Form Va 26-6681 - Application For Fee Or Roster Personnel Designation

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HUD OMB Approval No. 2502-0538

Check One

U.S. Department of Housing

Application for Fee or Roster

(exp. 7/31/2009)

and Urban Development (HUD)

Personnel Designation

VA OMB Approval No. 2900-0113

Department of Veterans Affairs (VA)

Respondent Burden: The information you provide will enable the designated agency to determine whether you qualify for designation in the position for which

you are applying. HUD is authorized to collect this information by Title 1, Section 1 of the National Housing Act (Pub. L 479, 48 Statute 1246,12 U.S.C., 1701 et

seq.). VA is authorized to collect this information by Chapter 37, Title 38 U.S.C. Public reporting burden for this collection is estimated at an average of 30

minutes to review the instructions, find the information, and complete this form. These agencies cannot conduct or sponsor a collection of information unless a

valid OMB number is displayed. You are not required to respond to a collection of information if this number is not displayed. Valid OMB numbers can be located

on the OMB Internet page at

- HUD

VA. If

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

Privacy Act Statement: These agencies 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 1.526 for routine uses (for example: Authorized for release of information to Congress when

requested for statistical purposes) identified in the VA systems of records, 17VA26, Loan Guaranty Fee Personnel and program Participant Records, and

published in the Federal Register. Reporting your social security number (SSN) is mandatory. The Housing and Community Development Act of 1987, 42 U.S.C.

3543 authorizes HUD to collect the SSN. VA is authorized to collect this information by Chapter 37, Title 38 U.S.C.

Penalty: The provision of the SSN is mandatory. Failure to provide any of the requested information could affect the decision to approve your application since

this decision will be made only on the basis of available information we currently have on record. This may result in a delay in the processing of your application.

Instructions: Please print clearly. Completed HUD applications must be mailed to the U.S. Department of Housing and Urban Development, Office of Single

Family Housing, 451 7

Street SW, Room 9270, Washington, DC 20410. HUD/FHA appraisers and inspectors may ascertain the roster status from HUD's web

sites at

https://entp.hud.gov/idapp/html/apprlook.cfm

https://entp.hud.gov/idapp/html/insplook.cfm?in_fha=No.

Completed VA applications may be submitted

electronically or by mail to the VA Regional Loan Center. Completed VA applications may be submitted electronically or by mail to the VA Regional Loan Center.

Ethnicity and Race: Please provide both ethnicity and race. For race, you may check more than one designation.

Appraisers: The application is to be submitted to HUD only after the appraiser is State licensed or certified with credentials based on the minimum licensing/

certification criteria issued by the Appraiser Qualifications Board (AQB) of the Appraisal Foundation.

Compliance Inspectors: This application is to be submitted to HUD only after the inspector is licensed or certified to inspect repairs and construction, when

such licensing or certification is required by the State or local jurisdiction where work will be performed. Upon availability, all inspector applicants currently

recognized by HUD to conduct inspections must provide evidence of passing the HUD/FHA Inspector Examination.

Designation being applied for:

Real Estate Appraiser

Compliance Inspector

1. Name of Applicant (first – middle – last)

2. Date of Birth (mm/dd/yyyy)

3. Social Security Number

HUD required / VA Voluntary

3a. Sex

(1) Male

(2) Female

3b. Ethnicity