Form 65 - Uniform Residential Loan Application Page 4

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Continuation Sheet/Residential Loan Application
Use this continuation sheet if you need
Borrower:
Agency Case Number:
more space to complete the Residential
Loan Application. Mark B for Borrower or
Co-Borrower:
Lender Case Number:
C for Co-Borrower.
I/We fully understand that it is a Federal crime punishable by fine or imprisonment, or both, to knowingly make any false statements concerning any of the above facts as applicable
under the provisions of Title 18, United States Code, Section 1001, et seq.
Borrower’s Signature
Date
Co-Borrower’s Signature
Date
X
X
Freddie Mac Form 65
01/04
Page 4 of 4
Fannie Mae Form 1003
01/04

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