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Uniform Residential Loan ApplicationThis application is designed to be completed by the applicant(s) with the Lender's assistance. Applicants should complete this form as "Borrower" or "Co-Borrower", asapplicable. Co-Borrower information must also be provided (and the appropriate box checked) when the income or assets of a person other than the "Borrower"(including the Borrower's spouse) will be used as a basis for loan qualification or the income or assets of the Borrower's spouse or other person who has communityproperty rights pursuant to state law will not be used as a basis for loan qualification, but his or her liabilities must be considered because the spouse or other personhas community property rights pursuant to applicable law and Borrower resides in a community property state, the security property is located in a community propertystate, or the Borrower is relying on other property located in a community property state as a basis for repayment of the loan.
If this is an application for joint credit, Borrower and Co-Borrower each agree that we intend to apply for joint credit (sign below):
Borrower Co-Borrower
VA Conventional Other (explain): Agency Case Number Lender Case NumberFHA USDA/Rural
Housing ServiceAmount$ %
Interest Rate No. of Months Fixed Rate Other (explain):GPM ARM (type):
Subject Property Address (street, city, state, & ZIP) No. of Units
Legal Description of Subject Property (attach description if necessary) Year Built
Purpose of Loan Purchase Construction Other (explain): Property will be:Refinance Construction-Permanent Primary Residence Secondary Residence Investment
Complete this line if construction or construction-permanent loan.Year LotAcquired
Original Cost
$
Amount Existing Liens
$
(a) Present Value of Lot
$
(b) Cost of Improvements
$
Total (a+b)
$Complete this line if this is a refinance loan.YearAcquired
Original Cost
$
Amount Existing Liens
$
Purpose of Refinance Describe Improvements made to be made
Cost: $Title will be held in what Name(s) Manner in which Title will be held Estate will be held in:
Fee SimpleLeasehold (showexpiration date)Source of Down Payment, Settlement Charges and/or Subordinate Financing (explain)
Borrower's Name (include Jr. or Sr. if applicable)
Social Security Number Home Phone (incl. area code) DOB (mm/dd/yyyy) Yrs. School
Married (includes registered domestic partners)Unmarried (includes single, divorced, widowed)Separated
Dependents (not listed by Co-Borrower)
No.Ages
Present Address (street, city, state, ZIP) Own Rent No. Yrs.
Mailing Address, if different from Present Address
If residing at present address for less than two years, complete the following:Former Address (street, city, state, ZIP) Own Rent No. Yrs.
Former Address (street, city, state, ZIP) Own Rent No. Yrs.
Co-Borrower's Name (include Jr. or Sr. if applicable)
Social Security Number Home Phone (incl. area code) DOB (mm/dd/yyyy) Yrs. School
Married (includes registered domestic partners)Unmarried (includes single, divorced, widowed)Separated
Dependents (not listed by Borrower)
No.Ages
Present Address (street, city, state, ZIP) Own Rent No. Yrs.
Mailing Address, if different from Present Address
Former Address (street, city, state, ZIP) Own Rent No. Yrs.
Former Address (street, city, state, ZIP) Own Rent No. Yrs.
