Public reporting burden for this collection of information is estimated to average 0.5 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 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. Response to this request for information is required in order to receive the benefits to be derived from the National Housing Act Section 232 Healthcare Facility Insurance Program. 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. While no assurance of confidentiality is pledged to respondents, HUD generally discloses this data only in response to a Freedom of Information Act request.
Warning: Anyone who knowingly submits a false claim or makes a false statement is subject to criminal and/or civil penalties, including confinement for up to 5 years, fines, and civil and administrative penalties. (18 U.S.C. §§ 287, 1001, 1010, 1012; 31 U.S.C. §3729, 3802). |
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Project Name: |
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Project Number: |
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Program Type: |
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Instructions |
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| 1. |
Complete the project name, project number, and program type on this page (column D). |
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It will be carried forward to other tabs. |
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| 2. |
Fields to be completed are shaded in aqua. |
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| 3. |
For 223f, 223a7, 223d, and 232i complete the applicable Sources and Uses tab before |
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completing the criteria. |
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For 223f if the Maximum Insurable Loan is less than Criteria H then amend the Sources |
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and Uses tab to reflect the correct loan amount and other line items affected by the loan amount. |
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For NC and 241a complete the Land Calculation, Other Fees, Replacement Cost |
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and Sources and Uses tabs before completing the criteria. |
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Formulas on the criteria pages use data from the Land Calculation, Replacement Cost and |
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Sources and Uses tab. |
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| 4. |
232 Handbook benchmarks should be used for all criteria. Do not use regulatory percentages. |
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| 5. |
The MILC should reflect benchmarks in the 232 Handbook. If the requested mortgage amount |
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exceeds the lowest of all applicable criteria a waiver request (Form HUD-2-ORCF) must |
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be included as part of the application and attached to the HUD-92264a-ORCF as an exhibit. |
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| 6. |
Applicable criteria are shown in the Criteria by Program tab. That tab and this instructions |
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tab are for information purposes only and are not to be attached to the Firm Commitment. |
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| 7. |
Fields with red arrows in the corner have additional notes. Placing your cursor over the |
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those fields will make them appear. |
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| 8. |
The percentage fields in the S & U tab for 223(f), 223(a)(7), 223(d) and 232(i) only drive the |
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calculations for Criteria G and H. Enter the actual, fixed dollar amount in the adjacent fields |
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when the mortgage amount has been determined. Both percentages and dollars must be |
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provided for all calculations to be completed. |
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| 9. |
The mortgage amount should be entered as the lowest of all applicable criteria. See the |
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Criteria by Program Type chart to determine which criteria apply. |
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| 10. |
A lender's underwriter signature and date are required for all submissions. |
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| 11. |
223f, 223a7, 223d, and 232i Firm Commitments should include the applicable Sources and |
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Uses page and the Maximum Insurable Loan Calculation pages. |
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| 12. |
NC, SR and 241a Firm Commitments should include the Land Calculation, Other Fees, |
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and Replacement Cost pages, the applicable Sources and Uses page, and the |
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Maximum Insurable Loan Calculation pages. |
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Requested Loan Amount |
Original Principal Balance |
Amount Based on Replacement Cost |
Amount Based on Loan to Value |
Amount Based on Debt Service Coverage |
Amount Based on Estimated Cost of Rehabilitation Plus |
Amount Based on Borrower's Total Cost of Acquisition |
Amount Based on the Cost to Refinance |
Amount Based on Total Indebtedness |
Amount Based on 100% of the Operating Loss |
Amount Based on 100% of the Cost of Fire Safety Equipment |
Amount Based on Deduction of Grant(s), Loan(s), LIHTCs and Gift(s) for Mortgageable Items |
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A. |
B. |
C. |
D. |
E. |
F. |
G. |
H. |
I. |
J. |
K. |
L. |
| Section 232 New Construction |
X |
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X |
X |
X |
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X |
| Section 232 Substantial Rehabilitation |
X |
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X |
X |
X |
X |
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X |
| Section 232/241(a) |
X |
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X |
X |
X |
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X |
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X |
| Section 232/223(f) |
X |
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X |
X |
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Used for Acquisition Projects
X |
Used for Refinances
X |
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X |
| Section 232/223(a)(7) |
X |
X |
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X |
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X |
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| Section 223(d) |
X |
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X |
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X |
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| Section 232(i) |
X |
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X |
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| Sources and Uses |
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| Pursuant to Sections 223(f), 223(a)(7), 223(d) and 232(i) |
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| Project Name: |
0 |
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| Project Number: |
0 |
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| Program Type: |
0 |
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| SOURCES |
HUD Insured Loan |
$0.00 |
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Existing Replacement Reserves to Transfer |
$0.00 |
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This should either be zero or a positive number.
