Fillable Va Form 26-6705b - Credit Statement Of Prospective Purchaser printable pdf download

OMB Approved No. 2900-0029

Respondent Burden: 20 Minutes

CREDIT STATEMENT OF PROSPECTIVE PURCHASER

Privacy Act Notice: VA and the Service Provider will not disclose information collected on this form to any source other than what has been authorized under the Privacy

Act of 1974 or Title 38, Code of Federal Regulations 1.576 for routine uses (i.e., This form will serve as an application for credit from VA in connection with an offer to

purchase a VA-acquired property, as authorized by law (38 U.S.C. 1820(a)(5)).) as identified in the VA system of records, 55VA26, Loan Guaranty Home, Condominium

and Manufactured Home Loan Applicant Records, Specially Adapted Housing Applicant Records and Vendee Loan Applicant Records - VA, and published in the Federal

Register. Your obligation to respond is required to obtain or retain benefits. VA may conduct computer matches to verify the information you will furnish. Under the

financial privacy act of 1978, VA may obtain financial records held by financial institutions in connection with the consideration or administration of assistance to you. Such

financial records will be available to VA without further notice or authorization.

Respondent Burden: We need this information to consider your offer to purchase a VA acquired property. Title 38, United States Code, allows us to ask for this information.

We estimate that you will need an average of 20 minutes to review the instructions, find the information, and complete this form. VA and the Service Provider cannot

conduct or sponsor a collection of information unless a valid OMB control number is displayed. You are not required to respond to a collection of information if this number

is not displayed. Valid OMB control numbers can be located on the OMB Internet Page at If desired, you

can call 1-800-827-1000 to get information on where to send comments or suggestions about this form.

GENERAL INFORMATION

1A. APPLICANT(S) NAME(S) AND MAILING ADDRESS

2. VA PROPERTY IDENTIFIER

3. VA PROPERTY ADDRESS

1B. HOME TELEPHONE NO.

4. DOWN PAYMENT

5. REQUESTED LOAN

6. REHABILITATION AMOUNT

8. APPLICANT HOME STATUS

9. MARITAL STATUS

10. AGES OF DEPENDENTS OTHER THAN SPOUSE

7. TERM AND INTEREST

RENT

MARRIED

SEPARATED

YEARS

PERCENT

YEARS

OWN

UNMARRIED

11. ATTACHMENTS

12. NEAREST RELATIVE NOT LIVING WITH APPLICANT

ALL INCOME DOCUMENTS

SEPARATE CREDIT STATEMENT FROM

NAME:

OTHER (Specify)

STREET:

(A Co-applicant who is not the spouse of the

CITY:

Applicant named in Item 1)

STATE:

ZIP CODE:

TELEPHONE NO.:

13. IF ANY OF THE FOLLOWING THREE STATEMENTS APPLIES TO THE REQUESTED LOAN, THEN CREDIT INFORMATION CONCERNING THE SPOUSE WILL BE

NECESSARY TO EVALUATE THE CREDIT RISK. PLEASE MARK THE STATEMENTS THAT APPLY TO THE REQUESTED LOAN:

THE APPLICANT IS MARRIED AND RESIDES IN, OR THE PROPERTY IS LOCATED IN, A COMMUNITY PROPERTY STATE

THE APPLICANT WILL RELY ON INCOME FROM ALIMONY, CHILD SUPPORT OR SEPARATE MAINTENANCE OR ON THE INCOME OR ASSETS OF A SPOUSE TO

REPAY THE LOAN

THE APPLICANT WILL BE JOINTLY OBLIGATED WITH THE SPOUSE TO REPAY THE LOAN

APPLICANT

SPOUSE/CO-APPLICANT

14A. DATE OF BIRTH

14B. SOCIAL SECURITY NUMBER

15A. DATE OF BIRTH

15B. SOCIAL SECURITY NUMBER

14C. EMPLOYER NAME AND MAILING ADDRESS

14D. DATES (From-To)

15C. EMPLOYER NAME AND MAILING ADDRESS

15D. DATES (From-To)

14E. MONTHLY

15E. MONTHLY

INCOME

SELF-EMPLOYED

14F. JOB TITLE/TYPE OF BUSINESS

14G. BUSINESS TELEPHONE

15F. JOB TITLE/TYPE OF BUSINESS

15G. BUSINESS TELEPHONE

NOTE - If working for more than one employer, or employed at present job less than two years, continue to furnish job or training

information to cover the latest two-year period. Use a separate sheet, if necessary.

16A. PREVIOUS EMPLOYER'S NAME AND MAILING

16B. DATES (From-To)

17A. PREVIOUS EMPLOYER'S NAME AND MAILING

17B. DATES (From-To)

ADDRESS

16C. MONTHLY

17C. MONTHLY

INCOME

SELF-EMPLOYED

16D. JOB TITLE/TYPE OF BUSINESS

16E. BUSINESS TELEPHONE

17D. JOB TITLE/TYPE OF BUSINESS

17E. BUSINESS TELEPHONE

18. COMBINED ASSETS AND CASH/MARKET VALUES

A. OTHER LOAN/GIFT TO BUY THIS PROPERTY

FURNITURE, HOUSEHOLD GOODS

B. CASH ON HAND, CHECKING ACCOUNTS

VEHICLE (YEAR AND MODEL)

C. SAVINGS ACCOUNTS, CERTIFICATES, BONDS

OTHER

D. STOCKS, OTHER SECURITIES

OTHER

E. REAL ESTATE OWNED OTHER THAN HOME

OTHER

VA FORM

EXISTING STOCKS OF VA FORM 26-6705b, FEB 2005,

26-6705b

PURCHASE OFFER NO:

AUG 2008

WILL BE USED.

AUTHORIZATION TO RELEASE INFORMATION

I hereby authorize VA (United States Department of Veterans Affairs) to verify records of my past and present employment and income, as well as financial

accounts and other asset balances, to obtain a consumer and/or business credit report and verify information regarding my past and present credit accounts,

including rental accounts, in order to process my credit statement to VA and the Service Provider. I acknowledge that VA and the Service Provider is in

compliance with the Right to Financial Privacy Act of 1978 (Title XI, Public Law 95-630), in connection with this request for access to financial records. I

request all referenced employers, financial institutions, landlords and other creditors to accept a photocopy of this signed authorization as evidence of my

consent to release the requested information to VA and the Service Provider. I understand that I may revoke this authorization at any time before the

financial records described above are disclosed.

SIGNATURE OF APPLICANT

DATE SIGNED

SIGNATURE OF SPOUSE/ CO-APPLICANT

DATE SIGNED

CONTINUED ON REVERSE

VA FORM

26-6705b

EXISTING STOCKS OF VA FORM 26-6705b, FEB 2005,

AUG 2008

WILL BE USED.