Form Hud-9746-A - Draw Request - U.s. Department Of Housing And Urban Development - Office Of Housing Page 2

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I hereby certify that all the information stated herein, as well as any information provided in the accompaniment herewith, is true and accurate.

Warning: HUD will prosecute false claims and statements. Conviction may result in criminal and/or civil penalties. (18 U.S.C. 1001, 101 0, 1012; 31 U.S.C. 3729, 3802)

This draw request is submitted for payment. All completed work has been done in a workmanlike manner. I hereby certify to the actual costs of rehabilitation as

shown above in column 3. I understand that I cannot obtain additional monies from the rehabilitation escrow account without the approval of the lender. I also

understand that a 10% holdback will not be released until all work is complete and it is determined that no mechanic's and materialmen's liens have been placed

on the property. After the final inspection, the monies in the escrow account will be distributed as required by the 203(k) program procedures.

Borrower's Signature

Owner-Occupant

Investor/Builder

Date

This draw request is submitted for payment. All completed work has been done in a workmanlike manner. I understand that a 10% holdback will not be released until

all work is completed and it is determined that no mechanic's and materialmen's liens have been placed on the property.

General Contractor's Signature (if any) X

Date

I certify that I have carefully inspected this property on this date.The draw amounts are acceptable except as modified in column 4. I further certify that I have not accepted

any work that is not yet completed in a workmanlike manner and I recommend that the rehabilitation escrow funds be released for the completed work.

Inspector's Signature

I.D. Number

Date

The Lender is hereby authorized to release the following funds from the escrow

account

Approved for Release

This Draw

Totals to Date

Payable to the Borrower

Payable to the Fee Inspector

Total from Above

Payable to

Less 10% Holdback

Signature & Date

Net Amount Due Borrower

Lender-Authorized Agent

DE Underwriter

Lender Holding Rehabilitation Escrow Account (name, address, & phone number)

Originating Lender still Retains Funds

Rehab Funds Transferred to:

Rehabilitation Inspection Report

FHA Case Number

I. Inspection of On-Site Repairs and/or Improvements Reveals

Unable to make inspection. (explain below)

No noncompliance observed.

Correction essential as explained below:

Acceptable variations as described below.

Will examine at next inspection.

On-site improvements acceptably completed.

Do not conceal until reinspected.

II. Explanation

of statements checked above

Inspection Number

Draw

Contingency

Final

Change

Other

(explain)

Inspection

Reserve Inspection

Inspection

Order

No.

Certification: I certify that I have carefully inspected this property on this date. I have no personal interest, present or prospective, in the property, applicant,

or proceeds of the mortgage. To the best of my knowledge I have reported all noncompliance, work requiring correction, and unacceptable work. I also certify

that this Draw Request is for completed work and I have not accepted any work that is not properly installed in a workmanlike manner.

Consultant / Inspector

Signature & Date

Inspection Fee

ID Number

Fee Inspector

DE Staff Inspector

ref. Handbook 4240.4

form HUD-9746-A (8/95)

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