HUD-50119-A Section 184A Native Hawaiian Housing Loan Guarantee Prog

OMB Approval No.
(exp. )

SECTION 184A NATIVE HAWAIIAN HOUSING LOAN GUARANTEE PROGRAM
POST ENDORSEMENT SUBMISSION CHECKLIST – DIRECT GUARANTEE
(Single Close New Construction and Rehabilitation Documents)
BORROWER(S): _________________________________________________ CASE#:______________
ITEM

INCLUDED

ALL SINGLE CLOSE NEW CONSTRUCTION / REHABILITATION LOANS:
Builder Permit (issued prior to start of construction)
Certificate of Occupancy (or its equivalent issued by local jurisdiction in those jurisdictions that perform three
local inspections and issue a Certificate of Occupancy [or equivalent], this certificate is evidence of
completion of the local inspections)
If both items listed above are not submitted, a HUD-approved 10-year warranty plan with a final inspection
(by an FHA roster inspector or qualified individual) is required to be submitted.
Builder Certification of Plans, Specifications and Site (Form HUD-92541)
Warranty of Substantial Completion (184A Form HUD-50110-A)
Modification to Plans and Specifications – A set of revised plans and specifications showing all approved
changes to the original plans and specifications
Draw Requests (all draws including final) showing the amount and to whom disbursements were made and
copies of corresponding checks for disbursement
Compliance Inspection Reports, Form HUD-92051 (one for each draw) signed by the inspector
Request for Acceptance of Changes in Approved Drawings and Specifications (Change Orders) Form HUD92577 – copy of all change order requests
Final Inspection OR Recertification of Value of the completed property by the Appraiser with photos
Mortgagor’s Letter of Completion – Borrower certification that construction was completed in a workman like
manner in accordance with the plans and specifications and approved change orders, if any
Contingency Release Notice – Executed notice that shows amount and use of contingency funds
Construction Escrow Breakdown – documenting all funds disbursed from each category and the amount
remaining in each category
Specific Condition(s) Clearance documentation (such as termite inspections, local health authority approvals
for well and septic, etc.)
Final Release Notice (prepared for DG underwriter’s signature) – upon receipt of the above items, the DG
underwriter will execute the final release notice and provide instructions on release of the remaining funds, if
applicable
Release of Funds – submission of mortgage payment history that confirms the principle reduction payment
made and evidence of any reimbursements made to third parties
Mortgagee’s Assurance of Completion – Where escrow was established for minor incomplete work (184A
form HUD-50118-A)

Privacy Act Statement. This statement is provided pursuant to the Privacy Act of 1974, 5 USC § 552a. The authority
for collecting personally identifiable information (PII) in the Regulatory Consistency Communication Board
(RCCB) Electronic Feedback Form is based in Section 313 of Public Law 112-95.

Form HUD-50119-A (date)

OMB Approval No.
(exp. )

Public reporting burden for this collection of information is estimated to average .15 hours per response, including
the time for reviewing instructions, searching existing data sources, gather and maintaining the data needed, and
completing and reviewing the collection of information. HUD may not collect this information, and you are not
required to complete this form, unless it displays a currently valid OMB control number.
This information is required in order for an eligible homebuyer to obtain a benefit and for HUD to administer the
Loan Guarantee Program for low-income Native Americans, Alaska Natives, and native Hawaiians (24 CFR
Parts1000 and 6000). The requested information is necessary to determine the income and credit worthiness of low
income homebuyers. If HUD did not collect this information, it would prevent HUD from guaranteeing mortgages
to eligible homebuyers. While no assurances of confidentiality are pledged to respondents, HUD generally discloses
this data only in response to a Freedom of Information request.

Form HUD-50119-A (date)