HUD-56146 Debt Resolution Program Repayment Agreement

Debt Resolution Program
Repayment Agreement

U.S. Department of Housing

OMB Approval No. 2502-0483

and Urban Development
Office of Housing
Federal Housing Commissioner

(exp.07/31/2019)

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 voluntary. HUD may not collect this information, and you are not required to complete this
form, unless it displays a currently valid OMB control number.
Section 2(c) of the National Housing Act authorizes the Secretary of the Department of Housing and Urban Development to collect or
compromise all obligations assigned to or held by the Secretary and all legal or equitable rights accruing to HUD in connection with
the payment of a HUD-insured loan until such times as such obligations may be referred to the Attorney General for suit or collection.
The information is collected under P.L. 479 and is used to determine the debtor’s attitude about repayment of the debt and her/his
ability to repay the debt. Attempts should be made to secure a signed Repayment Agreement. The information is considered
confidential. The Privacy Act of 1974 protects the debtors. HUD generally discloses this data only in response to a Freedom of
Information request.
HUD Claim Number: ______________. This Agreement is entered into on this date ____________between ___________________________
hereafter referred to as “I” , “My”, or "Me", and the Secretary of Housing and Urban Development, his/her successors and assigns,
hereafter referred to as “HUD."
My address is:
I am indebted to HUD in the amount of $__________ and my debt is past due. HUD has made demand for payment, but I am unable
to pay the debt in a lump sum. HUD is willing to forego collection of the entire amount of the debt, at this time and accept periodic
payments of the amount I owe, with interest, if I pay the debt in accordance with the conditions set forth below.
In consideration of my signing this Agreement, HUD agrees to forbear the pursuing legal and equitable remedies against me, but only for so long
as I make timely payments under the terms of this Agreement.
I shall pay $_________on or before the ____ of each month, until this debt plus continuing interest at ____% and fees, is paid in full, or  otherwise
settled. The first payment is due by ______________. I will make monthly payments as specified on monthly billing statements sent by
HUD. However, the failure of HUD to provide a monthly statement shall not relieve me of the responsibility to make the required payment.
No delay or omission by HUD to exercise any right to which it might be entitled shall be construed to be a waiver of any such right, and
every such right may be exercised from time to time and as often as may be deemed necessary by HUD.
This Agreement is assignable by HUD but may be amended only by a written instrument executed by HUD or its assignee, and by me.
Upon HUD’s request, I will furnish HUD annually on the anniversary date of this Agreement a financial statement that shows my assets
and liabilities and my monthly income and expenses. If, in HUD’s opinion, my financial status has changed sufficiently to warrant a
change in payment, this Agreement will be subject to modification or termination, depending on the circumstances at the time.
Further, this Agreement is made knowingly, voluntarily and intelligently and not under any degree of duress or compulsion whatsoever.

__________________________________
Debtor: (Print or type name here.)

______________________________
(Sign name here.)

___________
Date

___________________________________
Debtor: (Print or type name here.)

_______________________________
                        (Sign name here.)

____________
Date

___________________________________
Debt Servicing Representative for HUD

_______________________________
(Sign name here.)

____________
Date

__________________________________________________________________________________________________________
Form HUD-56146 (07/2012)
            Ref. Handbook 4740.2