Form HUD 92001-A HUD 92001-A Application for Federal Housing Administration (FHA) Len

Application for Federal Housing Administration (FHA)
Lender Approval
U.S. Department of Housing and Urban Development
Section 1: Applicant Information
Name:

OMB Approval Number 2502-0005
exp.10/31/2014

TAX ID:

DBA name(s), if applicable. Use separate sheet for any additional DBAs
NMLS ID of Applicant:
Geographic Address

Date Incorporated, Organized or Chartered:
Mailing Address (if different)

County:

Phone:

Web Site:

eMail:

Contact
Person

Name:

Phone:
Affiliation with Home Builder
Yes
No If yes,

Fiscal Year
End (Month):

Fax:
eMail:

Fax:
Minority/Women-Owned Business (Optional)
Minority-Owned
Women-Owned
Minority-Owned/Women-Owned

Name:
Tax ID:
Offices and Owners. Please see Mortgagee Letter 2011-34 for details on which owners and officers must be listed. In
addition, please indicate which officer will be in charge of the day-to-day operations of the applicant’s planned FHA operations.
Attach a separate sheet for any additional persons or owning entities.
Name of Person or Owning Entity
Title (If Applicable)
Officer in Social Security or Percent
Ownership
Charge? TAX ID Number

FHA Lender Approval Types: Please read the following to determine which approval type to apply for.
Nonsupervised Lender: Correspondent lenders and mortgage lenders should apply for this type of approval if
they want to underwrite, service, and/or own FHA insured loans. This type of approval also allows them to apply
for approval to originate all types of FHA insured loans, including multifamily loans.
Supervised Lender: Banks, savings banks, savings & loans and credit unions should apply for this type of
approval if they want to underwrite, service, and/or own FHA insured loans. This type of approval also allows them
to apply for approval to originate all types of FHA insured loans, including multifamily loans.
Government Lender: Federal, State and local government agencies should apply for this type of approval if they
want to underwrite, service, and/or own FHA insured loans. This type of approval also allows them to apply for
approval to originate all types of FHA insured loans, including multifamily loans.
Investing Lender: Any entity that only wants to own FHA insured loans should apply for this type of approval.

Form HUD-92001-A (08/11)
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Section 2: FHA Lender Approval Type, Loan Programs and Lender Functions
FHA Lender Approval Type
Nonsupervised Lender
Supervised Lender
Government Lender
Investing Lender

FHA Loan Programs

Lender Functions

Title II Single Family (Forward and
Reverse Mortgage Programs)
Title II Multifamily (Rental Housing,
Nursing Homes, Hospitals, etc.)
Title I (Property Improvement and
Manufactured Home Loans)

Originate
Underwrite***
Service
Own

***See HUD Handbook 4155.2 for information on how to obtain Direct Endorsement (DE) Underwriting Approval for Single Family Loans.

Supervised Applicants -- Examined and Supervised by:
Federal Reserve System
Federal Deposit Insurance Corporation
Office of Thrift Supervision

National Credit Union Administration

Other:

Section 3: Certifications and Acknowledgments: Check the appropriate box next to each certification and/or
acknowledgment. You must provide a detailed explanation for any certification where you mark the “No” box. The
explanation must be on the applicant’s letterhead, and must be dated and signed by the same person who signs this
application.
1. I certify I am a corporate officer and/or principal/owner of the above-named applicant with
Yes
the authority to legally bind the applicant and to execute these certifications and
acknowledgments on behalf of the applicant.
2. I certify the applicant is not subject to any assessments or contingent liabilities not disclosed Yes
No
in its financial statements.
3. I certify any required application fee has been paid
Yes
No
4. I certify that neither the applicant nor any of its principals, partners, officers, individuals serving on its board of
directors, managers, supervisors, loan originators, loan processors, loan underwriters, individuals acting as
authorized signatories or other employees are:
(a) Suspended, debarred, under a limited denial of participation (LDP), or otherwise
Yes
No
restricted under Part 25 of Title 24 of the Code of Federal Regulations, 2 Code of
Federal Regulations, Part 180 as implemented by Part 2424, or any successor
regulations to such parts, or under similar provisions of any other Federal or State
agencies;
(b) Under indictment for, have been convicted of, or charged with a felony offense that
Yes
No
reflects adversely upon the applicant’s integrity, competence or fitness to meet the
responsibilities of a FHA approved lender;
(c)
Subject to unresolved findings contained in a Department of Housing and Urban
Yes
No
Development or other governmental audit, investigation, or review;
(d) Engaged in business practices that do not conform to generally accepted practices
Yes
No
of prudent lenders or that demonstrate irresponsibility, including, but not limited to,
failure to satisfy debts due and owing to FHA/HUD, or associating or affiliating, for
the purpose of conducting mortgage business, with a person or entity previously
sanctioned/fined by HUD;
(e) Convicted of, or has pled guilty or nolo contendre (“no contest”) to, a felony related
Yes
No
to participation in the real estate, mortgage loan, or financial services industry—
(1) During the 7-year period preceding the date of the application for licensing
and registration; or
(2) At any time preceding such date of application, if such felony involved an act
of fraud, dishonesty, breach of trust, or money laundering;
(f)
In violation of provisions of the S.A.F.E. Mortgage Licensing Act of 2008 (12 U.S.C.
Yes
No
5101 et seq.) or any applicable provision of state law;
(g) In violation of any other requirement established by the Secretary;
Yes
No
(h) Currently or presently suspended, terminated, debarred, sanctioned, fined,
Yes
No
convicted, denied approval, or subject to a license/approval revocation by any
federal, state, or local government agency, or a government-related entity, where
the action is related to the responsibilities that are commensurate with those of the
financial services industry; and
(i)
Currently involved in a proceeding or subject to an investigation that could result, or
Yes
No
Form HUD-92001-A (08/11)
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5.

