Form 26-1820 Report and Certification of Loan Disbursement

OMB Control No. 2900-0521
Respondent Burden: 15 minutes
Expiration Date: XX/XX/XXXX

REPORT AND CERTIFICATION OF LOAN
DISBURSEMENT

AUTOMATIC PROCEDURE

PRIOR APPROVAL PROCEDURE

INSTRUCTIONS TO LENDERS: For use by lenders closing VA loans under 38 U.S.C. 3710. After closing of the loan and completion of the form, the original is to
be forwarded to the VA; the duplicate is to be retained by the lender; the triplicate is to be provided to the veteran. With this report, unless previously submitted to VA,
please submit the following: (a) copy of the borrower's loan application to you showing income, assets, and obligations; (b) the ORIGINAL verification(s) of
employment and earnings; (c) ORIGINAL credit report on the borrower and co-borrower, if any; (d) ORIGINAL VA Form 26-8937, Verification of VA Benefit Related
Indebtedness; (e) ORIGINAL VA Form 26-0503, Federal Collection Policy Notice; (f) VA Form 26-0551, Debt Questionnaire; (g) Veteran's Certificate of Eligibility; (h)
a copy of the veteran's executed sales or construction contract, as appropriate; (i) ORIGINAL verification of bank deposit; (j) a true copy of the HUD Form 1 or, if a
refinancing loan, a statement of the loan disbursement and costs, showing the fees and costs charged to the borrower and seller (HUD Form 1 may be used); (k) if the
home is of new construction, an executed copy of the builder's warranty, VA Form 26-1859; a copy of the Master Certificate of Reasonable Value, VA Form 26-1843a
and any related endorsements, and a VA or FHA final compliance inspection report. In special cases, such as loans wherein some of the proceeds are to be escrowed to
cover the completion of postponed exterior improvements, etc., other attachments to the report may be necessary. Lenders should consult with the VA regional office in
this regard. For refinancing loans under 38 U.S.C. 3710 (a)(5), provide evidence of the lien of record on the property and the veteran's ownership of the property. For all
loans, submit VA Form 26-8998, Acknowledgment of Receipt of Funding Fee From Mortgagee, if required.
RESPONDENT BURDEN: We need this information to confirm that the lender has closed the loan in compliance with all applicable VA laws and regulations and that
the veteran has entered into the loan with an understanding of all relevant requirements and responsibilities. Title 38, United States Code, allows us to ask for this
information. We estimate that you will need an average of 15 minutes to review the instructions, find the information, and complete this form. VA cannot conduct or
sponsor a collection of information unless a valid OMB control number is displayed. You are not required to respond to a collection of information if this number is not
displayed. Valid OMB control numbers can be located on the OMB Internet Page at www.reginfo.gov/public/do/PRAMain. If desired, you can call 1-800-827-1000 to
get information on where to send comments or suggestions about this form.
1. VA LOAN NUMBER

2A. LENDER'S LOAN NUMBER

2B. LENDER'S VA IDENTIFICATION NUMBER 3. DATE OF REPORT

4A. FIRST NAME - MIDDLE NAME - LAST NAME OF VETERAN
5. PRESENT ADDRESS OF VETERAN (Include ZIP Code)

4B. VETERAN'S SOCIAL SECURITY NO.
6. NAME AND ADDRESS OF RELATIVE NOT LIVING WITH VETERAN (Include ZIP Code and complete

telephone number if available)

This report of the undersigned lender is made pursuant to Section 3702(c), Title 38, United States Code. The undersigned lender and veteran each agree that the
Regulations issued under Chapter 37, Title 38, United States Code, and in effect on the date of the loan shall govern the rights, duties, and liabilities of the parties and that
any provisions of the loan instruments inconsistent with such Regulations are hereby amended and supplemented to conform thereto
GUARANTY
INSURANCE
and request issuance of evidence of the loan to the full extent permitted by the veteran's available entitlement.
SECTION I - PURPOSE, AMOUNT, TERMS AND SECURITY FOR LOAN
REFINANCE

7. PURPOSE OF LOAN
PURCHASE
EXISTING
HOME
PREVIOUSLY
OCCUPIED

PURCHASE EXISTING
CONDOMINIUM UNIT

FINANCE
IMPROVEMENTS
TO EXISTING
PROPERTY

PURCHASE NEW
CONDOMINIUM UNIT

PURCHASE EXISTING
HOME NOT PREVIOUSLY
OCCUPIED

CONSTRUCT HOMEPROCEEDS TO BE PAID OUT
DURING CONSTRUCTION

REFINANCE PERMANENTLY
SITED MANUFACTURED
HOME TO BUY LOT

PURCHASE PERMANENTLY
REFINANCE PERMANENTLY
SITED MANUFACTURED
SITED MANUFACTURED
HOME AND LOT
HOME/LOT LOAN
9. AMOUNT OF LOAN
8. ADDRESS OF PROPERTY SECURING LOAN (Include lot and block numbers, subdivision name and ZIP Code)
PURCHASE PERMANENTLY
SITED MANUFACTURED
HOME

