Issuer’s Monthly Serial
U.S. Department of Housing
OMB Approval No. 2503-0033 (Exp. 05/31/2016)
and Urban Development
Note Remittance Advice
Government National Mortgage Association
Public reporting burden for this collection of information is estimated to average 1 minute 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. Ginnie Mae
agency may not collect this information, and you are not required to complete this form, unless it displays a currently valid OMB control number.
The information is required by Sec. 306(g) of the National Housing Act or by Ginnie Mae Handbook 5500.3, Rev. 1. The purpose of this information is to
provide summary information to the holders of Serial Note securities with respect to the current month’s account transactions, calculation of interest and
principal to be distributed, and data with respect to the redemption of Serial Units. The information will not be disclosed outside of the Department except
as required by law.
To the following Security Holder:
●
●
Ginnie Mae pool/commitment Number
Date
Serial Note Certificate Number
Reporting Month
●
●
Serial Units Number
Security Interest Rate
The check for distribution of
The check will be forwarded
The remittance will be made electronically on
The remittance includes payment for
th
th
interest for the above
separately but no later than
the 15
of the month or, if the 15
is not a
Serial Unit(s) retired
th
reporting month is enclosed.
the 15
of the month.
business day, on the next business day.
during the above reporting month.
A. Cash distribution due Security Holder for interest
$
$ –
B. Less Federal income tax withheld from interest (if any)
C. Cash distribution due Security Holder for retirement of _________ Serial Unit(s) No. ____________; at $25,000 each
$
D. Total cash distribution due Security Holder
$
E. Outstanding balance of this certificate after credit of the above distribution
$
F. The last Serial Unit redeemed was number _____________ on _______________ 15, 20_____
G. The scheduled maturity date of such Serial Unit was ________________________ 15, 20_____
H. The number of outstanding Serial Units under this Serial Note is ____________
Explanation for items above:
I hereby certify that all the information stated herein, as well as any information provided in the accompaniment herewith, is true and accurate.
Warning:
(18 U.S.C. 1001, 1010, 1012; 31 U.S.C. 3729, 3802)
HUD will prosecute false claims and statements. Conviction may result in criminal and/or civil penalties.
Issuer
Authorized Signature
Street Address
City and State
form HUD-11714SN (01/2006)
Previous editions are obsolete.
Page 1 of 1
ref. Ginnie Mae Handbook 5500.3, Rev. 1