Form HUD92915-H4H

HOPE for Homeowners
Consumer Disclosure and
Certification Form

OMB Approval No. 2502-0579
(exp. 11/30/2012)

U.S. Department of Housing and
Urban Development
Federal Housing Administration

I M P O R T A N T
Mortgages made under the FHA’s HOPE for Homeowners Program have some special restrictions. If you refinance your home through this program:
1.

You must share with FHA a portion of any equity newly created by your new HOPE for Homeowners mortgage, as described below.

2.

You cannot take out a second mortgage, home equity loan, or home equity line of credit for the first five years you have your new loan,
except under certain circumstances for emergency repairs.

3.

You will pay an upfront mortgage insurance premium of 2% and a 0.75% annual mortgage insurance premium on the current principal
balance of your new mortgage. The annual premium will be included in your monthly payments.

4.

To apply for a mortgage under the HOPE for Homeowners Program, you must certify that the Borrower Certification statements below are
true. There are serious penalties if you provide false information.

Equity Sharing Requirements. I/we agree to share the initial equity
created at the beginning of this mortgage with FHA. Initial equity is the
difference between the appraised value of the home at the time of the
new HOPE for Homeowners mortgage (or the amount owed on my/our
existing mortgage, if that is less), and the initial balance on my/our
HOPE for Homeowners mortgage.

Furthermore, I/we certify:
•

I/we have not intentionally defaulted on my/our mortgage or
any other substantial debt (any amount greater than $100,000)
in the last 5 years. An intentional default is defined as a
default that occurred when a borrower had readily available
funds at the time a mortgage payment or other debt was due,
such that the borrower could have paid the mortgage or other
debt without undue hardship.

•

I/we have not been convicted of fraud under federal or state
law in the past 10 years. I/we agree that FHA may perform
routine background checks, including automated searches of
federal, state, and county databases, to confirm that I/we have
not been convicted of fraud.

•

I/we have not knowingly, or willfully and with actual
knowledge, furnished material false information for the
purpose of obtaining my/our new HOPE for Homeowners
mortgage.

•

If I/we make any willful false statement in this certification or
any other documentation I/we provide for Program eligibility,
I/we may be punished with fines or imprisonment of up to 5
years, or both, under section 1001 of title 18, United States
Code, and I/we also may be subject to civil and/or
administrative penalties and sanctions.

If I/we sell or refinance my/our home, I/we agree to share the newly
created equity with FHA according to the following schedule:
If I/we sell or refinance:
During year 1
During year 2
During year 3
During year 4
During year 5
After year 5

FHA will receive:
100% of initial created equity
90% of initial created equity
80% of initial created equity
70% of initial created equity
60% of initial created equity
50% of initial created equity

Understanding Shared Equity. As an example, say you have no
equity in your home. You have one mortgage for $200,000 and the
appraisal report just said your home is worth $200,000. If your new
HOPE for Homeowners mortgage is for $180,000, the amount of newly
created equity is $20,000. This newly created equity is what you must
share with FHA when you later decide to move or refinance.
Continuing the example, if you decide to move three years after
receiving your new HOPE for Homeowners mortgage, at closing, FHA
will receive $16,000 (80%), and you will be entitled to the remaining
$4,000. Remember, this is equity that you did not have prior to
receiving your new HOPE for Homeowners mortgage.
Borrower Certification. I/we certify that I/we have read the above
restrictions. If I/we are offered and accept a mortgage under FHA’s
HOPE for Homeowners Program, I/we understand that I/we will be
agreeing to be bound by these restrictions on the new mortgage for as
long as we hold that mortgage.

I/we understand that if I/we misrepresent or falsify anything in this
statement or any other documentation I/we provide for Program
eligibility, and I/we refinance through this program, I/we will be liable
to repay the Federal Housing Administration any direct financial benefit
I/we gain from the reduction of debt on my/our existing mortgage(s).

Signature
Signature

Date
Date
The originating lender is not responsible for verifying certifications made by the Borrower(s) in this document.

"Public reporting burden for this collection of information is estimated to average .5 hours. This includes the time for collecting, reviewing, and reporting the
data. The information is being collected for a temporary FHA program that offers homeowners and existing mortgage loan holders (or servicers acting on their
behalf) insurance on the refinancing of loans for distressed mortgagors. The information w ill be used for determining the eligibility requirements and underwriting
procedures. Response to this request for information is required in order to receive the benefits to be derived. This agency may not collect this information, and
you are not required to complete this form unless it displays a currently valid OMB control number.
Privacy Act Notice: The United States Department of Housing and Urban Development, Federal Housing Administration, is authorized to solicit the information
requested in the form by virtue of Title 12, United States Code, Section 1701 et seq., and regulations promulgated thereunder at Title 12, Code of Federal
Regulations. While no assurance of confidentiality is pledged to respondents, HUD generally discloses this data only in response to a Freedom of Information Act
request.

Previous editions are obsolete.

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Form HUD-92915-H4H (10/2009)