OPG 7.25 Payment Information Form

OMB No. 2502-0533
(Exp, 12/31/2017)
Mark-to-Market

Form 7.25

Payment Information Form
FHA Project Number:

-

The information requested concerning the mortgagee's financial institution should be available through the mortgagee's
Treasurer.
If the mortgagee's financial institution has access to the Federal Reserve Communication System, please complete only items 1
through 9 and items 14-16. If the mortgagee's financial institution does not have access to the Federal Reserve Communication
System, please complete all items except item 7.
1. Bank Account Name (must match Section III of Form 7.5 EXACTLY)
2. Full Address for named account

3. Contact Person (must match Closing Escrow Agent name from Section I of Form 7.5)

4. Phone Number

5. Name of Financial Institution
6. Full Address of Financial Institution

7. Financial Institution ABA Number (Only 1 digit per box) (Complete only if the mortgagee's financial institution has access to the Federal Reserve Communication System)

8. Telegraphic abbreviation of Financial Institution

9. Account Number at the mortgagee's financial institution to be credited with the funds

10. Type of Correspondent Financial Institution to Receive Electronic Funds Transfer
(If the mortgagee does not have access to the Federal Reserve Communication
)

11. Full Address of Correspondent Financial Institution

12. Correspondent Financial Institution ABA Number (Only 1 digit per box) (For routing transfer of funds)

13. Telegraphic abbreviation of Correspondent Financial Institution

14. Mortgagor Tax Identification Number (must match Form 7.5)

15. Mortgagee Tax Identification Number (must match Form 7.5)

Comments

PAE Name and address

February 3, 2005

form 7.25

16. Name and Title of person at PAE preparing form

Signature

Date (mm/dd/yyyy)

Public reporting burden for this collection of information is estimated to average 1 hour 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 information is required to obtain benefits. The Office of Multifamily Housing,
Office of Recapitalization, 451 7th Street SW, Room 6230 Washington, DC 20410. HUD may
not collect this information, and you are not required to complete this form, unless it displays a
currently valid OMB control number. Title V of the Departments of Veterans Affairs and
Housing and Urban Development and Independent Agencies Appropriations Act of 1988
(P.L.105-65, 111 Stat. 1384) authorizes the FHA Multifamily Housing Mortgage and Housing
Assistance Restructuring Program. HUD implemented a statutory permanent program directed
at FHA-insured multifamily projects that have project- based Section 8contracts with abovemarket rents. The information collection is used to determine criteria eligibility of FHA-insured
multifamily properties for participation in the Mark to Market program and the terms on which
participation should occur. The purpose of the program is to preserve low-income rental housing
affordability while reducing the long-term costs of Federal rental assistance. While no
assurances of confidentiality are pledged to respondents, HUD generally discloses this data only
in response to a Freedom of Information request.
February 3, 2005

form 7.25