HUD-90092 HUD Multifamily and Healthcare Loan Sale Qualification S

HUD MULTIFAMILY AND
HEALTHCARE LOAN SALE
QUALIFICATION STATEMENT

U. S. Department of Housing and
Urban Development

OMB Approval No. 2502-0576
(exp. 04/30/2024)

Office of Housing
Federal Housing Commissioner

Public Reporting Burden for this collection of information is estimated to average .25 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. HUD may not conduct and sponsor, and a person is not required to respond to, a collection of information unless
the collection displays a valid OMB control number. The collection of information is necessary to ensure that bidders are qualified to bid
on the assets available for sale. HUD will use the information to: (1) monitor program participants’ compliance with requirements, and (2)
to detect fraud. The information requested is required to obtain and retain benefits. HUD is authorized to collect this information under
Section 204 of the Departments of Veterans Affairs and Housing and Urban Development, and Independent Appropriations Act of 1997
(12 U.S.C 1715z-11a) and 24 C.F.R. Part 290. No assurance of confidentiality is pledged to respondents, although HUD generally
discloses this data only in response to a Freedom of Information Act request to the extent required by law. Send comments regarding this
burden estimate or any other aspect of this collection of information, including suggestions to reduce this burden, to the Reports
Management Officer, REE, Department of Housing and Urban Development, 451 7th Street, SW, Room 4176, Washington, DC 204105000. When providing comments, please refer to OMB Approval No. 2502-0576.

The United States Department of Housing and Urban Development (“HUD”) is planning to offer
certain HUD-held notes and mortgages secured by multifamily projects and/or healthcare facilities (the
“Mortgage Loans”) in Multifamily and/or Healthcare Loan Sale (MHLS/HLS) _____ (the “Loan Sale”). The
undersigned understands and acknowledges that, before it can register for the Loan Sale, it must meet certain
requirements to be a “qualified bidder.” The undersigned understands further that the information requested
herein is being requested for the purpose of providing HUD with information to determine whether the
undersigned is a qualified bidder. All or part of the information provided on this form may also be subject to
disclosure under the Privacy Act of 1974, 5 U.S.C. § 552(a). The Department of Housing and Urban
Development (HUD) is authorized to collect this information under 12 U.S.C. § 1715z-11a and 24 C.F.R.
Part 290. Providing the requested information is voluntary; however, failure to furnish all of the requested
information may result in the prospective purchaser, or agent, if any, not being permitted to bid at the Loan
Sale or other loan sale initiatives and/or not receiving notice of future loan sale initiatives.
The following information is being solicited in order to determine if the individual or entity listed
below is qualified to bid. Hereinafter and for the purposes of this document, the individual or entity
seeking to be a qualified bidder in the Loan Sale is referred to as “Purchaser.” This information will also
be used to prepare the transfer documents if the qualified bidder ultimately bids and is determined to be
the successful bidder:

HUD MULTIFAMILY AND
HEALTHCARE LOAN SALE
QUALIFICATION STATEMENT

U. S. Department of Housing and
Urban Development

OMB Approval No. 2502-0576
(exp. xx/xx/xxxx)

Office of Housing
Federal Housing Commissioner

I. Purchaser Information (identify Purchaser exactly as the name will appear on the Confidentiality
Agreement, Loan Sale Agreement, and other Loan Sale documents; all Loan Sale documents must be
executed by the same qualified bidder):
A.

Name of Purchaser Entity (or Individual, if Purchaser is purchasing in its individual capacity)
B.

Corporate or Partnership Designation and State of Formation/Origination (if applicable)
C.

D.

Address of Purchaser

City, State, Zip Code

E.

F.
Phone

Facsimile

G.

H.
Purchaser Tax I.D

I.

