Part III - Notices to Borrowers
Form HUD-92900-A (09/2016)
VA Form 26-1802a (03/2020)
Public reporting burden for this collection of information is estimated to average 6 minutes 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 conduct or sponsor, and a person is not required to respond to, a collection of information unless that collection displays a valid OMB control number can
be located on the OMB Internet page at http://www.reginfo.gov/public/do/PRAMain. Privacy Act Information: The information requested on the Uniform Residential Loan Application and this Addendum is authorized by 38 U.S.C.
3710 (if for DVA) and 12 U.S.C. 1701 et seq. (if for HUD/FHA). The Debt Collection Act of 1982, Pub. Law 97-365, and HUD's Housing and Community Development Act of 1987, 42U.S.C. 3543, require persons applying for a
federally insured or guaranteed loan to furnish his/her social security number (SSN). You must provide all the requested information, including your SSN. HUD and/or VA may conduct a computer match to verify the information you
provide. HUD and/or VA may disclose certain information to Federal, State and local agencies when relevant to civil, criminal, or regulatory investigations and prosecutions. It will not otherwise be disclosed or released outside of
HUD or VA, except as required and permitted by law. The information will be used to determine whether you qualify as a mortgagor. Any disclosure information outside VA or HUD/FHA will be made only as permitted by law. Failure
to provide any of the requested information, including SSN, may result in disapproval of your loan application. This is notice to you as required by the Right to Financial Privacy Act of 1978 that VA or HUD/FHA has a right of access
to financial records held by financial institutions in connection with the consideration or administration of assistance to you. Financial records involving your transaction will be available to VA and HUD/FHA without further notice or
authorization but will not be disclosed or released by this institution to another Government Agency or Department without your consent except as required or permitted by law. Caution. Delinquencies, defaults, foreclosures and
abuses of mortgage loans involving programs of the Federal Government can be costly and detrimental to your credit, now and in the future. The lender in this transaction, its agents and assigns as well as the Federal Government,
its agencies, agents and assigns, are authorized to take any and all of the following actions in the event loan payments become delinquent on the mortgage loan described in the attached application: (1) Report your name and
account information to a credit bureau; (2) Assess additional interest and penalty charges for the period of time that payment is not made; (3) Assess charges to cover additional administrative costs incurred by the Government to
service your account; (4) Offset amounts owed to you under other Federal programs; (5) Refer your account to a private attorney, collection agency or mortgage servicing agency to collect the amount due, foreclose the mortgage,
sell the property and seek judgment against you for any deficiency; (6) Refer your account to the Department of Justice for litigation in the courts; (7) If you are a current or retired Federal employee, take action to offset your salary,
or civil service retirement benefits; (8) Refer your debt to the Internal Revenue Service for offset against any amount owed to you as an income tax refund; and (9) Report any resulting written off debt of yours to the Internal Revenue
Service as your taxable income. All of these actions can and will be used to recover any debts owed when it is determined to be in the interest of the lender and/or the Federal Government to do so.
Read consent carefully. Review accuracy of social security number(s) and birth dates provided on this application.
The reasonable value of the property as determined by VA or;
The statement of appraised value as determined by HUD/FHA
Note: If the contract price or cost exceeds the VA “Reasonable Value" or HUD/FHA
"Statement of Appraised Value", mark either item (a) or item (b), whichever is applicable.
I have elected to complete the transaction at the contract purchase price or cost. I have
paid or will pay in cash from my own resources at or prior to loan closing a sum equal
to the difference between contract purchase price or cost and the VA or HUD/FHA
established value. I do not and will not have outstanding after loan closing any unpaid
contractual obligation on account of such cash payment.
I was not aware of this valuation when I signed my contract but have elected to
complete the transaction at the contract purchase price or cost. I have paid or will pay
in cash from my own resources at or prior to loan closing a sum equal to the difference
between contract purchase price or cost and the VA or HUD/FHA established value. I
do not and will not have outstanding after loan closing any unpaid contractual obligation
on account of such cash payment.
I and anyone acting on my behalf are, and will remain, in compliance with the Fair Housing
Act, 42 U.S.C. 3604, et seq., with respect to the dwelling or property covered by the loan
and in the provision of services or facilities in connection therewith. I recognize that any
restrictive covenant on this property related to race, color, religion, sex, disability, familial
status, national origin, marital status, age, or source of income is illegal and void. I further
recognize that in addition to administrative action by HUD, a civil action may be brought by
the Attorney General of the United States in any appropriate U.S. court against any person
responsible for a violation of the applicable law.
All information in this application is given for the purpose of obtaining a loan to be insured
under the National Housing Act or guaranteed by the Department of Veterans Affairs and
the information in the Uniform Residential Loan Application and this Addendum is true and
complete to the best of my knowledge and belief. Verification may be obtained from any
source named herein.
For HUD Only (for properties constructed prior to 1978) I have received information on
lead paint poisoning.
