HUD 50131 - Revise Family Self-Sufficiency (FSS) Program Coordinator Fundin

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 must be ELECTRONICALLY FILLED & EMAILED to [email protected].

1. L

   
   

   
   

   
   

   ender Name: TIN# (No Dashes):

2. L

   
   

   
   

   ender Contact Name: Email:

3. L

   
   

   ender Telephone: Lender Fax:

4. Lender Sponsor (if applicable):

5. Please Indicate Purpose of Loan (select one):

­­­­­­­­­­­­ Refinance: Acquisition: Construction:

Streamline with Appraisal Acquisition of existing Single Closed Proposed

Streamline without Appraisal Acquisition/Rehab of existing

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

Credit Qualifying with cash out

Credit Qualifying with no cash

Credit Qualifying with escrow

6. Prior Case Number REQUIRED for Streamline Refinances:

7. Please Select One:

Direct Guarantee Underwritten

HUD Underwritten

8. Borrower: First Name: M.I.: Last Name:

   
   

9. B

   
   

   orrower: Tribal Affiliation:

10. Co-Borrower Name & Tribe: ________________________________________________________



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

11. P

    
    

    
    

    
    

    
    

    roperty Street Address:

C

ity: County: State: Zip Code:

12. Proposed Mortgage Amount: $ Loan Term (months): Number of Units:

13. Please Indicate Land Status of Property:

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

Tribal Trust Land

Allotted or Individual Trust

(

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

N

ame of Tribe with Land Jurisdiction:

Condominium FHA Condo ID #: Submission #:

Condominium Name:

Form HUD-50131 (11/23/2015)