E-mail Address

Please check the description that best describes Purchaser’s business designation:
__

__

Commercial Bank
Savings Association/Bank
Mortgage Banker
Investment Bank
Real Estate Company
Project Mortgagor

Insurance Company
__
Financial Services Company
__ Pension Fund
Individual
__
__ Healthcare Operator
Non-Profit
Other, please describe

II. Purchaser Qualification. The undersigned understands that if it is determined to be a “qualified bidder”
for the Loan Sale, its status as such does not necessarily mean that it will be a “qualified bidder” for any other
loans or assets offered in any other HUD sale. The undersigned also understands that its status as a “qualified
bidder” for any other HUD sale does not necessarily mean that it will be a “qualified bidder” for the Loan
Sale. Purchaser hereby certifies, represents and warrants to HUD that it is a “qualified bidder” based upon
Purchaser’s satisfaction of one or more of the following qualifying statements 1 through 8. Purchaser must
check one or more of the following qualifying statements 1 through 8 to qualify as a

HUD MULTIFAMILY AND
HEALTHCARE LOAN SALE
QUALIFICATION STATEMENT

U. S. Department of Housing and
Urban Development

OMB Approval No. 2502-0576
(exp. xx/xx/xxxx)

Office of Housing
Federal Housing Commissioner

“qualified bidder” for the Mortgage Loans being sold in the Loan Sale. (CHECK ALL THAT ARE
APPROPRIATE):
( ___ ) 1.

Purchaser is a corporation, partnership, limited liability company or business trust with
total assets in excess of $5,000,000, or a wholly-owned subsidiary of such an entity, and
was not formed for the specific purpose of acquiring the Mortgage Loans to be offered
for sale at the Loan Sale.

( ___ ) 2.

Purchaser is a bank (as defined in Section 15 U.S.C. § 77c(a)(2), of the Securities Act of
1933, as amended (the “Exchange Act”)); savings and loan association or other
institution (as referenced in Section 15 U.S.C. § 77c(a)(5), of the Exchange Act);
insurance company (as defined in Section 15 U.S.C. § 77b(a)(13) of the Exchange Act);
investment company registered under or business development company as defined in
the Investment Company Act of 1940, 15 U.S.C. § 80a–2(a)(48), as amended; Small
Business Investment Company licensed by the U.S. Small Business Administration
under Section 15 U.S.C. § 661 in the Small Business Investment Act of 1958, as
amended; or a broker or dealer registered under Section 15 U.S.C. § 78l(a) of the
Securities Exchange Act of 1934 as amended.

( ___ ) 3.

Purchaser is a trust with total assets in excess of $5,000,000 not formed for the specific
purpose of acquiring the Mortgage Loans to be offered for sale at the Loan Sale, whose
investment decisions are directed by a person who has such knowledge and experience in
financial and business matters that he or she is capable of evaluating the merits and risks
of purchasing the Mortgage Loans offered for sale at the Loan Sale.

( ___ ) 4.

Purchaser is a business entity, all of whose equity owners are either entities that are
“accredited investors” as defined in Section 15 U.S.C. §77b(a)(15) the Exchange Act or
individuals who (i) have a net worth, or joint net worth with his or her spouse, in excess of
$1,000,000, or (ii) had an individual income in excess of $200,000 in each of the two most
recent years or joint income with that person’s spouse in excess of $300,000 in each of
those years, and has a reasonable expectation of reaching the same level of income in the
current year.

( ___ ) 5.

Purchaser is an individual (i) whose individual net worth, or joint net worth with his or her
spouse, currently exceeds, and at the time of purchase of the Mortgage Loans will exceed,
$1,000,000, or (ii) who had an individual income in excess of $200,000 in each of the two
most recent years or joint income with that person’s spouse in excess of $300,000 in each
of those years, and has a reasonable expectation of reaching the same level of income in
the current year.

( ___ ) 6.

Purchaser either (i) is in the business of buying, originating or selling some or all of the

HUD MULTIFAMILY AND
HEALTHCARE LOAN SALE
QUALIFICATION STATEMENT

U. S. Department of Housing and
Urban Development

OMB Approval No. 2502-0576
(exp. xx/xx/xxxx)

Office of Housing
Federal Housing Commissioner

types of mortgage loans being offered for sale in this Loan Sale or (ii) otherwise deals in
the ordinary course of Purchaser’s business in assets identical or similar to the types of
mortgage loans being offered for sale in this Loan Sale.
( ___ ) 7.

Purchaser is a mortgagor, or healthcare operator with respect to any HUD insured or
subsidized mortgage loans (excluding the Mortgage Loans being offered in the Loan
Sale). (If checking only this box, Purchaser must meet the requirements in
Paragraphs AL, inclusive, below to be qualified to bid). Please list any applicable
HUD insured or subsidized mortgage loan(s) here:
FHA Project No.

