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Why this document matters

This form is utilized when a bank statement presented to Underwriting indicates a recurring withdrawal. It allows the borrower to provide an explanation for said withdrawal. The purpose of acquiring this information is to confirm that the withdrawal does not represent an undisclosed liability that could impact loan qualification. Recurring withdrawals may indicate undisclosed liabilities that could impact DTI calculations, or they may reduce available assets for down payment, closing costs, or reserves. Without proper explanation, recurring withdrawals may be treated as undisclosed liabilities, potentially affecting loan qualification.

When this document is requested

This document is requested when:
  • Recurring withdrawal pattern identified in bank statements
  • Withdrawal amount is significant relative to borrower’s income
  • Withdrawal frequency is regular (weekly, bi-weekly, monthly)
  • Underwriting requires explanation to rule out undisclosed debt

Required data fields

Loan information fields

Field NameTypeRequiredData SourceNotes
Loan numberStringYesLoan entityAlphanumeric identifier
Borrower nameStringYesBorrower entityFull legal name, repeatable for N borrowers
Property addressStringYesLoan entityFull street address of property being financed

Withdrawal details fields

Field NameTypeRequiredData SourceNotes
Withdrawal amountNumberYesUser inputAmount in dollars, positive number
Bank nameStringYesUser inputName of financial institution where withdrawal occurs
FrequencyEnumYesUser inputEnum values: WEEKLY, BI_WEEKLY, MONTHLY, OTHER
Other frequencyStringConditionalUser inputRequired if frequency = OTHER

Explanation fields

Field NameTypeRequiredData SourceNotes
ExplanationStringYesUser inputDetailed explanation for the recurring withdrawal, free text

Signature fields

Field NameTypeRequiredData SourceNotes
Borrower signatureSignatureYesE-signatureDigital signature with timestamp, repeatable for N borrowers
Signature dateDateYesE-signatureAuto-populated on signature, repeatable for N borrowers
Note: Borrower name and signature fields can be repeated for each borrower on the loan (up to N borrowers).

Suggested questions for data collection

QuestionResponse TypeValidation
”Borrower #X: What is your full legal name?”Text inputRequired, min 2 words, repeat for each borrower
”What is the property address?”Text inputAuto-populated from loan entity
”What is the withdrawal amount?”Number inputRequired, positive number, format: currency
”What is the name of the bank where the withdrawal occurs?”Text inputRequired, name of financial institution
”What is the frequency of this withdrawal?”Enum selectionRequired, select from enum values: WEEKLY, BI_WEEKLY, MONTHLY, OTHER
”If ‘Other’, please specify the frequency:“Text inputRequired if frequency = OTHER
”Please provide a detailed explanation for this recurring withdrawal”Text areaRequired, detailed explanation of withdrawal purpose and why it’s not an undisclosed liability
”Please sign and date this document”E-signatureRequired, includes timestamp
Note: Questions marked with “#X” should be repeated for each borrower on the loan (up to N borrowers).

Template

Pre-made templates for this document will be provided separately. When a task is created requesting this document, you can provide borrowers with the template to complete and upload.