Uniform Residential Loan Application Page 3
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6FARM CREDIT EAST, ACA
VI. ASSETS AND LIABILITIES (cont’d)
Assets
Liabilities
Name and address of Bank, S&L, or Credit Union
Name and address of Company
$ Payment/Months
Unpaid Balance
Acct. No.
$ Payment/Months
Name and address of Company
$
Acct. No.
$
Name and address of Bank, S&L, or Credit Union
Acct. No.
$ Payment/Months
$
Name and address of Company
Acct. No.
$
Stocks & Bonds (Company Name/number &
Description)
Acct. No.
$ Payment/Months
$
Name and address of Company
Life Insurance net cash value
$
Face amount: $
Subtotal Liquid Assets
$
Real estate owned (enter market value from
$
Schedule of real estate owned)
Acct. No.
$ Payment/Months
$
Vested interest in retirement fund
$
Name and address of Company
Net worth of business(es) owned (attach financial
$
Statement)
Automobiles owned (make and year)
$
Acct. No.
Alimony/Child Support/Separate
$
Other Assets (itemize)
$
Maintenance Payments Owed to:
$
Job Related Expense (child care, union
$
dues, etc.)
Total Monthly Payments
$
Net Worth
Total Assets a.
$
(a minus b)
$
Total Liabilities b.
$
Schedule of Real Estate Owned (If additional properties are owned, use continuation sheet.)
Property Address (enter S if sold, PS if
Insurance
Pending sale or R if rental being held
Type of
Present
Amount of
Gross
Mortgage
Maintenance
Net
For income)
Property
Market Value
Mortgages & Liens
Rental Income
Payments
Taxes & Misc.
Rental Income
Totals
$
$
$
$
$
List any additional names under which credit has previously been received and indicate appropriate creditor names and account number(s):
Alternate Name
Creditor Name
Account Number
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Freddie Mac 07/05
Page 3 of 6
Fannie Mae Form 1003 07/05
1003
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