( ___ ) 8.

Project Name

Purchaser is a shareholder, a limited partner or a non-managing member (including tax
credit investors) with respect to any Mortgage Loan being offered in the Loan Sale.
Purchaser certifies that Purchaser has the requisite knowledge and experience with respect
to such Mortgage Loan and the property securing the Mortgage Loan to enable Purchaser
to evaluate the merits and risks of a purchase of and to make an informed decision with
respect to the Mortgage Loan. (If checking only this box, Purchaser must meet the
requirements in Paragraphs A-I and L-N, inclusive, to be qualified to bid).
Please list any applicable Mortgage Loan(s) here:
FHA Project No.

Project Name

HUD MULTIFAMILY AND
HEALTHCARE LOAN SALE
QUALIFICATION STATEMENT

U. S. Department of Housing and
Urban Development

OMB Approval No. 2502-0576
(exp. xx/xx/xxxx)

Office of Housing
Federal Housing Commissioner

By executing this Qualification Statement, Purchaser certifies, represents and warrants to
HUD that EACH of the following statements A through and including N is true and
correct as to such Purchaser:
A.
Purchaser is a sophisticated person or entity and, without limiting the foregoing, has such
knowledge and experience in the origination, sale and/or purchase of performing and
non-performing or distressed loans, including, without limitation, loans secured by real
estate, as well as knowledge and experience, by itself or with its advisers, in other
financial and business matters, as to enable Purchaser to utilize the information available
in connection with the Loan Sale to evaluate the merits and risks of a prospective
acquisition and ownership of the Mortgage Loans and to make an informed decision with
respect thereto.
B.

Purchaser acknowledges, understands and is able to bear the economic risks associated with
the acquisition and ownership of the Mortgage Loans, including, without limitation, the risk
of a total loss of Purchaser’s purchase price for and other costs and expenses and losses as
might be incurred in connection with the Mortgage Loans and/or the risk that Purchaser may
be required to hold the Mortgage Loans for an indefinite period of time.

C.

Purchaser acknowledges and agrees that, whether or not it chooses to review any
information made available to it regarding the Mortgage Loans being offered for sale at
the Loan Sale, Purchaser has the ability and shall be responsible for making its own
independent investigation and evaluation of the Mortgage Loans and the economic, credit
or other risks involved in a purchase of the Mortgage Loans, including, without
limitation, the ability to resell or otherwise liquidate any of the Mortgage Loans
purchased at the Loan Sale.

D.

Purchaser is bidding for and will purchase the Mortgage Loans for its own account and
not for or with a view toward resale (in whole or in part) in a “distribution” within the
meaning of the Act, and Purchaser’s ownership and intended use and disposition of the
Mortgage Loans will comply fully with all applicable federal and state laws, regulations
and requirements, including, without limitation, any and all laws and/or restrictions
imposed on resale of the Mortgage Loans by federal and state securities or Blue Sky laws,
rules, regulations or requirements.

E.

Purchaser represents and warrants that it will not cause or allow any interest it acquires
in any Mortgage Loan, or any interest it may ultimately acquire in the project secured by
the Mortgage Loan, to be resold or assigned, in whole or in part, by real interest or
beneficial interest, to any individual or entity who is (i) a mortgagor, including their
principals, affiliates, and assigns, with respect to the Mortgage Loan being offered in the
Loan Sale; (ii) an FHA-approved mortgagee, including any principals, affiliates, or

HUD MULTIFAMILY AND
HEALTHCARE LOAN SALE
QUALIFICATION STATEMENT

U. S. Department of Housing and
Urban Development

OMB Approval No. 2502-0576
(exp. xx/xx/xxxx)