$
10. TERMS OF LOAN
C. DATE OF NOTE
A. PRINCIPAL AND INTEREST PAYABLE B. RATE OF INTEREST PER ANNUM
EACH PERIOD
$
E. DATE LOAN WAS CLOSED

F. DATE LOAN PROCEEDS FULLY PAID OUT

D. DATE OF FIRST PAYMENT

G. TERM OF LOAN

H. DATE OF MATURITY

YEARS
11. TYPE OF LIEN (38 CFR 36.4351)
FIRST REALTY
SECOND REALTY
MORTGAGE
MORTGAGE

FIRST CHATTEL
MORTGAGE

MONTHS

OTHER (Specify)

UNSECURED

12. TITLE OF PROPERTY IS VESTED IN THE FOLLOWING PERSON(S)
VETERAN
VETERAN AND SPOUSE
13. ESTATE IN PROPERTY IS (38 CFR 36.4350)
FEE SIMPLE

OTHER (Specify)

LEASEHOLD (Give expiration date)

14. APPROXIMATE
ANNUAL REAL
ESTATE TAXES

OTHER (Specify)

15. INSURANCE

A. HAZARD

B. FLOOD (Where applicable)

FACE AMOUNT OF POLICY $

ANNUAL PREMIUM
$
18. ANNUAL MAINTENANCE ASSESSMENT

16. APPROXIMATE
17. TOTAL UNPAID
ANNUAL ASSESSMENT
SPECIAL
PAYMENT
ASSESSMENTS

$
$
$
19. DESCRIBE NONREALTY, IF ANY, ACQUIRED WITH PROCEEDS OF LOAN (Attach separate sheet if necessary)

$
20. DESCRIBE ADDITIONAL SECURITY TAKEN AND LIST OF OTHERS (Including Spouse) LIABLE ON INDEBTEDNESS, IF ANY (Attach separate sheet, if necessary)

IF LAND ACQUIRED
BY SEPARATE TRANSACTION
COMPLETE ITEMS
21 AND 22

21. DATE ACQUIRED 22. PURCHASE PRICE (If acquired

other than by purchase, state "None")

$

23. AMOUNT WITHHELD FROM LOAN PROCEEDS AND
DEPOSITED IN
ESCROW

EARMARKED ACCOUNT $

SECTION II - LENDER'S CERTIFICATION

24. I, THE UNDERSIGNED LENDER, CERTIFY THAT:
A. If this loan was closed under the automatic procedure, no default exists which has continued for more than 30 days.
B. The lender has not imposed and will not impose any charges or fees against the veteran borrower in excess of those permissible under the schedule set forth in paragraph (d) of 38 CFR
36.4313.
C. The information furnished in Section I is true, accurate and complete.
D. The information contained in the loan application was obtained directly from the veteran by an employee of the undersigned lender or the lender's duly authorized agent and is true to the
best of the lender's knowledge and belief.
E. The credit report submitted on the subject veteran (and co-borrower, if any) was ordered by the undersigned lender or the lender's duly authorized agent directly from the credit bureau
which prepared the report and was received directly from said credit bureau.
F. The verification(s) of employment and verification(s) of deposits were requested and received by the lender or the lender's duly authorized agent without passing through the hands of
any third persons and are true to the best of the lender's knowledge and belief.
G. This report was signed by the veteran after Sections I, II and III were completed.
H. VA Forms 26-0503, Federal Collection Policy Notice, and 26-0551, Debt Questionnaire, were signed by the veteran and a signed copy of each was furnished to the veteran.
(NOTE: These forms are not required for loans in which an URLA and HUD/VA Addendum are used.)
I. This loan to the named veteran meets the income and credit requirements of the governing law in the judgment of the undersigned.
J. The names and functions of any duly authorized agents who developed on behalf of the lender any of the information or supporting credit data submitted are as follows:
NAME

ADDRESS

FUNCTION (e.g. obtained information for loan application; ordered
credit report, verification of employment, verification of deposits, etc.)

