Va Form 26 1802A – Fill Out and Use

Great Mortgage Lender, NMLS# 99999999

HUD/VA Addendum to Uniform Residential Loan Application

OMB Approval No.

VA: 2900-0144

HUD: 2502-0059

(exp (2/28/2014))

Part I - Identifying Information (mark the type of application)

2. Agency Case No: (include any suffix)

3. Lender's Case No.

4. Section of the

Act

1.

VA Application for

HUD/FHA Application for Insurance

(for HUD cases)

022222222

Home Loan Guaranty

under the National Housing Act

5. Borrower's Name & Present Address (include zip code)

7. Loan Amount (include the UFMIP if

8. Interest Rate

9. Proposed Maturity

Joe VA

for HUD or Funding Fee if for VA)

252,000.00

3.500 %

30 yrs.

$

mos.

555 12th St

10. Discount Amount

11. Amount of Up

12a. Amount of Monthly

12b.Term of Monthly

Nantucket, MA 02554

(only if borrower is

Front Premium

Premium

Premium

6. Property Address (including name of subdivision, lot & block no. & zip code)

permitted to pay)

$

$

/mo.

months

1234 Anywhere St

Nantucket, MA 02554

13. Lender's I.D. Code

14. Sponsor/Agent I.D. Code

123456789

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.

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 supporting 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.)

If no agent is shown above, the undersigned lender affirmatively certifies that all information and supporting credit data were 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 item H as to the functions with which they are identified

J.The proposed loan conforms otherwise with the applicable provisions of Title 38, U.S. Code, and of the regulations concerning guaranty or insurance of loans to veterans.

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, 42 U.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 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

page 1	form HUD-92900-A (09/2010)
	VA Form 26-1802a

Great Mortgage Lender, NMLS# 99999999

Case No: 022222222

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.

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 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 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 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.

Read consent carefully. Review accuracy of social security number(s) and birth dates provided on this application.

Signature(s) of Borrower(s)	Date signed			Signature(s) of Co-Borrower(s)	Date signed
	/	/			/	/

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 subdivision or group of concentrated

rental properties involving eight or more dwelling units in which you have any financial interest?						Yes	No If "Yes" give details.
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 contract. The fact that you dispose of your property after the loan has been madewill 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.

Signature(s) of Borrower(s) --	Do not sign unless this application is fully completed. Read the certifications carefully & review accuracy of this application.
Signature(s) of Borrower(s)	Date signed			Signature(s) of Co-Borrower(s)	Date signed
X	/	/		X	/	/

(Borrowers Must Sign Both Parts IV & V ) Federal statutes provide severe penalties for any fraud, intentional misrepresentation, or criminal connivance or conspiracy purposed to influence the issuance of any guaranty or insurance by the VA Secretary or the HUD/FHA Commissioner.

page 2	form HUD-92900-A (09/2010)
	VA Form 26-1802a

Great Mortgage Lender, NMLS# 99999999

Approved: Approved subject to the additional conditions stated below, if any.

Date Mortgage Approved						Date Approval Expires
Modified &	Loan Amount (include UFMIP)		Interest Rate	Proposed Maturity		Monthly Payment	Amount of Up		Amount of Monthly	Term of Monthly
Approved							Front Premium		Premium	Premium
as follows:	$		%	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 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
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.

page 3	form HUD-92900-A (09/2010)
	VA Form 26-1802a

Great Mortgage Lender, NMLS# 99999999

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 Great Mortgage Lender, 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.

page 4	form HUD-92900-A (09/2010)
	VA Form 26-1802a