26-1820 Report and Certification of Loan Disbursement

OMB Control No. 2900-0521
Respondent Burden: 15 minutes

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REPORT AND CERTIFICATION OF LOAN DISBURSEMENT

Department of Veterans Affairs

D

AUTOMATIC PROCEDURE D

PRIOR APPROVAL PROCEDURE

INSTRUCTIONS TO LENDERS: For use by lenders closing VA loans under 38 U.S.C. 3710. After closing of the loan and completion of the form, the
original is to be forwarded to the VA; the duplicate is to be retained by the lender; the triplicate is to be provided to the veteran. Wtth this report, unless
previously submitted to VA, please submit t1ie following: (a) copy of the borrower's loan application to you showing income, assets, and obligations; (b) the
ORIGINAL verification(s) of employment and earnings; (c) ORIGINAL credit report on the borrower and coborrower, if any; (d) ORIGINAL VA Form 26-8937,
Verification of VA Benefit Related Indebtedness; (e) ORIGINAL VA Form 26-0503, Federal Collection Policy Notice; (f) VA Form 26-0551, Debt Questionnaire;
(g) Veteran's Certificate of Eligibility; (h) a copy of the veteran's executed sales or construction contract, as appropriate; (i) ORIGINAL verification of bank
deposit; (j) a true cOEY of the HUD Form 1 or, tf a refmancing loan, a statement of the loan disbursement and costs, showing the fees and costs charged to the
borrower and seller tHUD Form 1 may be used); (k) if the home is of new construction, an executed copy of the builder's warranty, VA Form 26-1859; a copy of
the Master Certificate of Reasonable Value, VA Form 26-1843a and any related endorsements, and a VA or FHA final compliance inspection report. In spectal
cases, such as loans wherein some of the proceeds are to be escrowed to cover the completion of postponed exterior improvements, etc., other attachments to the
report may be necessary. Lenders should consult with the VA regional office in this regard. For refIDancing loans under 38 U.S.C. 3710 (a)(5), provide evidence
of the lien of record on the property and of the veteran's ownershtp of the property. For all loans, submit VA Form 26-8998, Acknowledgment of Receipt of
Funding Fee From Mortgagee, if required.
RESPONDENT BURDEN: We need this information to confirm that the lender has closed the loan in comp.liance with all applicable VA laws and regulations
and that the veteran has entered into the loan with an understanding of all relevant requirements and responstbilities. Title 38, United States Code, allows us to ask
for this information. We estimate that you will need an average of 15 minutes to review the instructions, fmd the information, and complete this form. VA carmot
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 tS not displayed. Valid OMB control numbers can be located on the OMB Internet Page at
www.whitehouse.gov/omb/library/OMBINV.VA.EPA.htrnl#VA. If desired, you can call 1-800-827-1000 to get information on where to send comments or
suggestions about this form.
1. VA LOAN NUMBER

12A. LENDER'S LOAN NUMBER

12B. LENDER'S VA IDENTIFICATION NUMBERI 3. DATE OF REPORT

4A. FIRST NAME - MIDDLE NAME - LAST NAME OF VETERAN

4B. VETERAN'S SOCIAL SECURITY NO.

5. PRESENT ADDRESS OF VETERAN (Include ZiP Code)

6. NAME AND ADDRESS OF RELATIVE NOT LIVING WITH VETERAN (Include ZiP

Code and complete telephone number if available)

This rellPrt of the the lIndeJsilmedJeuder iSJIlade pursuant to Section 3702(C)f Title 38, United States Cod.e. The undersigned lender aud veteran eachdagree that the B.egulatiQns issued
under Chapter 37, Title 3~, Omte :states Code, and III effect on the date 6 the loan shall govern the nghts, duties, aIm Iiabililies of the parlies an IDat any provlsf6ns of the loan
instrumentS jnconSlstent with such Regulations are hereby amended and supplemented to conform thereto and request issuance of evidence of
the loan to the tull extent oermltted bv the veteran's avaflable entitlement.
GUARANTY
INSURANCE

n

SECTION I - PURPOSE, AMOUNT, TERMS AND SECURITY FOR LOAN
7. PURPOSE OF LOAN
DpURCHASE
EXISTING HOME
PREVIOUSLY
OCCUPIED

~REFINANCE

DFINANCE
IMPROVEMENTS
TO EXISTING
PROPERTY

PURCHASE EXISTING
CONDOMINIUM UNIT
D

PURCHASE NEW
CONDOMINIUM UNIT

U PURCHASE EXISTING

D

U CONSTRUCT HOME-

HOME NOT PREVIOUSLY
OCCUPIED
PURCHASE PERMANENTLY D
SITED MANUFACTURED
HOME

8. ADDRESS OF PROPERTY SECURING LOAN (Include lot and block numbers, subdivision name and ZiP Code)

n

U

REFINANCE PERMANENTLY
PROCEEDS TO BE PAID OUT
SITED MANUFACTURED HOME
DURING CONSTRUCTION
TO BUY LOT
PURCHASE PERMANENTLY D REFINANCE PERMANENTLY
SITED MANUFACTURED
SITED MANUFACTURED
HOME AND LOT
HOME/LOT LOAN
19. AMOUNT OF LOAN

