HUD-92023-OHF Request for Final Endorsement of Credit Instrument - Hos

Request for Final Endorsement of Credit Instrument Section 242

U.S. Department of Housing and Urban Development Office of Hospital Facilities

OMB Approval No. 2502-0602 (Exp. 08/31/2019)

Public reporting burden for this collection of information is estimated to average 2 hours. This includes the time for collecting, reviewing, and reporting the data. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Reports Management Officer, QDAM, U.S. Department of Housing and Urban Development, Washington, DC 20410-5000. Do not send this completed form to the above address. The information requested is required to obtain the benefit under Section 242 of the National Housing Act. No confidentiality is assured. The information is being collected to obtain the supportive documentation which must be submitted to HUD for approval, and is necessary to ensure that viable projects are developed and maintained. The Department will use this information to determine if properties meet HUD requirements with respect to development, operation and/or asset management, as well as ensuring the continued marketability of the properties. This agency may not collect this information, and you are not required to complete this form, unless it displays a currently valid OMB control number. 

Warning: Federal law provides that anyone who knowingly or willfully submits (or causes to submit) a document containing any false, fictitious, misleading, or fraudulent statement/certification or entry may be criminally prosecuted and may incur civil administrative liability. Penalties upon conviction can include a fine and imprisonment, as provided pursuant to applicable law, which includes, but is not limited to, 18 U.S.C. 1001, 1010, 1012; 31 U.S.C. 3729, 3802; 24 C.F.R. Parts 25, 28 and 30, and 2 C.F.R. Parts 180 and 2424. 

Project Name:		FHA Project Number:
Project Address:
Date of Commitment:	Borrower:

The definition of any capitalized term or word used herein can be found in this Request for Final Endorsement of Credit Instrument, the Security Instrument, the Note and/or the Regulatory Agreement between Borrower and HUD.

To the Department of Housing and Urban Development (“HUD”):

The undersigned declares that construction of this Project is complete for purposes of going to final endorsement*; and that advances have been made to Borrower in accordance with your Certificate of Insurance on the dates and in the amounts set forth in the schedule below; that the undersigned has paid no kickback and no fee or other consideration, directly or indirectly, to any person who has received payment or other consideration from any other person in connection with this transaction, including the purchase or sale of the Mortgaged Property, except for compensation paid, if any, for the actual performance of services and approved by you; and that to the best of the undersigned's knowledge and belief the Loan is now eligible for mortgage insurance and, accordingly, the undersigned hereby requests final endorsement of the Note for mortgage insurance in the total sum of $______________________ .

Schedule of Advances
Date	Amount		Date	Amount
Subtotal (amount advanced to date):					$
A final advance in the following amount will be disbursed immediately upon your final endorsement of the Note for insurance					$
The total of all advances made, including the final advance, is:					$
The Lender affirms that the statements and representations of fact by Lender contained in this instrument are, to the best of Lender’s knowledge, true, accurate, and complete. This instrument has been made, presented, and delivered for the purpose of influencing an official action of HUD in insuring the Loan, and may be relied upon by HUD as a true statement of the facts contained therein.
Lender:		By: (Signature & Title) X			Date:
* Minor items of construction still to be completed are covered by an Escrow Agreement for Incomplete Construction (HUD-92456-OHF), three conformed copies whereof are herewith delivered to you. There is held in escrow as a guarantee of the completion thereof the amounts determined by your office as necessary for such purpose.

Certificate of Borrower

FHA Project Number:

To: Department of Housing and Urban Development (HUD):

In order to induce HUD to finally endorse the Note for mortgage insurance, and with the intent that HUD rely upon the statements hereinafter set forth, the undersigned makes the following certifications:

1. That it has received the sum of $______________________________________________ which when added to the final advance will total $_________________________________, constituting the full insurable amount of the Loan for this Project.

2. That construction of the Project is complete and is in accordance with the plans and specifications approved by HUD; that the Security Instrument is a good and valid first lien on the Mortgaged Property therein described; that the Mortgaged Property is free and clear of all liens other than that of the Security Instrument except for a lien approved by HUD given in favor of a government entity or other HUD-approved lien expressly subordinate to the first lien of the Loan; that all outstanding unpaid obligations and past due interest payments contracted by or on behalf of Borrower, directly or indirectly, in connection with the Loan transaction, the acquisition of the Mortgaged Property, the construction of the Project, or any arrearages are listed below:

*	(a) HUD-approved notes (copies attached)	$
	(b) Due General Contractor [or Construction Manager]	$
*	(c) Other	$

3. That, except for the amounts due on notes listed in item (a) of paragraph 2 above, the undersigned agrees to pay the foregoing obligations in cash and to furnish HUD receipts, or other evidence of payment satisfactory to HUD, within 45 days following receipt of the final advance of Loan proceeds on its “Borrower’s Certificate of Actual Cost” (HUD-92330-OHF), supported by the documentation required therein. Borrower further agrees that if HUD accepts estimates for any items, Borrower shall, at final endorsement, establish a cash escrow in the amount of $___________________ to pay all the “to be paid in cash items” identified on its Certificate of Actual Cost and debts to third parties who made the original disbursements for an item listed as paid on HUD-92330-OHF, unless documentation, satisfactory to HUD, evidences that these amounts were paid by Borrower subsequent to the submission of its Certificate of Actual Cost. Borrower understands that the items covered by this cash escrow must be paid within 45 days of the date of final endorsement.

The Borrower certifies under penalty of perjury that the statements and representations of fact by Borrower contained in this instrument are, to the best of Borrower’s knowledge, true, accurate, and complete. This instrument has been made, presented, and delivered for the purpose of influencing an official action of HUD in insuring the Loan, and may be relied upon by HUD as a true statement of the facts contained therein.

Borrower:	By: (Signature & Title) X	Date:
*Note: This includes any past due amount under the construction loan. (If the space provided is inadequate to list all unpaid obligations, insert the total in each category and attach itemizations. If there are no outstanding obligations, so state.)

Certificate of General Contractor [or Construction Manager]

FHA Project Number:

To the Department of Housing and Urban Development (HUD):

The undersigned, as General Contractor [or Construction Manager] of the above project, makes the following certifications:

1. That construction is in accordance with the plans and specifications that were approved by HUD.

2. That all outstanding unpaid obligations contracted by or on behalf of the undersigned in connection with the construction contract are listed below. (If space below is inadequate, continue listing on an attached sheet and so note.)

(a)	$
(b)	$
(c)	$

3. That, except for unfinished work covered by an approved escrow deposit, the undersigned agrees to pay the foregoing obligations in cash, within 15 days following receipt of payment from Borrower.

The General Contractor [or Construction Manager] certifies under penalty of perjury that the statements and representations of fact by General Contractor [or Construction Manager] contained in this instrument are, to the best of General Contractor’s [or Construction Manager’s] knowledge, true, accurate, and complete. This instrument has been made, presented, and delivered for the purpose of influencing an official action of HUD in insuring the Loan, and may be relied upon by HUD as a true statement of the facts contained therein.

General Contractor [or Construction Manager]:

By: (Signature & Title) X

Date:

Previous versions obsolete Page 3 of 3 form HUD-92023-OHF