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TEXAS MORTGAGE BROKER LOAN OFFICER DISCLOSURE

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TEXAS MORTGAGE BROKER LOAN OFFICER DISCLOSURE Powered By Docstoc
					                               TEXAS MORTGAGE BROKER/LOAN OFFICER DISCLOSURE


                     Property Address:


                     Mortgage Broker or Loan Officer:
                     License Number:     14978

                     The information in this disclosure is provided to clarify the nature of our relationship, my
                     duties to you, and how I am to be compensated as a Mortgage Broker or Loan Officer.
                     This disclosure is a requirement of the Texas Mortgage Broker License Act.

                     Since I may be working for a company, references to ''we" or ''us'' refer to me and any
                     company for which I am working.

                                                               Check ALL that apply

                     Duties and Nature of Relationship

                     You, the applicant(s), have applied with us for a residential mortgage loan.

                     ( )       We will submit your loan application to a participating lender which we may from
                               time to time contract upon such terms as you may request or a lender may require.
                               In connection with this mortgage loan, we are acting as an independent contractor
                               and not as your agent.     We will enter into separate independent contractor
                               agreements with various lenders. While we will seek to assist you in meeting
                               your financial needs, we do not distribute the products of all lenders or investors
                               in the market and cannot guarantee the lowest or best terms available in the
                               market.

                     ( )       In connection with this mortgage loan, we are acting as an independent contractor
                               and not as your agent. We will make your loan ourselves. We may either sell the
                               loan to an investor or retain it. (You will receive a separate disclosure as to how
                               we will handle servicing rights on any such loan.) We have a number of
                               established independent contractor relationships with various investors to whom
                               we sell closed loans. We are not an agent for any such investor in connection
                               with the sale of a loan. While we will seek to assist you in meeting your financial
                               needs, we cannot guarantee the lowest or best terms available in the market.

                     ( )       We will be acting as follows:



                     How we will be compensated

                     ( )       The retail price we offer you - your interest rate, total points, and fees - will
                               include our compensation. In some cases we may be paid all or part of our
                               compensation by you or by the lender or investor. Alternatively, we may be paid
                               a portion of our compensation by both you and the lender. For example, in some
                               cases, if you would rather pay a lower interest rate, you may pay higher up-front
                               points and fees. Also, in some cases, if you would rather pay less up-front, you

                                                                            1
CALYX Form MTBRLO1.FRM 08/00
                                may be able to pay a higher rate, in which case some or all of my compensation
                                will be paid by the lender. We also may be paid by the lender based on other
                                goods, services, or facilities performed or provided by us to the lender.

                     (    )     Our pricing for your loan is based upon current wholesale options available to us
                                in the secondary market where closed loans are sold. Fees charged directly to you
                                by us may vary depending on the type of loan for which you have applied.

                     At the time of this disclosure, we are receiving $ 22.00             in fees. The services for
                     which these fees are being charged include the following:

                     ( )        Application fee                               $
                     ( )        Processing fee                                $
                     ( )        Appraisal Fee                                 $
                     ( )        Credit report fee                             $   22.00
                     ( )        Automated underwriting fee                    $
                     Other     (list):
                                                                              $
                                                                              $

                     Of this amount, $ 22.00      is not refundable under any conditions.
                     The remainder of this amount will not be subject to refund at any time after we
                     have ordered or obtained the services for which such fees are being collected.

                     The estimated fees which we will charge will be as shown on the good faith estimate
                     which we are providing to you now or which we will provide you within three (3) days in
                     accordance with the requirements of the Real Estate Settlement Procedures Act and its
                     implementing regulations.

                                COMPLAINTS REGARDING MORTGAGE BROKERS OR LOAN
                                OFFICERS SHOULD BE SIGNED AND SHOULD BE SENT TO THE
                                TEXAS SAVINGS AND LOAN DEPARTMENT, 2601 NORTH LAMAR,
                                SUITE 201, AUSTIN, TEXAS 78705. A TOLL-FREE CONSUMER
                                HOTLINE IS AVAILABLE AT 1-877-276-5550.

                                Applicant(s)                                Mortgage Broker/Loan Officer

                                Signed:                                     Signed:
                                Name:                                       Name:
                                Date:                                       Date:

                                Signed:
                                Name:
                                Date:




                                                                        2
CALYX Form MTBRLO2.FRM 08/00
                             SERVICING DISCLOSURE STATEMENT
Lender: Mortgage Loan Consultants of Texas                                                 Date:
          1203 Firebush Drive
          Pflugerville , TX 78660


NOTICE TO FIRST LIEN  MORTGAGE LOAN APPLICANTS: THE RIGHT TO COLLECT YOUR
MORTGAGE LOAN PAYMENTS MAY BE TRANSFERRED. FEDERAL LAW GIVES YOU CERTAIN
RELATED RIGHTS. IF YOUR LOAN IS MADE, SAVE THIS STATEMENT WITH YOUR LOAN
DOCUMENTS. SIGN THE ACKNOWLEDGMENT AT THE END OF THIS STATEMENT ONLY IF YOU
UNDERSTAND ITS CONTENTS.
Because you are applying for a mortgage loan covered by the Real Estate Settlement Procedures Act (RESPA)
(12 U.S.C. Section 2601 et seq.) you have certain rights under that Federal law.

This statement tells you about those rights. It also tells you what the chances are that the servicing for this loan
may be transferred to a different loan servicer.       "Servicing" refers to collecting your principal, interest and
escrow account payments, if any. If your loan servicer changes, there are certain procedures that must be
followed. This statement generally explains those procedures.

Transfer practices and requirements

If the servicing of your loan is assigned, sold, or transferred to a new servicer, you must be given written
notice of that transfer. The present loan servicer must send you notice in writing of the assignment, sale
or transfer of the servicing not less than 15 days before the effective date of the transfer. The new loan
servicer must also send you notice within 15 days after the effective date of the transfer. The present servicer
and the new servicer may combine this information in one notice, so long as the notice is sent to you 15 days
before the effective date of transfer. The 15 day period is not applicable if a notice of prospective transfer
is provided to you at settlement. The law allows a delay in the time (not more than 30 days after a transfer)
for servicers to notify you, upon the occurrence of certain business emergencies.

Notices must contain certain information. They must contain the effective date of the transfer of the servicing
of your loan to the new servicer, and the name, address, and toll-free or collect call telephone number of the
new servicer, and toll-free or collect call telephone numbers of a person or department for both your present servicer
and your new servicer to answer your questions. During the 60 day period following the effective date of the
transfer of the loan servicing, a loan payment received by your old servicer before its due date may not be treated
by the new loan servicer as late, and a late fee may not be imposed on you.

