HUD-11701-A Application Fee for Title I

Application Fee for Title I Lender Approval, Additional Branch(es), or Conversion of Lender Type

U.S. Department of Housing and Urban Development Office of Housing / Federal Housing Commissioner

OMB Approval No. 2502-0005 (exp. 10/31/2006)

This form MUST accompany all application fee payments. Mail this form and your check to: HUD, P. O. Box 198608, Atlanta, GA 30384. A copy should be included with your application.

Lender Name:

Federal Tax Identification Number: (10 digits)

HUD/FHA Identification Number: (10 digits)

(if applicable)

Type of application: (please check the appropriate box)

Initial Application ($1,000)

Additional Branch ($300)

Conversion of Lender Type ($300)

Lenders seeking first time approval (initial applications) must enter their federal tax identification number in the memo portion of the check. Lenders filing all other types of applications should put their 10-digit Title I HUD/FHA identification number in the memo portion of the check.

Public Reporting Burden for this collection of information is estimated to average 0.05 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. The information requested on this form is required by 24 CFR Part 202. The information collected assists FHA in determining which lenders should be approved to participate in the FHA single and multifamily insurance programs. It is used to help FHA minimize its risk in insuring single family and multifamily mortgages to minimize its risk. Applicants are not required to respond to this collection of information unless a currently valid approved OMB control number is displayed.

Form HUD-11701-A (1/25/2005)