Form 3555-11 Form 3555-11 Guaranteed Rural Housing Record Change

USDA-RHS
Form RD 3555-11
(Rev. 04-24)
UNITED STATES DEPARTMENT OF AGRICULTURE
RURAL DEVELOPMENT
SINGLE FAMILY HOUSING
GUARANTEED LOAN PROGRAM

FORM APPROVED
OMB NO. 0575-0179
Exp. Date XX/XX/XXXX

Lender Record Change
(See reverse side for Instructions)

Email the completed Form to:
[email protected]
Effective Date of Transfer: _______________________________

All Blocks, A-D are required to be completed by the transferor.
A. Transferor (The Lender who is transferring the loan(s) and/or servicing of the loan(s). i.e. where the loan is being transferred from):
Lender Tax ID: _____________________________________

USDA Assigned Branch Number: _____________

Lender Name: _________________________________________________________________________________________________________
Address: _____________________________________________________________________________________________________________
City: __________________________________

State: __________

Zip Code: _________________ Zip+4_____________

B. Servicing Lender (The lender that will be servicing the loan(s) after the effective date of transfer):
Lender Tax ID: _____________________________________

Agency Assigned Branch Number: ______________

Lender Name: _________________________________________________________________________________________________________
Address: _____________________________________________________________________________________________________________
City: __________________________________

State: __________

Zip Code: _________________ Zip+4_____________

C. Holding Lender (The RHS approved Lender who will be holding/owning the mortgage note after the effective date of transfer, i.e. Fannie Mae, Freddie Mac, etc.,
not Ginnie Mae; See Instructions on back):
Lender Tax ID: _____________________________________

Agency Assigned Branch Number: _____________

Lender Name: _________________________________________________________________________________________________________
Address: _____________________________________________________________________________________________________________
City: __________________________________

State: __________

Zip Code: _________________Zip+4_______________

D. Borrower Information (If more than one (1) borrower, you may attach a list with all of the following information):
This Loan was securitized into a Ginnie Mae Pool (Mark an X in the box if loan is securitized into a Ginnie Mae pool)
Borrower’s USDA ID Number: ________________________ Borrower’s Name: __________________________________________________
Address: _____________________________________________________________________________________________________________
City: __________________________________

State: __________

Zip Code: ___________________

As the lender selling or transferring the servicing of the above loan(s), We certify that the information in this submission is true and correct, and that all loans sold
were sold to an RHS approved lender.
____________________________________________________

(Signature of Authorized Lender Representative/Official)
____________________________________________________

(Please PRINT Authorized Lender Representative/Official’s Name)

_____________________________________

Date
(________)____________________________

Telephone Number

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
0575-0179. Public reporting for this collection of information (form) 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. 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].

Instructions for Completing Form RD 3555-11, “Guaranteed Rural Housing Lender Record Change”
All items on this form are required to be completed by the transferor. The transferor is the lender who is selling the loan(s) to an RHS
approved lender and/or transferring the servicing of the loan(s) to another lender.
- E-mail all completed forms and any attachments to [email protected].
- Complete the date the transfer becomes effective in the space above block A.
All blocks, A through D must be completed.
Block A:
This block should indicate the lender that is transferring the loan servicing to another lender or is selling the loan to another RHS
approved lender or investor.
Block B:
This block should indicate the lender that will be servicing the loan after the effective date of transfer. It may be the holder of the
mortgage note or it may be another lender that does the servicing for the holder of the mortgage note.
Block C:
This block should indicate the lender or investor that will actually own the loan (mortgage note) as of the effective date of transfer.
DO NOT put Ginnie Mae as a holding lender as Ginnie Mae does not hold the mortgage note. Any lender or investor must be RHS
approved to own loans guaranteed by RHS.
Block D:
This block should contain the information on the specific loan being transferred. If more than one loan is being transferred, and
Blocks A and C are identical, the lender may attach a list of all borrowers affected by the transfer that includes all the requested
information and send to [email protected]. If the loan has been sold in a Ginnie Mae pool, indicate so by checking the box in
Block D or indicating “Yes” on an attached list.
A signature or electronic signature of the transferor lender’s authorized representative or official is required. The official’s name
must be printed, and a telephone number provided in case of questions concerning the transfer.