Va Form 26-6807a - Supplemental Certification For Financial Statement

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SUPPLEMENTAL CERTIFICATION FOR FINANCIAL STATEMENT
THIS CERTIFICATION is attached and made part of a financial disclosure form being completed in connection with a request for
refunding a guaranteed loan.
1. NAME OF BORROWER(S)
3. VA LOAN NUMBER
2. SOCIAL SECURITY NUMBER OF
BORROWER(S)
CERTIFICATION
In consideration of the Department of Veterans Affairs refunding the above cited loan:
I (We) agree to pay all expenses associated with the transfer.
I (We) also agree to the establishment of a tax and insurance account and to make the required monthly payments to maintain the same.
I (We) further agree to indemnify the Department of Veterans Affairs for any loss it suffers as a result of foreclosure.
I (We) affirm that all financial information provided to the Department of Veterans Affairs is true, correct, and complete to the best of my (our)
knowledge.
4A. SIGNATURE
4B. DATE
5A. SIGNATURE
5B. DATE
VA FORM
EXISTING STOCK OF VA FORM 26-6807a, MAY 1994,
26-6807a
JUNE 2002
WILL BE USED.

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