HUD-50114 Land Status and Jurisdiction Form

LAND STATUS AND JURISDICTION FORM

SECTION 184 INDIAN HOUSING LOAN GUARANTEE PROGRAM

HUD, OFFICE OF NATIVE AMERICAN PROGRAMS

APPLICANT NAME: ____________________________________

CO-APPLICANT NAME: _________________________________

LENDER: _____________________________________________

TRIBE: _______________________________________________

PROPOSED PROPERTY ADDRESS/LOCATION: _______________________________________

_____________________________________________________________________________________

LAND STATUS:

_____ TRIBAL TRUST LAND

_____ FEE SIMPLE LAND

_____ ALLOTTED OR INDIVIDUAL TRUST LAND

_____ RESTRICTED FEE

_____ LAND ASSIGNMENT

_____ TRIBAL LEASEHOLD

DOES THE TRIBE HAVE A TRIBAL COURT SYSTEM: ____ YES ____ NO

IF YES, DOES THE TRIBAL COURT SYSTEM HAVE JURISDICTION TO HEAR FORECLOSURE AND/OR EVICTION CASES FOR THE PROPOSED SITE:

____ YES _____ NO

SIGNATURE OF TRIBAL OFFICIAL: __________________________________

TITLE/NAME OF TRIBE: __________________________________

DATE: __________________________________

HUD-50114 (09/2012)