Cash/Letter of Credit |
$0.00 |
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Interest rate premiums may only be applied on behalf of the borrower to prepayment penalties and reserves for replacement. The transaction costs in MILC Criterion H are reduced by the amount of the interest rate premium.
Interest Rate Premium |
$0.00 |
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Other (Describe) |
$0.00 |
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Other (Describe) |
$0.00 |
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TOTAL |
$0.00 |
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| USES |
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HUD ELIGIBLE COSTS |
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Refer to the 232 Handbook for guidance on eligible debt and purchases. If you still have questions after reviewing the 232 Handbook, email [email protected].
Existing Indebtedness or Purchase Price |
$0.00 |
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Prepayment Penalty |
$0.00 |
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This does not include any R4R transfer.
Initial Deposit to the Reserve for Replacement |
$0.00 |
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Existing Replacement Reserves to Transfer |
$0.00 |
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Estimate of Repair Cost (Critical & Non Critical) |
$0.00 |
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Appraisal (incl. update) |
$0.00 |
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Phase I ESA / HUD 4128 |
$0.00 |
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PCNA |
$0.00 |
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Financing/Placement Fee |
$0.00 |
0.00% |
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If this is included in the financing/placement fee percentage calculation please detail the dollars here.
Lender Legal |
$0.00 |
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Borrower Legal |
$0.00 |
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Title & Recording |
$0.00 |
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If the lender is administering the non-critical repair escrow then the refundable payment is a non-eligible use of funds.
HUD Inspection Fee |
$0.00 |
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First Year MIP |
$0.00 |
0.00% |
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.15% of the requested mortgage amount for 223(a)(7)s
HUD Application Fee |
$0.00 |
0.00% |
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Survey |
$0.00 |
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Additional Other Fees (Describe) |
$0.00 |
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Lender Inspection Fee/PCNA Closeout Fee |
$0.00 |
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Other (Describe) |
$0.00 |
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TOTAL HUD ELIGIBLE COSTS |
$0.00 |
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NON-ELIGIBLE COSTS |
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This is to be used for non-mortgageable debt service reserve escrow.
Special Escrow - Debt Service Reserve |
$0.00 |
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20% of incomplete repairs for 223(f), 10% for 223(a)(7).
Repair Completion Assurance Escrow |
$0.00 |
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Other (Describe) |
$0.00 |
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Other (Describe) |
$0.00 |
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Other (Describe) |
$0.00 |
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TOTAL ADDITIONAL COSTS |
$0.00 |
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TOTAL COSTS |
$0.00 |
ok |
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| Information Concerning Land or Property |
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Pursuant to New Construction, Substantial
Rehabilitation and Section 241(a) |
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| Last Arms-Length Transaction |
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| Buyer |
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| Seller |
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| Date Acquired |
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| Purchase Price |
$0.00 |
| Additional Cost |
$0.00 |
| Total Cost |
$0.00 |
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| Annual Ground Rent |
$0.00 |
| Note: If this is an allocation of a purchase of a larger site or a combination of multiple sites |
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| provide detail (including basis of allocation) below. Insert additional page if needed. |
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| Special Assessments |
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| Prepayable, Non-Prepayable or N/A |
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| Principal Balance |
$0.00 |
| Annual Payment |
$0.00 |
| Remaining Term |
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| Value of Land and Cost Certification |
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| Fair Market Value of land fully improved |
$0.00 |
| Deduct unusual land improvements |
$0.00 |
| Equals warranted price of land fully improved |
$0.00 |
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| For Cost Certification Purposes: |
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| Demolition |
$0.00 |
| Off-site Cost |
$0.00 |
| Estimate of "as is" by subtraction from improved value |
$0.00 |
| Estimate of "as is" by comparison (from appraisal) |
$0.00 |
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Only enter if land is purchased from LPA or other Governmental authority for specific reuse.
"As is" based on acquisition cost (include legal, title, etc.) |
$0.00 |
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If this differs from the warranted price of land on the replacement cost tab include additional page with explanation.