Office of Housing
Federal Housing Commissioner

assigns thereof, that has received FHA insurance benefits directly or indirectly for the
same Mortgage Loan being offered in the Loan Sale; (iii) an FHA-approved mortgagee
and/or loan servicer, including any principals, affiliates, or assigns thereof, that originated
the Mortgage Loan being offered in the Loan Sale if the Mortgage Loan defaulted within
two years of origination and resulted in the payment of an FHA insurance claim; (iv) an
Active Shareholder, or a healthcare operator, including their principals, affiliates, assigns,
and family member(s), with respect to the Mortgage Loan being offered in the Loan Sale.
For the purposes of this document, Active Shareholder means any individual shareholder,
or any entity that is comprised of a shareholder(s), with respect to a Mortgage Loan or the
project securing such Mortgage Loan, provided such shareholder(s) had an investment in
the Mortgage Loan or the project securing such Mortgage Loan being offered for sale in
this Loan Sale within the two year period prior to and up through the date of the Loan
Sale, and whose investment is more than 1 percent (1%) individually, or more than ten
percent (10%) collectively; (v) a mortgagor or a healthcare operator, including their
principals, affiliates, and assigns, with respect to any HUD insured or subsidized mortgage
loan (excluding the Mortgage Loan being offered in the Loan Sale) unless the
requirements of provisions K and L herein have been met; (vi) a shareholder whose
investment in the Mortgage Loan or the project securing the Mortgage Loan provided
such shareholder’s investment was one percent (1%) or less within the two year period
prior to and up through the date of the Loan Sale, limited partner or non-managing
member (including tax credit investors), unless the requirements of provision N herein
have been met; or (vii) any other entity or individual that is excluded from bidding in
provision G below; and (viii) Purchaser represents and warrants that it will cause any
subsequent purchaser, assign, owner (including any beneficial interest owner) to adhere
to this paragraph E for a term of not less than five (5) years from the date the sale of the
Mortgage Loan closes.
F.

G.

Purchaser acknowledges and agrees that (i) the proposed sale of the Mortgage Loans in the
Loan Sale does not involve, nor is it intended in any way to constitute, the sale of a “security”
within the meaning of the Act or any applicable federal or state securities laws, (ii) no
inference as to whether the Mortgage Loans are or are not “securities” under such federal or
state securities laws shall be drawn from any of the certifications, representations or warranties
made by Purchaser in this Qualification Statement for purposes of qualifying Purchaser as a
“qualified bidder” at the Loan Sale, (iii) it is not contemplated that any filing will be made
with the Securities and Exchange Commission or pursuant to the Blue Sky or securities laws
of any jurisdiction, and (iv) if the Mortgage Loans are securities, they may not be resold or
otherwise transferred by Purchaser except in accordance with any and all applicable securities
and Blue Sky laws.
Purchaser represents and warrants that it is not: (i) a mortgagor, including its principals,
affiliates, family members, and assigns, with respect to the Mortgage Loans

HUD MULTIFAMILY AND
HEALTHCARE LOAN SALE
QUALIFICATION STATEMENT

U. S. Department of Housing and
Urban Development

OMB Approval No. 2502-0576
(exp. xx/xx/xxxx)

Office of Housing
Federal Housing Commissioner

being offered in the Loan Sale; (ii) a mortgagor, including its principals, affiliates,
family members, and assigns, with respect to any HUD insured or subsidized mortgage
loan (excluding the Mortgage Loans being offered in the Loan Sale) who is in violation,
default, or noncompliance with any HUD mortgage, regulatory or business agreement
that cannot satisfy the requirements of provisions K and L herein; (iii) an individual or
entity that is debarred, suspended, or excluded from doing business with HUD pursuant
to Title 2 of the Code of Federal Regulations, Part 2424; (iv) a contractor, subcontractor
and/or consultant or advisor (including any agent, employee, partner, director, principal
or affiliate of any of the foregoing) who performed services for, or on behalf of, HUD in
connection with the Loan Sale; (v) an FHA-approved mortgagee, including any
principals, affiliates, or assigns thereof, that has received FHA insurance benefits for the
Mortgage Loans being offered in the Loan Sale; (vi) an FHA-approved mortgagee
and/or loan servicer, including any principals, affiliates, or assigns thereof, that
originated the Mortgage Loans being offered in the Loan Sale if the Mortgage Loan(s)
defaulted within two years of origination and resulted in the payment of an FHA
insurance claim; (vii) a healthcare operator with respect to the Mortgage Loans being
offered in the Loan Sale, including its principals, affiliates, assigns, or member(s) of
such individuals’ family and its Related Party; (viii) an employee of HUD, a member of
such employee’s household, or an entity owned or controlled by any such employee or
member of such an employee’s family; (ix) a limited partner or non-managing member
(including tax credit investors), including any of its principals, affiliates, assigns, or
member(s) of such individual(s)’s family, with respect to the Mortgage Loans being
offered for sale in the Loan Sale that cannot satisfy the requirements of provisions A-I
and L-N, inclusive; (x) an Active Shareholder, or a healthcare operator, including their
principals, affiliates, assigns, and family member(s), with respect to the Mortgage Loans
being offered in the Loan Sale or (xi) an individual or entity that uses the services,
directly or indirectly, of any person or entity ineligible under subsections (i) through (x)
above to assist in preparing its bid on the Mortgage Loans.
In addition, (xii) Purchaser represents and warrants that (A) within the two-year period
prior to the Bid Date, as provided for in the Loan Sale documents, it has not, and it is
not an affiliate, principal or employee of any person or entity that, within such two-year
period, serviced any of the Mortgage Loans or performed other services for or on
behalf of HUD with respect to any of the Mortgage Loans, (B) within the two year
period prior to the Bid Date, as provided for in the Loan Sale documents, it was not a
contractor or subcontractor to and it did not otherwise have access to information
concerning the Mortgage Loans or provide services to any person or entity which,
within such two-year period, had access to information with respect to the Mortgage
Loans, and (C) no employee, officer, director or any other person that provides or will
provide services to Purchaser with respect to such Mortgage Loans during any
warranty period established for the Loan Sale, within the two-