a.
b.
c.
d.
e.
If no agent is shown above, the undersigned lender affirmatively charges that all information and supporting credit data were obtained directly by the lender.
K. The undersigned lender understands and agrees that the lender is responsible for the acts of agents identified in Item 24J as to the functions with which they are identified.
L. The loan conforms with the applicable provisions of Title 38, U.S. Code and the Regulations concerning guaranty or insurance of loans to veterans.
M. COMPLETE WHERE AUTHORIZED BY CERTIFICATE OF REASONABLE VALUE.
Any construction, repairs, alterations, or improvements upon which the reasonable value of the property is predicated and which were not inspected and approved subsequent
to completion by a compliance inspector designated by the Secretary have been completed properly.
N. If the loan application has been submitted for the prior approval of the VA, the proceeds of the loan were expended for the purposes described in the loan application or refinancing proposal
originally submitted for the prior approval of the VA and in the amounts shown in the statement of loan disbursement and costs or HUD Form 1 that is attached to and incorporated in this report.
VA FORM
SUPERSEDES VA FORM 26-1820, SEP 2012,
Continued on Reverse
JAN 2014
WHICH WILL NOT BE USED.

26-1820

24. Continued
O. Any deviations or changes of identity in the security of the property from that set forth in the plans and specifications upon which the original
appraisal was based are itemized in an attachment hereto and have been approved as required in 38 C.F.R. 36.4304 and have been completed properly.
P. If this is a refinancing loan under section 3710a(5) of title 38, U.S.C., the veteran's secured liens of record identified on the property and shown on
the loan application, and any debts listed on the application which were not secured by liens of record and which were to have been retired from the
proceeds of the loan, have, in fact, been paid in full. The amount of cash, if any, shown as paid to the veteran on the statement of loan disbursement
and costs or HUD Form 1 that is attached to and incorporated in this report was, in fact, disbursed to him or her personally.
Q. If this loan is required to be personally reviewed and approved by a VA-approved underwriter, the name of that underwriter is as follows:
25A. NAME AND ADDRESS OF LENDER

26A. DATE SIGNED

25B. TELEPHONE NO. OF LENDER

26B. SIGNATURE AND TITLE OF LENDER REPRESENTATIVE

PRIVACY ACT NOTICE: VA will not disclose information collected on this form to any source other than what has been authorized under the Privacy Act of 1974
or Title 38, Code of Federal Regulations 1.576 for routine uses (e.g., information may be disclosed to Congress when requested on behalf of a veteran for statistical
purposes in specific geographic regions) as identified in the VA system of records, 55VA26, Loan Guaranty Home, Condominium and Manufactured Home Loan
Applicant Records, Specially Adapted Housing Applicant Records and Vendee Loan Applicant Records - VA, and published in the Federal Register. Your obligation to
respond is voluntary, but failure to provide requested information could impede processing. Giving us your SSN account information is voluntary. Refusal to provide
your SSN by itself will not result in the denial of benefits. VA will not deny any individual benefits for refusing to provide his or her SSN unless the disclosure of the
SSN is required by a Federal Statute of law in effect prior to January 1, 1975, and still in effect.
NOTICE TO BORROWERS: This is notice to you as required by the Right to Financial Privacy Act of 1978 that the VA has a right of access to financial records
held by financial institutions in connection with the consideration or administration of assistance to you. Financial records involving your transaction will be available
to VA without further notice or authorization but will not be disclosed or released by this institution to another Government Agency or Department without your
consent except as required or permitted by law.
SECTION III - VETERAN'S CERTIFICATIONS (To be executed by the veteran on the date loan is closed)
27. As a GI home loan borrower you will be legally obligated to make the mortgage payments called for by your mortgage loan contract. The fact that you
dispose of your property after the loan has been made WILL NOT RELIEVE YOU OF LIABILITY FOR MAKING THESE PAYMENTS.
Some GI home buyers have the mistaken impression that if they sell their homes when they move to another locality, or dispose of it for any other reason, they are
no longer liable for the mortgage payments and that liability for these payments is solely that of the new owners. Even though the new owner may agree in writing
to assume liability for your mortgage payments, this assumption agreement will not relieve you from liability to the holder of the note which you signed when you
obtained the loan to buy the property. Also, unless you are able to sell the property to a credit-worthy obligor who is acceptable to the VA and who will assume the
payment of your obligation to the lender and the Department of Veterans Affairs, you will not be relieved from liability to repay any guaranty claim which the VA
may be required to pay your lender on account of default in your loan payments.
THE AMOUNT OF ANY SUCH CLAIM PAYMENT WILL BE A DEBT OWED BY YOU TO THE FEDERAL GOVERNMENT. This debt will be the object of
established collection procedures. Payment of the loan in full ordinarily is the way in which continuing liability on a mortgage note is ended. Therefore, if you
expect to move from the area in which you are now considering the purchase of a home and should you be unable to sell such home with the purchaser obtaining
new financing to pay off your loan, you should understand that you may continue to be liable to the holder of your mortgage and the Department of Veterans Affairs.
I, THE UNDERSIGNED VETERAN, CERTIFY THAT:
a. I have read and understand the foregoing concerning the liability on the loan.
b. Occupancy:
(1)

I now actually occupy the above-described property as my home or intend to move into and occupy said property as my home within a
reasonable period of time or intend to reoccupy it after the completion of major alterations, repairs or improvements.

