HUD 92900-A HUD/VA ddendum to Uniform Residential Loan Application

OMB Approval No.

HUD/VA Addendum to Uniform Residential Loan Application
Part I - Identifying Information (mark the type of application)
VA Application for Home Loan Guaranty

VA: 2900-0144 (exp. 11/30/2016)
HUD: 2502-0059 (exp. 04/30/2017)

2. Agency Case No. (include any suffix)

4. Section of the Act
(for HUD cases)

3. Lender/Mortgagee Case No.

HUD/FHA Application for Insurance
under the National Housing Act

5. Borrower's Name & Present Address (Include zip code)

8. Interest Rate

7. Loan Amount (include the UFMIP if for HUD
or Funding Fee if for VA)

$

9. Proposed Maturity

%

10. Discount Amount
(only if borrower is
permitted to pay)

11. Amount of Up Front
Premium

$

$

6. Property Address (including name of subdivision, lot & block no. & zip code)

13. Lender/Mortgagee I.D. Code

15. Lender/Mortgagee Name & Address (include zip code)

yrs.

12a. Amount of Monthly
Premium

mos.

12b.Term of Monthly
Premium

/ mo.

mos.

14. Sponsor / Agent I.D. Code

16. Name & Address of Sponsor / Agent

17. Lender/Mortgagee Telephone Number

Type or Print all entries clearly

FHA Sponsored
Originations

Name of Loan Origination Company

Tax ID of Loan Origination Company

NMLS ID of Loan Origination Company

VA: The veteran and the lender hereby apply to the Secretary of Veterans Affairs for Guaranty of the loan described here under Section 3710, Chapter 37, Title
38, United States Code, to the full extent permitted by the veteran’s entitlement and severally agree that the Regulations promulgated pursuant to Chapter
37, and in effect on the date of the loan shall govern the rights, duties, and liabilities of the parties.

18. First Time
Homebuyer?

a.
b.

19. VA Only
Title will be Vested in:

Yes
No

20. Purpose of Loan (blocks 9 - 12 are for VA loans only)

Veteran

1)

Purchase Existing Home Previously Occupied

7)

Construct Home (proceeds to be paid out during construction)

Veteran & Spouse

2)

Finance Improvements to Existing Property

8)

Finance Co-op Purchase

Other (specify)

3)

Refinance (Refi.)

9)

Purchase Permanently Sited Manufactured Home

4)

Purchase New Condo. Unit

10)

Purchase Permanently Sited Manufactured Home & Lot

5)

Purchase Existing Condo. Unit

11)

Refi. Permanently Sited Manufactured Home to Buy Lot

6)

Purchase Existing Home Not Previously Occupied

12)

Refi. Permanently Sited Manufactured Home/Lot Loan

HUD Instructions: The capitalized terms used in the following sections of this form refer to those terms as used in the relevant sections of the current version of Single Family Housing Policy Handbook, HUD 4000.1.

Part II – Lender/Mortgagee Certification
21. The undersigned lender/mortgagee makes the following certifications to induce the Department of Veterans Affairs to issue a certificate of commitment to guarantee the subject loan or a Loan Guaranty
Certificate under Title 38, U.S. Code, or to induce the Department of Housing and Urban Development - Federal Housing Commissioner to issue a firm commitment for mortgage insurance or a Mortgage
Insurance Certificate under the National Housing Act.
A. The loan terms furnished in the final Uniform Residential Loan Application and this Addendum are true, accurate and complete.
B. (1) The information contained in the initial Uniform Residential Loan Application and this Addendum was obtained from the Borrower by an employee of the undersigned lender/mortgagee or its duly
authorized agent and is to the best of lender/mortgagee’s knowledge true, complete and accurate as of the date the Borrower provided the information to the undersigned lender/mortgagee or its duly
authorized agent.
(2) The information contained in the final Uniform Residential Loan Application, which was signed by the Borrower at the time of settlement, was obtained by an employee of the undersigned
lender/mortgagee or its duly authorized agent is to the best of lender/mortgagee’s knowledge true, complete and accurate as of the date verified by the lender/mortgagee.
C. The credit report submitted on the subject Borrower (and Co-Borrower, if any) was ordered by the undersigned lender/mortgagee or its duly authorized agent from the credit agency which prepared the
report and was received directly from said credit agency.
D. The Verifications of Employment, Deposit, Rent and Mortgage, as applicable, were requested and received by the lender/mortgagee or its duly authorized agent without passing through the hands of
the Borrower or any Interested Third Party and are to the best of lender/mortgagee’s knowledge true.
E. (1) To the best of my knowledge, neither I nor any parties to this transaction are suspended, debarred, under a limited denial of participation, or otherwise restricted under 2 CFR part 2424, or under
similar procedures of any other federal agency.
(2) The lender/mortgagee involved in this transaction is not suspended, debarred, under a limited denial of participation, or otherwise restricted under 2 CFR part 2424 or 24 CFR part 25, or under
similar procedures of any other federal agency.
Items "F" through "H" are to be completed as applicable for VA loans only.
F. The names and functions of any duly authorized agents who developed on behalf of the lender/mortgagee any of the information or supporting credit data submitted are as