HUD MULTIFAMILY AND
HEALTHCARE LOAN SALE
QUALIFICATION STATEMENT

U. S. Department of Housing and
Urban Development

OMB Approval No. 2502-0576
(exp. xx/xx/xxxx)

Office of Housing
Federal Housing Commissioner

year period prior to the Bid Date, as provided for in the Loan Sale documents, (C-i)
serviced any of the Mortgage Loans or performed other services for or on behalf of
HUD with respect to any of the Mortgage Loans or (C-ii) had access to
information concerning the Mortgage Loans or provided services to any person or
entity which, within such two-year period, serviced, performed services for HUD
or otherwise had access to information with respect to the Mortgage Loans.
If Purchaser satisfies any of the criteria identified in subsections (i)(xii) above, Purchaser is ineligible to bid in the Loan Sale.
H.

Purchaser acknowledges and agrees that HUD has the right to request additional or updated
information at any time, including, without limitation, financial statements, bank
references, corporate brochures, experience resume, etc., and/or confirmation of the
representations, warranties and certifications made herein, and, in its sole discretion, to
refuse to qualify any prospective bidder who, in HUD’s sole judgment, does not have the
requisite financial capability to complete the purchase of the Mortgage Loans and/or
knowledge and experience to enable such prospective bidder to evaluate the merits and
risks of purchasing and to make an informed decision with respect to the purchase of the
Mortgage Loans to be offered for sale at the Loan Sale. The undersigned further
understands that this Qualification Statement is being furnished to permit HUD to qualify
Purchaser and, in connection therewith, Purchaser authorizes HUD and its agents to
conduct credit investigations of Purchaser and all principals of Purchaser through
appropriate third-party reporting agencies.

I.

Purchaser represents and warrants that, if it is an entity, it has full authority to deliver
this Qualification Statement and that the individual executing this Qualification
Statement has full authority to do so on behalf of the undersigned and all principals
thereof, and that, to the best of such undersigned’s knowledge, all information provided
herein is true, complete and correct.

J.

If Purchaser is a mortgagor or a healthcare operator with respect to any HUD insured or
subsidized mortgage loans (excluding the Mortgage Loans being offered in the Loan
Sale), Purchaser has identified such mortgage loans under Number 7 above.

K.

If Purchaser is a mortgagor or a healthcare operator with respect to any HUD insured or
subsidized mortgage loans (excluding the Mortgage Loans being offered in the Loan Sale),
before executing this Qualification Statement, Purchaser has submitted to HUD, in
accordance with HUD’s regulations and the regulatory agreements relating to the projects
securing such mortgage loans, the annual audited financial statements for each such
project for the three preceding fiscal years __________________ . If any such audited
financial statements for the three preceding fiscal years for a project securing a mortgage

HUD MULTIFAMILY AND
HEALTHCARE LOAN SALE
QUALIFICATION STATEMENT

U. S. Department of Housing and
Urban Development

OMB Approval No. 2502-0576
(exp. xx/xx/xxxx)