Yes Not Applicable
I am aware that neither HUD/FHA nor VA warrants the condition or value of the
Signature(s) of Co-Borrower(s)
Complete for VA-Guaranteed Mortgage.
Have you ever had a VA home Loan?
If “Yes” give details.
IMPORTANT: If you are certifying that you are married for the purpose of VA benefits, your marriage must be recognized by the place where you and/ or your spouse resided at the time of
marriage, or where you and/or your spouse resided when you filed your claim (or a later date when you become eligible for benefits) (38 U.S.C. § 103(c)). Additional guidance on when VA
recognizes marriages is available at http://www.va.gov/opa/marriage/.
Applicable for Both VA & HUD. As a home loan borrower, you will be legally obligated to make the mortgage payments called for by your mortgage loan contract. The fact that you dispose
of your property after the loan has been made will not relieve you of liability for making these payments. Payment of the loan in full is ordinarily the way liability on a mortgage note
is ended. Some home buyers have the mistaken impression that if they sell their homes when they move to another locality, or dispose of it for any other reasons, they are no longer liable
for the mortgage payments and that liability for these payments is solely that of the new owners. Even though the new owners may agree in writing to assume liability for your mortgage
payments, this assumption agreement will not relieve you from liability to the holder of the note which you signed when you obtained the loan to buy the property. Unless you are able to sell
the property to a buyer who is acceptable to VA or to HUD/FHA and who will assume the payment of your obligation to the lender, you will not be relieved from liability to repay any claim
which VA or HUD/FHA may be required to pay your lender on account of default in your loan payments. The amount of any such claim payment will be a debt owed by you to the
Federal Government. This debt will be the object of established collection procedures.
22e. If the dwelling to be covered by this mortgage is to be rented, is it a part of, adjacent or contiguous to any project subdivision or group of concentrated rental properties involving eight or
more dwelling units in which you have any financial interest?
22c. Original Mortgage AmtIs it to be sold? 22b. Sales Price
Complete the following for a HUD/FHA Mortgage.
22a. Do you own or have you sold other real estate within the
past 60 months on which there was a HUD/FHA mortgage?
I authorize the Social Security Administration to verify my Social Security number to the Mortgagee identified in this document and HUD/FHA, through a computer match conducted by HUD/FHA.
I understand that my consent allows no additional information from my Social Security records to be provided to the Mortgagee, and HUD/FHA and that verification of my Social Security number
does not constitute confirmation of my identity. I also understand that my Social Security number may not be used for any other purpose than the one stated above, including resale or redisclosure
to other parties. The only other redisclosure permitted by this authorization is for review purposes to ensure that HUD/FHA complies with SSA's consent requirements. I am the individual to whom
the Social Security number was issued or that person's legal guardian. I declare and affirm under the penalty of perjury that the information contained herein is true and correct. I know that if I make
any representation that I know is false to obtain information from Social Security records, I could be punished by a fine or imprisonment or both. This consent is valid for 180 days from the date
signed, unless indicated otherwise by the individual(s) named in this loan application.
I, the Undersigned Borrower(s) Certify that:
I have read and understand the foregoing concerning my liability on the loan
and Part III Notices to Borrowers.
Occupancy: HUD Only (CHECK APPLICABLE BOX)
I, the Borrower or Co-Borrower will occupy the property within 60 days of signing
the security instrument, and intend to continue occupancy for at least one year; or
I do not intend to occupy the property as my primary residence.
Occupancy: VA Only
I now actually occupy the above-described property as my home or
intend to move into and occupy said property as my home within a
reasonable period of time or intend to reoccupy it after the completion of
major alterations, repairs or improvements.
My spouse is on active military duty and in his or her absence; I occupy
or intend to occupy the property securing this loan as my home.
I previously occupied the property securing this loan as my home. (for
interest rate reduction loans).
While my spouse was on active military duty and unable to occupy the
property securing this loan, I previously occupied the property that is
securing this loan as my home. (for interest rate reduction loans). Note:
If box 2b or 2d is checked, the veteran's spouse must also sign below.
The veteran is on active military duty and in his or her absence, I certify
that a dependent child of the veteran occupies or will occupy the
property securing this loan as their home. Note: This requires that the
veteran's attorney-in-fact or legal guardian of the dependent child sign
the Borrower’s Certificate below.
While the veteran was on active military duty and unable to occupy the
property securing this loan, the property was occupied by the veteran's
dependent child as his or her home (for interest rate reduction loans).
Note: This requires that the veteran’s attorney-in-fact or legal guardian
of the dependent child sign the Borrower’s Certificate below.
Mark the applicable box (not applicable for Home Improvement or Refinancing
Loan) I have been informed that ($ ) is:
Part IV - Borrower Consent for Social Security Administration to Verify Social Security Number
Part V - Borrower Certification
Signature(s) of Borrower(s) Date Signed
Signature(s) of Borrower(s) – Do not sign unless this application is fully completed. Read the certifications carefully and review accuracy of this application.
Signature(s) of Co-Borrower(s)
Signature(s) of Borrower(s) Date Signed