26-6850A Notice of Default and Intention to Foreclose

OMB Approved No. 2900-0021
Respondent Burden: 20 minutes

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.
1. DATE OF THIS
NOTICE

NOTE: VA LIN
(loan
identification
number) must
be numeric 12

2. VA LIN

3. PURPOSE OF LOAN (Check one)
HOME (1)

HOME REFINANCING (5)

HOME CONDO (0)
MANUFACTURED HOME (8)
5.HOLDER’S NAME, ADDRESS AND TELEPHONE NUMBER

4. To (Complete Regional Office/Center Address)
DEPARTMENT OF VETERANS AFFAIRS
LOAN GUARANTY DIVISION

6A. SERVICING AGENT’S NAME, ADDRESS AND TELEPHONE
NUMBER (Complete only if different from holder shown
above)

6B. SERVICER CODE
(6 Digits)

DESCRIPTION OF DELINQUENT LOAN
7. SERVICER LOAN NUMBER

NOTE: Enter number only
without spaces, dashes, etc.
DO NOT ENTER MORE
THAN 14 CHARACTERS

NOTE: In item 10A
enter last name,
comma, first name,
and middle initial.
Limit entries in Items
10A, 10B and 10C
to not more than
25 characters.

MONTH

DAY

9. SOCIAL SECURITY
NO.(Present Owners)

YEAR

10A. NAME OF PRESENT OWNER

11. COUNTY OR PARISH (Property Location)

10B. NUMBER AND STREET OR RURAL ROUTE

12. PROPERTY ADDRESS (If different than 10B and 10C)

10D.
ZIP
CODE
15. ORIGINAL VETERAN’S NAME AND PRESENT
ADDRESS (If different than Items 10A,10B and 10C above)

10C. CITY AND STATE

14. DATE OF FIRST PAYMENT
(Per loan instruments)

EXAMPLE: Enter
02 01 86 for
February 1, 1986

8. DATE OF FIRST UNCURED
DEFAULT (Example: enter
02 01 86 for February 1, 1986

MONTH

DAY

13. AMOUNT OF EACH INSTALLMENT
PRINCIPAL AND INTEREST

$

TAX AND INSURANCE
YEAR

OTHER

16. OTHER DEFAULT (Specify, real estate, taxes,
insurance, special assessments, etc.)

17.
AMOUNT
OF
DEFAULT

PRINCIPAL

$
TOTAL
18. OUTSTANDING LOAN BALANCE
A. AS OF: (Date)
B. AMOUNT

$

INTEREST
TAX AND INSURANCE

TOTAL

$

$

19. OCCUPANCY DATA
A. IS PROPERTY OCCUPIED? B. OCCUPANT IS (Check One)
YES

NO

ORIGINAL BORROWER

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

YES
20.

TENANT

OTHER (Specify)

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

TRANSFEREE

E. POSSIBILITIES OF CURING DEFAULT HAVE BEEN EXHAUSTED?

F. WERE OTHER TRANSFEREES INVOLVED?

YES
NO (If "No," explain in Item 27)
B. LAST KNOWN ADDRESS
C. NAME

NO
A. NAME

NO (If "Yes,"complete Item 20)
YES
D. LAST KNOWN ADDRESS

OTHER
TRANSFEREE
DATA

21.
REPOSSESSION
AND/OR

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

C. ESTIMATED COST OF 22. VOLUNTARY CONVEYANCE DATA
FORECLOSURE AND/0R (Is deed in lieu of foreclosure or voluntary
REPOSSESSION
conveyance of the security obtainable)
YES

FORECLOSURE

NO

HOLDERS LOAN SERVICING
23.

TYPE

CONTACT(S)

NUMBER

24. DATES OF PROPERTY 25. CONDITION OF PROPERTY
INSPECTIONS

LETTER/WIRE

WITH

FACE TO FACE

MORTGAGOR

TELEPHONE
A. MONTHLY
INCOME

26.

B. MONTHLY
OBLIGATIONS

C. ATTITUDE TOWARD DEFAULT

D. PLACE OF EMPLOYMENT

E. WORK
F. HOME
TELEPHONE NO. 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)

VA FORM
JAN 2007

26-6850a

HOLDER

29. SIGNATURE OF AUTHORIZED OFFICIAL

SERVICING AGENT
EXISTING STOCKS OF VA FORM 26-6850a, JUL 1996,
WILL BE USED.

(SEE REVERSE)

VA COPY 1

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
and 36.4330.

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.whitehouse.gov/library/omb/OMBINV.VA.EPA.html#VA. If desired, you can call
1-800-827-1000 to get information on where to send comments or suggestions about this form.

