Fillable OMB Approval No. VA: 2900-0144 HUD: 2502-0059 (exp. (Web Master Pulic Affair)

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OMB Approval No. VA: 2900-0144 HUD: 2502-0059 (exp. (Web Master Pulic Affair)

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BROWSE WEB MASTER PULIC AFFAIR (DC) FORMS

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Items "H" through "J" are to be completed as applicable for VA loans only.
H.
The names and functions of any duly authorized agents who developed on behalf of the lender any of the information or supportin
g credit data submitted are as follows:
Name & Address
Function
(e.g., obtained information on the Uniform Residential Loan
Application, ordered credit report, verifications of employment, deposits, etc.)
obtained directly by the lender.
I.
The undersigned lender understands and agrees that it is responsible for the omissions, errors, or acts of agents identified in
obtained directly by the lender.
The undersigned lender understands and agrees that it is responsible for the omissions, errors, or acts of agents identified in
obtained directly by the lender.
item H as to the functions
obtained directly by the lender.
item H as to the functions
obtained directly by the lender.
with which they are identified.
The undersigned lender understands and agrees that it is responsible for the omissions, errors, or acts of agents identified in
with which they are identified.
The undersigned lender understands and agrees that it is responsible for the omissions, errors, or acts of agents identified in
J.
The proposed loan conforms otherwise with the applicable provisions of Title 38, U.S. Code, and of the regulations concerning g
uaranty or insurance of loans
to veterans.
The proposed loan conforms otherwise with the applicable provisions of Title 38, U.S. Code, and of the regulations concerning g
to veterans.
The proposed loan conforms otherwise with the applicable provisions of Title 38, U.S. Code, and of the regulations concerning g
Signature of Officer of Lender Title of Officer of Lender Date (mm/dd/yyyy)
Part III - Notices to Borrowers. Public reporting burden for this collection of information is estimated to average 6 minutes per response, including the time for
Part II - Lender’s Certification
21.
The undersigned lender makes the following certifications to induce the
Department of Veterans Affairs to issue a certificate of commitment to
guarantee the subject loan or a Loan Guaranty Certificate under Title 38, U.S.
Code, or to induce the Department of Housing and Urban Development -
Federal Housing Commissioner to issue a firm commitment for mortgage
insurance or a Mortgage Insurance Certificate under the National Housing Act.
A.
The loan terms furnished in the Uniform Residential Loan Application and
this Addendum are true, accurate and complete.
B.
The information contained in the Uniform Residential Loan Application and
this Addendum was obtained directly from the borrower by an employee
of the undersigned lender or its duly authorized agent and is true to the best
of the lender’s knowledge and belief.
C.
The credit report submitted on the subject borrower (and co-borrower , if
any) was ordered by the undersigned lender or its duly authorized agent
directly from the credit bureau which prepared the report and was received
directly from said credit bureau.
D.
The verification of employment and verification of deposits were requested
and received by the lender or its duly authorized agent without passing
through the hands of any third persons and are true to the best of the
lender’s knowledge and belief.
E.
The Uniform Residential Loan Application and this Addendum were signed
by the borrower after all sections were completed.
F.
This proposed loan to the named borrower meets the income and credit
requirements of the governing law in the judgment of the undersigned.
G.
To the best of my knowledge and belief, I and my firm and its principals:
(1)
are not presently debarred, suspended, proposed for debarment, declared
ineligible, or voluntarily excluded from covered transactions by any Federal
department or agency;
(2)
have not, within a three-year period preceding
this proposal, been convicted of or had a civil judgment rendered against
them for (a) commission of fraud or a criminal offense in connection with
obtaining, attempting to obtain, or performing a public (Federal, State or
local) transaction or contract under a public transaction; (b) violation of
Federal or State antitrust statutes or commission of embezzlement, theft,
forgery, bribery, falsification or destruction of records, making false state-
ments, or receiving stolen property;
(3)
are not presently indicted for or
otherwise criminally or civilly charged by a governmental entity (Federal,
State or local) with commission of any of the offenses enumerated in
paragraph G(2) of this certification; and
(4)
have not, within a three-year
period preceding this application/proposal, had one or more public trans-
actions (Federal, State or local) terminated for cause or default.
1) Purchase Existing Home Previously Occupied
2) Finance Improvements to Existing Property
3) Refinance (Refi.)
