Land Mortgage Lender Loan Checklist

OMB# 1076-NEW

Expiration XX-XXXX

Land Mortgage Lender Loan Checklist

Instructions for the Trust Land Mortgage Checklist

We are committed to providing prompt and courteous service in the processing of a mortgage request. In order to help expedite this process the following checklist is provided for your convenience.

This checklist guides you through submitting documents to BIA for a mortgage request review and to provide you with general guidance for documents required for a complete package.

Place a checkmark in each box as the documentation is added to the package contents. Write N/A in the space to the right of the unnecessary items to indicate they are not pending and the review is complete. We recommend submitting an electronic copy of the package, however, we will accept a paper copy. Contact information for Regional and Agency Offices can be found at https://www.bia.gov/regional-offices.

The documentation should be gathered and completed for all borrowers listed on the loan request. The required documentation may vary by loan type, lender, program, and borrower circumstances. Additional documentation may be required after initial submission. Documents listed may or may not apply to all packages since required documents are based on each borrower’s situation and application type.

Land Mortgage Lender Loan Checklist

COMPANY INFORMATION
Borrower(s) Name(s) and Address, City, State, Zip:
Lender Name and mailing address:
Lender phone number:
Lender fax number:
Request Received date:
Lender Email Address:
Loan Amount:
Allotment Name and Number:

CHECKLIST*                                                                                                                       Notes
☐	Commitment Letter Stating Loan Terms and Conditions, loan purpose (rehab, new construction, refinance, consolidation, purchase)
☐	Original/Certified Copy of Satisfaction, if this is a request for refinance
☐	Copy of borrower’s Application (signed by borrower(s))
☐	Copy of the Lender’s Appraisal
☐	Authorization/Consent to Share Information with BIA (if applicable)
☐	NEPA review (if applicable)
☐	Survey(s)/Site Reports/Site Assessments (if applicable)
☐	Preliminary Site Plan Drawings (if applicable)
☐	ROW Ingress/Egress (if applicable)
☐	Certified Title Status Report (TSR)
☐	Draft mortgage/deed of trust, promissory note, and any applicable riders
☐	Loan Program Utilized (HUD 184, VA, etc.) [Could be stated in the commitment letter stating loan terms and conditions].
☐	Statement: Borrower is not delinquent on Federal debt  (HUD 184 only).
☐	Proof of Employment
☐	Request Certified Title Status Report (with new mortgage noted)

*BIA reserves the right to request additional information as needed.

Paperwork Reduction Act (PRA) Statement: This information is collected to meet reporting requirements and is subject to the PRA. An agency may not request nor sponsor, and a person need not answer a request for information that does not display a valid OMB control no. A response to this request is required to obtain a benefit. The public reporting burden for this form is estimated to average 20 hours per response, including the time for reviewing the instructions, gathering and maintaining data, and completing and reviewing the form. Send comments on the burden estimate or any other aspect of this form to Information Collection Clearance Officer–Indian Affairs, 1849 C Street, NW, MS-3642, Washington, DC 20240.

#19-02, Issued: 3

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