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Get FFIEC FR HMDA-LAR

Form FR HMDA-LAR OMB Nos. 1557-0159 OCC 3064-0046 FDIC 1550-0021 OTS and 7100-0247 FRB and 2502-0539 HUD NCUA number pending. LOAN/APPLICATION REGISTER TRANSMITTAL SHEET You must complete this transmittal sheet please type or print and attach it to the Loan/Application Register required by the Home Mortgage Disclosure Act that you submit to your supervisory agency. Agency Code Reporter s Identification Number Total line entries contained in attached Loan/Application Register Reporter s Tax Identification Number The Loan/Application Register that is attached covers activity during the year pages. and contains a total of Enter the name and address of your institution* The disclosure statement that is produced by the Federal Financial Institutions Examination Council will be mailed to the address you supply below Name of Institution Address City State ZIP Enter the name telephone number and facsimile number of a person who may be contacted about questions regarding your register Name Telephone Number Facsimille Number An officer of your institution must complete the following section* I certify to the accuracy of the data contained in this register. Name of Officer Signature Date Page Name of Reporting Institution of All columns except Reasons for Denial must be completed for each entry. See the instructions for details. Application or Loan Information Loan Number Action Taken Received mm/dd/ccyy Owner Pur- OccuType pose pancy Loan Amount in thousands Applicant Information A Applicant Property Location Race or National Origin Type FourDigit MA Number TwoDigit State ThreeDigit County Six-Digit Census Tract Sex A CA Gross Annual Income Type of Purchaser of Loan Reasons for Denial Optional Example of Loan Originated L B - 6 8 7 4 3 9 Example of Application Denied 01/15/2003 02/22/2003. LOAN/APPLICATION REGISTER TRANSMITTAL SHEET You must complete this transmittal sheet please type or print and attach it to the Loan/Application Register required by the Home Mortgage Disclosure Act that you submit to your supervisory agency. Agency Code Reporter s Identification Number Total line entries contained in attached Loan/Application Register Reporter s Tax Identification Number The Loan/Application Register that is attached covers activity during the year pages. Agency Code Reporter s Identification Number Total line entries contained in attached Loan/Application Register Reporter s Tax Identification Number The Loan/Application Register that is attached covers activity during the year pages. and contains a total of Enter the name and address of your institution* The disclosure statement that is produced by the Federal Financial Institutions Examination Council will be mailed to the address you supply below Name of Institution Address City State ZIP Enter the name telephone number and facsimile number of a person who may be contacted about questions regarding your register Name Telephone Number Facsimille Number An officer of your institution must complete the following section* I certify to the accuracy of the data contained in this register.

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