OMB Approved No. 2900-0021
Respondent Burden: 20 minutes

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.
1. DATE OF THIS
NOTICE

NOTE: VA LIN
(loan
identification
number) must
be numeric 12

2. VA LIN

3. PURPOSE OF LOAN (Check one)
HOME (1)

HOME REFINANCING (5)

HOME CONDO (0)
MANUFACTURED HOME (8)
5.HOLDER’S NAME, ADDRESS AND TELEPHONE NUMBER

4. To (Complete Regional Office/Center Address)
DEPARTMENT OF VETERANS AFFAIRS
LOAN GUARANTY DIVISION

6A. SERVICING AGENT’S NAME, ADDRESS AND TELEPHONE
NUMBER (Complete only if different from holder shown
above)

6B. SERVICER CODE
(6 Digits)

DESCRIPTION OF DELINQUENT LOAN
7. SERVICER LOAN NUMBER

NOTE: Enter number only
without spaces, dashes, etc.
DO NOT ENTER MORE
THAN 14 CHARACTERS

NOTE: In item 10A
enter last name,
comma, first name,
and middle initial.
Limit entries in Items
10A, 10B and 10C
to not more than
25 characters.

MONTH

DAY

9. SOCIAL SECURITY
NO.(Present Owners)

YEAR

10A. NAME OF PRESENT OWNER

11. COUNTY OR PARISH (Property Location)

10B. NUMBER AND STREET OR RURAL ROUTE

12. PROPERTY ADDRESS (If different than 10B and 10C)

10D.
ZIP
CODE
15. ORIGINAL VETERAN’S NAME AND PRESENT
ADDRESS (If different than Items 10A,10B and 10C above)

10C. CITY AND STATE

14. DATE OF FIRST PAYMENT
(Per loan instruments)

EXAMPLE: Enter
02 01 86 for
February 1, 1986

8. DATE OF FIRST UNCURED
DEFAULT (Example: enter
02 01 86 for February 1, 1986

MONTH

DAY

13. AMOUNT OF EACH INSTALLMENT
PRINCIPAL AND INTEREST

$

TAX AND INSURANCE
YEAR

OTHER

16. OTHER DEFAULT (Specify, real estate, taxes,
insurance, special assessments, etc.)

17.
AMOUNT
OF
DEFAULT

PRINCIPAL

$
TOTAL
18. OUTSTANDING LOAN BALANCE
A. AS OF: (Date)
B. AMOUNT

$

INTEREST
TAX AND INSURANCE

TOTAL

$

$

19. OCCUPANCY DATA
A. IS PROPERTY OCCUPIED? B. OCCUPANT IS (Check One)
YES

NO

ORIGINAL BORROWER

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

YES
20.

TENANT

OTHER (Specify)

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

TRANSFEREE

E. POSSIBILITIES OF CURING DEFAULT HAVE BEEN EXHAUSTED?

F. WERE OTHER TRANSFEREES INVOLVED?

YES
NO (If "No," explain in Item 27)
B. LAST KNOWN ADDRESS
C. NAME

NO
A. NAME

NO (If "Yes,"complete Item 20)
YES
D. LAST KNOWN ADDRESS

OTHER
TRANSFEREE
DATA

21.
REPOSSESSION
AND/OR

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

C. ESTIMATED COST OF 22. VOLUNTARY CONVEYANCE DATA
FORECLOSURE AND/0R (Is deed in lieu of foreclosure or voluntary
REPOSSESSION
conveyance of the security obtainable)
NO

YES

FORECLOSURE

HOLDERS LOAN SERVICING
23.

TYPE

CONTACT(S)

NUMBER

24. DATES OF PROPERTY 25. CONDITION OF PROPERTY
INSPECTIONS

LETTER/WIRE

WITH

FACE TO FACE

MORTGAGOR

TELEPHONE
A. MONTHLY
INCOME

26.

B. MONTHLY
OBLIGATIONS

C. ATTITUDE TOWARD DEFAULT

D. PLACE OF EMPLOYMENT

E. WORK
F. HOME
TELEPHONE NO. 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)

VA FORM
JAN 2007

26-6850a

HOLDER

29. SIGNATURE OF AUTHORIZED OFFICIAL

SERVICING AGENT
EXISTING STOCKS OF VA FORM 26-6850a, JUL 1996,
WILL BE USED.

(SEE REVERSE)

SERVICER’S COPY 2

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
and 36.4330.

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.whitehouse.gov/library/omb/OMBINV.VA.EPA.html#VA. If desired, you can call
1-800-827-1000 to get information on where to send comments or suggestions about this form.