Form Hud-92900-A - Hud/va Addendum To Uniform Residential Loan Application Page 4
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4Borrower's Certificate:
The undersigned certifies that:
(a) I will not have outstanding any other unpaid obligations contracted in connection with the mortgage transaction or the purchase of
the said property except obligations which are secured by property or collateral owned by me independently of the said mortgaged
property, or obligations approved by the Commissioner;
(b) One of the undersigned intends to occupy the subject property, (note: this item does not apply if owner-occupancy is not required
by the commitment);
(c) All charges and fees collected from me as shown in the settlement statement have been paid by my own funds, and no other charges
have been or will be paid by me in respect to this transaction;
(d) Neither I, nor anyone authorized to act for me, will refuse to sell or rent, after the making of a bona fide offer, or refuse to negotiate
for the sale or rental of or otherwise make unavailable or deny the dwelling or property covered by this loan to any person because
of race, color, religion, sex, handicap, familial status or national origin. I recognize that any restrictive covenant on this property
relating to race, color, religion, sex, handicap, familial status or national origin is illegal and void and any such covenant is hereby
specifically disclaimed. I understand that civil action for preventative relief may be brought by the Attorney General of the United
States in any appropriate U.S. District Court against any person responsible for a violation of this certificate.
Borrower'(s) Signature(s) & Date
Lender's Certificate:
The undersigned certifies that to the best of its knowledge:
(a) The statements made in its application for insurance and in this Certificate are true and correct;
(b) The conditions listed above or appearing in any outstanding commitment issued under the above case number have been fulfilled;
(c) Complete disbursement of the loan has been made to the borrower, or to his/her creditors for his/her account and with his/her consent;
(d) The security instrument has been recorded and is a good and valid first lien on the property described;
(e) No charge has been made to or paid by the borrower except as permitted under HUD regulations;
(f) The copies of the credit and security instruments which are submitted herewith are true and exact copies as executed and filed for record;
(g) It has not paid any kickbacks, fee or consideration of any type, directly or indirectly, to any party in connection with this transaction
except as permitted under HUD regulations and administrative instructions.
I, the undersigned, as authorized representative of
,
mortgagee at this time of closing of this mortgage loan, certify that I have personally reviewed the mortgage loan documents, closing
statements, application for insurance endorsement, and all accompanying documents. I hereby make all certifications required for this
mortgage as set forth in HUD Handbook 4000.4.
Lender's Name
Note: If the approval is executed by an agent in the
name of lender, the agent must enter the lender's
code number and type.
Title of Lender's Officer
Code Number (5 digits)
Type
Signature of Lender's Officer
Date
page 4
form HUD-92900-A (0 /2010)
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VA Form 26-1802a
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