Form RD 3555-21 at a glance
What it is: Form RD 3555-21 is the Request for Single Family Housing Loan Guarantee.
Who signs: The Lender's Authorized Representative signs the Approved Lender Certification. The Applicant and each Co-Applicant sign under Applicant(s) Acknowledgments and Certifications.
This is the request of the Approved Lender that originated the loan: "Please issue a Single Family Housing Loan Guarantee."
A filled-in Form RD 3555-21 example: a single applicant asks for a loan guarantee
How to fill out Form RD 3555-21, box by box
Approved Lender, Contact for this File and Third Party Originator (TPO)
Fill in the Approved Lender and Approved Lender Tax ID No., the Contact for this File with Contact E-Mail and Contact Phone Number, and the Third Party Originator (TPO) with TPO Tax ID No.
Primary Information
Under Primary Information, enter the Name.
Co-Applicant Information
Under Co-Applicant Information, complete as appropriate: enter the Name of each Co-Applicant.
Approved Lender Certification
In order to induce the Agency to issue the requested guarantee, the Approved Lender certifies that it has originated the loan in compliance with all Agency loan requirements. This form contains or is supplemented with all information required by 7 CFR § 3555.107 and further clarified in Chapter 15 of HB-1-3555 of 7 CFR 3555.
Under SIGN, enter the Lender's Authorized Representative Signature / Title and Date, then the Name of Authorized Representative and Title/Company.
Applicant's Signature
Under SIGN, enter the Print Applicant's Name, Applicant's Signature and Date.
Co-Applicant's Signature
For each Co-Applicant, enter the Print Co-Applicant's Name, Co Applicant's Signature and Date under SIGN.
More rules for Form RD 3555-21
The annual fee for the first year is calculated when the loan is closed based upon the loan amount. Thereafter, the annual fee is calculated every 12 months based upon the average scheduled amortized unpaid principal balance. Billing for the annual fee will begin 12 months from the closing of the loan.
Under Applicant(s) Acknowledgments and Certifications, the applicant is unable to provide the housing the applicant needs on the applicant's own account, and is unable to secure the credit necessary for this purpose from other sources upon terms and conditions which the applicant can reasonably fulfill.
The applicant certifies that the statements made in this application are true, complete and correct to the best of the applicant's knowledge and belief and are made in good faith to obtain a loan.
Disclosure of information requested is voluntary. However, failure to disclose certain items of information requested, including your Social Security Number or Federal Identification Number, may result in a delay in the processing of an application or its rejection.
Common questions about Form RD 3555-21
Are there fees?
The loan will be subject to payment of an annual fee by the Lender. The Lender may pass this fee on to the applicant.
Is there a penalty?
Section 1001 of Title 18, United States Code provides: “Whoever, in any matter within the jurisdiction of any Department or Agency of the United States knowingly and willfully falsifies, conceals or covers up by any trick, scheme, or device a material fact, or makes any false, fictitious or fraudulent statements or representations, or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry, shall be fined under this title or imprisoned not more than five years, or both.”
What am I certifying when I sign?
Under Applicant(s) Acknowledgments and Certifications, the applicant certifies to the best of the applicant's knowledge and belief that (1) the applicant is not presently debarred, suspended, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency; (2) the applicant has not within a three year period preceding this proposal been convicted or had a civil judgment rendered against the applicant for 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; or commission of embezzlement, theft, forgery, bribery, falsification, or destruction of records, making false statement, or receiving stolen property; (3) the applicant does not have an outstanding judgment lien on any property for a debt in favor of the United States which was obtained in any Federal court other than the United States Tax Court; and (4) the applicant is not delinquent on any outstanding debt to the Federal Government (excluding any Federal Tax debt).
Sources
[1] Form RD 3555-21 (Rev. 08-25), Request for Single Family Housing Loan Guarantee, USDA Rural Development (the Official source link on this page).
