3 Secondary Loan Requirements Certification with Itemizati

U.S. Department of Treasury
CDFI Bond Guarantee Program

Secondary Loan Requirements Certification
Name and Address of Qualified Issuer:
Loan Number:
Name and Address of Eligible CDFI:

Name and Address of Secondary Borrower:

Name and Address of Project:

Asset Class (check one):
CDFI-to-CDFI
CDFI to Financing Entity (other than a Certified
CDFI)
Charter Schools
Commercial Real Estate
Daycare Centers
Healthcare Facilities
Rental Housing
Rural Infrastructure
Owner-occupied homes
Licensed Senior Living and Long-Term Care
Facilities
Small Business (for-profit)
Not-For-Profit Organizations

Project Description:

OMB Control Number: 1559-0044
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U.S. Department of Treasury
CDFI Bond Guarantee Program

Certification of Secondary Loan Requirements:
I, [INSERT NAME OF AUTHORIZED REPRESENTATIVE], do hereby certify that I am the duly appointed
[INSERT TITLE OF AUTHORIZED REPRESENTATIVE] of [INSERT NAME OF ELIGIBLE CDFI]
(the Eligible CDFI). As the Authorized Representative of the Eligible CDFI, I do hereby certify:
1. The proposed Secondary Loan to [INSERT NAME OF SECONDARY BORROWER] (the
Proposed Secondary Loan) is for the purpose of [financing/refinancing] [INSERT PROJECT
NAME] (the Project).
2.

Loan #_________:
Is for an Eligible Purpose as such term is defined in the CDFI Bond Guarantee Program
regulations (12 CFR 1808) and in the Bond Loan Agreement, dated
, 20
, between
the Qualified Issuer (as lender) and the Eligible CDFI (as borrower).
Has received credit approval from Eligible CDFI’s credit committee (or equivalent). Evidence of
approval is attached hereto.
Has received such approval pursuant to the loan policies and procedures reviewed and approved
by the CDFI Fund for purposes of the CDFI Bond Guarantee Program.
Will satisfy all conditions of said credit committee approval upon closing.
Secondary Borrower has not experienced any material events that may adversely affect the credit
quality of this loan.
Upon closing, will be secured by senior lien on pledged collateral or Principal Loss Collateral
provision as required by the CDFI Bond Guarantee Program.
Satisfies in form and substance to the applicable Secondary Loan Requirements.

3. The Proposed Secondary Loan will close in a commercially reasonable time but in all cases within
CDFI Bond Guarantee Program parameters.
By signing this Certification on behalf of the Eligible CDFI, I certify that the statements herein are true, complete
and accurate to the best of my knowledge. I am aware that any false, fictitious, or fraudulent statements or claims
may subject me to criminal, civil, or administrative penalties (U.S. Code, Title 218, Section 1001).

Name and Title:
Signature:
Date:

OMB Control Number: 1559-0044
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U.S. Department of the Treasury
CDFI Bond Guarantee Program
Report Submission Date

Itemization of Collateral Form:

Secondary Loans and Other Pledged Loans

mm/dd/yyyy

ABCD

Eligible CDFI ID

Please use this form to list all loans that are currently pledged to the Trust Estate, and any loans for which the status has changed since the last submission of this form.

Loan ID:
Loan ID:
Loan ID:
Loan ID:
Loan ID:
Loan ID:
Loan ID:
Loan ID:
Loan ID:
Loan ID:
Loan ID:
Loan ID:

The "Add Row for New Pledged Collateral" button
adds a row above the row in which a cell is
currently selected. Prior to clicking the button to the
left, ensure that a cell within the last available Loan
ID row (double underlined) is selected.

TOTAL

$

OMB Control Number: 1559-0044

-

$

-

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Item H: Other

Item G: Intercreditor Agreement

Date of
Maturity

Item F: Security Agreement

Outstanding
Principal

Original Principal

Item E: Loan Agreement

Release Date3

Item D: Assignment Agreement

Pledge Date2

Item C: Promissory Note

Status1

Item B: Recorded UCC-1

Collateral Type

Item A: Recorded Mortgage

Certification Diligence Items

Comment Section: In the space below, please include the following: identify those loans listed above that involve a parity lien structure; briefly describe the reason why a loan is being "Released" (and
specifically note any loans being released as a result of non-performance); for "Other" diligence items, please provide a brief description of the item's content.

Loan ID:
Loan ID:
Loan ID:
Loan ID:
Loan ID:
Loan ID:
The "Add Row for Pledged Collateral Comment" button
adds a row above the row in which a cell is currently
selected. Prior to clicking the button to the left, ensure
that a cell within the last available comment row (double
underlined) is selected.
By signing this Certification, I certify that: i) the statements herein are true, complete and accurate to the best of my knowledge, ii) the Secondary Loans and Other Pledged Loans listed in this Itemization of
Collateral Form continue to satisfy the applicable Secondary Loan Requirements, and iii) the original executed specimen promissory notes or other instruments of indebtedness for the Secondary Loans and
Other Pledged Loans contained in this Itemization of Collateral Form have been delivered (or will be delivered upon submission of this Itemization to the CDFI Fund) to the Qualified Issuer or Custodian.
Designated Officer Signatures
Eligible CDFI

Qualified Issuer

Designated Officer Signature

Designated Officer Signature

Designated Officer Name

Designated Officer Name

Designated Officer Title

Designated Officer Title

1

"Added" should be selected for those loans that were not included on a previously submitted version of this form, and are now being pledged as collateral.

"Pledged" should be selected for those loans that were listed on a previously submitted version of this form, and are continuing to be pledged as collateral.

"Released" refers to those loans that were listed on a previously submitted version of this form, and were previously pledged as collateral, but are no longer being pledged as of the submission date on this form.

2
The "Pledge Date" should reflect the date on which Bond Loan proceeds were used to fund any portion of the Pledged Loan. This date should be no earlier than the "Submission Date" listed on this Itemization of Collateral

Form, and no later than the "Requested Advance Date" listed on the Requisition Approval Notice.

3

The "Release Date" should reflect the date on which the Pledged Loan is no longer being pledged as collateral for the Bond Loan.

OMB Control Number: 1559-0044

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