MortgageApplied for:
Amortization Type:
I. TYPE OF MORTGAGE AND TERMS OF LOAN
II. PROPERTY INFORMATION AND PURPOSE OF LOAN
III. BORROWER INFORMATIONBorrower Co-Borrower
BorrowerCo-Borrower
CALYX Form Loanapp1.frm 09/05Freddie Mac Form 65 07/05
Page 1 of 5Fannie Mae Form 1003 07/05
TC008.fnm
124,000 8.500 180/180
8 Ash Street, Fairfax, VA 22033 County: Fairfax 1
Equity from Pending Sale175 Thirteenth Street
John Harmon Homeowner, II Mary Faith Homeowner
300-40-5000 202-555-1210 02/14/1970 24 500-22-2000 202-555-1210 09/21/1975 21
3 3175 Thirteenth Street NWWashington, DC 20013
175 Thirteenth Street NWWashington, DC 20013
Post Office Box 10 Farragut StWashington, DC 20013-1234
Post Office Box 15 Farragut StWashington, DC 20013-1234
3.42 3.424540 TalmadgeAnnandale, VA 22091-1234
4540 TalmadgeAnnandale, VA 22091-1234
IV. EMPLOYMENT INFORMATIONBorrower Co-Borrower
If employed in current position for less than two years or if currently employed in more than one position, complete the following:
Name & Address of Employer Self Employed Yrs. on this job
Yrs. employed in thisline of work/profession
Position/Title/Type of Business Business Phone (incl. area code)
Name & Address of Employer Self Employed Dates (from-to)
Monthly Income$
Position/Title/Type of Business Business Phone (incl. area code)
Name & Address of Employer Self Employed Dates (from-to)
Monthly Income$
Position/Title/Type of Business Business Phone (incl. area code)
Name & Address of Employer Self Employed Dates (from-to)
Monthly Income$
Position/Title/Type of Business Business Phone (incl. area code)
Name & Address of Employer Self Employed Dates (from-to)
Monthly Income$
Position/Title/Type of Business Business Phone (incl. area code)
Name & Address of Employer Self Employed Yrs. on this job
Yrs. employed in thisline of work/profession
Position/Title/Type of Business Business Phone (incl. area code)
Name & Address of Employer Self Employed Dates (from-to)
Monthly Income$
Position/Title/Type of Business Business Phone (incl. area code)
Name & Address of Employer Self Employed Dates (from-to)
Monthly Income$
Position/Title/Type of Business Business Phone (incl. area code)
Name & Address of Employer Self Employed Dates (from-to)
Monthly Income$
Position/Title/Type of Business Business Phone (incl. area code)
Name & Address of Employer Self Employed Dates (from-to)
Monthly Income$
Position/Title/Type of Business Business Phone (incl. area code)
V. MONTHLY INCOME AND COMBINED HOUSING EXPENSE INFORMATION
Gross Monthly Income Borrower Co-Borrower Total
Combined MonthlyHousing Expense Present Proposed
Total Total
Base Empl. Income*OvertimeBonusesCommissionsDividends/InterestNet Rental IncomeOther(before completing,see the notice in "describeother income," below)
RentFirst Mortgage (P&I)Other Financing (P&I)Hazard InsuranceReal Estate TaxesMortgage Insurance
Other:
$ $ $ $$
$ $ $ $ $
Homeowner Assn. Dues
* Self Employed Borrower(s) may be required to provide additional documentation such as tax returns and financial statements.
Describe Other Income Alimony, child support, or separate maintenance income need not be revealed if theBorrower (B) or Co-Borrower (C) does not choose to have it considered for repaying this loan.
Notice:
B/C Monthly Amount$
BorrowerCo-Borrower
Freddie Mac Form 65 07/05Page 2 of 5
Fannie Mae Form 1003 07/05CALYX Form Loanapp2.frm 09/05
NIH8050 Wisconsin AvenueBethesda, MD 20730
3 yr(s) 0 mth(s)
8
Physician 301-555-1000
Columbia Hospital3514 M StreetWashington, DC 20010
3 yr(s) 0 mth(s)
9
Specialist 202-555-3434
7,300.00
7,300.00
3,000.001,000.00
4,000.00
10,300.001,000.00
11,300.00
1,200.00
20.0080.00
1,300.00
1,221.08100.0015.00
100.0015.0075.0011.00
1,537.08
VI. ASSETS AND LIABILITIESThis Statement and any applicable supporting schedules may be completed jointly by both married and unmarried Co-borrowers if their assets and liabilities are sufficiently joinedso that the Statement can be meaningfully and fairly presented on a combined basis; otherwise, separate Statements and Schedules are required. If the Co-Borrower sectionwas completed about a non-applicant spouse or other person, this Statement and supporting schedules must be completed by that spouse or other person also.
Completed Jointly Not JointlyASSETS Cash or
Market ValueDescriptionCash deposit toward purchase held by: $
List checking and savings accounts belowName and address of Bank, S&L, or Credit Union
Acct. no. $Name and address of Bank, S&L, or Credit Union
Acct. no. $Name and address of Bank, S&L, or Credit Union
Acct. no. $Stocks & Bonds (Companyname/number description)
$
Life insurance net cash value
Face amount: $
$
Subtotal Liquid Assets $
Real estate owned (enter market valuefrom schedule of real estate owned)
$
Vested interest in retirement fund $
Net worth of business(es) owned(attach financial statement)
$
Automobiles owned (make and year) $
Other Assets (itemize) $
Liabilities and Pledged Assets.
Total Assets a. $
LIABILITIES Monthly Payment &Months Left to Pay
Unpaid Balance
List the creditor's name, address and account number for all outstandingdebts, including automobile loans, revolving charge accounts, real estate loans, alimony, child support,stock pledges, etc. Use continuation sheet, if necessary. Indicate by (*) those liabilities which will besatisfied upon sale of real estate owned or upon refinancing of the subject property.
