VA Form 26-6850a Notice of Default and Intention to Foreclose

OMB Control No. 2900-0021
Respondent Burden: 20 minutes
Expiration Date: XX-XX-XXXX

NOTICE OF DEFAULT AND INTENTION TO FORECLOSE
INSTRUCTIONS: See Privacy Act Information on reverse. Type or print. Note the special instructions for Items 2, 7, 10 and 14. For 38 CFR 36.4600 loans
use VA Form 26-6850, NOTICE OF DEFAULT. Return copy 1 to VA. Copy 2 may be retained.
NOTE: VA LIN
2. VA LIN
(loan identification
number) must be
numeric 12 digits.
4. To (Complete Regional Office/Center Address)
DEPARTMENT OF VETERANS AFFAIRS
LOAN GUARANTY DIVISION

3. PURPOSE OF LOAN (Check one)

1. DATE OF THIS NOTICE

HOME (1)

HOME REFINANCING (5)

HOME CONDO (0)

MANUFACTURED HOME (8)

5. HOLDER'S NAME, ADDRESS AND TELEPHONE NUMBER

6A. SERVICING AGENT'S NAME, ADDRESS AND
TELEPHONE NUMBER (Complete only if different from

6B. SERVICER CODE
(6 Digits)

holder shown above)

DESCRIPTION OF DELINQUENT LOAN

NOTE: Enter number only without 7. SERVICER LOAN NUMBER 8. DATE OF FIRST UNCURED
9. SOCIAL SECURITY
MONTH
DAY
YEAR
spaces, dashes, etc.
NO. (Present Owners)
DEFAULT (Example: enter 02
DO NOT ENTER MORE
01 86 for February 1, 1986)
THAN 14 CHARACTERS
10A. NAME OF PRESENT OWNER
11. COUNTY OR PARISH (Property Location)
NOTE: In item 10A
enter last name, comma,
first name, and middle
10B. NUMBER AND STREET OR RURAL ROUTE
12. PROPERTY ADDRESS (If different than 10B and 10C)
initial. Limit entries in
Items 10A, 10B and 10C
10C. CITY AND STATE
10D. ZIP CODE
to not more than
13. AMOUNT OF EACH INSTALLMENT
25 characters.
15. ORIGINAL VETERAN'S NAME AND PRESENT
ADDRESS (If different than Items 10A,10B and

14. DATE OF FIRST PAYMENT

(Per loan instruments)

EXAMPLE: Enter
02 01 86 for
February 1, 1986

MONTH

DAY

10C above)

YEAR

TAX AND INSURANCE
OTHER

insurance, special assessments, etc.)

17.
AMOUNT
OF
DEFAULT

$

PRINCIPAL

A. AS OF: (Date)

B. AMOUNT

INTEREST
TAX AND INSURANCE
TOTAL

$

$

19. OCCUPANCY DATA
A. IS PROPERTY
OCCUPIED?

B. OCCUPANT IS (Check One)

NO

21.
REPOSSESSION
AND/OR
FORECLOSURE

C. KEYS TO PROPERTY MAY BE OBTAINED FROM: (If vacant)

TRANSFEREE

E. POSSIBILITIES OF CURING DEFAULT HAVE BEEN EXHAUSTED?

NO

20. OTHER
TRANSFEREE
DATA

OTHER (Specify)

TENANT

ORIGINAL BORROWER

D. IF VACANT, HAVE STEPS BEEN TAKEN TO
PROTECT PROPERTY?
YES

$

TOTAL

18. OUTSTANDING LOAN BALANCE

16. OTHER DEFAULT (Specify, real estate, taxes,

YES

$

PRINCIPAL AND INTEREST

YES

NO

F. WERE OTHER TRANSFEREES INVOLVED?

(If "No," explain in Item 27)

A. NAME

B. LAST KNOWN ADDRESS

C. NAME

A. PROCEEDINGS WILL BE
INSTITUTED ON OR
AFTER (Date)

B. PROCEEDINGS UNDER EMERGENCY
PROVISIONS OF 38 CFR 36.4280(e) or
36.4317(A) WERE INSTITUTED ON (Date)

C. ESTIMATED COST OF
FORECLOSURE AND/
OR REPOSSESSION

NO (If "Yes," complete Item 20)

YES

D. LAST KNOWN ADDRESS

22. VOLUNTARY CONVEYANCE DATA

(Is deed in lieu of foreclosure or voluntary
conveyance of the security obtainable)
YES

NO

HOLDERS LOAN SERVICING
23.
CONTACT(S)
WITH
MORTGAGOR

TYPE

24. DATES OF PROPERTY
INSPECTIONS

25. CONDITION OF PROPERTY

FACE TO FACE
TELEPHONE
A. MONTHLY
INCOME

26.

NUMBER

LETTER/WIRE

B. MONTHLY
OBLIGATIONS

C. ATTITUDE TOWARD DEFAULT

D. PLACE OF EMPLOYMENT

E. WORK
TELEPHONE NO.

F. HOME
TELEPHONE NO.

BORROWER
SPOUSE
27. REASON FOR DEFAULT AND SUMMARY OF LOAN SERVICING (Must give complete details to support conclusion that forbearance is not warranted.

Include description of broken repayment schedules or other arrangements, etc.) (If additional space is needed, continue on reverse)

28. NAME AND TITLE OF AUTHORIZED OFFICIAL (Type or Print)

HOLDER

29. SIGNATURE OF AUTHORIZED OFFICIAL

SERVICING AGENT
VA FORM
XXXX

26-6850a

(SEE REVERSE) Distribution Copy List:

PRIVACY ACT INFORMATION: VA will not disclose information collected on this form to any source other than what has been
authorized under the Privacy Act of 1974 or Title 38, Code of Federal Regulations 1.576 for routine uses (e.g., to a member of Congress
inquiring on behalf of a veteran) as identified in the VA system of records, 55VA26, Loan Guaranty Home, Condominium and
Manufactured Home Loan Applicant Records, Specially Adapted Housing Applicant Records, and Vendee Loan Applicant Records VA, and published in the Federal Register. Your obligation to respond is mandatory under 38 CFR 36.4315, 36.4317.
RESPONDENT BURDEN: We need this information to determine compliance with the applicable reporting requirements of VA
regulations. We estimate that you will need an average of 20 minutes to review the instructions, find the information, and complete this
form. VA cannot conduct or sponsor a collection of information unless a valid OMB control number is displayed. You are not required
to respond to a collection of information if this number is not displayed. Valid OMB control numbers can be located on the OMB
Internet Page at www.reginfo.gov/public/do/PRAMain. If desired, you can call 1-800-827-1000 to get information on where to send
comments or suggestions about this form.

VA FORM 26-6850a, JAN 2007