4) Purchase New Condo. Unit
5) Purchase Existing Condo.Unit
6) Purchase Existing Home Not Previously Occupied
7) Construct Home
7) Construct Home
(proceeds to be paid out during construction)
7) Construct Home (proceeds to be paid out during construction) 7) Construct Home
8) Finance Co-op Purchase
8) Finance Co-op Purchase
9) Purchase Permanently Sited Manufactured Home
9) Purchase Permanently Sited Manufactured Home
10) Purchase Permanently Sited Manufactured Home & Lot
10) Purchase Permanently Sited Manufactured Home & Lot
11) Refi. Permanently Sited Manufactured Home to Buy Lot
11) Refi. Permanently Sited Manufactured Home to Buy Lot
12) Refi. Permanently Sited Manufactured Home/Lot Loan
12) Refi. Permanently Sited Manufactured Home/Lot Loan
VA:
The veteran and the lender hereby apply to the Secretary of Veterans Affairs for Guaranty of the loan described here under Section 3710, Chapter 37, Title
38, United States Code, to the full extent permitted by the veteran’s entitlement and severally agree that the Regulations promulgated pursuant to Chapter
37, and in effect on the date of the loan shall govern the rights, duties, and liabilities of the parties.
37, and in effect on the date of the loan shall govern the rights, duties, and liabilities of the parties.
37, and in effect on the date of the loan shall govern the rights, duties, and liabilities of the parties.
37, and in effect on the date of the loan shall govern the rights, duties, and liabilities of the parties.
37, and in effect on the date of the loan shall govern the rights, duties, and liabilities of the parties.
37, and in effect on the date of the loan shall govern the rights, duties, and liabilities of the parties.
a. Yes Veteran
a. Yes Veteran
a. Yes Veteran
a. Yes Veteran
b. No Veteran & Spouse
b. No Veteran & Spouse
b. No Veteran & Spouse
b. No Veteran & Spouse
Other (specify)
18.
First Time
19.
VA Only
20.
Purpose of Loan
(blocks 9 - 12 are for VA loans only)
Homebuyer?
Title will be Vested in:
page 1
HUD/VA Addendum to Uniform Residential Loan Application
Part I - Identifying Information
(mark the type of application)
1.
5.
Borrower's Name & Present Address
(Include zip code)
6.
Property Address
(including name of subdivision, lot & block no. & zip code)
15
.
Lender's Name & Address
(include zip code)
Type or Print all entries clearly
2. Agency Case No. (include any suffix) 3. Lender’s Case No. 4. Section of the Act
(for HUD cases)
7. Loan Amount (include the UFMIP if 8. Interest Rate 9. Proposed Maturity
for HUD or Funding Fee if for VA)
$ % yrs. mos.
$ % yrs. mos.
10. Discount Amount 11.Amount of Up Front 12a.Amount of Monthly12b.Term of Monthly
(only if borrower is
Premium Premium Premium
permitted to pay)
$ $
/ mo. months
13. Lender's I.D. Code 14.Sponsor / Agent I.D. Code
16. Name & Address of Sponsor / Agent
VA
Application for
HUD/FHA
Application for Insurance
Home Loan Guaranty under the National Housing Act
Home Loan Guaranty under the National Housing Act
17. Lender's Telephone Number
OMB Approval No. VA: 2900-0144
HUD: 2502-0059 (exp. 9/30/2007)
Part III - Notices to Borrowers. Part III - Notices to Borrowers. Public reporting burden for this collection of information is estimated to average 6 minutes per response, including the time Public reporting burden for this collection of information is estimated to average 6 minutes per response, including the time forfor
Part III - Notices to Borrowers. Public reporting burden for this collection of information is estimated to average 6 minutes per response, including the time forreviewing 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 information unless that collection displays a valid OMB control number can be located on the OMB Internet page at http://www.whitehouse.gov/omb/library/
required to respond to, a collection information unless that collection displays a valid OMB control number can be located on the OMB Internet page at http://www.whitehouse.gov/omb/library/
OMBINV.LIST.OF.AGENCIES.html#list_OF_AGENCIES’.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 requestedinformation, including your SSN.
HUD and/or VA may conduct a computer match to verify the information you provide. HUD and/or VA may disclose certaininformation to Federal, State and local agencies when relevant to civil,
criminal, or regulatory investigations and prosecutions. It will not otherwise be disclosed orreleased 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. Anydisclosure of 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
Part III - Notices to Borrowers. 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 information unless that collection displays a valid OMB control number can be located on the OMB Internet page at http://www.whitehouse.gov/omb/library/OMBINV.LIST.OF.AGENCIES.
html#LIST_OF_AGENCIES. 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 requestedinformation, including your SSN. HUD and/or VA may conduct a computer match
to verify the information you provide. HUD and/or VA may disclose certaininformation to Federal, State and local agencies when relevant to civil, criminal, or regulatory investigations and prosecutions.