Name and address of Company $ Payment/Months $
Acct. no.Name and address of Company $ Payment/Months $
Acct. no.Name and address of Company $ Payment/Months $
Acct. no.Name and address of Company $ Payment/Months $
Acct. no.Name and address of Company $ Payment/Months $
Acct. no.Name and address of Company $ Payment/Months $
Acct. no.Alimony/Child Support/SeparateMaintenance Payments Owed to:
$
Job-Related Expense (child care, union dues, etc.) $
Total Monthly Payments $Net Worth(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 pendingsale or R if rental being held for income)
Type ofProperty
PresentMarket Value
Amount ofMortgages & Liens
GrossRental Income
MortgagePayments
Insurance,Maintenance,Taxes & Misc.
NetRental Income
Totals
$ $ $ $ $ $
$ $ $ $ $ $List any additional names under which credit has previously been received and indicate appropriate creditor name(s) and account number(s):
Alternate Name Creditor Name Account Number
Freddie Mac Form 65 07/05Page 3 of 5
Fannie Mae Form 1003 07/05CALYX Form Loanapp3.frm 09/05
BorrowerCo-Borrower
Crestar Bank342 Harvey StreetBaltimore, MD 37485
Crestar Bank7593 Harold SquareWashington, DC 85930
Fidelity
39845
743682
5,000
30,000
3,232
38,232
400,000
438,232
Best BuyPO Box 356Tampa, FL 63782
*
CHASE
58652333
SALLIE MAE
950254520
SALLIE MAE
950752340
TOYOTA CREDIT
3210989098
UNIVERSAL VISA
6011785239
(1,200) /121
257 /20
49 /51
25 /45
500 /32
25 /38
856
145,000
5,000
2,500
1,100
15,838
950
170,388267,844
175 Thirteenth Street NWWashington, DC 20013 PS SFR 400,000
400,000
145,000
145,000
1,200
1,200
100
100
VII. DETAILS OF TRANSACTION VIII. DECLARATIONS
IX. ACKNOWLEDGEMENT AND AGREEMENT
X. INFORMATION FOR GOVERNMENT MONITORING PURPOSES
a. Purchase price $b. Alterations, improvements, repairsc. Land (if acquired separately)d. Refinance (incl. debts to be paid off)e. Estimated prepaid itemsf. Estimated closing costsg. PMI, MIP, Funding Feeh. Discount (if Borrower will pay)i. Total costs (add items a through h)j. Subordinate financingk. Borrower's closing costs paid by Sellerl. Other Credits (explain)
m. Loan amount (exclude PMI, MIP,Funding Fee financed)
n. PMI, MIP, Funding Fee financedo. Loan amount (add m & n)p. Cash from/to Borrower (subtract j, k, l &
o from i)
If you answer "Yes" to any questions a through i, please use continuation sheet for explanation.
Borrower Co-Borrower
Yes No Yes Noa. Are there any outstanding judgments against you?b. Have you been declared bankrupt within the past 7 years?c. Have you had property foreclosed upon or given title or deed in lieu thereof
in the last 7 years?d. Are you a party to a lawsuit?e. Have you directly or indirectly been obligated on any loan which resulted in
foreclosure, transfer of title in lieu of foreclosure, or judgment?(This would include such loans as home mortgage loans, SBA loans, home improvementloans, educational loans, manufactured (mobile) home loans, any mortgage, financialobligation, bond, or loan guarantee. If "Yes," provide details, including date, name and address of Lender, FHA or VA case number, if any, and reasons for the action.)
f. Are you presently delinquent or in default on any Federal debt or any otherloan, mortgage, financial obligation, bond, or loan guarantee?If "Yes," give details as described in the preceding question.
g. Are you obligated to pay alimony, child support, or separate maintenance?h. Is any part of the down payment borrowed?i. Are you a co-maker or endorser on a note?
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -j. Are you a U. S. citizen?k. Are you a permanent resident alien?l. Do you intend to occupy the property as your primary residence?
If "Yes," complete question m below.
m. Have you had an ownership interest in a property in the last three years?(1) What type of property did you own-principal residence (PR),
second home (SH), or investment property (IP)?(2) How did you hold title to the home-solely by yourself (S),
jointly with your spouse (SP), or jointly with another person (O)?
