Form Va 26-6681 - Application For Fee Or Roster Personnel Designation Page 3

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20e. To be completed by HUD appraiser applicants only:

HUD published in the Code of Federal Regulations (24 CFR 200.202(b)) a set of eligibility requirements for appraisers seeking placement on

the FHA Appraiser Roster.

Appraisers can check on the Department’s website, under FHA Approved Appraisers, at

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

, to verify

placement on the FHA Appraiser Roster. Appraisers will not receive a registration confirmation if approved. However, HUD will send a denial

letter to appraisers whose applications are determined not eligible, indicating that the appraiser did not meet one or more of the requirements.

20f. To be completed by HUD inspector applicants only:

HUD published in the Code of Federal Regulations (24 CFR 200.171(b)) a set of eligibility requirements for inspectors seeking placement on

the FHA Inspector Roster.

Inspectors can check on the Department’s website under, under Inspectors, at

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

verify placement on the FHA Inspector Roster. Inspectors will not receive a registration confirmation if approved. However, HUD will send a

denial letter to inspectors whose applications are determined not eligible, indicating that the inspector did not meet one or more of the

requirements.

I, the undersigned, understand and agree that:

(a) The approval of this application does not constitute my appointment as an agent or employee of HUD/FHA or DVA/VA.

(b) In performing fee work my status is that of an independent contractor.

(c)

My sole interest in all transactions shall be to perform fee assignments as required by HUD or VA standards and criteria.

(d) An appraisal/inspection is a substantial and material element in the determination of the eligibility of an application for FHA mortgage insurance,

and HUD/FHA will rely upon the accuracy and truthfulness of an appraisal/inspection completed by me in approving any insurance.

Warnings

I hereby certify that to the best of my knowledge all the information stated herein, as well as any information provided in the accompaniment herewith, is

true, accurate, and complete. I further certify that I have read the Warnings set forth below.

Any person who knowingly presents materially false, fictitious, or fraudulent statements in a matter within the jurisdiction of HUD is subject to penalties,

sanctions, or other regulatory actions, including but not limited to:

(i)

Fines and imprisonment under 18 USC 287, 1001, 1010, 1012, which provides for fines of a maximum of $25,000 for individual and $500,000

for organizations of imprisonment for up to 5 years, or both; or

(ii)

civil penalties and damages under 31 USC 3729, of not less than $5000 and not more than $10,000, plus 3 times the amount of damages which

the government sustains; and

(iii) administrative sanctions, claims, and penalties by HUD pursuant to 24 CFR Part 24, 28, and 30.

21. Date Signed (mm/dd/yyyy)

22. Applicant’s Signature (do not print, must be legible)

Reviewing Official

Complete the following items