Transactional Documents for Mortgagees and Contractors

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Multifamily Insurance Benefit Claim
Section 232
Payment Information in
Support of Claim
Treasury Financial Communication System for Mortgage Wiring Instructions
U.S. Department of Housing
and Urban Development
Office of Residential
Care Facilities
OMB Approval No. 2502-0605
(exp. 03/31/2018)

Public reporting burden for this collection of information is estimated to average 0.5 hours.  This includes the time for collecting, reviewing, and reporting the data.  The information is being collected to obtain the supportive documentation that 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: Any person who knowingly presents a false, fictitious, or fraudulent statement or claim in a matter within the jurisdiction of the U.S. Department of Housing and Urban Development is subject to criminal penalties, civil liability, and administrative sanctions.  

The information requested concerning the mortgagee's financial institution should be available through the mortgagee's Treasurer.
If the mortgagee's financial institution has access to the Federal Reserve Communication System, please complete only items 1 through 9 and item 14.
If the mortgagee's financial institution does not have access to the Federal Reserve Communication System, please complete all items except item 7.
FHA Project Number:      
    1. Name of Mortgagee:
     
    2. Full Address:
     
    3. Contact Person:
     
    4. Phone Number:
     
    5. Name of Financial Institution:
     
    6. Full Address of Financial Institution:
     
    7. Financial Institution ABA Number (Only 1 digit per box) (Complete only if the mortgagee's financial institution has access to the Federal Reserve Communication System)
                                         
    8. Telegraphic abbreviation of Financial Institution:
     
    9. Account Number at the Mortgagee's Financial Institution to be credited with the Funds:
     
    10. Type of Correspondent Financial Institution to receive Electronic Funds Transfer (if the mortgagee does not have access to the Federal Reserve Communication System):
     

    11. Full Address of Correspondent Financial Institution:      

    12. Correspondent Financial Institution ABA Number (Only 1 digit per box) (For routing transfer of funds)
                                         
    13. Telegraphic abbreviation of Correspondent Financial Institution:      
Comments:
     

Mail to:
                   
    14. Title of Person completing this Form:      
Signature
Date:      


Mortgagee/Servicer should retain 1 copy.
Send original and 1 copy to the: U.S. Department of Housing and Urban Development
                                                      Multifamily Claims Branch, HWAFRC
                                                      451 Seventh Street, S.W.
                                                      Washington, DC 20410-8000.