Each of the undersigned specifically represents to Lender and to Lender's actual or potential agents, brokers, processors, attorneys, insurers, servicers, successors and assigns andagrees 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 mis-representation 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 anymisrepresentation 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 StatesCode, 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) theproperty 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) theproperty 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, whetheror 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, andI am obligated to amend and/or supplement the information provided in this application if any of the material facts that I have represented herein should change prior to closing of theLoan; (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 mayhave relating to such delinquency, report my name and account information to one or more consumer credit reporting agencies; (9) ownership of the Loan and/or administration of the Loanaccount 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 representa- tion 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 containedin this application or obtain any information or data relating to the Loan, for any legitimate purpose through any source, including a source named in this application or a consumer reporting agency.Right to Receive Copy of Appraisal I/We have the right to a copy of the appraisal report used in connection with this application for credit. To obtain a copy, I/we must send Lendera written request at the mailing address Lender has provided. Lender must hear from me/us no later than 90 days after Lender notifies me/us about the action taken on this application,or I/we withdraw this application.
Borrower's Signature Date Co-Borrower's Signature DateX X
The following information is requested by the Federal Government for certain types of loans related to a dwelling in order to monitor the lender's compliance with equal creditopportunity, fair housing and home mortgage disclosure laws. You are not required to furnish this information, but are encouraged to do so. The law provides that a Lender maynot discriminate either on the basis of this information, or on whether you choose to furnish it. If you furnish the information, please provide both ethnicity and race. For race, youmay check more than one designation. If you do not furnish ethnicity, race, or sex, under Federal regulations, this lender is required to note the information on the basis of visualobservation and surname if you have made this application in person. If you do not wish to furnish the information, please check the box below. (Lender must review the above material to assure that the disclosures satisfy all requirements to which the lender is subject under applicable state law for the particular type of loan applied for.)BORROWER CO-BORROWER
Ethnicity:
Race:
Sex:
Ethnicity:
Race:
Sex:
I do not wish to furnish this information
Hispanic or Latino Not Hispanic or Latino
American Indian orAlaska Native
Asian Black orAfrican American
Native Hawaiian orOther Pacific Islander
White
Female Male
I do not wish to furnish this information
Hispanic or Latino Not Hispanic or Latino
American Indian orAlaska Native
Asian Black orAfrican American
Native Hawaiian orOther Pacific Islander
White
Female Male
To be Completed by InterviewerThis application was taken by:
Face-to-face interviewMailTelephoneInternet
Interviewer's Name (print or type)
Interviewer's Signature Date
Interviewer's Phone Number (incl. area code)
Name and Address of Interviewer's Employer
CALYX Form Loanapp4.frm 07/07Freddie Mac Form 65 07/05
Page 4 of 5Fannie Mae Form 1003 07/05
134,000.000.000.00
0.001,000.00
0.000.00
135,000.00
0.00
CASH DEPOSIT ON SALES CONTRACT 1,000.00
124,000.000.00
124,000.00
10,000.00
PR
SP
PR
SP
Larry Loantaker
TAX FORM 1098 INFORMATION
Recipient's/Lender's name, address, and telephone number
Recipient's Federal ID: Payer's SSN:
Payer's/Borrower's name:
Payer's/Borrower's address:
Account number:
1. Mortgage interest received from payer(s)/borrower(s):2. Points paid on purchase of principal residence:3. Refund of overpaid interest:4.
300-40-5000
John Jacop Homeowner, III
5510 Clifford Blvd
Frederick, MD 21705
GOOD FAITH ESTIMATEApplicants: Application No:Property Addr: Date Prepared:
Loan Program:Prepared By:
The information provided below reflects estimates of the charges which you are likely to incur at the settlement of your loan. The fees listed are estimates-actual chargesmay be more or less. Your transaction may not involve a fee for every item listed. The numbers listed beside the estimates generally correspond to the numbered linescontained in the HUD-1 settlement statement which you will be receiving at settlement. The HUD-1 settlement statement will show you the actual cost for items paid at settlement.