Estimate of value of land "as is" for cost certification purposes |
$0.00 |
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All construction contract items should match figures on the 92328-ORCF.
Estimated Replacement Cost |
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Pursuant to New Construction, Substantial
Rehabilitation and Section 241(a) |
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| Unusual Land Improvements |
$0.00 |
| Other Land Improvements |
$0.00 |
| Total Land Improvements |
$0.00 |
| Main Building |
$0.00 |
| Other Structures (identify) |
$0.00 |
| Other Structures (identify) |
$0.00 |
| Total Structures |
$0.00 |
| General Requirements |
$0.00 |
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This should not exceed 2% of the total contract amount.
Contractor General Overhead |
$0.00 |
| Contractor Profit |
$0.00 |
| Architect Design Fee |
$0.00 |
| Architect Supervisory Fee |
$0.00 |
| Bond Premium |
$0.00 |
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| Borrower Other Fees |
$0.00 |
| Contractor Other Fees |
$0.00 |
| Total Other Fees |
$0.00 |
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| Total For All Improvements |
$0.00 |
| Note: Estimated Construction Time (months) |
0 |
| Note: Estimated Interest Time (months) |
0 |
| Note: Estimated Interest Rate (percent) |
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| Interest |
$0.00 |
| Taxes |
$0.00 |
| Insurance |
$0.00 |
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Use detailed guidance from email blasts, mortgagee letters, etc. to determine this figure.
HUD Mortgage Insurance Premium |
$0.00 |
| HUD Application Fee |
$0.00 |
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The formula in cell B33 is for New Construction projects. For Substantial Rehabilitation, and Section 241(a) projects modify the formula to .005*cell B10.
HUD Inspection Fee |
$0.00 |
| Initial Financing Fee |
$0.00 |
| Permanent Placement Fee |
$0.00 |
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Survey may be in Borrower's Other Fees or included in this line item. If it is included here indicate that in lender narrative.
Title and Recording |
$0.00 |
| Total Carrying Charges and Financing |
$0.00 |
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| Legal |
$0.00 |
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Details should be provided in the lender narrative.
Organizational |
$0.00 |
| Borrower's Cost Certification Audit Fee |
$0.00 |
| Total Legal, Organizational, Audit |
$0.00 |
| Major Movable Equipment |
$0.00 |
| Marketing |
$0.00 |
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Rehab only
Contingency |
$0.00 |
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Rehab only--a budget should be provided indicating budgeted number of relocations and detailed cost estimates.
Relocation |
$0.00 |
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Rehab only
Initial Deposit to Reserve for Replacement |
$0.00 |
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Repairs in SR or should be included here.
Other (Describe) |
$0.00 |
| Total Estimated Development Cost |
$0.00 |
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"As is" Value for Rehab projects
Warranted Price of Land |
$0.00 |
| Offsite Costs (Rehab only) |
$0.00 |
| Total Estimated Replacement Cost |
$0.00 |
| Sources and Uses |
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Pursuant to New Construction, Substantial
Rehabilitation and Section 241(a) |
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| Project Name: |
0 |
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| Project Number: |
0 |
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| Program Type: |
0 |
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| SOURCES |
HUD Insured Loan |
$0.00 |
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This should either be zero or a positive number.
