Loan/Application Register

• Legal Form Number: FDIC 3064-0046
• Section: Federal Deposit Insurance Corporation

LOAN/APPLICATION REGISTER Page ____of____ Form FR HMDA-LAR

Agency

_______________________________________ _____________________________________________________ Reporter's Identification Number Code

Name of Reporting Institution City, State, Zip |__|__|__|__|__|__|__|__|__|__| -- |__|

Application or Loan Information

Action Taken

Property Location

Applicant Information A = Applicant CA = Co-Applicant

Application or Loan Number

Date Application Received (mm/dd/ccyyy)

Type

Pur- pose

Owner Occu- pancy

Loan amount in thou- sands

Type

Date (mm/dd/ccyy)

Four- Digit MA Number

Two- Digit State Code

Three- Digit County Code

Six-Digit Census Tract

Race or National Origin

Sex

Gross Annual Income in thou- sands

Type of Pur- chaser of Loan

Reasons for Denial (Optional)

A

CA

A

CA

Example of Loan Originated L B - 6 8 7 4 3 9

01/15/2003

2

1

1

00065

1

02/22/2003

8840

51

059

4 2 1 9 . 8 5

3

8

1

4

0024

7

Example of Application Denied 0 1 2 3 4 5 6 7 8 9 - 9 8 7 6 5 4 3 2 1 0

03/20/2003

1

1

1

00125

3

04/30/2003

0450

01

015

0 0 2 1 . 0 0

5

4

2

1

0055

0

4 1 5

(A)

(B)

(C)

(D)

(E)

(F)

(G)

(H)

(I)

(J)

(K)

(L)

(M)

(N)

(O)

(P)

(Q)

(R)

(S)

All columns (except Reasons for Denial) must be completed for each entry. See the HMDA-LAR instructions for explanations regarding the proper use of each code listed below.

Application or Loan Information ; Type: (C) ; 1 -- Conventional (any loan other than FHA, VA, or FmHA loans 2 -- FHA-insured (Federal Housing Administration) 3 -- VA-guaranteed (Veterans Administration) 4 – FSA/RHS – (guaranteed Farm Service Agency or Rural Housing Service)	Action Taken: (G) ; 1 -- Loan originated 2 -- Application approved but not accepted 3 -- Application denied by financial institution 4 -- Application withdrawn by applicant 5 -- File closed for incompleteness 6 -- Loan purchased by your institution	Type of Purchaser (R) ; 0 -- Loan was not originated or was not sold in calendar year covered by register 1 -- FNMA (Federal National Mortgage Association) 2 -- GNMA (Government National Mortgage Association) 3 -- FHLMC (Federal Home Loan Mortgage Corporation) 4 – FAMC (Federal Agricultural Mortgage Corporation) 5 -- Commercial bank 6 -- Savings bank or savings association 7 -- Life insurance company 8 -- Affiliate institution 9 -- Other type of purchaser ; Reasons for Denial (optional) (S) ; 1 -- Debt-to-income ratio 2 -- Employment history 3 -- Credit history 4 -- Collateral 5 -- Insufficient cash (downpayment, closing costs) 6 -- Unverifiable information 7 -- Credit application incomplete 8 -- Mortgage insurance denied 9 -- Other
Purpose: (D) ; 1 -- Home purchase (one-to-four family) 2 -- Home improvement (one-to-four family) 3 -- Refinancing (home purchase or home improvement, one-to-four family) 4 -- Multifamily dwelling (home purchase, home improvement, and refinancings)	Applicant Information ; Race or National Origin: (M) (N) ; 1 -- American Indian or Alaskan Native 2 -- Asian or Pacific Islander 3 -- Black 4 -- Hispanic 5 -- White 6 -- Other 7 -- Information not provided by applicant in mail or telephone application 8 -- Not applicable
Owner-Occupancy: (E) ; 1 -- Owner-occupied as a principal dwelling 2 -- Not owner occupied 3 -- Not applicable	Sex: (O) (P) ; 1 -- Male 2 -- Female 3 -- Information not provided by applicant in mail or telephone application 4 -- Not applicable