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pdfOMB Approved No. 2900-0110
Respondent Burden: 10 minutes
APPLICATION FOR ASSUMPTION APPROVAL AND/OR RELEASE FROM
PERSONAL LIABILITY TO THE GOVERNMENT ON A HOME LOAN
INSTRUCTIONS: Please complete this form fully and accurately and return it to the office of the Department of Veterans Affairs (VA) shown below.
Enclose remittance (certified check or money order) payable to VA in the amount shown on the instruction letter which accompanied this form. (NOTE: Use
of this form does not affect the seller’s liability on a VA-guaranteed loan from a private lender. For more information on GI loan liability, see VA Pamphlet
26-5, Pointers for the Veteran Homeowner, Chapter 4.) See Section II for Privacy Act Information.
SECTION I (To be completed by VA)
ADDRESS (Complete)
1. VA LOAN NUMBER
DEPARTMENT OF VETERANS AFFAIRS
Attn: Loan Guaranty Officer
RETURN
TO:
SECTION II (To be completed by Seller)
PRIVACY ACT INFORMATION: VA will not disclose information collected on this form to any source other than what has been authorized under the Privacy Act of
1974 or Title 38, Code of Federal Regulations 1.576 for routine uses (i.e. providing information that is used in determining whether VA can approve a request for
assumption approval and/or release of liability to the Government on a loan) as identified in the VA system of records, 55VA26, Loan Guaranty Home, Condominium
and Manufactured Home Loan Applicant Records, Specially Adapted Housing Applicant Records and Vendee Loan Applicant Records - VA, and published in the
Federal Register. Your obligation to respond is required to obtain or retain benefits. Giving us your SSN account information is voluntary. Refusal to provide your SSN
by itself will not result in the denial of benefits. VA will not deny an individual benefits for refusing to provide his or her SSN unless the disclosure of the SSN is
required by a Federal Statute of law in effect prior to January 1, 1975, and still in effect.
RESPONDENT BURDEN: We need this information to help determine your qualifications for the desired benefit. Title 38, United States Code, allows us to ask for
this information. We estimate that you will need an average of 10 minutes to review the instructions, find the information, and complete this form. VA cannot conduct
or sponsor a collection of information unless a valid OMB control number is displayed. You are not required to respond to a collection of information if this number is
not displayed. Valid OMB control numbers can be located on the OMB Internet Page at www.whitehouse.gov/omb/library/OMBINV.VA.EPA.html#VA. If desired,
you can call 1-800-827-1000 to get information on where to send comments or suggestions about this form.
2A. FIRST-MIDDLE-LAST NAME OF SELLER (Type or Print)
2B. SOCIAL SECURITY NUMBER
3A. HOME TELEPHONE NO. (Include Area Code)
3B. WORK TELEPHONE NO. (Include Area Code)
4A. MAILING ADDRESS OF SELLER (Number and street or rural route, city or
P.O. Box, State and ZIP Code)
4B. ADDRESS OF PROPERTY WHICH IS SECURITY FOR THE LOAN ON WHICH
YOU WISH TO BE RELEASED FROM LIABILITY (If rural property give directions
to locate it)
5. INFORMATION ABOUT PURCHASER OR OWNER OF PROPERTY WHO WILL ASSUME YOUR LOAN
A. FIRST-MIDDLE-LAST NAME OF ASSUMER OF LOAN (Type or Print)
B. MAILING ADDRESS OF ASSUMER OF LOAN (Number and street or rural route,
city or P.O. Box, State and ZIP Code)
6A. STATUS OF SALE TRANSACTION (Check one)
6B. AGREED PURCHASE PRICE
HAVE AGREED ON PURCHASE PRICE BUT NO SALE HAS BEEN
COMPLETED AND NO CONTRACT OR DEED SIGNED (Complete Item 6B)
NO SALE HAS BEEN COMPLETED BUT CONTRACT FOR SALE HAS BEEN SIGNED AND COPY
IS ATTACHED (Complete Item 6B)
$
6C. SALE PRICE
SALE HAS BEEN COMPLETED AND DEED EXECUTED AND DELIVERED TO PURCHASER (Complete Item 6C)
7A. PAYMENT ENCLOSED FOR CREDIT REPORT AND/OR PROCESSING CHARGE (Check one)
$
7B. AMOUNT
OTHER (Specify)
MONEY ORDER
8A. NAME OF LENDER YOU MAKE YOUR
PAYMENTS TO
$
8C. LENDER’S LOAN NO. (If known)
9A. AMOUNT OF MONTHLY LOAN PAYMENT
$
8B. ADDRESS OF LENDER
9B. APPROXIMATE LOAN BALANCE (May be obtained from year-end statement)
$
10. ASSESSMENTS AND/OR OTHER LIENS OUTSTANDING (Note: Lien is a legal claim against a property that must be paid off when the property is
sold. Assessment is a tax or levy imposed against specific parcels of real estate that can benefit from improvements such as a street or sewer.)
A. AMOUNT
B. PURPOSE (Streets, sidewalks, sewers, etc.)
C. HOW PAYABLE
11. HAVE YOU DELIVERED VA FORMS 26-6382 AND 26-6807 TO YOUR PURCHASER FOR COMPLETION AND FORWARDING TO VA?
YES
NO
IMPORTANT - In order for VA to release you from liability, it will be necessary that your purchaser assume all of your liability to the Government, as well as to the
loan holder, if this is other than VA. The instruction letter you received with this form indicates whether this liability may be assumed through a clause in the deed
transferring the property to the purchaser. If not, or if you have already completed the sale of the property without a proper clause included in the deed, then it will be
necessary that a separate "Agreement Creating Liability to Holder and to U.S." be executed by your purchaser. You must ensure that the purchaser is willing to
assume your liability by a clause in the deed or by executing the agreement. This may be accomplished by a provision in your sales contract, or by other written
assurance. Should your purchaser be willing to assume your liability, please call the VA office above for guidance on your available options. If you already completed
the sale of your home and included a VA approved clause in the deed, please attach to this form a copy of the deed showing the date and place it was recorded.
Similarly, a copy of the agreement should be submitted if this has already been executed at the time of sale.
12A. SIGNATURE OF SELLER
VA FORM
JUN 2003
26-6381
12B. DATE
EXISTING STOCKS OF VA FORM 26-6381, DEC 1996,
WILL BE USED.
File Type | application/pdf |
File Modified | 0000-00-00 |
File Created | 0000-00-00 |