OPG 7.6 Application for 541b Payment

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

Mark-to-Market

Form 7.6

Application for 541(b) Payment
Application for Section 541(b) Payment in connection with a mortgage restructuring under
Section 514 of the Multifamily Assisted Housing Reform and Affordability Act of 1997
Return the completed form to (Closing Escrow Agent) :______________________________________
______________________________________
______________________________________

________________________, Mortgagee, or _________________________, Servicer on behalf of Mortgagee
agrees to accept a Section 541(b) payment from the Department of Housing and Urban Development in the
approximate amount of $________________ as a non-default partial prepayment of the FHA-insured
mortgage.

Project Number:

Name and Location of Project:

Date of this Application:

Aggregate Cash Escrows on Hand at this Date (including Reserves for Replacement)

Mortgagee’s Name, Address, Zip Code:

Servicer’s Name, Address, Zip Code:

Employer Identification Number:
Signature & Title of Mortgagee Official:

Signature & Title of Servicer Official

Public reporting burden for this collection of information is estimated to average 1 hours 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 above- market 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.

Warning: HUD will prosecute false claims and statements. Conviction may result in criminal and/or civil penalties. (18
U.S.C. 1001, 1010, 1012; 31 U.S.C. 3729, 3802)

September 30, 2004

Form 7.6, Page 2