HUD 90041 Request for Variance

OMB Approval No.2502-0464

U. S. Department of Housing
and Urban Development

Request for Variance
Pre-foreclosure Sale Program

(exp. 10/31/2012)

Office of Housing
Federal Housing Commissioner

Public reporting burden for this collection of information is estimated to average 15 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 information is required to obtain benefits. HUD may not collect this information, and
you are not required to complete this form, unless it displays a currently valid OMB control number.
Section 204 of the National Housing Act authorizes the Secretary to pay an insurance claim that bridges the gap between
the fair market value proceeds from the HUD-approved third party sale of a property. The respondent’s maybe lenders
(mortgagee’s), counselors and homeowners who are attempting to sell their properties prior to foreclosure. The Privacy Act of 1974
pledges assurances of confidentiality to respondents. HUD generally discloses this data only in response to a Freedom of
Information request.
Mortgagee Name and ID No:

Date of Request:

Homeowner Name(s):

Name & Telephone No. of Contact Person:

FHA Case Number:

Property Address:

Homeowner Name(s):

Mark one, as appropriate: The following variance is requested, for reason indicated below:
Approval of the subject homeowner’s participation in the Pre-foreclosure Sale procedure has been withheld
due to surchargable damage.
Approval of a proposed contract of sale has been withheld because the estimated net sale proceeds are less
than the required 84 percent of “FMV” appraised value of the subject property. A copy of the HUD-1 is
attached.
“FMV” Appraised Value

Gross Sales Price

Estimated Net Sales Proceeds

Ratio of estimated Net Sale Proceeds to
“FMV” appraised value (as percent)

$

$

$

%

Request variance from other criterion (identify the criterion)

Justification for requesting HUD approval of this variance from customary Pre-foreclosure Sale procedure.

Local HUD Office Response: Comments (if any)
Granted
Denied

Signature & Title of HUD Official:

Date:

form HUD-90041 (06/2003)
ref. Handbook 4330.1