(2)

My spouse is on active military duty and in his or her absence, I occupy or intend to occupy the property securing this loan as my home.

(3)

The veteran is on active military duty and in his or her absence, I certify that a dependent child of the veteran occupies or will occupy the property
securing this loan as their home. (NOTE: this requires that the veteran's attorney-in-fact or legal guardian of the dependent child sign in Item 31.)
I previously occupied the property securing this loan as my home. (For interest rate reduction loans.)

(4)
(5)

While my spouse was on active military duty and unable to occupy the property securing this loan, I previously occupied the property that is securing
this loan as my home. (For interest rate reduction loans.)

While the veteran was on active military duty and unable to occupy the property securing this loan, the property was occupied by the veteran's
dependent child as his or her home. (For interest rate reduction loans.) (NOTE: this requires that the veteran's attorney-in-fact or legal guardian of
the dependent child sign in Item 31.)
NOTE: If Item b(2) or b(5) is checked the veteran's spouse must also sign Item 32 below.
(6)

c. I have been informed that $________________________________________ is the reasonable value of the property as determined by VA.
IF THE CONTRACT PRICE OR COST EXCEEDS THE VA REASONABLE VALUE, COMPLETE EITHER ITEM D OR E.
d.
I was aware of this valuation when I signed my contract and I have paid or will pay in cash from my own resources at or prior to loan closing a sum
equal to the difference between the contract purchase price or cost and the VA reasonable value. I do not and will not have outstanding after loan closing
any unpaid contractual obligation on account of such cash payment.
e.
I was not aware of this valuation when I signed my contract but have elected to complete the transaction at the contract purchase price or cost. I
have paid or will pay in cash from my own resources at or prior to loan closing a sum equal to the difference between the contract purchase price or cost
and the VA reasonable value. I do not and will not have outstanding after loan closing any unpaid contractual obligation on account of such cash
payment.
f. Neither I, nor anyone authorized to act for me, will refuse to sell or rent, after the making of a bona fide offer, or refuse to negotiate for the sale or rental of,
or otherwise make unavailable or deny the dwelling of property covered by this loan to any person because of race, color, religion, sex or national origin. I
recognize that any restrictive covenant on this property relating to race, color, religion, sex or national origin is illegal and void and civil action for preventive
relief may be brought by the Attorney General of the United States in any appropriate U.S. District Court against any person responsible for the violation of
the applicable law.
g. I AM AWARE THAT VA DOES NOT WARRANT THE CONDITION OR VALUE OF THE PROPERTY.
IF CERTIFICATE OF ELIGIBILITY REQUIRES CERTIFICATION OF ACTIVE
I certify that I have not been discharged or released from active duty
DUTY STATUS, FOLLOWING CERTIFICATION MUST BE CHECKED
since the date my Certificate of Eligibility was issued.
28A. VETERAN

INITIALS

(If you do not wish to
complete Items 28B thru 28D,
INFORMATION FOR please initial here)

VOLUNTARY

GOVERNMENT
MONITORING
PURPOSES

30. DATE SIGNED

29A. COBORROWER

(If you do not wish to
complete Items 29B thru 29D,
please initial here)

28B. ETHNICITY
HISPANIC
OR LATINO
NOT
HISPANIC
OR LATINO

INITIALS

29B. ETHNICITY
HISPANIC
OR LATINO
NOT
HISPANIC
OR LATINO

28C. RACE
AMERICAN INDIAN
OR ALASKAN
NATIVE
NATIVE HAWAIIAN
OR OTHER
PACIFIC ISLANDER
29C. RACE
AMERICAN INDIAN
OR ALASKAN
NATIVE
NATIVE HAWAIIAN
OR OTHER
PACIFIC ISLANDER

31. SIGNATURE OF VETERAN (Read Certifications Carefully before Signing)

ASIAN
WHITE

ASIAN
WHITE

BLACK OR
AFRICAN
AMERICAN

BLACK OR
AFRICAN
AMERICAN

28D. SEX
MALE
FEMALE

29D. SEX
MALE
FEMALE

32. SIGNATURE OF SPOUSE (If applicable)

Federal Statutes provide severe penalties for any fraud, intentional misrepresentation, or Criminal Connivance or conspiracy purposed to influence the issuance of any
guaranty or insurance by the Department of Veterans Affairs.
VA FORM 26-1820, JAN 2014