Office of Housing
Federal Housing Commissioner

loan have not already been submitted to HUD, Purchaser must meet the requirement for
electronic submission of the audited financial statements and HUD must receive the
completed Qualification Statement on or before _________________ , the first day of the
month of the Bid Date (the “Deadline”). If HUD did not receive the required financial
statements by the Deadline, Purchaser will be ineligible to bid in the Loan Sale.
Purchaser agrees to provide any additional information relating to such a mortgage loan or
project as HUD may reasonably request in connection with the Loan Sale.
L. _______ If Purchaser or any Related Party, as defined below, is a mortgagor in any of HUD's
multifamily housing programs or a mortgagor or operator in any of HUD’s healthcare
programs (excluding the Mortgage Loans being offered in the Loan Sale) and Purchaser is
not otherwise disqualified under paragraph G above, Purchaser represents and warrants that:
(i) neither Purchaser nor any Related Party is in default (whether monetary or nonmonetary)
under any HUD loan, and neither Purchaser nor any Related Party has been notified by HUD
that it is in violation of, or not in compliance with, any regulatory or business agreements
with HUD; or (ii) if such a default or violation exists, Purchaser shall cure such default or
violation on or before the Deadline. Curing any nonmonetary default means specific
performance in accordance with instructions provided by HUD. Curing any monetary default
includes repaying HUD for any monetary amounts that may have been advanced by HUD
or by an FHA approved mortgagee or servicer that subsequently received FHA insurance
benefits with respect to the Mortgage Loan. If Purchaser does not cure such default or
violation on or before the Deadline, Purchaser will be ineligible to bid in the Loan Sale.
In addition, Purchaser represents and warrants that neither Purchaser nor any Related Party
is flagged in HUD’s Active Partners Performance System (APPS).
If Purchaser or any Related Party is in default under any HUD loan, in violation of any
HUD regulatory or business agreement, or is flagged in APPS, please check the
following line __________and on an attachment submitted with this Qualification Statement
either (A) indicate the FHA loan number, the name of the project, the name of the mortgagor,
and the nature of the default, violation, or flag; or (B) provide a complete listing or
organizational chart of any known Related Party or affiliates. HUD will undertake a review,
to determine whether Purchaser or any Related Party is in default under or has violated any
HUD loan, HUD regulatory agreement or other HUD business agreement, or has been flagged
by HUD in APPS. HUD reserves the right, in its sole and absolute discretion, to refuse to
qualify a prospective bidder if the Purchaser or any Related Party is in default under any HUD
loan, in violation of any HUD regulatory or business agreement, or is flagged in APPS
prospective bidder shall be final and not subject to appeal. Subject to paragraph G above,
if Purchaser does not cure (or cause to be

HUD MULTIFAMILY AND
HEALTHCARE LOAN SALE
QUALIFICATION STATEMENT

U. S. Department of Housing and
Urban Development

OMB Approval No. 2502-0576
(exp. xx/xx/xxxx)

Office of Housing
Federal Housing Commissioner

cured) such violation on or before the Deadline, Purchaser will be ineligible to bid
in the Loan Sale.
For purposes of this Qualification Statement, Related Party shall include any principal of
Purchaser, any affiliate of Purchaser, and any principal of any affiliate of Purchaser. An
affiliate is any party that controls, is controlled by, or is under common control with
Purchaser. A principal in a partnership is any general partner, or a limited partner with a 25%
or greater equity or ownership interest. A principal in a corporation is any officer or director,
and any stockholder with a 10% or greater equity or ownership interest. A principal in a
limited liability company is any manager, officer or director, and any owner with a 10% or
greater equity interest. Purchaser represents and warrants that each Related Party that is a
mortgagor in a HUD multifamily housing program or a mortgagor or operator in a HUD
healthcare program is identified on an attachment submitted with this Qualification
Statement.
M.

If Purchaser is a shareholder, a limited partner or non-managing member (including tax
credit investors) with respect to a Mortgage Loan being offered in the Loan Sale,
Purchaser has checked Number 8 above.

N.

Notwithstanding the definition of Related Party above, if Purchaser checked Number 8
under Part II above, with respect to a Mortgage Loan, Purchaser represents and warrants
that: (i) Purchaser, or any Related Party, is not an Active Shareholder as defined in
paragraph E above; (ii) prior to the loan becoming a HUD-held asset, Purchaser’s and
any of its Related Party’s involvement in the property securing the Mortgage Loan was
solely financial; and (iii) Purchaser and any Related Party did not participate directly or
indirectly in the ongoing management of the property (or properties) securing the
Mortgage Loan.