6.

7.

8.

9.

10.

11.

has resulted, in suspension, fine, debarment, or other sanction by a federal, state, or
local government agency, conviction in a criminal matter, bankruptcy or loss of
fidelity insurance or errors and omissions insurance coverage.
I certify that no mortgage insurance companies, secondary marketing agencies, warehouse
lenders, or broker/dealers have denied the applicant approval in the past three years from
the date of these certifications.
I certify the applicant, its principals, partners, officers, and/or directors, have not been
subject to any past or present action by HUD, VA, Fannie Mae, Freddie Mac, or other
government-related entity in which there has been a request to repurchase a loan or to
indemnify the entity against loss.
I certify the applicant is not currently subject to, previously been, or is proposed for
regulatory or supervisory action by any regulatory entity. Regulatory actions include, but are
not limited to, supervisory agreements, cease and desist orders, notices of determination,
notices of proposed actions, formal memoranda of understanding, informal memoranda of
understanding, unresolved audits, revocation of license(s) and investigations. Supervisory
actions include, but are not limited to, the appointment of a trustee, receiver, conservator, or
managing agent.
I acknowledge on behalf of the applicant, its continuing obligation to notify HUD’s Lender
Approval and Recertification Division, in writing, within 5 days of any change to the
information or documentation provided in connection with this application for approval while
the this application is pending review.
I certify that neither the applicant nor any of its owners, principals, officers, managers or
supervisors have been involved, through ownership or otherwise, with a previously defaulted
Ginnie Mae issuer(s), an FHA-approved mortgagee that was subject to action by the
Mortgagee Review Board, and/or an entity subject to a civil or criminal action by federal or
state law enforcement.
I certify that, upon the submission of this application, and with its submission of each loan for
insurance or request for insurance benefits, the applicant has and will comply with the
requirements of the Secretary of Housing and Urban Development, which include, but are
not limited to, the National Housing Act (12 U.S.C. § 1702 et seq.) and, HUD’s regulations,
FHA handbooks, mortgagee letters, and Title I letters and policies with regard to using and
maintaining its FHA lender approval.
I acknowledge on behalf of the applicant, its continuing obligation to notify HUD’s Lender
Approval and Recertification Division, in writing, within 10 days of issuance of any notice (or
proposed notice) of violation, revocation, sanction, suspension, or any other administrative
action/proceeding initiated by a state or federal regulatory entity.

Yes

No

Yes

No

Yes

No

Yes

Yes

No

Yes

Yes

I hereby certify that all of the information I have provided on this form and in any accompanying
documentation is true and accurate to the best of my knowledge and belief. I acknowledge that if I
knowingly have made any false, fictitious, or fraudulent statement, representation, or certification
on this form or on any accompanying documents, I, as well as the applicant, may be subject to
administrative action, as well as civil and criminal penalties, including fines and/or imprisonment,
under applicable federal law, including but not limited to 18 U.S.C. §§1001, 1010, and 1012, and
31 U.S.C. §§3729 and 3802.
Name:

Title:

Signature:

Date:

Send the executed application form 92001-A and all required exhibits to one of the following addresses.
US Mail
Overnight Delivery
Dept of HUD
Dept of HUD
FHA Lender Approval & Recertification Division
FHA Lender Approval & Recertification Division
451 7th Street, S.W., Room B133/P3214
490 L’Enfant Plaza East, SW, Suite 3214
Washington, DC 20410
Washington, DC 20024

Form HUD-92001-A (08/11)
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Public Reporting Burden for this collection of information is estimated to average 2.0 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. The information requested on this form is required by 24 CFR Part 202, HUD Handbook 4060.1 or HUD Handbook, 4700.2. The
information collected assists FHA in determining which lenders should be approved to participate in the FHA single and multifamily insurance
programs. It is used to help FHA minimize its risk in insuring single family and multifamily mortgages. Applicants are not required to respond to this
collection of information unless a currently valid approved OMB control number is displayed on the form.
Privacy Act Statement. Names and Social Security Numbers are requested in order for the Department to obtain positive identification of the
applicant’s officers, directors, stockholders and employees who have authority to obligate the applicant. The information requested will be used
solely to determine the eligibility of the individuals to participate in the Department’s mortgage insurance programs. The Department is authorized to
request this information by Executive Order 9397 and it will not be disclosed outside the Department without prior consent except as required or
permitted by law. The Social Security Numbers are provided to HUD on a voluntary basis. Failure to provide this information could cause delay in
processing of the applications. While no assurances of confidentiality are pledged to respondents, HUD generally discloses this data only in
response to a Freedom of Information Act request

Warning: It is a crime to knowingly make false statements to the United States on this or
any other similar form. Penalties upon conviction can include a fine and imprisonment. For
details, see: Title 18 U.S. Code, Sections 1001 and 1010.

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