92330 Mortgagor's Certificate of Actual Cost

Submission Requirements for the Capital Advance Program Section 202/811

92330

Submission Requirements for the Capital Advance Program Section 202/811

OMB: 2502-0470

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Mortgagor's Certificate of
Actual Cost

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

OMB Approval No. 2502-0112
(exp. 12/31/2014)

Public reporting burden for this collection of information is estimated to average 8 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. 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.
The collection of this information is required by Section 227 of the National Housing Act (P.L. 479, 48 Stat., 1246, 12 USC 1701 et seq). Regulations
stipulating these rules are Section 200.95 and 891.545. This form must be completed so that HUD can make an informed determination of mortgage insurance
acceptability and to prevent windfall profits. The data collected is from the mortgagor relative to the actual cost of the project. The actual cost data is
reviewed by HUD staff to determine that the mortgagor’s original endorsement mortgage is supported by the applicable percentage of approved costs.
Failure to receive and review the cost certification data could result in the Department’s over-insurance of the mortgage in violation of the law. No questions
of a sensitive nature are included on this form.
To: Federal Housing Commissioner

Project Number

Project Name

Location

No mortgage shall be insured unless a Certificate of Actual Cost is executed upon completion of all physical improvements on the
mortgaged property and prior to final endorsement (Section 227, P.L. 479, 49 Stat., 12 U.S.C.)

This Certificate is made pursuant to the provisions of that Agreement
and Certification of

(Mortgagor)
dated(mm/dd/yyyy) _______________________ and in order to
induce you to finally endorse the mortgage for insurance.
The actual cost to the owner of labor and materials and necessary
services for construction of the physical improvements in connection
with the subject project, after deduction of all kickbacks, rebates,
adjustments, discounts, promotional or advertising recoupment made
or to be made to the mortgagor, sponsor or any corporation, trust,
partnership, joint venture or other legal entity in which they or any of
them hold any interests set forth below, the cost of construction is (is
not) supported by Form HUD-92330-A, Contractor Certificate of
Actual Cost. (Form HUD-92330-A must be submitted when there is an
identity of interest between mortgagor and general contractor and
when a Cost Plus Contract is required in nonprofit projects.)
Note: This Certificate must be supported by a certification as to
actual cost by an independent Certified Public Accountant or by an
independent public accountant if required by HUD regulations or
handbooks.
The undersigned hereby certifies that, except as noted below, there
has not been and is not now any identity of interest between mortgagor
and general contractor and/or any subcontractor, material supplier, or
equipment lessor. It is further certified that, except as noted, there are
not and have not been any such relationships between sponsor(s) of
this project and general contractor and/or subcontractor, material
supplier and equipment lessor.

All references to "Identity of Interest" herein made are made in the
context of the definition printed below, which has been read by the
undersigned.
Identity of Interest between the mortgagor and/or sponsor as
parties of the first part and general contractors, subcontractors, material suppliers, or equipment lessors as parties of the second part will be
construed as existing under any of the following conditions:
When there is any financial interest of the party of the first part in
the party of the second part; when one or more officers, directors
or stockholders of the party of the first part is also an officer,
director, or stockholder of the party of the second part; when any
officer, director, or stockholder of the party of the first part has
any financial interest whatsoever in the party of the second part;
when the party of the second part advances any funds to the party
of the first part; when the party of the second part provides and
pays on behalf of the party of the first part the cost of any
architectural or engineering services other than those of a surveyor, general superintendent, or engineer employed by a general
contractor in connection with his or its obligations under the
construction contract; when the party of the second part takes
stock or any interest in the party of the first part as part of the
consideration to be paid them; when there exists or comes into
being any side deals, agreements, contracts or undertaking entered into or contemplated, thereby altering, amending, or cancelling any of the required closing documents except as approved by
the commissioner; when any relationship (e.g. family) existing
which would give the mortgagor or general contractor control or
influence over the price of the contract or the price paid to the
subcontractor, material supplier or lessor of equipment.
The following identities of interest exist: If none, so state.

I hereby certify that all the information stated herein, as well as any information provided in the accompaniment herewith, is true and accurate.
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)
Mortgagor Name

Title

Signature

Previous editions are obsolete.

Date (mm/dd/yyyy)

Page 1 of 2

form HUD-92330 (3/94)
ref. Handbooks 4470.1, 4470.2

Item

Column A

* Attach itemized schedules and copies of bills and receipts where applicable

Paid in Cash

*
*

1a. Amount due under terms of Lump-Sum Construction Contract (as adjusted)

*

1c. Allowable Builder's Profit (Use only if 1b is used)

Column B
To be paid in cash
within 45 days after final
endorsement

Column C
Total

1b. Amount due under terms of Cost-Plus Construction Contract (as adjusted
and exclusive of Builder's Profit)

2a. Architect's Fee - Design
2b. Architect's Fee - Supervision

*

2c. Architect's Fee - Additional Services

*

3.

Interest During Construction

*

4.

Taxes During Construction

*

5.

Property Insurance

*

6.

Mortgage Insurance Premium (MIP)

7.

FHA Examination Fee

8.

FHA Inspection Fee

*

9.

Title and Recording Fees

*

10. Allowance To Make Project Operational (AMPO)

*

11a. Initial Financing Fee

*

11b. Permanent Placement fee

*

11c. Discounts

*

11d. Other Approved Financing Expenses

*

12a. Legal

*

12b. Organization

*

12c. Mortgagor's Cost Certification Audit Fee

*

13. Other (exclusive of items required by the Construction Contract)

Subtotal
14. Profit and Risk (if applicable)
15a. Consultant's Fee

*

15b. Major Moveable Equipment

*

15c. Offsite and Demolition

*

15d. Other

Subtotal

*

16a. Reduction (if any) resulting from Operating Statement Attached

*

16b. Reduction (if any) resulting from Grants / Loans
Total

Previous editions are obsolete.

Page 2 of 2

form HUD-92330 (3/94)
ref. Handbooks 4470.1, 4470.2


File Typeapplication/pdf
File Modified2011-12-08
File Created2011-12-08

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