Complaint Resolution

Section 6 of RESPA (12 U.S.C. Section 2605) gives you certain consumer rights, whether or not your loan
servicing is transferred.   If you send a "qualified written request" to your servicer, then your servicer must
provide you with a written acknowledgment within 20 Business Days of receipt of your request. A "qualified
written request" is a written correspondence, other than notice on a payment coupon or other payment medium
supplied by the servicer, which includes your name and account number, and the information regarding your
request. Not later than 60 Business Days after receiving your request, your servicer must make any appropriate
corrections to your account, or must provide you with a written clarification regarding any dispute. During this
60 Business Day period, your servicer may not provide information to a consumer reporting agency concerning any
overdue payment related to such period or qualified written request.

A Business Day is any day in which the offices of the business entity are open to the public for carrying on
substantially all of its business functions.

Damages and Costs

Section 6 of RESPA also provides for damages and costs for individuals or classes of individuals in circumstances
where servicers are shown to have violated the requirements of that Section.
CALYX Form Sds.hp 6/96                               Page 1 of 2
Servicing Transfer Estimates

1.    The following is the best estimate of what will happen to the servicing of your mortgage loan:

      A.        We may assign, sell or transfer the servicing of your loan while the loan is outstanding.

                We are able to service your loan, and we
                    will service your loan.
                    will not service your loan.
                    haven't decided whether to service your loan.


      B.        We do not service mortgage loans                and we have not serviced mortgage loans in the
                                                                 past three years.
                We presently intend to assign, sell or transfer the servicing of your mortgage loan. You will be
                informed about your servicer.

2.    For all mortgage loans that we make in the 12 month period after your mortgage loan is funded,
      we estimate that the percentage of such loans for which we will transfer servicing is between:


      _____ 0 to 25%                _____ 26 to 50%                _____ 51 to 75%          _____ 76 to 100%

      This estimate        does       does not        include assignments, sales or transfers to affiliates or subsidiaries.



      This is only our best estimate and it is not binding. Business conditions or other circumstances may
      affect our future transferring decisions.

3.    A.        We have previously assigned, sold, or transferred the servicing of mortgage loans.

      B.       This is our record of transferring the servicing of mortgage loans we have made in:

                                    Year                     Percentage of Loans Transferred

                                    2003                                   100   %

                                    2002                                   100   %

                                    2001                                   100   %

      This information       does          does not     include assignments, sales or transfers to affiliates or subsidiaries.

Acknowledgment of Mortgage Loan Applicant(s)

I/We have read and understood the disclosure; and understand that the disclosure is a required part of the
mortgage application as evidenced by my/our signature(s) below;



Applicant                                             Date         Applicant                                       Date



Applicant                                             Date         Applicant                                       Date




CALYX Form Sds2.frm 2/99                                     Page 2 of 2
                                    PRIVACY POLICY DISCLOSURE
                             (Protection of the Privacy of Personal Non-Public Information)

Respecting and protecting customer privacy is vital to our business. By explaining our Privacy Policy to you, we
trust that you will better understand how we keep our customer information private and secure while using it to serve
you better. Keeping customer information secure is a top priority, and we are disclosing our policies to help you
understand how we handle the personal information about you that we collect and disclose. This notice explains how
you can limit our disclosing of personal information about you. The provisions of this notice will apply to former cust-
omers as well as current customers unless we state otherwise.

The Privacy Policy explains the Following:

    ·   Protecting the confidentiality of our customer information.
    ·   Who is covered by the Privacy Policy.
    ·   How we gather information.
    ·   The types of information we share, why, and with whom.
    ·   Opting Out - how to instruct us not to share certain information about you or not to contact you.

Protecting the Confidentiality of Customer Information:
   We take our responsibility to protect the privacy and confidentiality of customer information very seriously.
   We maintain physical, electronic, and procedural safeguards that comply with federal standards to store
   and secure information about you from unauthorized access, alteration, and destruction. Our control policies,
   for example, authorize access to customer information only by individuals who need access to do their work.

    From time to time, we enter into agreements with other companies to provide services to us or make products
    and services available to you. Under these agreements, the companies may receive information about you
    but they must safeguard this information, and they may not use it for any other purposes.

Who is Covered by the Privacy Policy:
  We provide our Privacy Policy to customers when they conduct business with our company. If we change our
  privacy policies to permit us to share additional information we have about you, as described below, or to permit
  disclosures to additional types of parties, you will be notified in advance. This Privacy Policy applies to consumers
  who are current customers or former customers.

How We Gather Information:
    As part of providing you with financial products or services, we may obtain information about you from the following
    sources:

    ·   Applications, forms, and other information that you provide to us, whether in writing, in person, by telephone,
        electronically, or by any other means. This information may include your name, address, employment
        information, income, and credit references;
    ·   Your transaction with us, our affiliates, or others. This information may include your account balances,
        payment history, and account usage;
    ·   Consumer reporting agencies. This information may include account information and information about your
        credit worthiness;
    ·   Public sources. This information may include real estate records, employment records, telephone numbers, etc.

Information We Share:
    We may disclose information we have about you as permitted by law. We are required to or we may provide
    information about you to third-parties without your consent, as permitted by law, such as:
    ·   To regulatory authorities and law enforcement officials.
    ·   To protect against or prevent actual or potential fraud, unauthorized transactions, claims, or other liability.
    ·   To report account activity to credit bureaus.
    ·   To consumer reporting agencies.
                                                                                                       Calyx Form - privacy1.frm (07/01)
   ·   To respond to a subpoena or court order, judicial process or regulatory authorities.
   ·   In connection with a proposed or actual sale, merger, or transfer of all or a portion of a business or an operating
       unit, etc.

   In addition, we may provide information about you to our service providers to help us process your applications
   or service your accounts. Our service providers may include billing service providers, mail and telephone service
   companies, lenders, investors, title and escrow companies, appraisal companies, etc.

   We may also provide information about you to our service providers to help us perform marketing services. This
   information provided to these service providers may include the categories of information described above under
   "How We Gather Information" limited to only that which we deem appropriate for these service providers to carry
   out their functions.

   We do not provide non-public information about you to any company whose products and services are being
   marketed unless you authorize us to do so. These companies are not allowed to use this information for purposes
   beyond your specific authorization.

Opting Out

   We also may share information about you within our corporate family of office(s). We may share all of the
   categories of information we gather about you, including identification information (such as your name and
   address), credit reports (such as your credit history), application information (such as your income or credit
   references), your account transactions and experiences with us (such as your payment history), and information
   from other third parties (such as your employment history).