Cash/Letter of Credit |
$0.00 |
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Not applicable for new construction
Existing Reserve for Replacement Deposit |
$0.00 |
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Grants/Other Loans (Describe) |
$0.00 |
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Other (Describe) |
$0.00 |
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TOTAL |
$0.00 |
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| USES |
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HUD ELIGIBLE COSTS |
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Existing Indebtedness |
$0.00 |
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Repairs |
$0.00 |
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Initial Deposit to the Reserve for Replacement |
$0.00 |
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Land Purchase |
$0.00 |
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Land Improvements |
$0.00 |
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Structures |
$0.00 |
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General Requirements |
$0.00 |
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Builder’s Overhead |
$0.00 |
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Builder’s Profit |
$0.00 |
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Architect Fees (Design) |
$0.00 |
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Architect Fees (Supervisory) |
$0.00 |
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Bond Premium |
$0.00 |
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during construction period
Interest |
$0.00 |
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during construction period
Taxes |
$0.00 |
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during construction period
Insurance |
$0.00 |
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Appraisal (incl. update) |
$0.00 |
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Market Study |
$0.00 |
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Phase I ESA / HUD 4128 |
$0.00 |
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A&E / Cost Reviews |
$0.00 |
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Financing/Placement Fee/Lender Legal |
$0.00 |
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Borrower Legal |
$0.00 |
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Title and Recording |
$0.00 |
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Borrower's Cost Certification Audit Fee |
$0.00 |
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Major Movable Equipment |
$0.00 |
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Marketing |
$0.00 |
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Pre-Opening Management Fees |
$0.00 |
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HUD Inspection Fee |
$0.00 |
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HUD Initial MIP |
$0.00 |
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HUD Application Fee |
$0.00 |
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Other Fees |
$0.00 |
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Other (Describe) |
$0.00 |
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Other (Describe) |
$0.00 |
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Other (Describe) |
$0.00 |
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Other (Describe) |
$0.00 |
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TOTAL HUD ELIGIBLE COSTS |
$0.00 |
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NON-ELIGIBLE COSTS |
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Initial Operating Deficit Escrow |
$0.00 |
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Working Capital Escrow |
$0.00 |
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Special Escrow - Minor Moveable Equipment |
$0.00 |
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Special Escrow - Demolition |
$0.00 |
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Special Escrow - Off-site Construction |
$0.00 |
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Special Escrow - Short-Term Debt Service Reserve |
$0.00 |
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Non Profit Developer's Fee/Consultant |
$0.00 |
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Other (Describe) |
$0.00 |
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Other (Describe) |
$0.00 |
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TOTAL ADDITIONAL COSTS |
$0.00 |
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TOTAL COSTS |
$0.00 |
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Replacement Cost minus HUD Eligible Costs |
$0.00 |
ok |
Public reporting burden for this collection of information is estimated to average 0.5 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 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. Response to this request for information is required in order to receive the benefits to be derived from the National Housing Act Section 232 Healthcare Facility Insurance Program. 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. While no assurance of confidentiality is pledged to respondents, HUD generally discloses this data only in response to a Freedom of Information Act request.
Warning: Anyone who knowingly submits a false claim or makes a false statement is subject to criminal and/or civil penalties, including confinement for up to 5 years, fines, and civil and administrative penalties. (18 U.S.C. §§ 287, 1001, 1010, 1012; 31 U.S.C. §3729, 3802). |
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| Project Name: |
0 |
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| Project Number: |
0 |
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| Program Type: |
0 |
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| A. Requested Loan Amount |
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$0 |
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232 NC |
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232 SR |
| B. Original Principal Amount |
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$0 |
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232 BR |
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241(a) |
| C. Amount Based on Replacement Cost |
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223(f) |
| a. Replacement Cost in Fee Simple |
241(a): if building an addition, only use replacement cost of the addition. This figure should be recalculated as needed to include costs based on the mortgage amount.
$0 |
x |
90% |
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$0 |
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223(a)(7) |
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When land is leased, enter the optional purchase price specified in the 92070M.
b.(1) Optional Purchase Price from 92070M |
$0 |
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223(d) |
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H08023:
Only deduct items from non-govt. sources here. Use Criteria L to deduct govt. sources.
(2) Grant/Loan funds attributable to R.C. items |
$0 |
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232(i) |
| (3) Excess Unusual Land Improvement |
$0 |
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| (4) Total lines (1) to (3) |
$0 |
x |
90% |
$0 |
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| c. Unpaid Balance of Special Assessment |
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$0 |
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| d. Total line b plus line c |
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$0 |
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| e. Line a minus line d |
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$0 |
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| D. Amount Based on Required Loan to Value |
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| a. Value in Fee Simple |
241(a): Use As-Proposed Value.
$0 |
x |
Use the OHP Loan to Value Limit for the program and project type
241(a): Use 90%
0% |
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$0 |
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When land is leased, enter the optional purchase price specified in the 92070M.
