HUD 50131 - Curren Family Self-Sufficiency (FSS) Program Coordinator Fundii

OMB Approval No. 2577-0200

(exp. 2/29/2016)

HUD Office of Native American Programs: Section 184 Loan Guarantee Program

Case Number Request Form

All case requests should be emailed to [email protected] or faxed to 202-401-2475.

All appraisals should be sent to [email protected].

1. Lender Name & TIN #______________________________________________________________

2. Lender Contact Name: __________________________Email_____________________________

3. Lender Telephone: _______________________ Lender Fax: ____________________________

4. Please Indicate Purpose of Loan: (check or circle)

­­­­­­­­­­­­Refinance: Acquisition: Construction:

 Streamline with appraisal  Acquisition of existing  Single Close Proposed

 Streamline without appraisal  Acquisition/Rehab of exist

 New- Less than 1 year  Acquisition-Less than 1 year

 Credit Qualifying with cash out

 Credit Qualifying with no cash out

 Credit Qualifying with escrow

5. Prior Case Number REQUIRED for Streamline Refinances: ________________________________

6. Please Check:  Direct Guarantee Underwritten  HUD Underwritten

7. Borrower Name & Tribe:____________________________________________________________

8. Co-Borrower Name & Tribe:_________________________________________________________

 Documentation from borrower(s) that evidences current enrollment with a federally recognized tribe or Alaskan Native Corp

9. Property Street Address: _________________________________________________________

City: _____________County_______________ State: ________ Zip Code: _____________

10. Proposed Mortgage Amount: $___________________Loan Term ________________________

11. Please Indicate Land Status of Property:

 Fee Simple (If entire State Approved, No Land Status Form Required)

Tribal Trust Land  Allotted or Individual Trust Land

(For Tribal Trust/Allotted land only) BIA Reservation # ____________ BIA Track # __________

Name of Tribe with Land Jurisdiction: ________________________________________________

 Condominium FHA Condo ID #:____________ Submission #: __________

Condominium Name: ______________________________________________________________

Form HUD-50131 (2/14/2013)