   By sharing this information we can better understand your financial needs. We can then send you notification
   of new products and special promotional offers that you may not otherwise know about. For example, if you
   originally obtained a mortgage loan with us, we would know that you are a homeowner and may be interested
   in hearing how a home equity loan may be a better option than an auto loan to finance the purchase of a new car.

   You may prohibit the sharing of application and third-party credit-related information within our company or any
   third-party company at any time. If you would like to limit disclosures of personal information about you as
   described in this notice, just check the appropriate box or boxes to indicate your privacy choices.

                Please do not share personal information about me with non-affilliated third-parties.

                Please do not share personal information about me with any of your affiliates except as necessary to
                effect, administer, process, service or enforce a transaction requested or authorized by myself.
                Please do not contact me with offers of products or services by mail.

                Please do not contact me with offers of products or services by telephone.

   Note for Joint Accounts: Your Opt Out choices will also apply to other individuals who are joint account holders.
   If these individuals have separate accounts, your Opt Out will not apply to those separate accounts.

                                                                 Mortgage Loan Consultants of Texas
   Name                                                          Company Name

                                                                 1203 Firebush Drive
   Address                                                       Address

                                                                 Pflugerville TX, 78660
   City, State, Zip                                              City, State, Zip

                                                                 512-989-3404
   Phone#                                                        Phone #


   Loan #




   Signature                                              Date
                                                                                                      Calyx Form - privacy2.frm (07/01)
                        NOTICE TO APPLICANT OF RIGHT
                     TO RECEIVE COPY OF APPRAISAL REPORT




APPLICATION NO:

PROPERTY ADDRESS:




You have the right to receive a copy of the appraisal report to be obtained in connection with the
loan for which you are applying, provided that you have paid for the appraisal. We must receive your
written request no later than      90 days after we notify you about the action taken on your application or
you withdraw your application. If you would like a copy of the appraisal report, contact :
                                 Mortgage Loan Consultants of Texas
                                 1203 Firebush Drive
                                 Pflugerville, TX 78660




                                 (Applicant)   (Date)                                     (Applicant)       (Date)




                                 (Applicant)   (Date)                                     (Applicant)       (Date)




                                                                                                        Calyx Form rra.frm 12/96
                                        DISCLOSURE NOTICES
                                                                                                                           Date:

   Applicant(s):                                                           Property Address:




                                                    AFFIDAVIT OF OCCUPANCY
    Applicant(s) hereby certify and acknowledge that, upon taking title to the real property described above, their occupancy
    status will be as follows:
                 Primary Residence - Occupied by Applicant(s) within 30 days of closing.
                 Secondary Residence - To be occupied by Applicant(s) at least 15 days yearly, as second home (vacation, etc.),
                 while maintaining principal residence elsewhere. [Please check this box if you plan to establish it as your primary
                 residence at a future date (e.g., retirement)].
                 Investment Property - Not owner occupied. Purchased as an investment to be held or rented.
    The Applicant(s) acknowledge it is a federal crime punishable by fine or imprisonment, or both, to knowingly make any false
    statement concerning this loan application as applicable under the provisions of Title 18, United States Code, Section 1014.



    APPLICANT SIGNATURE                                                    CO-APPLICANT SIGNATURE


                                                   ANTI-COERCION STATEMENT
    The insurance laws of this state provide that the lender may not require the applicant to take insurance through any
    particular insurance agent or company to protect the mortgaged property. The applicant, subjected to the rules adopted by
    the Insurance Commissioner, has the right to have the insurance placed with an insurance agent or company of his choice,
    provided the company meets the requirement of the lender. The lender has the right to designate reasonable financial
    requirements as to the company and the adequacy of the coverage.
    I have read the foregoing statement, or the rules of the Insurance Commissioner relative hereto, and understand my rights
    and privileges and those of the lender relative to the placing of such insurance.
    I have selected the following agencies to write the insurance covering the property described above:


    Insurance Company Name                                                 Agent


    Agent's Address                                                        Agent's Telephone Number



    APPLICANT SIGNATURE                                                    CO-APPLICANT SIGNATURE

                                                   FAIR CREDIT REPORTING ACT
    An investigation will be made as to the credit standing of all individuals seeking credit in this application. The nature and scope
    of any investigation will be furnished to you upon written request made within a reasonable period of time. In the event of credit
    denial due to an unfavorable consumer report, you will be advised of the identity of the Consumer Reporting Agency making such
    report and of your right to request within sixty (60) days the reason for the adverse action, pursuant to provisions of section 615(b)
    of the Fair Credit Reporting Act.



    APPLICANT SIGNATURE                                                    CO-APPLICANT SIGNATURE

                                                           FHA LOANS ONLY
    IF YOU PREPAY YOUR LOAN ON OTHER THAN THE REGULAR INSTALLMENT DATE, YOU MAY BE ASSESSED INTEREST
    CHARGES UNTIL THE END OF THAT MONTH.

                                                     GOVERNMENT LOANS ONLY
    RIGHT TO FINANCIAL PRIVACY ACT OF 1978 - This is a notice to you as required by the Right to Financial Privacy Act of 1978 that the
    Department of Housing and Urban Development or Department of Veterans Affairs has a right of access to financial records held by a financial
    institution in connection with the consideration of administration of assistance to you. Financial records involving your transaction will be
    available to the Department of Housing and Urban Development or Department of Veterans Affairs without further notice or authorization but
    will not be disclosed or released to another Government agency or Department without your consent except as required or permitted by law.




    APPLICANT SIGNATURE                                                    CO-APPLICANT SIGNATURE

Calyx Form - disnot.frm (9/98)
                                 EQUAL CREDIT OPPORTUNITY ACT




         APPLICATION NO:

         PROPERTY ADDRESS:




         The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit
         applicants on the basis of race, color, religion, national origin, sex, marital status, age (provided
         the applicant has the capacity to enter into a binding contract); because all or part of the
         applicant's income derives from any public assistance program; or because the applicant has in
         good faith exercised any right under the Consumer Credit Protection Act. The Federal Agency that
         administers compliance with this law concerning this company is the Federal Trade Commission,
         Pennsylvania and 6th Street N.W., Washington, DC 20580


         We are required to disclose to you that you need not disclose income from alimony, child support
         or separate maintenance payment if you choose not to do so.

         Having made this disclosure to you, we are permitted to inquire if any of the income shown on
         your application is derived from such a source and to consider the likelihood of consistent
         payment as we do with any income on which you are relying to qualify for the loan for which you
         are applying.




