56001-MH Credit Application

Credit Application for
Manufactured (Mobile) Home

U.S. Department of Housing
and Urban Development
Office of Housing

OMB Approval No. 2502-0328
(exp. 08/31/2009)

This application is submitted to obtain credit under the provisions of Title I of the National Housing Act. Please answer all questions.
Public reporting burden for this collection of information is estimated to average 0.5 hour per response, including the time for reviewing instructions,
searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. This agency may
not collect this information, and you are not required to complete this form, unless it displays a currently valid OMB control number.
Privacy Act Statement: The Department of Housing and Urban Development (HUD) is authorized to collect this information by Title I, section 2 of the
National Housing Act (12 U.S.C. 1703), and to obtain and verify your Social Security Number (SSN) by section 165 of the Housing and Community
Development Act of 1967 (42 U.S.C. 3543). You must provide all of the information requested. This information will be used to determine your
creditworthiness and to assist HUD in accounting for and monitoring the use of Title I funds. Your SSN is a unique identifier which may be used to conduct
computer matches to verify the information you provide. This information may be given to Federal, State, or local agencies when relevant to civil, criminal,
or regulatory investigations or prosecutions. It will not be otherwise disclosed or released outside of HUD or the lending institution which will provide the
loan funds, except as required or permitted by law. Failure to provide any of the requested information may result in delay or rejection of your application.
General Information: You are required to answer the questions on sex, race and ethnic background. Your answers are needed to determine the
characteristics of Title I program beneficiaries, and willl not affect consideration of your application. By providing this information, you will assist us in
ensuring that this program is administered in a nondiscriminatory manner. If you feel you have been discriminated against and you want to report it, the
Fair Housing and Equal Opportunity Hotline Number is (800) 424-8590.
This information is being collected to permit more efficient risk management of the Title I loan portfolio as well as facilitate claims processing for loan
defaults. The information provides a more comprehensive basis for evaluating Title I lender underwriting practices and thereby improving risk management
of the loan portfolio and also enhances management’s ability to determine appropriate policy changes affecting the Title I portfolio as a whole. Responses
are required in order to obtain benefits. No assurance of confidentiality is provided.

I/We hereby apply for a loan of $

(net) to be repaid in

months Date

1. Do you have any past due obligations owed to or insured by any agency of the Federal Government? (check the appropriate box)
(If the answer is "Yes," you are not eligible to apply for an FHA Title I loan until the existing debt has been brought current.)
2. Have you any other application for an FHA Title I loan pending
3. Are there any unsatisfied judgments against you?
Yes
at this time?
Yes
No
4. Have you been declared bankrupt in the last seven years?
If "Yes," with whom? (Name and address)
Explain any "Yes" answers to items 3 and 4.

5a. Applicant(s)

5b. Co-Applicant

Name of Applicant

Name of Co-Applicant

Social Security Number

Telephone Number

Social Security Number

Yes

No

No
Yes

No

Telephone Number

Present Address

How Long

Present Address

How Long

Previous Address

How Long

Previous Address

How Long

Marital Status

Married
Separated
Unmarried (including Single, Divorced, Widowed)

Sex

Date of Birth

Male

Marital Status

Number of Dependents

Sex

Female

Date of Birth

Male

Number of Dependents

Female

Ethnicity: (select only one)

Ethnicity: (select only one)
Hispanic or Latino

Married
Separated
Unmarried (including Single, Divorced, Widowed)

Hispanic or Latino

Not Hispanic or Latino

Not Hispanic or Latino

Race: (select one or more)

Race: (select one or more)
American Indian or Alaska Native

Asian

Black or African American

White

American Indian or Alaska Native

Asian

Black or African American

White

Native Hawaiian or Other Pacific Islander

Native Hawaiian or Other Pacific Islander

Name & Address of Nearest Relative Not Living With You

Name & Address of Nearest Relative Not Living With You

Relationship

Relationship

Telephone Number

6. Applicants' Bank Account

Yes
No

Telephone Number

Name & Address of Bank or Branch

Savings
Checking

Previous editions are obsolete.

