VA Form 26-6851 Notice of Intention to Foreclose

OMB Approved No. 2900-0021
Respondent Burden: 15 minutes
Expiration Date: XX/XX/XXXX

NOTICE OF INTENTION TO FORECLOSE
(SUBMIT ORIGINAL ONLY BY CERTIFIED MAIL)

VA LOAN NUMBER

SERVICER'S LOAN NUMBER

DATE OF THIS NOTICE

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 15
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.

To (Complete Regional Office/Center Address)

1A. HOLDER’S NAME, ADDRESS, AND TELEPHONE NUMBER

1B. NAME AND TELEPHONE NUMBER OF PROPERTY OWNER

1C. SERVICING AGENT’S NAME, ADDRESS, AND PHONE NUMBER (Complete only

2. ORIGINAL VETERAN BORROWER (Name and present or last known

3A. LOCATION OF PROPERTY

DEPARTMENT OF VETERANS AFFAIRS
LOAN GUARANTY DIVISION

if different from holder shown in Item 1A above)

address if different from Item 1B)

3B. PURPOSE OF LOAN
HOME (1)

HOME (5)

HOME (0)

MANUFACTURED
HOME (8)

(Refinancing)

(Condominium)
4. DATE OF FIRST UNCURED DEFAULT

5. POSSIBILITIES OF CURING DEFAULT HAVE BEEN EXHAUSTED?
YES

NO

6. WERE OTHER TRANSFEREES INVOLVED?

(If "NO," explain in Item 12)

YES

NO

(If "YES," complete as much
as possible of Item 7)

7. OTHER TRANSFEREE DATA
NAME

LAST KNOWN ADDRESS

SOCIAL SECURITY NUMBER

8. REPOSSESSION AND/OR FORECLOSURE DATA
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)

10. TOTAL AMOUNT OF DELINQUENCY

C. ESTIMATED COST OF
FORECLOSURE AND/
OR REPOSSESSION

A. DATE

B. AMOUNT

11. IS DEED IN LIEU OF FORECLOSURE OR VOLUNTARY CONVEYANCE OF THE SECURITY
OBTAINABLE?
YES

A. PRINCIPAL

9. UNPAID BALANCE OF LOAN INCLUDING
UNPAID ACCRUED INTEREST

NO
12. HOLDER’S LOAN SERVICING

A. CONTACT(S) WITH MORTGAGOR

B. INTEREST
C. CHARGES

TYPE

(Under 38 CFR 36.4246(a)
or 36.4313(a))

NUMBER

B. SUMMARY OF LOAN SERVICING SINCE NOTICE
OF DEFAULT WAS GIVEN

LETTER/WIRE
FACE TO FACE
TELEPHONE

D. TOTAL DELINQUENCY

13. OCCUPANCY DATA
A. IS PROPERTY OCCUPIED?
YES

NO

B. OCCUPANT IS (Check)
ORIGINAL BORROWER

C. IF VACANT, KEYS TO PROPERTY MAY BE OBTAINED FROM:

TRANSFEREE

TENANT

OTHER (Specify)

D. NAME OF OCCUPANT (If other than original borrower)

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

NO

14. NAME AND TITLE OF AUTHORIZED OFFICIAL
HOLDER
SERVICING AGENT
VA FORM
XXXX

26-6851

15. SIGNATURE OF AUTHORIZED OFFICIAL