Mac Form 710 - Uniform Borrower Assistance Form Page 7

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UNIFORM BORROWER ASSISTANCE FORM
Monthly Household Income
Monthly Household Expenses and Debt
Household Assets (associated with the
Payments
property and/or borrower(s)excluding
retirement funds)
Gross wages
$
First Mortgage Payment
$
Checking Account(s)
$
Overtime
$
Second Mortgage Payment
$
Checking Account(s)
$
Child Support / Alimony*
$
Homeowner’s Insurance
$
Savings / Money Market
$
Non-taxable social security/SSDI
$
Property Taxes
$
CDs
$
Taxable SS benefits or other monthly
$
Credit Cards / Installment Loan(s) (total
$
Stocks / Bonds
$
income from annuities or retirement
minimum payment per month)
plans
Tips, commissions, bonus and self-
$
Alimony, child support payments
$
Other Cash on Hand
$
employed income
Rents Received
$
Car Lease Payments
$
Other Real Estate (estimated value)
$
Unemployment Income
$
HOA/Condo Fees/Property Maintenance $
Other
$
Food Stamps/Welfare
$
Mortgage Payments on other properties $
$
Other
$
Other
$
$
0
0
0
Total (Gross income)
$
Total Household Expenses and Debt
$
Total Assets
$
Payments
Any other liens (mortgage liens, mechanics liens, tax liens, etc.)
Lien Holder’s Name
Balance and Interest Rate
Loan Number
Lien Holder’s Phone Number
Required Income Documentation
Do you earn a salary or hourly wage?
Are you self-employed?
For each borrower who is a salaried employee or
For each borrower who receives self-employed income, include a complete, signed
paid by the hour, include paystub(s) reflecting the
individual federal income tax return and, as applicable, the business tax return; AND
most recent 30 days’ or four weeks' earnings and
either the most recent signed and dated quarterly or year-to-date profit/loss statement
documentation reflecting year-to-date earnings, if
that reflects activity for the most recent three months; OR copies of bank statements for
not reported on the paystubs (e.g. signed letter or
the business account for the last two months evidencing continuation of business
printout from employer).
activity.
Do you have any additional sources of income? Provide for each borrower as applicable:
“Other Earned Income” such as bonuses, commissions, housing allowance, tips, or overtime:
Reliable third-party documentation describing the amount and nature of the income (e.g., paystub, employment contract or printouts
documenting tip income).
Social Security, disability or death benefits, pension, public assistance, or adoption assistance:
Documentation showing the amount and frequency of the benefits, such as letters, exhibits, disability policy or benefits statement from the
provider, and
Documentation showing the receipt of payment, such as copies of the two most recent bank statements showing deposit amounts.
Rental income:
Copy of the most recent filed federal tax return with all schedules, including Schedule E—Supplement Income and Loss. Rental income for
qualifying purposes will be 75% of the gross rent you reported reduced by the monthly debt service on the property, if applicable; or
If rental income is not reported on Schedule E – Supplemental Income and Loss, provide a copy of the current lease agreement with either
bank statements or cancelled rent checks demonstrating receipt of rent.
Investment income:
Copies of the two most recent investment statements or bank statements supporting receipt of this income.
Alimony, child support, or separation maintenance payments as qualifying income:*
Copy of divorce decree, separation agreement, or other written legal agreement filed with a court, or court decree that states the amount
of the alimony, child support, or separation maintenance payments and the period of time over which the payments will be received, and
Copies of your two most recent bank statements or other third-party documents showing receipt of payment.
*Notice: Alimony, child support, or separate maintenance income need not be revealed if you do not choose to have it considered for repaying
this loan.
Fannie Mae/Freddie Mac Form 710
Page 2 of 4
June 2014

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