Fillable Uniform Residential Loan Application

Subordinate financing

h. Is any part of the down payment

borrowed?

VII. DETAILS OF TRANSACTION (cont’d)

VIII. DECLARATIONS (cont’d)

Borrower’s closing

Are you a co-maker or endorser on a

costs paid by Seller

note?

-------------------------------------------------------

Other Credits (explain)

Are you a U.S. citizen?

k. Are you a permanent resident alien?

Loan amount (exclude

Do you intend to occupy the property

PMI, MIP, Funding Fee

as your primary residence?

financed)

If “Yes,” complete question m below.

PMI, MIP, Funding Fee

m. Have you had an ownership interest in

financed

a property in the last three years?

Loan amount

___

(1) What type of property did you

(add m & n)

own—principal residence (PR), second

home (SH), or investment property

(IP)?

___

Cash from/to Borrower

(2) How did you hold title to the

home—

yourself

(S),

jointly

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

with your spouse or jointly with

another person (O)?

ACKNOWLEDGMENT AND AGREEMENT

Each of the undersigned specifically represents to Lender and to Lender's actual or potential agents, brokers,

processors, attorneys, insurers, servicers, successors and assigns and agrees and acknowledges that: (1) the

information provided in this application is true and correct as of the date set forth opposite my signature and that any

intentional or negligent misrepresentation of this information contained in this application may result in civil liability,

including monetary damages, to any person who may suffer any loss due to reliance upon any misrepresentation that

I have made on this application, and/or in criminal penalties including, but not limited to, fine or imprisonment or both

under the provisions of Title 18, United States Code, Sec. 1001, et seq.; (2) the loan requested pursuant to this

application (the "Loan") will be secured by a mortgage or deed of trust on the property described in this application;

(3) the property will not be used for any illegal or prohibited purpose or use; (4) all statements made in this

application are made for the purpose of obtaining a residential mortgage loan; (5) the property will be occupied as

indicated in this application; (6) the Lender, its servicers, successors or assigns may retain the original and/or an

electronic record of this application, whether or not the Loan is approved; (7) the Lender and its agents, brokers,

insurers, servicers, successors, and assigns may continuously rely on the information contained in the application,

and I am obligated to amend and/or supplement the information provided in this application if any of the material facts

that I have represented should change prior to closing of the Loan; (8) in the event that my payments on the Loan

become delinquent, the Lender, its servicers, successors or assigns may, in addition to any other rights and remedies

that it may have relating to such delinquency, report my name and account information to one or more consumer

reporting agencies; (9) ownership of the Loan and/or administration of the Loan account may be transferred with

such notice as may be required by law; (10) neither Lender nor its agents, brokers, insurers, servicers, successors or

assigns has made any representation or warranty, express or implied, to me regarding the property or the condition or

value of the property; and (11) my transmission of this application as an "electronic record" containing my "electronic

signature," as those terms are defined in applicable federal and/or state laws (excluding audio and video recordings),

or my facsimile transmission of this application containing a facsimile of my signature, shall be as effective,

enforceable and valid as if a paper version of this application were delivered containing my original written signature.

Acknowledgement .

Each of the undersigned hereby acknowledges that any owner of the Loan, its servicers,

successors and assigns, may verify or reverify any information contained in this application or obtain any information

or data relating to the Loan, for any legitimate business purpose through any source, including a source named in this

application or a consumer reporting agency.

Borrower’s Signature

Date

Co-Borrower’s Signature

Date

Uniform Residential Loan Application

Page 6 of 8

Freddie Mac Form 65 7/05 (rev.6 /09)

Fannie Mae Form 1003

7/05 (rev.6/09)

Uniform Residential Loan Application - 2009 Page 6

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