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FEDERAL RESERVE BANK
O F NEW YORK
rCircular N o. 3 6 0 4 1
I October 16, 1950 J

R E G U L A T IO N X
R E SID E N T IA L R E A L E STA TE C R E D IT

Forms o f Statement o f Borrower

To all Persons Engaged in the Business o f Extending Real Estate Credit
in the Second Federal Reserve District:

Enclosed are specimen copies of forms of borrow er’s statements suggested
by the Board o f Governors of the Federal Reserve System for use in showing
compliance with section 4 (c) of the B oard ’s Regulation X affecting residential
real estate credit.
The first paragraph o f section 4 (c) o f the regulation provides that no
Registrant shall extend any credit unless he is satisfied, and maintains records
which reasonably demonstrate on their face, that the credit is or is not real estate
construction credit. One method of showing compliance with this provision where
no real estate construction credit is involved is a statement made by the borrower
to that effect. The statement should certify that the credit in question is not
wholly or partly secured by, or for the purpose o f purchasing or carrying, or for
the purpose of financing, or one which involves the right to acquire or use new
construction on real property or real property on which there is new construction
(or that such new construction, if any, is not a residence or m ajor addition or
m ajor improvement to a residence). The shorter o f the enclosed forms is
designed for this purpose; however, any substantially similar statement when
made by the borrower in a letter or application form or in any other written
form will be acceptable.
The other longer form may be used, if desired, for obtaining the information
required by the second paragraph of section 4 (c) of the regulation with respect
to residential real estate construction credit.
The Board o f Governors o f the Federal Reserve System pointed out that it is
not the intention o f the last sentence of section 4 (c) that Federal Reserve Banks
would supply Registrants’ needs for these forms, but only that samples would be
furnished upon request o f a Registrant, and he would make his own arrangements
for printing a supply meeting his needs.




A

llan

S proul,

President.

S T A T E M E N T O F B O R R O W E R W IT H R E SP E C T T O
R E S ID E N T IA L “ R E A L E S T A T E C O N ST R U C T IO N C R E D IT ”
(T o be filed by the Borrower with the Registrant in connection with credits subject
to Regulation X o f the Board o f Governors o f the Federal Reserve System)

(1) The credit in the amount of $ ...................... , for which the borrower is applying
t o ........................................................................................................................................................., is
(N am e o f Registrant)

with respect to new construction, or property on which there is new construction, involving:
.................. (a) Residential property
(Please check) .................. (b) Residence on farm property
.................. (c) M ajor addition or m ajor improvement to a residence.
As used here, “ new construction” means any structure, or m ajor addition or major
improvement to a structure, which is or has been begun after August 3, 1950.
(2)
I f the Registrant, relying on information furnished by the borrower, claims that
this credit is exempt from Regulation X , the reason fo r such exemption i s : ..........................

N o t e : I f the credit is e x e m p t fr o m R e gu lation X , the in fo r m a tio n called f o r in the rem a in d er o f this
statem ent n eed n ot b e fu rn ish e d .

(3) I f the credit is in connection with a sale, what is the bona fide sale price?

$ .................
(4) I f the credit is not in connection with a sale, what is the bona fide cost or estimated
cost to the borrower? (If, under section 2 (i) o f Regulation X , “ value” is determined by
an appraisal, this question should not be answered.)
$ ......................
(5) I f the credit is in connection with a sale, was any property accepted in part
p a y m e n t? ...................... (“ Y e s ” or “ N o ” ) I f so, attach a statement as to value and a
description of such property.
(6) I f the credit is in connection with a sale, is the vendor o f the property to have
any financial interest in the property after the sale or in the proceeds o f any subsequent
disposition thereof? ...................... (“ Y e s ” or “ N o” ) I f the answer is “ Y e s ” , state
amount and nature o f such interest.

(7)
Apart from the credit now applied fo r with respect to the property, what is the
total amount of any credit previously extended and now outstanding, and any credit
expected at this time to be extended, with respect to the same property?
$ ......................
I certify under the penalties of Regulation X o f the Board o f Governors o f the
Federal Reserve System that to the best of my knowledge and belief the facts stated above,
and those in any statement supplied by me and attached hereto, are correct.

(D a te)

(B orrow er’ s Signature)

(B orrow er’ s A ddress)

N o t e TO R e g i s t r a n t : W h e r e th e borrow er’ s statem ent shows oth er credit to b e ou tstan din g o r to be
co n tem p la ted in con n ection with th e p ro p erty, the R egistrant m u st ob tain fu rth e r in fo r m a tio n with respect
to such credit in ord er to d eterm in e w hether th e ap p licab le lo a n va lu e, m atu rity, an d am ortization requirem en ts
o f R e gu lation X an d th e S u p p le m en t thereto are m et.
A c o p y o f this statem ent sh o u ld b e retained by the R egistran t. A c o p y m a y b e attached to the credit
instrum en t so that i f an o th er R egistrant sh o u ld subsequently p urchase, d iscount o r len d on the credit instrum ent,
h e will have evidence that th e R egistrant w h o first exten d ed the credit ob tain ed a borrow er’s statem ent in
accordance with section 4 ( c ) o f R egu lation X .




STATEM ENT
W H IC H

OF

IS N O T

BORROW ER
“ REAL

W IT H

ESTATE

R E SP E C T

TO

C O N ST R U C T IO N

C R E D IT
C R E D IT ”

(This form may be used where the Registrant does not have other records which
reasonably demonstrate on their face that the credit is not ‘ ‘ real estate construction
credit” under Regulation X o f Board o f Governors o f the Federal Reserve System.
Credit extended, insured or guaranteed by the United States or any agency thereof
is not “ real estate construction credit” under Regulation X .)

W ith respect to the credit in the amount of $ ..................................
fo r which I am applying to ...........................................................................
(N am e o f Registrant)

I certify under the penalties of Regulation X o f the Board of Governors
o f the Federal Reserve System that the credit is not and will not be
either wholly or partly secured by, or for the purpose o f purchasing or
carrying, or for the purpose o f financing, or one which involves the
right to acquire or use, new construction* on real property or real
property on which there is new construction (or that such new con­
struction, if any, is not a residence or a m ajor addition or m ajor
improvement to a residence).

(D ate)

(B orrow er’s Signature)

(B orrow er’s A ddress)

* As used here, “ new construction” means any structure, or major addition or major
improvement to a structure, which is or has been begun after August 3, 1950.