A57
- A58
- A59
- A60
- A61
- A62
- A63
- A64
- A65
- A66
- A67
- A68
- A69
- A70
- A71
- A72
- A73
- A74
- Loan Purpose Off
- occupancy1 Off
- lien type Off
- lientype Off
- mixed use Off
- manufactured home Off
- deposit1 Off
- deposit2 Off
- B1
- B2
- B3
- B4
- B5
- B6
- B7
- B8
- B9
- B10
- fha Off
- Check Box51 Off
- B11
- B12
- B13
- B14
- B15
- B16
- B17
- B18
- B19 Off
- B20
- B21
- B22 Off
- B23
- B24
- B25
- B26
- B27
- B28
- A
-
- Will you occupy the property as your primary residence Off
- Will you occupy the property as your primary residence1 Off
-
- If yes have you had an ownership interest in another property in the last three years Off
- Text9-2
- B
-
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property Off
- If this is a Purchase Transaction Do you have a family relationship or business affiliation with the seller of the property1 Off
-
- 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 Off
- 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 application1 Off
-
- 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 Off
- 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 application1 Off
-
- new credit Off
- 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) Off
- the Property Assessed Clean Energy Program)1 Off
-
- F
-
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application Off
- Are you a co-signer or guarantor on any debtor loan that is not disclosed on this application1 Off
-
- G
-
- Are there any outstanding judgments against you Off
- Are there any outstanding judgments against you1 Off
-
- H
-
- Are you currently delinquent or in default on a Federal debt Off
- Are you currently delinquent or in default on a Federal debt1 Off
-
- I
-
- Are you a party to a lawsuit in which you potentially have any personal financial liability Off
- Are you a party to a lawsuit in which you potentially have any personal financial liability1 Off
-
- J
-
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years Off
- Have you conveyed title to any property in lieu of foreclosure in the past 7 years1 Off
-
- 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 Off
- 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 due1 Off
-
- L
-
- Have you had property foreclosed upon in the last 7 years Off
- Have you had property foreclosed upon in the last 7 years1 Off
-
- M
-
- Have you declared bankruptcy within the past 7 years Off
- Have you declared bankruptcy within the past 7 years1 Off
-
- Check Box8-2 Off
- Check Box8-3 Off
- Check Box8-4 Off
- Text9-3
- Text9-5
- Text9-6
- Text97
- military Off
- ethnicity Off
- sex Off
- race Off
- demo Off
- Text12-1
- Check Box11-1 Off
- Check Box11-2 Off
- Check Box11-3 Off
- Check Box11-4 Off
- Check Box11-5 Off
- Check Box11-6 Off
- Check Box11-7 Off
- Check Box11-8 Off
- Check Box11-9 Off
- Text12-2
- Check Box11-10 Off
- Check Box11-11 Off
- Check Box11-12 Off
- Check Box11-13 Off
- Check Box11-14 Off
- Check Box11-15 Off
- Text12-3
- Check Box11-16 Off
- Check Box11-17 Off
- Check Box11-18 Off
- Check Box11-19 Off
- Check Box11-20 Off
- Check Box11-21 Off
- Check Box11-22 Off
- Check Box11-23 Off
- Text12-4
- Check Box11-24 Off
- Check Box11-25 Off
- Check Box11-26 Off
- Check Box11-27 Off
- Check Box11-28 Off
- Check Box11-29 Off
- Text12-5
- Check Box11-30 Off
- Check Box11-31 Off
- citizen Off
- credit Off
- marital status1 Off
- housing-1 Off
- housing-2 Off
- own Off
- C1
- C2
- C3
- C6
- C7
- C8
- C9
- C10
- C11
- C12
- C13
- C14
- C15
- C16
- C17
- C18
- C19
- C20
- C21
- C22
- C23
- C24
- C25
- C26
- C27
- C28
- C29
- C30
- C31
- C32
- C33
- C34
- C35
- Check Box-2 Off
- C36
- C37
- C38
- C39
- C4
- C40
- C41