                                        (Applicant)   (Date)                                 (Applicant)   (Date)



                                        (Applicant)   (Date)                                 (Applicant)   (Date)




CALYX Form Ecoa.hp 4/95
                      THE HOUSING FINANCIAL DISCRIMINATION ACT OF 1977
                                     FAIR LENDING NOTICE


           DATE:                                                       COMPANY:     Mortgage Loan Consultants of Texas
                                                                                    1203 Firebush Drive
           APPLICATION NO:                                                          Pflugerville, TX 78660

           PROPERTY ADDRESS:




           It is illegal to discriminate in the provisions of or in the availability of financial assistance because of
           the consideration of:
               1. Trends, characteristics or conditions in the neighborhood or geographic area surrounding a
                  housing accommodation, unless the financial institution can demonstrate in the particular
                  case that such consideration is required to avoid an unsafe and unsound business practice;
                  or
               2. Race, color, religion, sex, marital status, national origin or ancestry.
           It is illegal to consider the racial, ethnic, religious or national origin composition of a neighborhood
           or geographic area surrounding a housing accommodation or whether or not such composition is
           undergoing change, or is expected to undergo change, in appraising a housing accommodation or
           in determining whether or not, or under what terms and conditions, to provide financial assistance.
           These provisions govern financial assistance for the purpose of the purchase, construction,
           rehabilitation or refinancing of a one-to-four unit family residence occupied by the owner and for
           the purpose of the home improvement of any one-to-four unit family residence.
           If you have any questions about your rights, or if you wish to file a complaint, contact the
           management of this financial institution or the agency noted below :




             I/we received a copy of this notice.




                                                     Date                                                    Date




Calyx Form - fln.hp (2/99)
Borrower Signature Authorization
Privacy Act Notice:This information is to be used by the agency collecting it or its assignees in determining whether you qualify as a prospective mortgagor under
its program. It will not be disclosed outside the agency except as required and permitted by law. You do not have to provide this information, but if you do not your
application for approval as a prospective mortgagor or borrower may be delayed or rejected. The information requested in this form is authorized by Title 38, USC,
Chapter 37 (if VA); by 12 USC, Section 1701 et. seq. (if HUD/FHA); by 42 USC, Section 1452b (if HUD/CPD); and Title 42 USC, 1471 et. seq., or 7 USC, 1921 et.
seq. (if USDA/FmHA).

Part I - General Information
1. Borrower(s)                                                                      2. Name and address of Lender/Broker
                                                                                      Mortgage Loan Consultants of Texas
                                                                                      1203 Firebush Drive
                                                                                      Pflugerville, TX 78660
                                                                                      TEL: 512-989-3404 FAX: 512-989-9019
3. Date                           4. Loan Number



Part II - Borrower Authorization

 I hereby authorize the Lender/Broker to verify my past and present employment earnings records, bank accounts, stock
 holdings, and any other asset balances that are needed to process my mortgage loan application. I further authorize
 the Lender/Broker to order a consumer credit report and verify other credit information, including past and present
 mortgage and landlord references. It is understood that a copy of this form will also serve as authorization.


 The information the Lender/Broker obtains is only to be used in the processing of my application for a mortgage loan.




       Borrower                                                                                                Date



       Borrower                                                                                                Date




CALYX Form Bsa.hp 10/98
                         Borrowers' Certification and Authorization

                                                CERTIFICATION

     The Undersigned certify the following:
     1.   I/We have applied for a mortgage loan from_____________________________________. In applying
                                                       Mortgage Loan Consultants of Texas
          for the loan, I/We completed a loan application containing various information on the purpose of the
          loan, the amount and source of the downpayment, employment and income information, and the assets
          and liabilities. I/We certify that all of the information is true and complete. I/We made no
          misrepresentations in the loan application or other documents, nor did I/We omit any pertinent
          information.

     2.   I/We understand and agree that ___________________________________________reserves the right to
                                           Mortgage Loan Consultants of Texas
          change the mortgage loan review processes to a full documentation program. This may include verifying
          the information provided on the application with the employer and/or the financial institution.

     3.   I/We fully understand that it is a Federal crime punishable by fine or imprisonment, or both, to
          knowingly make any false statements when applying for this mortgage, as applicable under the
          provisions of Title 18, United States Code, Section 1014.



                              AUTHORIZATION TO RELEASE INFORMATION

     To Whom It May Concern:
     1. I/We have applied for a mortgage loan from ________________________________. As part of
                                                              Mortgage Loan Consultants of Texas
        the application process, _____________________________________ and the mortgage guaranty insurer
                                  Mortgage Loan Consultants of Texas
        (if any), may verify information contained in my/our loan application and in other documents required in
        connection with the loan, either before the loan is closed or as part of its quality control program.
     2.   I/We authorize you to provide to ________________________________ and to any investor to
                                               Mortgage Loan Consultants of Texas
          whom ___________________________________ may sell my mortgage, any and all information and
                   Mortgage Loan Consultants of Texas
          documentation that they request. Such information includes, but is not limited to, employment history
          and income; bank, money market and similar account balances; credit history; and copies of income tax
          returns.
     3.   ____________________________________ or any investor that purchases the mortgage may address
            Mortgage Loan Consultants of Texas
          this authorization to any party named in the loan application.
     4.   A copy of this authorization may be accepted as an original.




 Borrower Signature                                             Co-Borrower Signature

 SSN:                        Date:                              SSN:                         Date:




BORCERA.frm-calyx-9/98
                                                                                                                                    OMB Approved No. 2900-0086
                                                                                                                                    Respondent Burden: 15 minutes

                                                                                                           Department of Veterans Affairs
          Department of Veterans Affairs                                                                   Attn: Loan Guaranty Division
       REQUEST FOR A CERTIFICATE OF ELIGIBILITY                                                     TO


NOTE: Please read information on reverse before completing this form. If additional space is required, attach a separate sheet.
1. FIRST-MIDDLE-LAST NAME OF VETERAN                                      2. DATE OF BIRTH                 3. VETERAN'S DAYTIME TELEPHONE NO.


4. ADDRESS OF VETERAN (No., street or rural route, city or P.O. State         5. MAIL CERTIFICATE OF ELIGIBILITY TO: (Complete Only if the Certificate is to be
   and ZIP Code)                                                                 mailed to an address different from the one listed in Item 4)




                           6. MILITARY SERVICE DATA (ATTACH PROOF OF SERVICE - SEE PARAGRAPH "D'' ON REVERSE)
          B. PERIODS OF ACTIVE SERVICE          C. NAME (Show your name exactly as it appears            D. SOCIAL SECURITY           E. SERVICE #            F. BRANCH OF
A. ITEM
             DATE FROM         DATE TO          on your separation papers or Statement of Service              NUMBER             (If different from SSN.)       SERVICE

  1.
  2.
  3.
  4.
7A. WERE YOU DISCHARGED RETIRED OR SEPARATED FROM SERVICE BECAUSE OF DISABILITY 7B. VA CLAIM FILE NUMBER
   OR DO YOU NOW HAVE ANY SERVICE-CONNECTED DISABILITIES?

