The following information is collected via a document generated by HUD and identified as
Premium Refund or Distributive Share Payment (form HUD-27050-B)
The information is submitted to apply for the unearned portion of the mortgage insurance premium or a distributive share payment.
Much of the information is provided by HUD for verification by the respondent..
Date You Purchased the Property
Date Paid in Full
Last Name
First Name
Percentage of the Property You Owned
Social Security Number or EIN (include hyphens)
Daytime Telephone (include area code)
Current Mailing Address
(optional) "Attention of..." or "Care of
Street (30 characters, max):
City (25 letters, max):
State (2 letters)
Zip Code (give all 9 digits if known)
Yes No The FHA mortgage was paid off by refinancing
Signature & Date
| File Type | application/msword |
| File Title | The following information is collected via a document generated by HUD and identified as |
| Author | HUD |
| Last Modified By | HUD |
| File Modified | 2004-03-22 |
| File Created | 2004-03-22 |