b. Optional Purchase Price from 92070M |
$0 |
x |
Use the OHP Loan to Value Limit for the program and project type
0% |
$0 |
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| c. Unpaid Balance of Special Assessment |
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$0 |
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| d. Less: 90% of As-is Value (for 241(a) only) |
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$0 |
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| e. Total line b plus line c (lines b through d for 241(a)) |
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$0 |
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| f. Line a minus line e |
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$0 |
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| E. Amount Based on Required Debt Service Coverage |
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| a. Mortgage Interest Rate |
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0.00% |
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| b. Mortgage Insurance Premium Rate |
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0.00% |
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| c. Initial Curtail Rate |
Loan term (years) |
0 |
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#NUM! |
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| d. Sum of Above Rates |
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#NUM! |
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Use Lender's Underwritten NOI
e. Net Operating Income |
223(d): insert NOI less existing debt service
$0 |
÷ |
Use 1.11 for 223(d) and 223(a)7
1.45 |
|
$0 |
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| f. Annual Ground Rent + Annual Special Assessment |
$0 |
+ |
$0 |
|
$0 |
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| g. Line e minus line f |
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$0 |
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| h. Line g divided by line d |
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#NUM! |
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| i. Annual Tax Abatement Savings |
$0 |
÷ |
Debt service constant for the abatement period
0.00 |
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$0 |
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| j. Line h plus line i |
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#NUM! |
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| F. Amount Based on Estimated Cost of Rehabilitation Plus |
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| a. Existing Mortgage Indebtedness (Property Owned) or Purchase Price of Property (to be Acquired) |
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$0 |
x |
90 |
% |
$0 |
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| b. "As Is" Value of Prop. Before Rehab. |
$0 |
x |
90 |
% |
$0 |
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| c. Lesser of a. or b. |
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$0 |
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| d. Total Estimated Development Cost |
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$0 |
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| e. Estimated Cost of Off-Site Construction |
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$0 |
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| f. Sum of lines d & e |
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$0 |
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| g. Grant/Loan funds attributable to Replacement Cost items |
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95% Non-Profit
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$0 |
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| h. Line f minus line g |
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$0 |
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| i. Line h plus line c |
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100% if refinance, 85% if purchase
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$0 |
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| G. Amount Based on Borrower's Total Cost of Acquisition Section 223(f) |
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| a. HUD Eligible Costs |
|
$0 |
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| b. Enter the Sum of any Grant/Loan and Reserves for |
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| Replacement and Major Movable Equipment to be |
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| Purchased as an asset of the project |
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| c. Line a minus line b |
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$0 |
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| d. Line c |
x |
90% Non-Profit
85 |
% |
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$0 |
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| H. Amount Based on the Cost to Refinance |
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| a. HUD Eligible Costs |
|
$0 |
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| b. Enter the Sum of any Grant/Loan and Reserves for |
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| Replacement and Major Movable Equipment on Deposit |
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| c. Line a minus line b |
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$0 |
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| I. Amount Based on Total Indebtedness |
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| a. As-Proposed Value |
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$0 |
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| b. Loan-to-Value Percentage |
|
90% |
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| c. Line a times line b |
|
$0 |
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| d. Total of All Outstanding Indebtedness Relating to Property |
|
$0 |
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| e. Line c minus line d |
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$0 |
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| J. Amount based on 100% of the Operating Loss |
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|
Use detailed guidance from email blasts, mortgagee letters, etc. to determine this figure.
$0 |
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| K. Amount based on 100% of the Cost of Fire Safety Equipment |
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| 100% of the Cost of Fire Safety Equipment |
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$0 |
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If grants or loans are used for non-mortgageable items details should be provided in the lender narrative.
L. Amount Based on Deduction of Grant(s), Loan(s), LIHTCs and Gift(s) for mortgageable items |
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| a. 100% Project (Replacement) Cost |
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241(a): if building an addition, only use replacement cost of the addition
$0 |
|
| b. (1) Grants/Loans/Gifts |
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|
$0 |
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| (2) Tax Credits |
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$0 |
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|
When land is leased, enter the optional purchase price specified in the 92070M.
(3) Optional Purchase Price from 92070M |
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$0 |
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| (4) Excess Unusual Land Improvement Cost |
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$0 |
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| (5) Unpaid Balance of Special Assessment |
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$0 |
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| (6) Sum of Lines (1) through (5) |
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|
$0 |
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| c. Line a. minus line b. (6) |
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$0 |
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| Maximum Insurable Loan (Lowest of Foregoing Criteria) |
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|
Round down to the nearest $100.
0 |
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| Notes: |
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| Estimated Liquidated Damages--Construction Contract |
|
0 |
|
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| Incentive Percentage--Construction Contract (if applicable) |
|
0 |
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| Estimated Soft Costs--Construction Period |
|
#DIV/0! |
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| Lender's Underwriter Signature |
Date: |
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| Office of Healthcare Programs Signature |
Date: |
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