       YES      No (If ''Yes,'' complete Item 7B)                                                           C.
                            8. PREVIOUS VA LOANS (Must answer N/A if no previous VA home loan. DO NOT LEAVE BLANK)
                                                                                                                      E. DO YOU   F. DATE PROPERTY
            B. TYPE
                                                                                                          D. DATE     STILL OWN   WAS SOLD (Submit
         (Home, Refinance,                                                                                                                                G. VA LOAN NUMBER
A. ITEM Manufactured Home,                          C. ADDRESS OF PROPERTY                                    OF          THE     a copy of HUD-1,
                                                                                                                      PROPERTY?   Settlement Statement,         (If known)
            or Direct)                                                                                       LOAN
                                                                                                                       (YES/NO)   if available)


  1.


  2.


  3.


  4.


  5.


  6.

I CERTIFY THAT the statements herein are true to the best of my knowledge and belief.
9. SIGNATURE OF VETERAN (Do NOT print)                                                                                10. DATE SIGNED


FEDERAL STATUTES PROVIDE SEVERE PENALTIES FOR FRAUD, INTENTIONAL MISREPRESENTATION, CRIMINAL CONNIVANCE OR
CONSPIRACY PURPOSED TO INFLUENCE THE ISSUANCE OF ANY GUARANTY OR INSURANCE BY THE SECRETARY OF VETERANS AFFAIRS.

                                                                        FOR VA USE ONLY




11 A. DATE CERTIFICATE ISSUED                                     11 B. SIGNATURE OF VA AGENT


VA FORM
FEB 2000      26-1880                                 SUPERSEDES VA FORM 26-1880, MAR 1999,
                                                      WHICH WILL NOT BE USED.
                                                                                                                                            CALYX Form Vaelig.frm 5/99
                                     INSTRUCTIONS FOR VA FORM 26-1880
PRIVACY ACT INFORMATION: No Certificate of Eligibility may be issued unless VA receives sufficient information to determine that
you are eligible (38 U.S.C 3702). You are not required to furnish the information, including the Social Security Number, but are urged to do
so, since it is vital to proper actions by VA in your case. Specifically, your Social Security Number is requested under authority of 38 U.S.C.
3702 and is requested only if the service department used your Social Security Number as a service number. Failure to provide a completed
application will deprive VA of information needed in reaching decisions which could affect you. Responses may be disclosed outside VA only
if the disclosure is authorized under the Privacy Act, including the routine uses identified in the VA system of records, 55VA26, Loan
Guaranty Home, Condominium and Manufactured Home Loan Applicant Records, Specially Adapted Housing Applicant Records, and
Vendee Loan Applicant Records - VA, published in the Federal Register.
RESPONDENT BURDEN: VA may not conduct or sponsor, and respondent is not required to respond to this collection of information unless it
displays a valid OMB Control Number. Public reporting burden for this collection of information is estimated to average 15 minutes 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. If you have comments regarding this burden estimate or any other aspect of this collection of information,
call 1-800-827-1000 for mailing information on where to send your comments.

A. Mail this completed form, along with proof of service, to the Eligibility Center at P.O. Box 20729, Winston-Salem, NC 27120 (for
veterans located in the eastern half of the country) or P.O. Box 240097, Los Angeles, CA 90024 (for veterans located in the western
half of the country). Veterans stationed overseas may use either address.
B. Military Service Requirements for VA Loan Eligibility:(NOTE: Cases involving other than honorable discharges will usually require
further development by VA. This is necessary to determine if the service was under other than dishonorable conditions.)
  1. Wartime Service. If you served anytime during World War II (September 16, 1940 to July 25, 1947), Korean Conflict(June 27, 1950 to
January 31, 1955), or Vietnam Era (August 5, 1964 to May 7, 1975) you must have served at least 90 days on active duty and have been
discharged or released under other than dishonorable conditions. If you served less than 90 days, you may be eligible if discharged because of
service-connected disability.
  2. Peacetime Service. If your service fell entirely within one of the following periods: July 26, 1947 to June 26, 1950, or February 1, 1955
to August 4, 1964, you must have served at least 181 days of continuous active duty and have been discharged or released under conditions
other than dishonorable. If you entered service after May 7, 1975 but prior to September 8, 1980 (enlisted) or October 17, 1981 (officer) and
completed your service before August 2, 1990, 181 days service is also required. If you served less than 181 days, you may be eligible if
discharged for a service connected disability.
  3. Service after September 7, 1980 (enlisted) or October 16, 1981 (officer) and prior to August 2, 1990. If you were separated from
service which began after these dates, you must have: (a) Completed 24 months of continuous active duty or the full period for which you were
called or ordered to active duty (at least 181 days), and been discharged or released under conditions other than dishonorable; or (b) Completed
at least 181 days of active duty and been discharged under the specific authority of 10 U.S.C. 1173 (hardship discharge), or 10 U.S.C. 1171
(early out discharge), or have been determined to have a compensable service-connected disability; or (c) Been discharged with less than 181
days of service for a service-connected disability. Individuals may also be eligible if they were released from active duty due to an involuntary
reduction in force, certain medical conditions, or, in some instances, for the convenience of the Government.
  4. Gulf War. If you served on active duty during the Gulf War (August 2, 1990 to a date yet to be determined), you must have: (a) Completed
24 months of continuous active duty or the full period for which you were called or ordered to active duty (at least 90 days), and been discharged
or released under conditions other than dishonorable; or (b) Completed at least 90 days of active duty, and been discharged under the specific
authority of 10 U.S.C. 1173 (hardship discharge), or 10 U.S.C. 1171 (early out discharge), or have been determined to have a compensable
service-connected disabiFlity; or (c) Been discharged with less than 90 days of service for a service-connected disability. Individuals may also be
eligible if they were released from active duty due to an involuntary reduction in force, certain medical conditions, or, in some instances,
for the convenience of the Government.
  5. Active Duty Service Personnel. If you are now on active duty, you are eligible after having served on continuous active duty for at least
181 days (90days during the Persian Gulf War) unless discharged or separated from a previous qualifying period of active duty service.
  6. Selected Reserve Requirements for VA Loan Eligibility. If you are not otherwise eligible and you have completed a total of 6 years in
the Selected Reserves or National Guard (member of an active unit, attended required weekend drills and 2-week active duty training) and (a)
Were discharged with an honorable discharge; or (b) Were placed on the retired list or (c) Were transferred to the Standby Reserve or an
element of the Ready Reserve other than the Selected Reserve after service characterized as honorable service; or (d) Continue to serve in the
Selected Reserve. Individuals who completed less than 6 years may be eligible if discharged for a service connected disability. Eligibility for
Selected Reservists expires October 28, 1999.
C. Unmarried surviving spouses of eligible veterans seeking determination of basic eligibility for VA Loan Guaranty benefits are NOT
required to complete this form, but are required to complete VA Form 26-1817. Request for Determination of Loan Guaranty
Eligibility-Unmarried Surviving Spouse.
D. Proof of Military Service
  1. "Regular" Veterans. Attach to this request your most recent discharge or separation papers from active military duty since September 16,
1940, which show active duty dates and type of discharge. If you were separated after January 1, 1950, DD Form 214 must be submitted. If
you were separated after October 1, 1979, and you received DD Form 214, Certificate of Release or Discharge From Active Duty, 1 July
edition, VA must be furnished Copy 4 of the form. You may submit either original papers or legible copies. In addition, if you are now on
active duty submit a statement of service signed by, or by direction of, the adjutant, personnel officer, or commander of your unit or higher
headquarters showing date of entry on you current active duty period and the duration of any time lost. Any Veterans Benefits Counselor in
the nearest Department of Veterans Affairs office or center will assist you in securing necessary proof of military service.
  2. Selected Reserves/National Guard. If you are a discharged member of the Army or Air Force National Guard you may submit a NGB
Form 22, Report of Separation and Record of Service, or NGB Form 23, Retirement Points Accounting, or it's equivalent (this is similar to a
retirement points summary). If you are a discharged member of the Selected Reserve you may submit a copy of your latest annual point
statement and evidence of honorable service. You may submit either your original papers or legible copies. Since there is no single form used
by the Reserves or National Guard similar to the DD214, it is your responsibility to furnish adequate documentation of at least 6 years of
honorable service. In addition, if you are currently serving in the Selected Reserve you must submit a statement service signed by, or by the
direction of, the adjutant, personnel officer or commander of your unit or higher headquarters showing the length of time that you have been a
member of the unit.