$
10. TERMS OF LOAN
A. PRINCIPAL AND INTEREST PAYABLE I B. RATE OF INTEREST PER ANNUM
1C. DATE OF NOTE
EACH PERIOD
E. DATE LOAN WAS CLOSED

D. DATE OF FIRST PAYMENT

H. DATE OF MATURITY

IG. TERM OF LOAN

F. DATE LOAN PROCEEDS FULLY PAID OUT

YEARS
11. TYPE OF LIEN (38 CFR 36.4351)
D
FIRST REALTY D SECOND REALTY D FIRST CHATTEL
MORTGAGE
MORTGAGE
D MORTGAGE
12. TITLE OF PROPERTY IS VESTED IN THE FOLLOWING PERSON(S)

D

D

D

LEASEHOLD (Give expiration date)

14. APPROXIMATE ANNUAL 1
REAL ESTATE TAXES

DOTHER (Specify)

15. INSURANCE

A. HAZARD

I

1

1 16 . ANNUAL
APPROXIMATE
ASSESSMEN

.
B. FLOOD (Where appllc.)

17. TOTAL UNPAID
SPECIAL
ASSESSMENTS

PAYMENT
FACE AMOUNT OF POLICY

$

OTHER (Specify)

OTHER (Specify)

VETERAN
DVETERAN AND SPOUSE D
13. ESTATE IN PROPERTY IS (38 CFR 36.4350)
D FEE SIMPLE

UNSECURED

MONTHS

$

$

ANNUAL PREMIUM

18. ANNUAL MAINTENANCE ASSESSMENT

I $

$

19. DESCRIBE NON REALTY, IF ANY, ACQUIRED WITH PROCEEDS OF LOAN (Attach separate sheet if necessary)

20. DESCRIBE ADDITIONAL SECURITY TAKEN AND LIST OF OTHERS (Including Spouse) LIABLE ON INDEBTEDNESS, IF ANY (Attach separate sheet, ifnecessary)

IF LAND ACQUIRED BY
~'21. DATE ACQUIRED
SEPARATE TRANSACTION
COMPLETE ITEMS
'
21 AND 22

22. PURCHASE PRICE (If acqUired

123. AMOUNT WITHHELD FROM LOAN PROCEEDS AND DEPOSITED IN

other than by purchase, state "None ")
$

D

ESCROW

D

EARMARKED ACCOUNT $

SECTION II - LENDER'S CERTIFICATION
24. I, THE UNDERSIGNED LENDER, CERTIFY THAT:
A. If this loan was closed under the automatic procedure, no default exists which has continued for more than 30 days.
B. The lender has not imposed and will not impose any charges or fees against the veteran borrower in excess of those permissible under the schedule set forth

in paragraph (d) of 38 CFR 36.4312.

C. The information furnished in Section I is true, accurate and complete.
D. The information contained in the loan application was obtained directly from the veteran by an employee of the undersigned lender' or the lender's

duly authorized agent and is true to the best of the lender's knowledge and belief.

E. The credit report submitted on the subject veteran (and coborrower, if any) was ordered by the undersigned lender or the lender's duly authorized agent

directly from the credit bureau which prepared the report and was received directly from said credit bureau.

F. The verification(s) of employment and verification(s) of deposits were requested and received by the lender or the lender's duly authorized agent without

passing through the hands of any third persons and are true to the best of the lender's knowledge and belief.

G. This report was signed by the veteran after Sections I, II and III were completed.
H. VA Forms 26-0503, Federal Collection Policy Notice, and 26-0551, Debt Questionnaire, were signed by the veteran and a signed copy of each was furnished

to the veteran. (NOTE: These forms are not required for loans in which an URLA and HUDIVA Addendum are used.)

I. This loan to the naIned veteran meets the income and credit requirements of the governing law in the jUdgment of the undersigned.
J. The naInes and functions of any duly authorized agents who developed on behalf of the lender any of the information or supporting credit data submitted

are as follows:
.