III. Purchaser Certifications.
HUD and the Purchaser agree that this Qualification Statement may be electronically signed pursuant to
applicable laws governing electronic transactions, including, without limitation, the Electronic
Signatures in Global and National Commerce Act (E-SIGN) (15 U.S.C. 7001 et seq.), and the Uniform
Electronic Transactions Act (UETA). Purchaser acknowledges and agrees that the electronic signature
appearing on this Qualification Statement is equivalent to a handwritten signature for purposes of
validity and enforceability. If Purchaser executes this Qualification Statement via electronic signature,
such party represents and warrants that:
(i) Purchaser has controls in place to ensure compliance with applicable laws governing
electronic transactions, including, without limitation, the E-SIGN Act and UETA, and
electronic records, retained by Purchaser will be stored to prevent unauthorized access to
or unauthorized alteration of the electronic signature and associated records;

HUD MULTIFAMILY AND
HEALTHCARE LOAN SALE
QUALIFICATION STATEMENT

U. S. Department of Housing and
Urban Development

OMB Approval No. 2502-0576
(exp. xx/xx/xxxx)

Office of Housing
Federal Housing Commissioner

(ii) Purchaser’s creation and maintenance of its electronic signature, and storage of its copy of
the fully executed Qualification Statement, will be in compliance with applicable laws
governing electronic transactions to ensure admissibility of such electronic signature and related
electronic records in a legal proceeding;
(iii)Purchaser has controls and systems in place to provide necessary information, including, but
not limited to, Purchaser’s business practices and methods, for record keeping and audit trails,
including audit trails regarding such party’s electronic signature to this Qualification Statement.
Purchaser understands that the above certifications, representations, and warranties are made for the purpose of
qualifying Purchaser as a “qualified bidder” at the Loan Sale.
Purchaser also agrees to update this Qualification Statement submission if any material changes occur that in any
way alters the information and responses provided herein, between the execution date of this Qualification
Statement and the date that Purchaser’s deposit is returned or the date that the sale of the Mortgage Loan closes,
whichever occurs first.
Purchaser hereby represents that the above certifications, representations, and warranties are true and correct in all
respects as of the time they are made and as of the time Purchaser purchases any of the Mortgage Loans offered
for sale at the Loan Sale and understands that HUD is relying upon the truthfulness and correctness of such
statements.

HUD MULTIFAMILY AND
HEALTHCARE LOAN SALE
QUALIFICATION STATEMENT

U. S. Department of Housing and
Urban Development

OMB Approval No. 2502-0576
(exp. xx/xx/xxxx)

Office of Housing
Federal Housing Commissioner

We, the undersigned, certify under penalty of perjury that the information provided above is true, correct,
and accurate. WARNING: Anyone who knowingly submits a false claim or makes a false statement is
subject to criminal and/or civil penalties, including confinement for up to 5 years, fines, and civil and
administrative penalties. (18 U.S.C. §§ 287, 1001, 1010, 1012, 1014; 31 U.S.C. §§ 3729, 3802).
The Purchaser and the person signing on behalf of the Purchaser certify that the information provided on this form
and in any accompanying documentation is true and accurate.
Dated:____________________________
PURCHASER: _____________________________
(Print Name of Purchaser – must match entity name on the
Confidentiality Agreement, Loan Sale Agreement, and other Loan Sale
documents.)
By: __________________________________________
(signature)
Print Name:
Print Title:

Note: Bidder eligibility criteria may change from sale to sale. As a result, some or all of the statements
listed in Section I and II may be utilized for any particular sale. Additionally, HUD’s Office of
Multifamily Housing and/or HUD’s Office of Healthcare Programs may, in their sole discretion,
require additional criteria for any sale. The eligibility criteria for any particular sale will be
determined prior to the date on which potential bidders for that particular sale are able to access
information on any asset being offered in that sale. Once determined and distributed to the potential
bidders, the eligibility criteria may not be changed unless distributed to all potential bidders in an
amendment to this Form 90092 and subsequently acknowledged in writing by each potential bidder.