                                                                                                                               CalyxForm vaelig2.frm
    Department of Veterans Affairs                                                       DEBT QUESTIONNAIRE
1. DURING THE PAST FIVE YEARS HAVE YOU DIRECTLY OR INDIRECTLY BEEN OBLIGATED ON ANY LOAN WHICH RESULTED IN FORECLOSURE,
   TRANSFER OF TITLE IN LIEU OF FORECLOSURE, OR JUDGMENT? (This would include home mortgage loans, SBA loans, home improvement loans, educational loans,
                                                                wouid Include                                                  loans, educational loans,
                                                      obligation.
  or manufactured home loans, any mortgage, financial obligation, bond, or loan guarantee)



     YES        NO     (If "Yes", provide details, including date, name and address of lender, FHA or VA case number, if any, and reasons for the action. Attach a separate
                       sheet, if needed.)




2. ARE YOU PRESENTLY DELINQUENT OR IN DEFAULT ON ANY DEBT TO THE FEDERAL GOVERNMENT                                (e.g., Public Health Service, U.S. Guaranteed
  Student Loan, GI Bill Education Benefits, etc.) ?

     YES        NO     (If "Yes", provide details, including date, name and address of lender, FHA or VA case number, if any, and reasons for the action. Attach a separate
                       sheet, if needed.)




 I CERTIFY THAT the statements herein are true and correct to the best of my knowledge and belief.
3. SIGNATURE OF VETERAN                                                                                                   4. DATE




5. SIGNATURE OF COBORROWER                                                                                                6.DATE




VA FORM
APR 1989
           26-0551                                                                                                                            CALYX Form Debque,frm 9/99
                       Department of Veterans Affairs

Property Address :                                           File No.:



                     FEDERAL COLLECTION POLICY NOTICE

The Federal Government is authorized by law to take any or all of the following actions in
the event your VA-guaranteed or VA-financed loan payments become delinquent or you default
on your VA-guaranteed or VA-financed loan:



    *    Your name and account information may be reported to a credit bureau.

         Additional interest and penalty charges may be assessed for the period of time
    *
         that payment is not made.

         Charges to cover additional administrative costs incurred by the Government to
    *
         service your account may be assessed.

    *    Amounts owed to you under other Federal programs may be offset.

         Your account may be referred to a private collection agency to collect the amount
    *
         due.


    *    Your account may be referred to the Department of Justice for litigation in the
         courts.

         If you are a current or retired Federal employee, your salary or civil service
    *
         retirement benefits may be offset.

         Your debt may be referred to the Internal Revenue Service for offset against any
    *
         amount owed to you as an income tax refund.

         Any written-off debt may be reported to the Internal Revenue Service as taxable
    *
         income.

All of these actions can and will be used to recover any debts owed the Department of
Veterans Affairs when it is determined to be in the best interest of the Government to do so.

CERTIFICATION

I have read and I understand the actions the Federal Government can take in the event that I
fail to meet my scheduled payments in accordance with the terms and conditions of my
agreement to purchase property with a VA-guaranteed or VA-financed loan.


Signature:                                                               Date:


Signature:                                                               Date:


  VA FORM                     SUPERSEDES VA FORM 26-0503, MAR 1987,
  JUL 1996
             26-0503          WHICH WILL NOT BE USED.
                                                                                 CALYX Form Fedcolpo.frm 9/99
          INTEREST RATE AND DISCOUNT STATEMENT



1.       This statement regarding the interest rate and discount points that you may pay on
a mortgage guaranteed by VA (Department of Veterans Affairs) must be delivered to you
prior to execution of the borrower's certification on the HUD/VA Addendum to the
Uniform Residential Loan Application.

2.        VA does not establish the interest rate for mortgage loans to be guaranteed or set
either a maximum or minimum on the interest rate or on discount points that may be paid
by you. This means that you may pay such interest rate and discount points as you and the
lender agree upon. The seller may also pay the discount points, or a portion thereof, if
you and the seller agree to such an arrangement.

3.        It is important for you to understand that the interest rate and discount points and
the length of time the lender will honor the loan terms are all freely negotiable with the
lender. Lenders may agree to offer the loan terms for a definite period of time (i.e., 30,
60, or 90 days), or may refuse to do so. This arrangement is commonly referred to as a
lock-in agreement. Keep in mind that your agreement with the seller will also affect the
date you can close your loan.

