HUD-50115 Lender Submission Contact Sheet

Loan Guarantees for Indian Housing

HUD-50115 Lender Submission Contact Sheet

Loan Guarantees for Indian Housing

OMB: 2577-0200

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Lender Submission Contact Sheet

(to be submitted with ALL Firm Commitment submissions and ALL LG Cert submissions)


Lender Info

Lender Name: _______________________________________________________________

Submitter’s Name: ____________________________________________________________

Submitter’s Phone #: __________________________________________________________

Submitter’s Email: ____________________________________________________________

Submitter’s Fax #: ____________________________________________________________

Fax # for Firm Commitments (if different): __________________________________________

Underwriter Name: ____________________________________________________________

Underwriter’s Email: ___________________________________________________________

Underwriter’s Fax #: ___________________________________________________________

Borrower Info

Section 184 Case #:___________________________________________________________

Section 184 Cohort # (if applicable): _____________________________________________

Borrower Name: _____________________________________________________________

Co-borrower Name: ___________________________________________________________

Tribal Affiliation: ______________________________________________________________


Type of Submission (CIRCLE): Firm Commitment OR Loan Guarantee OR Test Case

Type of Land (CIRCLE): Fee Simple OR Tribal Trust OR Allotted




HUD-50115 (09/2012)





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AuthorMatthew Douglas
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