RD 1980-86 Request for Reservation of Funds

FORM APPROVED
OMB NO. 0575-0078

Form RD 1980-86
(12-05)
UNITED STATES DEPARTMENT OF AGRICULTURE
RURAL DEVELOPMENT
SINGLE FAMILY HOUSING GUARANTEED LOAN PROGRAM (SFHGLP)

REQUEST FOR RESERVATION OF FUNDS
LENDER INFORMATION:
Tax I.D. No.

Submitting Lender Name:
Address:

Lender Contact Person:
Contact Phone No.

Ext.

Fax No.

Rural Development Approved Lender (Complete when Submitting Lender (listed above) is not an Rural Development Approved Lender):
Tax I.D. No.

Name:

APPLICANT/PROPERTY INFORMATION:
Reservation Amount Requested: $
Is this a Refinance Loan?

Yes

Applicant and Co-Applicant are both First Time Home buyers
Guaranteed Loan

If Yes, Loan being refinanced is a Rural Development Single Family Housing
OR

Number People in Household:

Direct Loan

Number of Dependents Under Age 18 or Full-time Student:

Applicant Information (Please complete, circle, or mark as appropriate)

Co-Applicant Information (Please complete, circle, or mark as
appropriate)

Name:

Name:

Date of Birth:
SSN:
Yes
No
US Citizen:
Permanent Resident/Qualified Alien:
Yes

Date of Birth:
SSN:
Yes
US Citizen:
No
Permanent Resident/Qualified Alien:
Yes
No

Veteran:

Yes

No

Gender:

M

F

Ethnicity:

Disabled:

No
Yes

No

Veteran:
Gender:

Hispanic or Latino

(Check only One Box)

No

Yes
M

Disabled:

Race:

Ethnicity: (Check only One Box)

Asian

Not Hispanic or Latino

Race:

Asian

American Indian or Alaska Native
Black or African American

Black or African American
Native Hawaiian or Other Pacific Islander
Married

Hispanic or Latino

(Check as many boxes as applicable)

American Indian or Alaska Native

Marital Status:

No

F

Not Hispanic or Latino
(Check as many boxes as applicable)

Yes

Separated

White
Unmarried

Native Hawaiian or Other Pacific Islander
Marital Status:

Married

Separated

White
Unmarried

Property Address:
City, State, Zip Code:

County:

We are processing an application from the above named person(s), and expect to have a complete package, to you within 60 days.
Please reserve funds for this loan. We have reviewed the applicant's income and credit history and have tentatively determined the
applicant(s) has sufficient qualifying income and credit history to proceed with this application.

Date:
(Authorized Lender Representative/Official)
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it
displays a valid OMB control number. The valid OMB control number for this information collection is 0575-0078. The time required to complete this information collection is
estimated to average 30 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.