4.        The terms of your agreement with the lender will determine the degree, if any, that
the interest rate and discount points may change before closing. An increase of more than
1 percent in the interest rate requires re-underwriting of the loan approval by VA or by the
lender. It may be necessary for the lender to obtain your signature on a new application.
If, after re-underwriting, it is determine that you remain qualified from a credit risk
standpoint, the conditions of your agreements with the lender and the seller may require
you to complete the transaction or lose your deposit.


          IT IS YOUR RESPONSIBILITY TO ASSURE THAT
              YOU UNDERSTAND THE TRANSACTION.


Signed:


Dated:
DEPARTMENT OF VETERANS AFFAIRS

                          RIGHTS OF VA LOAN BORROWERS
                               (IMPORTANT NOTICE)

Property Address :                                                    File No.:



You have certain basic rights as a VA loan borrower that you should know about. These include:

Assumable Loan. For all VA Loans committed on or after March 1, 1988, you may sell your home to
someone who agrees to assume your loan if the loan holder or VA approves the creditworthiness of the
purchaser(s). If the purchaser(s) is creditworthy and assumes the liability to the lender and VA to the
same extent that you did when you obtained the loan, you will be released from liability on the loan. To
obtain a release from liability, you should check with the company to whom you make your payments
before you sell your home. The loan may become immediately due and payable if you do not obtain
approval of the loan assumption before selling your home. Keep in mind that you will not be able to get
another VA loan with the entitlement that you used for this loan until the property is sold and the loan is
paid in full unless the purchaser is a veteran and can qualify for substitution of entitlement. The local VA
office can provide you with details concerning substitution of entitlement.

No Prepayment Penalty. If you pay off your loan early, your lender cannot require that you pay a
prepayment penalty.

No Late Charge Unless Payment Is More Than 15 Days Overdue. Also, late charge may not exceed 4
percent of payment amount.

These rights apply to you and, if you sell your home, to any buyer who assumes your loan. Some
mortgage notes used by lenders may have provisions which seem to take away these rights. However,
the lender cannot enforce these provisions for a VA loan.

Your loan is guaranteed or insured under Title 38, United States Code. The law and regulations that
are in effect on the date your loan is closed govern the rights, duties, and liabilities of you and the lender.
Any provision of any instrument executed in connection with your loan which is inconsistent with the
law or the regulations is invalid.

If your loan has been funded by a State or local housing program, these basic rights may not apply to you.
If you are a participant in this type of program you should receive a notice stating the restrictions that
apply to your loan.

If you believe your rights as a VA loan borrower are being violated by the lender, or it you have any
questions about your loan which the lender cannot answer to your satisfaction, please contact the local
VA office for assistance.



X
Applicant                                               Date

X
Applicant                                               Date



VA FORM
DEC 1998
            26-8978                                                                    Calyx Form - rigvalo.frm (05/02)
                                                                                                                                                 OMB Approved No. 2900-0406
                                                                                                                                                 Respondent Burden: 5 minutes

       Department of Veterans Affairs                              VERIFICATION OF VA BENEFIT - RELATED INDEBTEDNESS

     PRIVACY ACT INFORMATION : This information is to be used by the agency collecting it in determining whether you qualify for the VA loan
     benefit. This information request is authorized by Title 38, U.S.C., Chapter 37. Responses may be disclosed outside the VA only if the
     disclosure is authorized under the Privacy Act, including the routine uses identified in VA system of records, 55VA26, Loan Guaranty Home,
     Condominium and Manufactured Home Loan Applicant Records, Specially Adapted Housing Applicant Records and Vendee Loan Applicant
     Records - VA, published in the Federal Register.

TO: NAME AND ADDRESS OF LENDER

                                                                                                                                INSTRUCTIONS TO LENDER
                                                                                                                Complete Items 1 through 6.      Have veteran complete Items
                                                                                                                7 and 8. Forward to the Finance Officer (24) at the local VA
                                                                                                                office to determine whether the veteran has any VA benefit-
                                                                                                                related indebtedness.   If a debt is found to exist, the home
                                                                                                                loan must not be closed until the veteran presents evidence
                                                                                                                showing that the debt has been cleared or an acceptable
                                                                                                                repayment plan has been established with VA. After comple-
                                                                                                                tion by the Finance Officer, this form will be returned to
                                                                                                                the lender at the address shown.       VA Form 26-8937 is a
                                                                                                                required exhibit to accompany home or manufactured home
                                                                                                                loans closed on the automatic basis, and prior approval
                                                                                                                submissions.


1. NAME OF VETERAN (First, middle, last)                                            2. CURRENT ADDRESS OF VETERAN




3. DATE OF BIRTH




4. VA CLAIM FOLDER NUMBER (C-FILE No.)                  5. SERVICE NUMBER                                     6. SOCIAL SECURITY NUMBER




I HEREBY CERTIFY THAT I                    DO   DO NOT have a VA benefit-related indebtedness to my knowledge.        I authorize VA to furnish the
information listed below.
7. SIGNATURE OF VETERAN                                                                                       8. DATE SIGNED




                                                                        FOR VA USE ONLY
      The above named veteran does not have a VA benefit-related indebtedness

      The veteran has the following VA benefit-related indebtedness

                                                         VA BENEFIT-RELATED INDEBTEDNESS(If any)
                                     TYPE OF DEBT(S)                                                           AMOUNT OF DEBT(S)
                                                                                     $
                                                                                     $
                                                                                     $
TERMS OF REPAYMENT PLAN (If any)




      Veteran is exempt from funding fee due to receipt of service-connected disability compensation of $_____________________________ monthly.
      (Unless checked, the funding fee receipt must be remitted to VA with VA Form 26-1820, Report and Certification of Loan Disbursement)

      Veteran is not exempt from funding fee due to receipt of nonservice-connected pension of $______________________________ monthly.
      LOAN APPLICATION WILL REQUIRE PRIOR APPROVAL PROCESSING BY VA

      Vetern has been rated incompetent by VA. LOAN APPLICATION WILL REQUIRE PRIOR APPROVAL PROCESSING BY VA

      Insufficient information. VA cannot identify the veteran with the information given. Please furnish more complete information, or a copy of
      DD Form 214 or discharge papers. If on active duty, furnish a statement of service written on official government letterhead, singed by the
      adjutant, personnel officer, or commanding officer. The statement should include name, birth date, service number, entry date and time lost

SIGNATURE OF AUTHORIZED AGENT                                                                                 DATE SIGNED



 RESPONDENT BURDEN: VA may not conduct or sponsor, and respondent is not required to respond to this collection of information unless it displays
 a valid OMB Control Number. Public reporting burden for this collection of information is estimated to average 5 minutes 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. If you have comments regarding this burden estimate or any other aspect of this collection of information, call 1-800-827-1000 for
 mailing information on where to send your comments.
VA FORM                                                       EXISTING STOCK OF VA FORM 26-8937, APR 1993,                                      Calyx Form - vavb.hp (05/02)
FEB 2001   26-8937                                            WILL BE USED.
BORROWER'S ACKNOWLEDGEMENT OF DISCLOSURES


Borrower Name(s):                                 Lender:




                                                  Date:


Propery Address:




By signing below, I acknowledge that I have received a "Good Faith Estimate" and all the applicable
disclosures required by the Truth in Lending Act.




