90175-CA Request for Final Closing

Request for Final Closing

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

OMB Approval No. 2502-0016
(Exp. 8/31/2013)

Public reporting burden for this collection of information is estimated to average 1 hour 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. HUD may not collect this
information, and you are not required to complete this form, unless it displays a currently valid OMB control number.
This information collection is necessary to ensure that viable projects are developed. It is important to obtain information from applicants to assist HUD in
determining if nonprofit organizations initially funded continue to have the financial and administrative capacity needed to develop a project and that the
project design meets the needs of the residents. The Department will use this information to determine if the project meets statutory requirements with
respect to the development and operation of the project, as well as ensuring the continued marketability of the projects. This information is required in order
to obtain benefits. This information is considered non-sensitive and no assurance of confidentiality is provided.
Project Name

Project Number

Project Address

Date of Commitment

Owner

Date of this request
Project Number

Certificate of Owner
To the Department of Housing and Urban Development

In order to induce HUD to finally close, and with the intent that HUD rely upon the statements hereinafter set forth, the undersigned makes
the following certifications:
1.

That it has received the sum of $ _________________ which when added to the final advance will total $ ___________ ____ ,
constituting the full mortgage amount for this project, including any savings to which the owner may be entitled.

2.

That construction of the project is substantially complete and is in accordance with the plans and specifications approved by HUD;
that said mortgage is a good and valid first lien on the property therein described; that the property is free and clear of all liens other
than that of the subject mortgage; that all outstanding unpaid obligations contracted by or on behalf of the owner directly or indirectly,
in connection with the mortgage transaction, the acquisition of the property, or the construction of the project are listed below:
(a) HUD-approved notes (copies attached)*

$

(b) Due General Contractor

$

(c) Other*

$
$
$
$
$
$

3.

That, except for the amounts due on notes listed in item (a) of paragraph 2 above, the undersigned agrees to pay the foregoing
obligations in cash and to furnish HUD receipts, or other evidence of payment satisfactory to HUD, within 45 days following the final
disbursement of capital advance proceeds.

Owner

By (Signature, Title)

Date

X
*

Note: If the space provided is inadequate to list all unpaid obligations, insert the total in each category and attach itemizations. If there are no outstanding
obligations, so state.
Page 1 of 2

form HUD-90175-CA (12/20/2005)
ref Handbooks 4471.4 and 4571.5

Project Number:

Certificate of General Contractor
To the Department of Housing and Urban Development

The undersigned, as general contractor of the above project, makes the following certifications:
1.

That construction is in accordance with the plans and specifications which were approved by HUD.

2.

That all outstanding unpaid obligations contracted by or on behalf of the undersigned in connection with the construction contract
are listed below.
(If space below is inadequate, continue listing on an attached sheet and so note.)

3.

(a)

$

(b)

$

(c)

$

That, except for unfinished work covered by an approved escrow deposit, the undersigned agrees to pay the foregoing obligations
in cash and to furnish HUD receipts, or other evidence of payment satisfactory to HUD, within 15 days following receipt of payment
from owner.

General Contractor

By (Signature &Title)

Date

X
Warning: HUD will prosecute false claims and statements. Conviction may result in criminal and/or civil penalties. (18 U.S.C. 1001, 1010, 1012; 31 U.S.C. 3729, 3802)
Page 2 of 2

form HUD-90175-CA (12/20/2005)
ref Handbooks 4471.4 and 4571.5