RD 1944-36 Application for Conditional Commitment

Form RD 1944-36
(Rev 12-05)

Position 3
UNITED STATES DEPARTMENT OF AGRICULTURE
RURAL DEVELOPMENT

FORM APPROVED
OMB NO. 0575-0172
Expiration Date
mm/dd/yy

APPLICATION FOR CONDITIONAL COMMITMENT

Conditional Commitment Applicant's Name

RH Loan Applicant's Name

Complete Address

Complete Address

Number of commitments requested

. Application fee attached $

Number of previous commitments outstanding as of the date of this application
The following will be submitted with this form for each dwelling:
Proposed selling price.
I
II
Complete address and location.
III One of the following for each house to be built or improved:
(A) Evidence of ownership such as the deed or purchase contract; or
(B) A signed or certified copy of the lease if on leasehold estate; or
(C) A signed or certified copy of the option or agreement for purchase.
Conditional commitments will not be approved unless the commitment applicant furnishes the County Supervisor evidence
of ownership of the building site prior to the start of construction.
IV Form RD 424-2, ''Description of Materials'' with complete working drawings, including plot plan, foundation plan, plans of all
floors, including basement if proposed, all principal elevations, grade levels, cabinet and construction details, including a typical
wall section, electrical layout and heating layout. For:
(A) Conditional commitments on home to be built - one complete set.
(B) Houses to be built for a specific applicant - three complete sets.
(C) Rehabilitation of existing buildings - three sets of plans and specifications.
(D) Existing houses less than one year old - one set of plans and specifications. Include a certification by the builder that the
house and any individual water and waste disposal system was built or installed in accordance with the plans and
specifications and approved by appropriate health authorities.
V
If modular/panelized, identify manufacturer and list name, model and dates of plans for house.
VI If manufactured, provide the following:
(A) An itemized cost breakdown of the total package including the unit, eligible options, site development, installation and
lot cost.
(B)
A plot plan and grading plan with existing and finish grade elevations which may be shown on separate grading plan or
on the Master Plot Plan.
(C)
Design calculations, details and drawings for the installation, anchorage and construction of the site-built, permanent
foundation and the permanent perimeter enclosure.
(D)
A schematic floor plan.
(E)
Certification or approval of thermal design conformance in accordance with 7 CFR Part 3550.

A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with a collection of
information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a currently valid OMB Control Number. The OMB Control Number
for this information collection is 0575-0172. Public reporting for this collection of information is estimated to be approximately 30 minutes per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data needed, completing and reviewing the collection of information.
All responses to this collection of information are voluntary. However, in order to obtain or retain a benefit, the information in this form is required (cite authority). Rural
Development has no plans to publish information collected under the provisions of this program. Send comments regarding this burden estimate or any other aspect of this collection of
information, including suggestions for reducing this burden to: Information Collection Clearance Officer, Rural Development Innovation Center, Regulations Management Division at
[email protected]

VII

If an individual water and or waste disposal system is involved:
(A) In case of a home to be built or built within the past year, all of the following will be provided:
(1) Detail drawings with specifications of sewage system, showing cross-section of components with dimensions. If tank
is prefab, indicate make, model number and commercial standard label.
(2) Plot plan showing layout of system indicating distance between its components, dwelling and property lines.
(3) Current percolation test data.
(4) Soil characteristics at a depth of at least 6 feet for disposal field or bed-to-depth of seepage pit when pit is used.
(5) If well is involved, show whether well is dug or drilled and give complete specifications including depth and location
from disposal area, and from waste disposal area or pits on adjoining properties.
(6) Approval by health authority having jurisdiction in the area.
(B)
(C)

VIII

In case of an existing home which is more than one year old to be purchased, include evidence of satisfactory installation
and operation of water and/or waste disposal system.
For both new and existing homes include evidence that the water supply is adequate in both quantity and quality.

Termite certification when required by Rural Development.
EQUAL OPPORTUNITY IN HOUSING CERTIFICATION
TO INDUCE THE RURAL DEVELOPMENT, RURAL HOUSING SERVICE TO ISSUE A CONDITIONAL
COMMITMENT FOR PROPERTY INCLUDED IN THIS REQUEST, THE UNDERSIGNED HEREBY AGREES
THAT:
a.

NEITHER THE UNDERSIGNED NOR ANYONE AUTHORIZED TO ACT FOR THE APPLICANT HAS
DECLINED OR WILL DECLINE TO SELL ANY SUCH PROPERTY TO A PROSPECTIVE PURCHASER
BECAUSE OF RACE, COLOR, AGE (PROVIDED THE PROSPECTIVE PURCHASER HAS LEGAL
CAPACITY TO CONTRACT), HANDICAP, SEX, MARITAL STATUS, CREED, OR NATIONAL ORIGIN;
AND

b.

MISREPRESENTATION UNDER OR NONCOMPLIANCE WITH (a) SHALL BE A PROPER BASIS FOR THE
REJECTION OF REQUESTS FOR APPROVAL OF PROPERTIES WITH WHICH THE UNDERSIGNED IS
IDENTIFIED.

IN ADDITION, THE UNDERSIGNED AGREES THAT THE DENIAL OF PARTICIPATION IN ANY PROGRAM
ADMINISTERED BY THE DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT OR THE VETERANS
ADMINISTRATION BECAUSE OF REFUSAL TO SELL A RESIDENTIAL PROPERTY TO ANY PERSON ON
ACCOUNT OF RACE, COLOR, CREED, OR NATIONAL ORIGIN SHALL BE A PROPER BASIS FOR
REJECTION BY THE RURAL DEVELOPMENT, RURAL HOUSING SERVICE OF REQUESTS FOR
CONDITIONAL COMMITMENTS.
Certification: As applicant, I certify to the best of my knowledge and belief, that no participant in this transaction is debarred,
suspended, or proposed for debarment, declared ineligible, or voluntarily extended from participation in this transaction by any federal department or agency. I certify that all participants in this transaction will comply with subpart C of 7 CFR part 3017, "Responsibilities of Participants Regarding Transactions."
WARNING: Section 1001 of Title 18, United States Code provides: ''Whoever, in any matter within jurisdiction of any
department or agency of the United States knowingly and willfully falsifies, conceals or covers up by any
trick, scheme, or device a material fact, or makes any false, fictitious or fraudulent statements or
representations, or makes or uses any false writing or document knowing the same to contain any false,
fictitious or fraudulent statement or entry, shall be fined under this title or imprisoned not more than five
years or both."

(Date)

(Signature of applicant for a conditional commitment. If applicant is
a corporation include name of the corporation and title of the person
executing this certification on behalf of the corporation.)

RD 1944-36
(REVERSE)