follows:
Name & Address

Function (e.g., obtained information on the Uniform Residential Loan Application, ordered credit report,
verifications of employment, deposits, etc.)

If no agent is shown above, the undersigned lender/mortgagee affirmatively certifies that all information and supporting credit data were obtained directly by the lender/mortgagee.
G.
H.

The undersigned lender/mortgagee understands and agrees that it is responsible for the omissions, errors, or acts of agents identified in item F as to the functions with which
they are identified.
The proposed loan conforms otherwise with the applicable provisions of Title 38, U.S. Code, and of the regulations concerning guaranty or insurance of loans to veterans.

Signature of Officer of Lender/Mortgagee

Title of Officer of Lender/Mortgagee

Date (mm/dd/yyyy)

WARNING: This warning applies to all certifications made in this document.
The knowing submission of a false, fictitious, or fraudulent certification may be subject to criminal and civil penalties, including confinement for up to 5 years, fines, and civil penalties. 18 U.S.C. §§ 287, 1001 and 31 U.S.C. §3729
page 1

Form HUD-92900-A (04/2015)
VA Form 26-1802a (06/2014)

Part III - Notices to Borrowers
Public reporting burden for this collection of information is estimated to average 6 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 agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless that collection displays a valid OMB control number can be
located on the OMB Internet page at http://www.reginfo.gov/public/do/PRAMain. Privacy Act Information: The information requested on the Uniform Residential Loan Application and this Addendum is authorized by 38 U.S.C. 3710 (if
for DVA) and 12 U.S.C. 1701 et seq. (if for HUD/FHA). The Debt Collection Act of 1982, Pub. Law 97-365, and HUD’s Housing and Community Development Act of 1987, 42U.S.C. 3543, require persons applying for a federally
insured or guaranteed loan to furnish his/her social security number (SSN). You must provide all the requested information, including your SSN. HUD and/or VA may conduct a computer match to verify the information you
provide. HUD and/or VA may disclose certain information to Federal, State and local agencies when relevant to civil, criminal, or regulatory investigations and prosecutions. It will not otherwise be disclosed or released outside of HUD
or VA, except as required and permitted by law. The information will be used to determine whether you qualify as a mortgagor. Any disclosure information outside VA or HUD/FHA will be made only as permitted by law. Failure to
provide any of the requested information, including SSN, may result in disapproval of your loan application. This is notice to you as required by the Right to Financial Privacy Act of 1978 that VA or HUD/FHA has a right of access to
financial records held by financial institutions in connection with the consideration or administration of assistance to you. Financial records involving your transaction will be available to VA and HUD/FHA without further notice or
authorization but will not be disclosed or released by this institution to another Government Agency or Department without your consent except as required or permitted b y law. Caution. Delinquencies, defaults, foreclosures and
abuses of mortgage loans involving programs of the Federal Government can be costly and detrimental to your credit, now and in the future. The lender in this transaction, its agents and assigns as well as the Federal Government,
its agencies, agents and assigns, are authorized to take any and all of the following actions in the event loan payments become delinquent on the mortgage loan described in the attached application: (1) Report your name and
account information to a credit bureau; (2) Assess additional interest and penalty charges for the period of time that paymen t is not made; (3) Assess charges to cover additional administrative costs incurred by the Government to
service your account; (4) Offset amounts owed to you under other Federal programs; (5) Refer your account to a private attorney, collection agency or mortgage servicing agency to collect the amount due, foreclose the mortgage, sell
the property and seek judgment against you for any deficiency; (6) Refer your account to the Department of Justice for litigation in the courts; (7) If you are a current or retired Federal employee, take action to offset your salary, or civil
service retirement benefits; (8) Refer your debt to the Internal Revenue Service for offset against any amount owed to you as an income tax refund; and (9) Report any resulting written off debt of yours to the Internal Revenue Service
as your taxable income. All of these actions can and will be used to recover any debts owed when it is determined to be in the interest of the lender and/or the Federal Government to do so.