It will not otherwise be disclosed orreleased 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. Anydisclosure
of 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
HUD: 2502-0059 (exp (11/30/2010)
form
HUD-92900-A
(06/2005)
VA Form
26-1802a
(3/98)
(09/2010)
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/o
Signature(s) of Borrower(s) --
Do not sign
unless this application is fully completed. Read the
certifications carefully & review accuracy
of this
application.
Date
page 2
Part IV - Borrower Consent for Social Security Administration to Verify Social Security Number
I authorize the Social Security Administration to verify my Social Security number to the Lender identified in this document an
d 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 Lender, 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 ma
y 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 info
rmation 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 app
lication.
22
e.
If the dwelling to be covered by this mortgage is to be rented, is it a part of, adjacent or contiguous to any project subdivis
ion or group of concentrated
rental properties involving eight or more dwelling units in which you have any financial interest? Yes No If “Yes” give deta
ils.
22
f.
Do you own more than four dwellings ? Yes No If “Yes” submit form HUD-92561.
23.
Complete for VA-Guaranteed Mortgage .
Have you ever had a VA home Loan? Yes No
24.
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 contrac
t.
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 th
ese 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 t
o 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 a
ny 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.
Part V - Borrower Certification
22
. Complete the following for a HUD/FHA Mortgage .
Is it to be sold?
22
22
b.
Sales Price
22
22
c.
Original Mortgage Amt
22
a.
Do you own or have you sold
other
real estate within the
Yes
No
Yes
No $ $
No $ $
past 60 months on which there was a HUD/FHA mortgage?
22
d.
Address
Signature(s) of Borrower(s) - Read consent carefully. Review accuracy of social security number(s) and birth dates provided on
Date signed
(b)
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.
(4)
Neither I, nor anyone authorized to act for me, will refuse to sell or rent, after
the making of a bona fide offer, or refuse to negotiate for the sale or rental of,
or otherwise make unavailable or deny the dwelling or property covered by his/
her loan to any person because of race, color, religion, sex, handicap, familial status
or national origin. I recognize that any restrictive covenant on this property relating
to race, color, religion, sex, handicap, familial status or national origin is illegal and
void and civil action for preventive relief may be brought by the Attorney General
of the United States in any appropriate U.S. District Court against any person re-
sponsible for the violation of the applicable law.
(5)
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 Adden-
dum is true and complete to the best of my knowledge and belief. Verification may be
obtained from any source named herein.
(6) For HUD Only
(for properties constructed prior to 1978 ) I have received information
on lead paint poisoning. Yes Not Applicable
(7) I am aware that neither HUD / FHA nor VA warrants the condition or value of
the property
25. I, the Undersigned Borrower(s) Certify that:
(1)
I have read and understand the foregoing concerning my liability on the loan and Part
III Notices to Borrowers.
I have read and understand the foregoing concerning my liability on the loan and Part
III Notices to Borrowers.
I have read and understand the foregoing concerning my liability on the loan and Part
(2) Occupancy:
( for VA only -- mark the applicable box)
(a)
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
(a)
move into and occupy said property as my home within a reasonable period of time
(a)
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
I now actually occupy the above-described property as my home or intend to
or intend to reoccupy it after the completion of major alterations, repairs or improve-
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 improve-
move into and occupy said property as my home within a reasonable period of time
ments.
or intend to reoccupy it after the completion of major alterations, repairs or improve-
ments.
or intend to reoccupy it after the completion of major alterations, repairs or improve-
(b)
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.
(b)
to occupy the property securing this loan as my home.
(b)
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.
My spouse is on active military duty and in his or her absence, I occupy or intend
(c)
I previously occupied the property securing this loan as my home. (for interest
rate reductions)
(c)
rate reductions)
(c)
I previously occupied the property securing this loan as my home. (for interest
rate reductions)
I previously occupied the property securing this loan as my home. (for interest
(d)
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
(d)
securing this loan, I previously occupied the property that is securing this loan as my
(d)
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
While my spouse was on active military duty and unable to occupy the property
home. (for interest rate reduction loans)
securing this loan, I previously occupied the property that is securing this loan as my
home. (for interest rate reduction loans)
securing this loan, I previously occupied the property that is securing this loan as my
Note:
If box
2b
or
2d
is checked, the veteran's spouse must also sign below.
(3)
Mark the applicable box (not applicable for Home Improvement or Refinancing Loan)
I have been informed that ($ ) is :
Mark the applicable box (not applicable for Home Improvement or Refinancing Loan)
I have been informed that ($ ) is :
Mark the applicable box (not applicable for Home Improvement or Refinancing Loan)
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 appli-
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 appli-
If the contract price or cost exceeds the VA "Reasonable Value" or HUD/FHA
cable.