Total Loan Amount $ Interest Rate: % Term: mths800 ITEMS PAYABLE IN CONNECTION WITH LOAN:801 Loan Origination Fee $802 Loan Discount803 Appraisal Fee804 Credit Report805 Lender's Inspection Fee808 Mortgage Broker Fee809 Tax Related Service Fee810 Processing Fee811 Underwriting Fee812 Wire Transfer Fee
900 ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE:901 Interest for days @ $ per day $902 Mortgage Insurance Premium903 Hazard Insurance Premium904905 VA Funding Fee
1000 RESERVES DEPOSITED WITH LENDER:1001 Hazard Insurance Premium $months @ $ per month1002 Mortgage Ins. Premium Reserves months @ $ per month1003 School Tax months @ $ per month1004 Taxes and Assessment Reserves months @ $ per month1005 Flood Insurance Reserves months @ $ per month
months @ $ per monthmonths @ $ per month
Estimated Prepaid Items/Reserves
1100 TITLE CHARGES:1101 Closing or Escrow Fee: $1105 Document Preparation Fee1106 Notary Fees1107 Attorney Fees1108 Title Insurance:
1200 GOVERNMENT RECORDING & TRANSFER CHARGES:1201 Recording Fees: $1202 City/County Tax/Stamps:1203 State Tax/Stamps:
1300 ADDITIONAL SETTLEMENT CHARGES:1302 Pest Inspection $
Estimated Closing Costs
TOTAL ESTIMATED SETTLEMENT CHARGESCOMPENSATION TO BROKER (Not Paid Out of Loan Proceeds):
$
TOTAL ESTIMATED FUNDS NEEDED TO CLOSE: TOTAL ESTIMATED MONTHLY PAYMENT:
Total Monthly Payment
Principal & InterestOther Financing (P & I)Hazard InsuranceReal Estate TaxesMortgage InsuranceHomeowner Assn. DuesOther
This Good Faith Estimate is being provided by , a mortgage broker, and no lender hasbeen obtained. These estimates are provided pursuant to the Real Estate Settlement Procedures Act of 1974, as amended (RESPA). Additional information
can be found in the HUD Special Information Booklet, which is to be provided to you by your mortgage broker or lender, if your application is to purchaseresidential real property and the lender will take a first lien on the property. The undersigned acknowledges receipt of the booklet "Settlement Costs," and if applicablethe Consumer Handbook on ARM Mortgages.
Applicant Date Applicant Date
Calyx Form gfe.frm 11/01
John Jacop Homeowner, III / Mary Homeowner5510 Clifford Blvd, Frederick, MD 21705
WctSdkArmLoanCredit10/16/20065-1 IO ARM
77,600 8.000 360 / 60
17.2444
75.0085.00
225.00
Purchase Price/Payoff (+)Loan Amount (-)Est. Closing Costs (+)Est. Prepaid Items/Reserves (+)Amount Paid by Seller (-)
New First Mortgage(-)Sub Financing(-)New 2nd Mtg Closing Costs(+)
80,000.0077,600.00
0.000.00
Total Est. Funds needed to close 2,400.00
John Jacop Homeowner, III Mary Homeowner
517.33
75.00225.0085.00
902.33
PFC S F POC
PFC S F POC
PFC S F POC
PFC S F POC
PFC S F POC
PFC S F POC
GIFT LETTERApplicant(s): Loan Number:
I, , do hereby certify the following:
(1) I have made a gift of $ to
Whose relationship is:
(2) This gift is to be applied toward the purchase of the property located at:
(Donor)
(Property Address)
(Amount) (Recipient)
(Relationship)
(Source)
(3) No repayment of the gift is expected or implied in the form of cash or by futureservices of the recipient.
(4) The funds given to the homebuyer were not made available to the donor from anyperson or entity with an interest in the sale of the property including the seller,real estate agent or broker, builder, loan officer, or any entity associated with them.
(5) The source of this gift is:
Donor Signature Date
Donor Name (Print or Type)
Donor Address
Donor Phone Number( )
Borrower Signature
Borrower Signature
WARNING: Our signatures above indicate that we fully understand that it is a Federal Crime punishableby fine, imprisonment, or both to knowingly make any false statement concerning any of the above factsas applicable under the provision of Title 18, United States Code, Section 1012 and 1014.
Attachments:1. Evidence of Donor's Ability to Provide Funds.2. Evidence of Receipt of Transfer of Funds.
Calyx Form - giftlttr.frm (05/02)
WctSdkArmLoanCredit
5510 Clifford BlvdFrederick, MD 21705
5510 Clifford Blvd Frederick, MD 21705
John Jacop Homeowner, III
John Jacop Homeowner, III
Mary Homeowner
Mary Homeowner
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12/5/2007http://www.tax.state.nm.us/mvd/CDL.jpg