Part IV - Borrower Consent for Social Security Administration to Verify Social Security Number
I authorize the Social Security Administration to verify my Social Security number to the Lender identified in this document and HUD/FHA, through a computer match conducted by HUD/FHA.
I understand that my consent allows no additional information from my Social Security records to be provided to the Lender, and HUD/FHA and that verification of my Social Security number
does not constitute confirmation of my identity. I also understand that my Social Security number may not be used for any other purpose than the one stated above, including resale or
redisclosure to other parties. The only other redisclosure permitted by this authorization is for review purposes to ensure that HUD/FHA complies with SSA's consent requirements.
I am the individual to whom the Social Security number was issued or that person's legal guardian. I declare and affirm under the penalty of perjury that the information contained herein is true
and correct. I know that if I make any representation that I know is false to obtain information from Social Security records, I could be punished by a fine or imprisonment or both.
This consent is valid for 180 days from the date signed, unless indicated otherwise by the individual(s) named in this loan application.
Read consent carefully. Review accuracy of social security number(s) and birth dates provided on this application.
Signature(s) of Borrower(s)
Date Signed

/

Signature(s) of Co - Borrower(s)

Date Signed

/

/

Part V - Borrower Certification

Is it to be sold?

22. Complete the following for a HUD/FHA Mortgage.
22a. Do you own or have you sold other real estate within the

Yes

No

past 60 months on which there was a HUD/FHA mortgage?
22d. Address:

Yes

No

/

22b. Sales Price

22c. Original Mortgage Amt

$

$

NA

22e. If the dwelling to be covered by this mortgage is to be rented, is it a part of, adjacent or contiguous to any project subdivision or group of concentrated rental properties involving

eight or more dwelling units in which you have any financial interest?
Yes
No If “Yes” give details.
Yes
No If “Yes” submit form HUD-92561.
23. Complete for VA-Guaranteed Mortgage. Have you ever had a VA home Loan?
Yes
No
IMPORTANT: If you are certifying that you are married for the purpose of VA benefits, your marriage must be recognized by the place where you and/ or your spouse resided at the
time of marriage, or where you and/or your spouse resided when you filed your claim (or a later date when you become eligible for benefits) (38 U.S.C. § 103(c)). Additional guidance
on when VA recognizes marriages is available at http://www.va.gov/opa/marriage/.
24. Applicable for Both VA & HUD. As a home loan borrower, you will be legally obligated to make the mortgage payments called for by your mortgage loan contract. The fact that you
dispose of your property after the loan has been made will not relieve you of liability for making these payments. Payment of the loan in full is ordinarily the way liability on a
mortgage note is ended. Some home buyers have the mistaken impression that if they sell their homes when they move to another locality, or dispose of it for any other reasons,
they are no longer liable for the mortgage payments and that liability for these payments is solely that of the new owners. Even though the new owners may agree in writing to assume
liability for your mortgage payments, this assumption agreement will not relieve you from liability to the holder of the note which you signed when you obtained the loan to buy the
property. Unless you are able to sell the property to a buyer who is acceptable to VA or to HUD/FHA and who will assume the payment of your obligation to the lender, you will not be
relieved from liability to repay any claim which VA or HUD/FHA may be required to pay your lender on account of default in your loan payments. The amount of any such claim
payment will be a debt owed by you to the Federal Government. This debt will be the object of established collection procedures.
25. I, the Undersigned Borrower(s) Certify that:
22f. Do you own more than four dwellings?