"Statement of Appraised Value", mark either item (a) or item (b), whichever is appli-
cable.
"Statement of Appraised Value", mark either item (a) or item (b), whichever is appli-
(a)
I was aware of this valuation when I signed my contract and I have paid or will
pay in cash from my own resources at or prior to loan closing a sum equal to the
(a)
pay in cash from my own resources at or prior to loan closing a sum equal to the
(a)
I was aware of this valuation when I signed my contract and I have paid or will
pay in cash from my own resources at or prior to loan closing a sum equal to the
I was aware of this valuation when I signed my contract and I have paid or will
difference between the contract purchase price or cost and the VA or HUD/FHA
pay in cash from my own resources at or prior to loan closing a sum equal to the
difference between the contract purchase price or cost and the VA or HUD/FHA
pay in cash from my own resources at or prior to loan closing a sum equal to the
established value. I do not and will not have outstanding after loan closing any unpaid
difference between the 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
difference between the contract purchase price or cost and the VA or HUD/FHA
contractual obligation on account of such cash payment;
established value. I do not and will not have outstanding after loan closing any unpaid
contractual obligation on account of such cash payment;
established value. I do not and will not have outstanding after loan closing any unpaid
Signature(s) of Borrower(s)
Read consent carefully. Review accuracy of social security number(s) and birth dates provided on this application.
Date Signed
Signature(s) of Borrower(s)
Signature(s) of Co - Borrower(s)
Date Signed
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 accessto fi nancial records held by
fi nancial institutions in connection with the consideration or administration of assistance to you. Financial records involving yourtransaction will be available to VA and HUD/FHA without further
fi nancial institutions in connection with the consideration or administration of assistance to you. Financial records involving yourtransaction 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 GovernmentAgency 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 yourcredit, 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, areauthorized 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 Federalprograms; (5) Refer your account to a private attorney, collection agency or mortgage servicing agency to collect the amount due, foreclose the mortgage, sell theproperty and
seek judgment against you for any defi ciency; (6) Refer your account to the Department of Justice for litigation in the courts; (7) If you are a current orretired Federal employee, take action to offset
your salary, or civil service retirement benefi ts; (8) Refer your debt to the Internal Revenue Service for offset againstany 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. Allof 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.
( Borrowers Must Sign Both Parts IV & V
( Borrowers Must Sign Both Parts IV & V
)
Federal statutes provide severe penalties for any fraud, intentional misrepresentation, or criminal connivance or conspiracy purposed to infl uence
theissuance of any guaranty or insurance by the VA Secretary or the HUD/FHA Commissioner.
form
HUD-92900-A
(06/2005)
issuance of any guaranty or insurance by the VA Secretary or the HUD/FHA Commissioner.
issuance of any guaranty or insurance by the VA Secretary or the HUD/FHA Commissioner.
page 2
VA Form
26-1802a
(3/98)
(09/2010)
Date Signed
Date Signed
Signature(s) of Co - Borrower(s)
form HUD-92900-A (0/2010)
Approved: Approved subject to the additional conditions stated below, if any.
Date Mortgage Approved Date Approval Expires
Modified &
Approved
as follows:
Loan Amount (include UFMIP) Interest Rate Proposed Maturity Monthly Payment Amount of Amount of Monthly Term of Monthly
Up Front Premium Premium Premium
$ % Yrs. Mos $ $ $ months
Additional Conditions:
If this is proposed construction, the builder has certified compliance with HUD requirements on form HUD-92541.
If this is new construction, the lender certifies that the property is 100% complete (both on site and off site improvements) and the
property meets HUD's minimum property standards and local building codes.
Form HUD-92544, Builder's Warranty is required.
The property has a 10-year warranty.
Owner-Occupancy Not required ( item (b) of the Borrower's Certificate does not apply).
The mortgage is a high loan-to-value ratio for non-occupant mortgagor in military.
Other: (specify)
This mortgage was rated as an “accept” or "approve" by FHA's Total Mortgage Scorecard. As such, the undersigned representative of the mortgagee
certifies to the integrity of the data supplied by the lender used to determine the quality of the loan, that a Direct Endorsement Underwriter reviewed
the appraisal (if applicable) and further certifies that this mortgage is eligible for HUD mortgage insurance under the Direct Endorsement program.
