Form RD 1980-11 RD 1980-11 Lender Record Change

USDA-RHS
Form RD 1980-11
(Rev. 7-00)

FORM APPROVED
OMB NO. 0575- 0078
UNITED STATES DEPARTMENT OF AGRICULTURE
RURAL DEVELOPMENT
RURAL HOUSING SERVICE (RHS)
GUARANTEED RURAL HOUSING (GRH)

Guaranteed Rural Housing Lender Record Change
(See reverse side for Instructions)
MAIL TO:

Guaranteed Loan Branch
Rural Development, USDA
Attn: FC 350
PO Box 200011
St. Louis, MO 63120-0011
Effective Date of Transfer:

All Blocks, A-D are required to be completed by the transferor.
A. Transferor (The Lender who is transferring the loan(s) and/or servicing of the loan(s). i.e. where the loan is being transferred from):
USDA Assigned Branch Number:

Lender Tax ID:
Lender Name:
Address:
State:

City:

Zip Code:

B. Holding Lender (The RHS approved Lender who will be holding/owning the mortgage note after the effective date of transfer; i.e. Fannie Mae, Freddie Mac,
etc., not Ginnie Mae; See Instructions on back):

Agency Assigned Branch Number:

Lender Tax ID:
Lender Name:
Address:
State:

City:

Zip Code:

C. Servicing Lender (The lender that will be servicing the loan(s) after the effective date of transfer):
Agency Assigned Branch Number:

Lender Tax ID:
Lender Name:
Address:
State:

City:

Zip Code:

D. Borrower Information (If more than one (1) borrower, you may attach a list with all of the following information):
This Loan was securitized into a Ginnie Mae Pool

Borrower's Social Security Number:

(Mark an X in the box if loan is securitized into a Ginnie Mae pool)

Borrower's Name:
Address:
City:

State:

Zip Code:

As the lender selling or transferring the servicing of the above loan(s), We certify that the information in this submission is true and correct, and that all loans sold
were sold to an RHS approved lender.

(Signature of Authorized Lender Representative/Official)

Date

(Please PRINT Authorized Lender Representative/Official's Name)

Telephone Number

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.