9xxxM - Survey Aff 9xxxM - Survey Affidavit of No Change (7-20-22)

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Survey Affidavit of No Change - Multifamily

U.S. Department of Housing and Urban Development Office of Housing

OMB Approval No. (Exp. //)

Public Reporting Burden for this collection of information is estimated to average 0.5 hours 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. Response to this request for information is required in order to receive the benefits to be derived. This agency may not collect this information, and you are not required to complete this form unless it displays a currently valid OMB control number. While no assurance of confidentiality is pledged to respondents, HUD generally discloses this data only in response to a Freedom of Information Act request.

Warning: Any person who knowingly presents a false, fictitious, or fraudulent statement or claim in a matter within the jurisdiction of the U.S. Department of Housing and Urban Development is subject to criminal penalties, civil liability, and administrative sanctions.

The undersigned ("Affiant") being first duly sworn on oath does hereby depose, represent and say to the U.S. Department of Housing and Urban Development ("HUD"): as follows:

Affiant is the [insert title] ___________ of _____________ (“Borrower”) and is fully and well acquainted and knowledgeable concerning the physical characteristics and condition of the real estate legally described on Exhibit A attached hereto and made a part hereof and the buildings, structures and improvements (collectively the "Improvements") located thereon;

Said real estate and Improvements are part of the HUD Project named ___________ and designated HUD Project Number __________;

On _________________, _____________________ ("Surveyor") surveyed said real estate and Improvements and produced a written survey dated ________________ and identified as job, survey or order number ______________ of the surveying firm of _______________________________________________________ whose address is ______________________________________________________________________ ("Survey"). On ____________ an original of said Survey was delivered to HUD;

On _____________, the Affiant reviewed said Survey and physically inspected said real estate and Improvements including, without limitation, the perimeter boundaries of said real estate;

The Survey accurately and fully depicts the observable physical conditions of said real estate and the location and condition of all Improvements and any above ground physical indicia of any easements, licenses, roadways, paths or other physical usage located on said real estate as of _____ [the date of Affiant's said inspection] including, without limitation, all encroachments thereof on or into easements and set back lines and by Improvements primarily located on adjoining real estate onto the real estate described on Exhibit A hereto; EXCEPT [if none, state “NONE”] _____________.

{The following statement must appear on the same page as the executed signature for the Affiant.}

The signatory below certifies that all of the information provided in this affidavit and in any accompanying documentation is true, accurate, and complete, has been made, presented, and delivered for the purpose of influencing an official action of HUD, and may be relied upon by the HUD as a true statement of the facts contained therein. The signatory below acknowledges that the submission of any false, fictitious, or fraudulent statement, representation, or certification in this affidavit or on any accompanying documents may result in criminal, civil, and/or administrative sanctions, including fines, penalties, and/or imprisonment under applicable federal law.

AFFIANT:

By: ___________________________

Name:

Title:

Date:

I, the undersigned, a Notary Public in and for the county and State aforesaid, do hereby certify that ____________________, personally known to me to be the same person whose name is subscribed to the foregoing instrument, appeared before me this day in person and severally acknowledged that (s)he signed and delivered the said instrument as his/her free and voluntary act and purposes therein set forth. GIVEN under my hand and official seal this ______ day of _______________, 20__. (SEAL) Notary Public

Survey Affidavit of No Change –

Multifamily HUD-9xxxxM (x/xx)