VA Form 26-1820: Report and Certification of Loan Disbursement

Mark Automatic Procedure or Prior Approval Procedure, and Guaranty or Insurance.

Enter the VA loan number in Box 1, the lender's loan number in Box 2A, the lender's VA identification number in Box 2B and the date of report in Box 3.

Enter the first name, middle name and last name of the veteran in Box 4A, the veteran's Social Security number in Box 4B and the present address of the veteran, including the ZIP Code, in Box 5.

Enter the first name, middle name and last name of any co-obligor in Box 6A and the co-obligor's Social Security number in Box 6B.

In Box 7, mark the purpose of the loan: interest rate reduction refinance; purchase a manufactured home (not permanently affixed); cash out refinance; purchase a condominium; construction (two-time closing); purchase a 2-4 unit home; construction (one-time closing); purchase an existing home (includes manufactured homes permanently affixed); or alteration and repair.

Enter the address of the property securing the loan in Box 8, including lot and block numbers, subdivision name and ZIP Code.

In Box 9, enter the amount of the loan in 9A, the interest rate in 9B and the term of the loan in months in 9C, and mark the amortization type in 9D: Fixed, Adjustable or Hybrid-ARM.

Mark the ARM type in Box 9E, if applicable: 3/1, 5/1, 7/1 or 10/1.

Enter the principal and interest payable each period in Box 9F.

Enter the date the loan was closed in Box 9G, the date the loan proceeds were fully paid out in 9H, the date of first payment in 9I, the date of maturity in 9J and the date of note in 9K.

In Box 10, mark the type of lien: First Realty Mortgage, Second Realty Mortgage, First Chattel Mortgage, Unsecured or Other (specify).

In Box 11, mark the estate in property: Fee Simple, Leasehold (give expiration date) or Other (specify).

In Box 12, mark the person(s) in whom the title of the property is vested: Veteran; Veteran and Spouse; Veteran and Non-Veteran (who is not spouse); Veteran and Veteran (each using entitlement); or Other (specify).

List all title holders in Box 13.

Enter the discount points charged in Box 14 and the discount points financed in Box 15 (IRRRL only).

Box 16A (refinances only): was the loan being refinanced modified? Mark Yes, No or N/A. If No, skip to Box 17. Enter the modified interest rate in Box 16B and the modified term in Box 16C.

Box 17A (refinances only): was the loan being refinanced an adjustable-rate mortgage (ARM)? Mark Yes, No or N/A. If No, skip to Box 18. Enter the current rate in Box 17B if the loan being refinanced was an ARM.

In Box 21, enter the face amount of the policy and the annual premium for the hazard insurance (A) and the flood insurance (B, where applicable).

Describe the nonrealty, if any, acquired with proceeds of the loan in Box 25 and list the items to be completed as part of the escrow in Box 27 (attach separate sheet if necessary).

If land was acquired by separate transaction, complete Boxes 28 and 29: the date acquired and the purchase price (if acquired other than by purchase, state "None").

In Box 30 of Section II, Lender's Certification, the undersigned lender certifies that:

(A) If this loan was closed under the automatic procedure, no default exists which has continued for more than 30 days.

(B) The lender has not imposed and will not impose any charges or fees against the veteran borrower in excess of those permissible under the schedule set forth in paragraph (d) of 38 CFR 36.4312.

(C) The information furnished in Section I is true, accurate and complete.

(D) The information contained in the loan application was obtained directly from the veteran by an employee of the undersigned lender or the lender's duly authorized agent and is true to the best of the lender's knowledge and belief.

(E) The credit report submitted on the subject veteran (and co-borrower, if any) was ordered by the undersigned lender or the lender's duly authorized agent directly from the credit bureau which prepared the report and was received directly from said credit bureau.

(F) The verification(s) of employment and verification(s) of deposits were requested and received by the lender or the lender's 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.

(G) This report was signed by the veteran after Sections I, II and III were completed.

(H) This loan to the named veteran meets the income and credit requirements of the governing law in the judgment of the undersigned.

(I) 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. Enter each agent's name, address and function on lines a, b and c. If no agent is shown on lines a, b and c, the undersigned lender affirmatively charges that all information and supporting credit data were obtained directly by the lender.

(J) The undersigned lender understands and agrees that the lender is responsible for the acts of agents identified in Item 30I as to the functions with which they are identified.

(K) The loan conforms with the applicable provisions of Title 38, U.S. Code and the Regulations concerning guaranty or insurance of loans to veterans.

(P) If this loan is required to be personally reviewed and approved by a VA-approved underwriter, enter the name of that underwriter in Box 31A and the underwriter's VA ID number in Box 31B.

Enter the name and address of the lender in Box 32 and the telephone number of the lender in Box 33.

Enter the signature and title of the lender representative in Box 35 and the date signed in Box 34.

Section III, Veteran's Certifications, is to be executed by the veteran on the date the loan is closed.

In Box 37, the veteran marks ethnicity in 37B, race in 37C and sex in 37D, or initials in 37A if the veteran does not wish to complete Items 37B thru 37D.

Box 38 is the same for the co-obligor: if the co-obligor does not wish to complete Items 38B thru 38D, the co-obligor initials in 38A.

Enter the date signed in Box 39, the signature of the veteran in Box 40 (read certifications carefully before signing) and the signature of the co-obligor in Box 41, if applicable.

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 Department of Veterans Affairs.