(1)
(2)

(3)

I have read and understand the foregoing concerning my liability on the loan
and Part III Notices to Borrowers.
Occupancy: HUD Only
I, the Borrower or Co-Borrower will occupy the property within 60 days of
signing the security instrument, and intend to continue occupancy for at least
one year.
I do not intend to occupy the property as my primary residence.
Occupancy: VA Only
(a.) I now actually occupy the above-described property as my home or
intend to move into and occupy said property as my home within a
reasonable period of time or intend to reoccupy it after the completion
of major alterations, repairs or improvements.
(b.) My spouse is on active military duty and in his or her absence; I occupy
or intend to occupy the property securing this loan as my home.
(c.) I previously occupied the property securing this loan as my home. (for
interest rate reduction loans).
(d.) While my spouse was on active military duty and unable to occupy the
property securing this loan, I previously occupied the property that is
securing this loan as my home. (for interest rate reduction loans).
Note: If box 2b or 2d is checked, the veteran's spouse must also sign
below.
(e.) The veteran is on active military duty and in his or her absence, I certify
that a dependent child of the veteran occupies or will occupy the
property securing this loan as their home.
Note: This requires that the veteran's attorney-in-fact or legal guardian
of the dependent child sign the Borrower’s Certificate below.
(f.) While the veteran was on active military duty and unable to occupy the
property securing this loan, the property was occupied by the veteran's
dependent child as his or her home (for interest rate reduction loans).
Note: This requires that the veteran’s attorney-in-fact or legal guardian
of the dependent child sign the Borrower’s Certificate below.
Mark the applicable box (not applicable for Home Improvement or
Refinancing Loan) I have been informed that ($
) is :

The reasonable value of the property as determined by VA or;
The statement of appraised value as determined by HUD / FHA

(4)

(5)

(6)
(7)

Note: If the contract price or cost exceeds the VA “Reasonable Value" or HUD/FHA
"Statement of Appraised Value", mark either item (a) or item (b), whichever is applicable.
(a.) I was aware of this valuation when I signed my contract and I have paid or will pay in
cash from my own resources at or prior to loan closing a sum equal to the difference
between the contract purchase price or cost and the VA or HUD/FHA established
value. I do not and will not have outstanding after loan closing any unpaid
contractual obligation on account of such cash payment;
(b.) I was not aware of this valuation when I signed my contract but have elected to
complete the transaction at the contract purchase price or cost. I have paid or will
pay in cash from my own resources at or prior to loan closing a sum equal to the
difference between contract purchase price or cost and the VA or HUD/FHA
established value. I do not and will not have outstanding after loan closing any
unpaid contractual obligation on account of such cash payment.
I and anyone acting on my behalf are, and will remain, in compliance with the Fair Housing
Act, 42 U.S.C. 3604, et seq., respect to the dwelling or property covered by the loan and in
the provision of services or facilities in connection therewith. I recognize that any restrictive
covenant on this property related to race, color, religion, sex, disability, familial status,
national origin, marital status, age, or source of income is illegal and void. I further
recognize that in addition to administrative action by HUD, a civil action may be brought by
the Attorney General of the United States in any appropriate U.S. court against any person
responsible for a violation of the applicable law.
All information in this application is given for the purpose of obtaining a loan to be insured
under the National Housing Act or guaranteed by the Department of Veterans Affairs and
the information in the Uniform Residential Loan Application and this Addendum is true and
complete to the best of my knowledge and belief. Verification may be obtained from any
source named herein.
For HUD Only (for properties constructed prior to 1978) I have received information on
lead paint poisoning.
Yes
Not Applicable
I am aware that neither HUD / FHA nor VA warrants the condition or value of the
property.

Signature(s) of Borrower(s) – Do not sign unless this application is fully completed. Read the certifications carefully and review accuracy of this application.
Signature(s) of Co - Borrower(s)
Date Signed
Signature(s) of Borrower(s)
Date Signed

/

/

/
page 2

/

Form HUD-92900-A (04/2015)
VA Form 26-1802a (06/2014)

U.S. Department of Housing
and Urban Development

Direct Endorsement Approval for a HUD/FHA-Insured Mortgage
1. Borrower's Name & Present Address (Include zip code)

2. Property Address

3. Agency Case No. (include any suffix)

Approved:
Date Mortgage Approved

Modified &
approved
as follows:

Loan Amount (include UFMIP)

Date Approval Expires
Interest Rate

$

Proposed Maturity

%

Yrs.

Mos.

Monthly Payment

Amount of
Up Front Premium

Amount of Monthly
Premium

$

$

$

Term of Monthly
Premium

Mos.

