HUD-434 Statement of Taxes

Statement of Taxes

Street Address of Property

County

Kind of Tax
or Assessment

Public reporting burden for this collection of information 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.
This agency may not conduct or sponsor, and a person is not required to respond to, a collection
information unless that collection displays a valid OMB control number.

Name and Mailing Address of Owner

City

For Year

OMB Approval No. 2502-0418 (exp. 06/30/2021)

U.S. Department of Housing and Urban Development
Office of Housing - Federal Housing Commissioner

State

Tax Year
MM/DD/YYYY MM/DD/YYYY

HUD uses this information to update its records of the mortgagor’s real estate taxes, the location
(lot and block numbers) of the property, taxes due dates, and penalty dates. The information
can be used to verify the last taxes paid during an audit for insurance benefits. This information
is required by Statute 12 USC 1713(g) and Title II, Section 207(g) of the National Housing Act.
The debtors a protected by the Privacy Act of 1974. There is no sensitive information be
collected.

Project Number

Date(s) Payable
Annual Amount

Penalty Date(s)

How Paid?

Date Tax Paid

in installments,indicate which
installments have been paid.

Official to Whom Payable
(Title and Address)

Quarterly
Semi-Annually
Annually
Quarterly
Semi-Annually
Annually
Quarterly
Semi-Annually
Annually
Quarterly
Semi-Annually
Annually
Quarterly
Semi-Annually
Annually
Quarterly
Semi-Annually
Annually
Quarterly
Semi-Annually
Annually
Quarterly
Semi-Annually
Annually
Use this space to give complete information for each kind of tax and penalties which are charged for failure to pay bills before delinquent dates. If no bills are rendered, Property description
describe fully the procedure to determine taxes of assessments charged against a property. Give all additional information o
obtainable regarding local tax rules and
(as shown on assessment roll)
regulations. Tax bills for each kind of tax, whether paid or unpaid, and tax receipts should be forwarded with this form
form.

Certification:I certify that the information provided on this form and in any accompanying documentation is true and accurate. Warning: I acknowledge that making, presenting, or submitting a false, fictitious
, or fraudulent statement, representation, or certification may result in criminal, civil, and/or administrative sanctions, including, fines, penalties, and imprisonment.
Send original and 1 copy to the:

Use as many copies of this form as necessary.

Signature of Attorney or other person acting for mortgagee

Date

U.S. Department of Housing and Urban Development
Multifamily Claims Branch, HWAFRC, Room 6252
451 7th Street, SW
Washington, D.C. 20410 - 8000

form HUD-434 (12/09)
ref. Handbook 4110.2