NAME
ADDRESS
FUNCTION (e.g. obtained information for loan.application;

ordered credit report, verification of employment, verification
of deposits, etc.)
a.
b.

c.
d.

e.

If no agent is shown above, the undersigned lender affirmatively charges that all information and supporting credit data were obtained directly by the lender.

K. The undersigned lender understands and agrees that the lender is responsible for the acts of agents identified in Item 24J as to the functions with which they are identified.
L. The loan conforms with the applicable provisions of Title 38, U. S. Code and the Regulations concerning guaranty or insurance of loans to veterans.
M. COMPLETE WHERE AUTHORIZED BY CERTIFICATE OF REASONABLE VALUE.
D Any construction, repairs, alterations, or improvements upon which the reasonable value of the property is predicated and which were not inspected and approved subsequent
to completion by a compliance inspector designated by the Secretary have been completed properly.
N. If the ioan application has been submitted for the prior approval of the VA, the proceeds of the loan were expended for the purposes described in the loan application or refinancing
proposal originally submitted for the prior approval of the VA and in the aInounts shown in the statement of loan disbursement and costs or HUD Form 1 that is attached to and
incorporated in this report.
VA FORM
DEC 2007

26-1820

SUPERSEDES VA FORM 26-1820, FEB 2004,
WHICH WILL NOT BE USED.

Continued on Reverse

24. Continued

O. Any deviations or changes of identity in the security. of the property from that set forth in the plans and specifications upon
WhICh the original appraisal was based are itemized ill an attachment hereto and have been approved as reqUlred in 38 C.F.R.
36.4304 and have been completed properly.
P. If this is a refinancing loan under section 371Oa(5) of title 38, U.S.C., the veteran's secured liens of record identified on the
property and shown on the loan application, and any debts listed on the application which were not secured by liens of record
and WhICh were to have been retired from the proceeds of the loan, have, ill fact, been paid in full. The amount of cash, if any,
shown as paid to the veteran on the statement of loan disbursement and costs or HUD Form 1 that is attached to and
incorporated in this report was, in fact, disbursed to him or her personally.
Q. If this loan is required to be personally reviewed and approved by a VA-approved underwriter, the name of that underwriter is
as follows:
25A. NAME AND ADDRESS OF LENDER

26A. DATE SIGNED

25B. TELEPHONE NO. OF LENDER

126B. SIGNATURE AND TITLE OF OFFICER OF LENDER

PRIVACY ACT NOTICE: VA wll 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 (i.e., information may be disclosed to Congress when requested on behalf of a veteran for statistical purposes in specific geographic regions)
as identified in the VA system of records, 55VA26, Loan Guaranty Home, Condominium and Manufacmred 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 voluntary, but failure to provide requested information could
impede processing. Giving us your SSN account information is voluntary. Refusal to provide your SSN by itself will not result in the denial of benefits. VA will not deny any
individual benefits for refusing to provide his or her SSN unless the disclosure of the SSN is required by a Federal Starnte of law in effect prior to January I, 1975, and still in effect.
NOTICE TO BORROWERS: This is notice to you as required by the Right to Financial Privacy Act of 1978 that the VA has a right of access to financial records held by financial
institutions in connection with the consideration or administration of assistance to you. Financial records involving your transaction will be available to VA without further notice or
authorization but will not be disclosed or released bv this institution to another Government Agencv or Department without vour consent except as required or permitted bv law.
SECTION III - VETERAN'S CERTIFICATIONS (To be executed by the veteran on the date loan is closed)
27. As a GI home loan borrower you will be legally obligated to make the mortgage payments called for by your mortgage loan contract. The fact that you dispose
of.your property after the loan has been made WILL NOT RELIEVE YOU OF LIABILITY FOR MAKING THESE PAYMENTS.
Some GI home buyers have the mistaken impression that if they sell their homes when they move to another locality, or dispose of it for any other reason, they
are no longer liable for the mortgage payments and that liability for these payments is solely that of the new owners. Even though the new owner may agree in
writing to assume liability for your mortgage payments, this assumption agreement will not relieve you from liability to the holder of the note which you signed
when you obtained the loan to buy the property. Also, unless you are able to sell the property to a credit-worthy obligor who is acceptable to the VA and who
will assume the payment of your obligation to the lender and the Department of Veterans Affairs, you will not be relieved from liability to repay any guaranty
claim which the VA may be required to pay your lender on account of default in your loan payments.
THE AMOUNT OF ANY SUCH CLAIM PAYMENT WILL BE A DEBT OWED BY YOU TO THE FEDERAL GOVERNMENT. This debt will be the
object of established collection procedures. Payment of the loan in full ordinarily is the way in which continuing liability on a mortgage note is ended.
Therefore, if you expect to move from the area in which you are now considering the purchase of a home and should you be unable to sell such home with the
purchaser obtaining new fmancing to payoff your loan, you should understand that you may continue to be liable to the holder of your mortgage and to the
Department of Veterans Affairs.
I, THE UNDERSIGNED VETERAN, CERTIFY THAT:
a. I have read and understand the foregoing concerning the liability on the loan.
b. Occupancy:
(1)
I now actually occupy the above-described property as my home or intend to move into and occupy said property as my home within a reasonable
period of time or intend to reoccupy it after the completion of major alterations, repairs or improvements.