Owner Occupancy NOT required
All conditions of Approval have been satisfied

_____

This mortgage was rated as an “accept” or “approve” by FHA's TOTAL Mortgage Scorecard. As such, the undersigned representative of the
mortgagee certifies that the mortgagee reviewed the TOTAL Mortgage Scorecard findings and that this mortgage meets the Final Underwriting
Decision (TOTAL) requirements for approval. The undersigned representative of the mortgagee also certifies that all information entered into
TOTAL Mortgage Scorecard is supported by information obtained by the mortgagee and as a result, the data submitted to FHA’s TOTAL Mortgage
Scorecard is true, complete and accurate.
Mortgagee Representative:
Signature:__________________________________

Printed Name/Title: ____________________________________

And if applicable:
This mortgage was rated as an “accept” or “approve” by FHA's TOTAL Mortgage Scorecard and the undersigned Direct Endorsement underwriter
certifies that I have personally reviewed and underwritten the appraisal according to standard FHA requirements.
__________________________________
Direct Endorsement Underwriter Signature

_________________
DE's CHUMS ID Number

OR
_____

This mortgage was rated as a “refer” by a FHA's TOTAL Mortgage Scorecard, or was manually underwritten by a Direct Endorsement underwriter.
As such, the undersigned Direct Endorsement Underwriter certifies that I have personally reviewed the appraisal report (if applicable), credit
application, and all associated documents used in underwriting this mortgage. I further certify that:

I have approved this loan and my Final Underwriting Decision was made having exercised the required level of Care and Due Diligence;

I have performed all Specific Underwriter Responsibilities for Underwriters and my underwriting of the borrower’s Credit and Debt, Income,
Qualifying Ratios and Compensating Factors, if any, and the borrower’s DTI with Compensating Factors, if any, are within the parameters
established by FHA and the borrower has assets to satisfy any required down payment and closing costs of this mortgage; and

I have verified the Mortgage Insurance Premium and Mortgage Amount are true and correct and this loan is in an amount that is permitted by
FHA for this loan type, property type, and geographic area.
__________________________________
Direct Endorsement Underwriter Signature

The Mortgagee, its owners, officers, employees or directors
builder or seller involved in this transaction.

_________________
CHUMS ID Number

(do)

(do not) have a financial interest in or a relationship, by affiliation or ownership, with the

page 3

Form HUD-92900-A (04/2015)
VA Form 26-1802a (06/2014)

Borrower's Certification:
The undersigned certifies that:
(a.) I will not have outstanding any other unpaid obligations contracted in connection with the mortgage transaction or the purchase of the said

property except obligations which are secured by property or collateral owned by me independently of the said mortgaged property, or
obligations approved by the Commissioner;
(b.) One of the undersigned intends to occupy the subject property (note: this item does not apply if owner-occupancy is not required by the
commitment);
(c.) All charges and fees collected from me as shown in the settlement statement have been paid by my own funds, gift funds, or acceptable
Down Payment Assistance program funds, and no other charges have been or will be paid by me in respect to this transaction.
Borrower'(s) Signature(s) & Date

Mortgagee's Certification:
The Mortgagee by and through the undersigned certifies that to the best of its knowledge:
(a) The loan terms, loan type, property address, Borrower information including names, social security number, credit scores, marital status,
employment status, and Borrower occupancy status, in its application for insurance and in this Certificate are true and correct;
(b) All loan approval conditions appearing in any outstanding commitment issued under the above case number have been fulfilled and this
loan closed in a manner consistent with the lender/mortgagee’s approval;
(c) Complete disbursement of the loan has been made to the Borrower, or to his/her creditors for his/her account and with his/her consent and
any escrow has been established in accordance with applicable law;
(d) The note and security instrument are in a form acceptable to HUD and the security instrument has been recorded and is a good and valid
first lien on the property described;
(e) No charge has been made to, or paid by the Borrower, except as permitted under HUD regulations;
(f) The copies of the credit and security instruments which are submitted herewith are true and exact copies as executed and filed for record;
(g) It has not paid any kickbacks, fee or consideration of any type, directly or indirectly, to any party in connection with this transaction except
as permitted under HUD regulations and administrative instructions.
I, the undersigned authorized representative of the mortgagee certify that I have personally reviewed the mortgage documents, closing statements,
application for insurance endorsement, and all accompanying documents and request the endorsement of this mortgage for FHA insurance.
Mortgagee

Note: If the approval is executed by an agent
in the name of the mortgagee, the agent must
enter the mortgagee’s code number and type.

Name and Title of the Mortgagee's Officer

Code Number (5 digits)
Signature of the Mortgagee's Officer

Type

Date

page 4

Form HUD-92900-A (04/2015)
VA Form 26-1802a (06/2014)