Page 1 of 3

ref Handbook 1060.2

form HUD-56001-MH (06/2003)

7. Other Income Source Indicate source of income and amount per week or month.
Note: Income from alimony, child support, or separate maintenance income need not be reported unless you will rely upon it as a basis for undertaking or repaying this loan.
Source

Amount

$
Source

Source

$

Amount

$
Source

Source

8a. Employment and Salaries (if

per

Amount

per

$

Amount

$

Amount

per

Source

per

Amount

per

$

Self-Employed, Submit Current Financial Statement.)

per

8b. Co-Applicant

Applicant Employer Name & Business Address

Co-Applicant Employer Name & Business Address

Business Phone Number

Type of Work or Position

Business Phone Number

Salary per week or month (Gross)

Number of Years

Number of Years

$

Type of Work or Position
Salary per week or month (Gross)

per

per

$

Applicant Previous Employer Name & Business Address

Co-Applicant Previous Employer Name & Business Address

Business Phone Number

Type of Work or Position

Business Phone Number

Salary per week or month (Gross)

Number of Years

Number of Years

$

Type of Work or Position
Salary per week or month (Gross)

per

per

$

9. Applicants' Debts. List all fixed obligations, installment accounts, FHA loans, and debts to banks, finance companies and Government agencies outstanding or Paid in Full.
If more space is needed, list all additional debts on separate pages and attach them to this form.
Present
Balance

Automotive Liens

Monthly
Payment

Amount
Past Due

Lien Holder

Year & Make

$

$

$

Lien Holder

Year & Make

$

$

$

Other Liens (to whom indebted)
Name & Account Number

City & State

FHA Insured
Yes
No

Date
Incurred

Original
Amount

Present
Balance

Amount
Past Due

$

$

$

$

$

$

$

$

$

$

$

$

Monthly Rent

10. The Manufactured Home will be located in

Monthly
Payment

Monthly Utilities

Manufactured Home Park (name & address)
Type of Ownership

Private Site (address)

Land Contract
Mortgage or Trust Deed

11. Proceeds of this Loan Will be Used to Purchase a Manufactured (Mobile) Home, or Home and Lot Combination or Lot Only
Year
Manufacturer's Name
Model Name & Number Manufacturer's Serial No Length Width

Color

Cost
$

Describe Optional Equipment

$

Previous editions are obsolete.

Page 2 of 3

ref Handbook 1060.2

form HUD-56001-MH (06/2003)

I (We) certify that the above statements are true, accurate, and
complete to the best of My (Our) knowledge and belief. This Application shall remain the property of the Lending Institution to which
submitted for the purpose of obtaining a loan.
I (We) hereby consent to and authorize the Lending Institution or the
HUD-FHA, after the giving of reasonable notice, to enter the secured
property for the purpose of determining that the Manufactured (Mobile) Home specified in this Application has been delivered and
installed.

I / We certify that: (1) I / We am/are the person(s) who sold the
Manufactured (Mobile) Home. (2) The Contract contains the whole
agreement with the borrower. (3) The borrower has not been given
or promised a cash payment or rebate nor has it been represented
to the borrower that he/she will receive a cash bonus or commission on future sales as an inducement for the consummation of this
transaction; no encouragement of trial purchase; no promise that
the Manufactured (Mobile) Home will be used as a model for
advertising or other demonstration purposes; and no offer of debt
consolidation.

Applicant's Name & Signature

Dealer's Name & Signature

X
Co-Applicant's Name & Signature

X
Dealer Representative's Name & Signature

X

X

Warning: HUD will prosecute false claims and statements. Conviction may result in criminal and/or civil penalties. (18 U.S.C. 1001, 1010, 1012; 31
U.S.C. 3729,3802)
If application is prepared by any other than the applicant, the person preparing the application must sign below. I (we) certify that the statements
made herein are based upon information given to me (us) by the borrower(s) and are accurate to the best of my (our) knowledge and belief.
Signature & Address of Preparer other than Borrower

X

Previous editions are obsolete.

Page 3 of 3

ref Handbook 1060.2

form HUD-56001-MH (06/2003)