- C42
- C43
- C44
- C45
- C46
- C47
- Check Box-3 Off
- Check Box-4 Off
- C48
- C49
- C5
- C50
- C51
- C52
- C53
- C54
- C55
- Check Box-1-1 Off
- own1 Off
- Check Box-1 Off
- D1 Off
- D2
- D3
- D4
- D5
- D6
- D7
- D8
- D9
- D10
- D11
- D12
- D13
- D14 Off
- D15 Off
- D16
- D17
- D18
- D19
- D20
- D21
- D22
- D23
- D24 Off
- D25
- D26
- D27
- D28
- D29
- D30
- D31
- D32
- D33
- D34
- D35 Off
- D36
- D37 Off
- D38
- D39
- D40
- D41
- D42
- D43
- D44
- D45
- D46
- D47
- If yes have you had an ownership interest in another property in the last three years1 Off
- new credit1 Off
- Check Box8-1 Off
- Check Box8-1-2 Off
- Check Box8-1-1 Off
- Check Box8-1-3 Off
- Check Box8-1-4 Off
- Military Service mdash Did you (or your deceased spouse) ever serve or are you currently serving in the United States Armed Forces 1 Off
- Check1 Off
- Text9-1-1
- Check2 Off
- Check3 Off
- Check4 Off
- Text9-1
- E1
- E2
- E3
- Was the ethnicity of the Borrower collected on the basis of visual observation or surname1 Off
- Was the sex of the Borrower collected on the basis of visual observation or surname1 Off
- Was the race of the Borrower collected on the basis of visual observation or surname1 Off
- The Demographic Information was provided through1 Off
- F1 Off
- F2 Off
- F3 Off
- F4 Off
- F5 Off
- F6
- F7 Off
- F8 Off
- F9 Off
- F10 Off
- F11 Off
- F12 Off
- F13
- F14 Off
- F15 Off
- F16 Off
- F17 Off
- F18 Off
- F19 Off
- F20 Off
- F21 Off
- F22
- F23 Off
- F24 Off
- F25 Off
- F26 Off
- F27 Off
- F28 Off
- F29
- F30 Off
- F31 Off
- undefined_13-1
- undefined_13-2
- undefined_14-1
- undefined_15-1
- undefined_16-1
- undefined_17-1
- undefined_18-1
- undefined_19-1
- undefined_21-1
- undefined_20-1
- undefined_23-1
- undefined_13_1
- Single-Two Off
- Refi type Off
- refi program Off
- Estate Off
- Title held Off
- Trust Information Off
- Indian Country Land Tenure Off
- Mortgage Type Applied For Off
- Mortgage Lien Type Off
- Amortization Type Off
- G1 Off
- G2 Off
- G3 Off
- G4 Off
- G5 Off
- G6
- G7
- G8
- G9
- G10 Off
- G11 Off
- G12 Off
- G13 Off
- G14 Off
- G15 Off
- G16
- G17
- G18
- G19
- G20
- G21
- G22
- G23 Off
- G24
- G25 Off
- G26
- G27 Off
- G28 Off
- G29
- G30 Off
- G31
- G32 Off
- G33
- G34
- G35
- G36
- G37
- G38
- G39
- G40
- G41
- G42
- Property Held
- refi
- Text18-1
- Text18-2
- Text18-3
- Text18-4
- Text18-5
- Text18-6
- Text18-7
- Text18-8
- Text18-9
- Text18-10
- Text18-11
- Text18-12
- Text18-13
- Text18-14
- Text18-15
- Text18-16
- Text18-17
- Text18-18
- Text18-19
- Lender
- case no
- If you selected ldquoUnmarriedrdquo in Section 1 is there a person who is not your legal spouse but who currently has real property rights similar to those of a legal spouse Off
- Relationship and State Off
- Other-5
- Text19-1
- BName
- Additional Information
- ABN
- Additional Information1
- BSign
- BSDate
- ABSign
- ABDate
- MortageeNameAddress
- NAmeAddress
- Bname1
- DOB1
- DOB2
- SignOfBorr1
- SignOfBorr
- Date Signed
- SignOfBorr2
- SignOfBorr3
- Date Signed3
- Date Signed4
- MortgageeRepSign
- DirectSign
- DirectSign1
- Are any of the applicants a registered domestic partner civil union partner or a member of a similar and legally recognized union Off
- AppSign
- AppSign1
- AppSign2
- AppSign3
- Nopage38 Off
- Yespage38 Off
- Yes1 Off
- No1 Off
- Yes2 Off
- Yes3 Off
- Yes4 Off
- Yes5 Off
- Yes6 Off
- Yes7 Off
- Yes8 Off
- Yes9 Off
- Yes10 Off
- No2 Off
- No3 Off
- No4 Off
- No5 Off
- No6 Off
- No7 Off
- No8 Off
- No9 Off
- No10 Off
- BorrowerNo Off
- BorrowerYes Off
- AppSignature
- AppSignature1
- CurrentSign
- CurrentSign1
- InterviewSign
- Yes_1 Off
- No_1 Off
- Yes_2 Off
- No_2 Off
- Mail Off
- Phone Off