I hereby make all certifications required for this mortgage as set forth in HUD Handbook 4000.4
Mortgagee Representative
This mortgage was rated as a “refer” by a FHA's Total Mortgage Scorecard, and/or was manually underwritten by a Direct Endorsement
underwriter. As such, the undersigned Direct Endorsement underwriter certifies that I have personally reviewed the appraisal report (if
applicable), credit application, and all associated documents and have used due diligence in underwriting this mortgage. I find that this
mortgage is eligible for HUD mortgage insurance under the Direct Endorsement program and I hereby make all certifications required for
this mortgage as set forth in HUD Handbook 4000.4
Direct Endorsement Underwriter DE's CHUMS ID Number
U.S. Department of Housing
and Urban Development
The Mortgagee, its owners, officers, employees or directors do do not have a financial interest in or a
relationship, by affiliation or ownership, with the builder or seller involved in this transaction.
Direct Endorsement Approval for a HUD/FHA-Insured Mortgage
page 3
Part I - Identifying Information (mark the type of application)
1.
5.
Borrower's Name & Present Address (Include zip code)
6. Property Address (including name of subdivision, lot & block no. & zip code)
15.
Lender's Name & Address (include zip code)
Type or Print all entries clearly
7. Loan Amount (include the UFMIP) 8. Interest Rate 9. Proposed Maturity
$ % yrs. mos.
10. Discount Amount 11. Amount of Up Front 12a.Amount of Monthly12b. Term of Monthly
(only if borrower is Premium Premium Premium
permitted to pay)
$$
/ mo. months
13. Lender's I.D. Code 14. Sponsor / Agent I.D. Code
16. Name & Address of Sponsor / Agent
HUD/FHA Application for Insurance
under the National Housing Act
17. Lender's Telephone Number
2. Agency Case No. (include any suffix) 3. Lender’s Case No. 4. Section of the Act
(for HUD cases)
VA Form 26-1802a
Sponsored
Originations
Name of Loan Origination Company Tax ID of Loan Origination Company NMLS ID of Loan Origination Company
form HUD-92900-A (0/2010)
page 4
Borrower's Certificate:
The undersigned certifies that:
(a) I will not have outstanding any other unpaid obligations contracted in connection with the mortgage transaction or the purchase of
the said property except obligations which are secured by property or collateral owned by me independently of the said mortgaged
property, or obligations approved by the Commissioner;
(b) One of the undersigned intends to occupy the subject property, (note: this item does not apply if owner-occupancy is not required
by the commitment);
(c) All charges and fees collected from me as shown in the settlement statement have been paid by my own funds, and no other charges
have been or will be paid by me in respect to this transaction;
(d) Neither I, nor anyone authorized to act for me, will refuse to sell or rent, after the making of a bona fide offer, or refuse to negotiate
for the sale or rental of or otherwise make unavailable or deny the dwelling or property covered by this loan to any person because
of race, color, religion, sex, handicap, familial status or national origin. I recognize that any restrictive covenant on this property
relating to race, color, religion, sex, handicap, familial status or national origin is illegal and void and any such covenant is hereby
specifically disclaimed. I understand that civil action for preventative relief may be brought by the Attorney General of the United
States in any appropriate U.S. District Court against any person responsible for a violation of this certificate.
Borrower'(s) Signature(s) & Date
Lender's Certificate:
The undersigned certifies that to the best of its knowledge:
(a) The statements made in its application for insurance and in this Certificate are true and correct;
(b) The conditions listed above or appearing in any outstanding commitment issued under the above case number have been fulfilled;
(c) Complete disbursement of the loan has been made to the borrower, or to his/her creditors for his/her account and with his/her consent;
(d) The security instrument has been recorded and is a good and valid first lien on the property described;
(e) No charge has been made to or paid by the borrower except as permitted under HUD regulations;
(f) The copies of the credit and security instruments which are submitted herewith are true and exact copies as executed and filed for record;
(g) It has not paid any kickbacks, fee or consideration of any type, directly or indirectly, to any party in connection with this transaction
except as permitted under HUD regulations and administrative instructions.
I, the undersigned, as authorized representative of ,
mortgagee at this time of closing of this mortgage loan, certify that I have personally reviewed the mortgage loan documents, closing
statements, application for insurance endorsement, and all accompanying documents. I hereby make all certifications required for this
mortgage as set forth in HUD Handbook 4000.4.
Lender's Name
Title of Lender's Officer
Signature of Lender's Officer Date
Note: If the approval is executed by an agent in the
name of lender, the agent must enter the lender's
code number and type.
Code Number (5 digits) Type
VA Form 26-1802a
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OMB Approval No. VA: 2900-0144 HUD: 2502-0059 (exp. (Web Master Pulic Affair)

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Completed 2 June 2021

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