D

D My spouse is on active military duty and in his or her absence, I occupy or intend to occupy the property securing this loan as my home.
(3) D I previously occupied the property securing this loan as my home. (For interest rate reduction loans).
(4) D While my spous~ was on active military duty and unable to occupy the property securing this loan, I previously occupied the property that

(2)

is securing this loan as my home. (For interest rate reduction loans.)

NOTE: If Item b(2) or b(4) is checked the veteran's spouse must also sign Item 32 below.
c. I have been informed that $

_

is the reasonable value of the property as determined by VA.

IF THE CONTRACT PRICE OR COST EXCEEDS THE VA REASONABLE VALUE, COMPLETE EITHER ITEM D OR E.

D

d.

I was aware of this. valuation when I signed my contract and I have paid or will pay in cash from my own resources at or prior to loan closing a sum
equal to the difference between the contract purchase price or cost and the VA reasonable value. I do not and will not have outstanding after loan closing any
unpaid contractual obligation on account of such cash payment.

e.

I was not aware of this valuation when I signed my contract but have elected to complete the transaction at the contract purchase price or cost. I have
paid or will pay in cash from my own resources at or prior to loan closing a sum equal to the difference between the contract purchase price or cost and
the VA reasonable value. I do not and will not have outstanding after loan closing any unpaid contractual obligation on account of such cash payment.

D

f. Neither I, nor anyone authorized to act for me, will refuse to sell or rent, after the making of a bona fide offer, or refuse to negotiate for the sale or
rental of, or otherwise make unavailable or deny the dwelling of property covered by this loan to any person because of race, color, religion, sex or national
origin. I recognize that any restrictive covenant on this property relating to race, color, religion, sex or national origin is illegal and void and civil action for
preventive relief may be brought by the Attorney General of the United States in any appropriate U.S .District Court against any person responsible for the
violation of the applicable law.
g. I AM AWARE THAT VA DOES NOT WARRANT THE CONDITION OR VALUE OF THE PROPERTY.

IF CERTIFICATE OF ELIGIBILITY REQUIRES CERTIFICATION OF ACTIVE
DUI:Y STATUS, FOLLOWING CERTIFICATION MUST BE CHECKED
28A. VETERAN

INITIALS 128B. ETHNICITY
DHISPANIC
OR LATINO

VOLUNTARY

INFORMATION FOR
GOVERNMENT

(If you do not wish to

complete Items 288 thru

28D, please initial here)

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29A. COBORROWER

INITIALS

MONITORING

DNOT
HISPANIC
OR LATINO
29B. ETHNICITY

~

(If you do not wish to

complete Items 298 thru

29D, please initial here)

30. DATE SIGNED

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I certify that I have not been discharged or released from active
duty since the date my Certificate of Ehgibility was issued.

28C. RACE

28D. SEX

D AMERICAN INDIAN
OR ALASKA
NATIVE
DNATIVE HAWAIIAN
OR OTHER PACIFIC
ISLANDER

29C. RACE

DASIAN

D AMERICAN INDIAN
OR ALASKA
NATIVE

DASIAN

DHISPANIC
OR LATINO

PURPOSES

D

I

DNOT
DNATIVE HAWAIIAN
HISPANIC
OR OTHER PACIFIC
OR LATINO
ISLANDER
131. SIGNATURE OF VETERAN (Read Cenijications Carefully before Signing)

DBLACK OR
AFRICAN

AMERICAN

DWHITE

I

D

ID

MALE

FEMALE

29D. SEX

DWHITE

DBLACK OR
AFRICAN
AMERICAN

ID

MALE

ID

FEMALE

132. SIGNATURE OF SPOUSE (If applicable)

Federal Statutes provide severe penalties for any fraud, intentional misrepresentation, or Criminal Connivance or conspiracy purposed to influence the issuance of
any guaranty or insurance by tfie Department ofVeterans Affairs.
VA FORM 26-1820, DEC 2007