I/We have received a copy of this disclosure:



                                     Date                                                  Date




                                                                            Calyx Form - bacofdi.frm (09/02)
Department of
Veterans Affairs
                 COUNSELING CHECKLIST FOR MILITARY HOMEBUYERS
1. Failure on the part of a borrower on active duty to disclose that he/she expects to leave the area within 12 months
due to transfer orders or completion of his/her enlistment period may constitute "bad faith". If your loan is foreclosed under
circumstances which include such bad faith, you may be required to repay VA for any loss suffered by the Government
under the guaranty. (In ANY case which VA suffers a loss under the guaranty, the loss must be repaid before your loan
benefits can be restored to use in obtaining another VA loan.)

2. Although real estate values have historically risen in most areas, there is no assurance that the property for which you
are seeking financing will increase in value or even retain its present value.

3. It is possible that you may encounter difficulty in selling your house, recovering your investment or making any profit,
particularly if there is an active new home market in the area.

4. Receiving military orders for a permanent change of duty station or an unexpected early discharge due to a reduction in
force will not relieve you of your obligation to make your mortgage payments on the first of each month.

5. "Letting the house go back" is NOT an acceptable option. A decision to do so may be considered "bad faith". A
foreclosure will result in a bad credit record, a possible debt you will owe the government and difficulty in getting more
credit in the future.

6. If unexpected circumstances lead to difficulty in making your payments, contact your mortgage company promptly. It
will be easier to resolve any problems if you act quickly and be open and honest with the mortgage company.

7. YOUR VA LOAN MAY NOT BE ASSUMED WITHOUT THE PRIOR APPROVAL OF VA OR YOUR
LENDER.

8. DO NOT BE MISLED! VA does not guarantee the CONDITION of the house which you are buying, whether it is
new or previously occupied. VA guarantees only the LOAN. You may talk to many people when you are in the process
of buying a house. Particularly with a previously occupied house, you may pick up the impression along the way that you
need not be overly concerned about any needed repairs or hidden defects since VA will be sure to find them and require
them to be repaired. This is NOT TRUE! In every case, ultimately, it is your responsibility to be an informed buyer and
to assure yourself that what you are buying is satisfactory to you in all respects. Remember, VA guarantees only the loan -
NOT the condition.

9. If you have any doubts about the condition of the house which you are buying, it is in your best interest to seek expert
advice before you legally commit yourself in a purchase agreement. Particularly with a previously occupied house, most
sellers and their real estate agents are willing to permit you, at your expense, to arrange for an inspection by a qualified
residential inspection service. Also, most sellers and agents are willing to negotiate with you concerning what repairs are
to be included in the purchase agreement. Steps of this kind can prevent many later problems, disagreements, and major
disappointments.

10. Proper maintenance is the best way to protect your home and improve the chance that its value will increase.

11. If you are buying a previously owned house, you should look into making energy efficient improvements. You can
add up to $6,000 to your VA loan to have energy efficient improvements installed. Consult your lender or the local VA
office.

I HEREBY CERTIFY THAT            the lender has counseled me and I fully understand the counseling items set forth above.


                            (Borrower's Signature)                                             (Date)


I HEREBY CERTIFY THAT            the borrower has been counseled regarding the counseling items set forth above.


                            (Lender's Signature)                                               (Date)


VA Form                        EXISTING STOCK OF VA FORM 26-0592, JUL 1990, WILL
JUN 1995   26-0592             BE USED.                                                            Calyx Form - vaccfmh.frm (05/02)
Request for Certificate                                              U.S. Department of Housing and Urban Development
                                                                     Office of Housing - Federal Housing Commissioner
of Veteran Status                                                    Department of Veterans Affairs
                                                                     Loan Guaranty Division

Privacy Statement: This report is authorized by law (P.L. 479, 48 stat. 1246, 12 U.S.C. 1701 et seq). While you are Mail this form to:
not required to respond, your cooperation is needed to qualify you for benefits under Section 203(b)(2) and 220(d)
(3)(a) of the National Housing Act. Disclosure of information outside of VA and HUD will only be made as permitted         Department of Veterans Affairs
by law. Public Law 97-255, Financial Integrity Act, 31 U.S.C. 3512, authorizes the Department of Housing and Urban
Development(HUD) to collect all the information (except the Social Security Number (SSN)) which will be used by
HUD to monitor programs. The Housing and Community Development Act of 1987, 42 U.S.C. 3543, authorizes HUD
to collect the SSN. This number is used to ensure that a unique identifier is assigned to each participant in the program.
HUD uses it to measure the number of participants in the program and the services received. Provision of the SSN
is mandatory. Failure to provide the information requested may result in a sanction. This information will not be          Attn: Loan Guaranty Division
otherwise disclosed or released outside of HUD, except as permitted or required by law.
Instructions: Read carefully before completing form. Use typewriter or print legibly. Complete all applicable items.
A. This request should be sent to the VA Regional Office or Center serving the area in which the veteran resides.
B. Attach to this request all your discharge or separation papers from the periods of active service in the Armed Forces of the U.S. listed in item 4.
C. If you lack proper discharge or separation papers, any Veterans Benefits Counselor will assist you in procuring such papers. If you are in doubt regarding the
    proper documents to be submitted with this request, you should contact the nearest VA Office for that information.
1. Name (Last, First, Middle) of Veteran                      2. Address of Veteran (Number, Street, City, State and Zip Code)                         3. Date of Birth




Military Service Data
I request that I be issued a Certificate of Veteran Status which I may furnish to a lender when applying for a HUD-insured loan under section 203(b)(2) or 220(d)(a)
of that National Housing Act, as amended. (Begin on line 4A and enter your latest period of service followed by preceding service, if any, on line 4B, continuing
on reverse if necessary).

        Period of Active Service                                      Name
                                           (Show your name exactly as it appears on your discharge papers          Service Number or
      Date From           Date To                        for each period of service.)                             Social Security Number               Branch of Service
4A.


4B.


5. VA Claim Number                     Note: If upon your release from the latest period of active military duty, you received DD Form 214, NAVPERS Form
      C-                               553, or similar form or form letter in lieu of a discharge, complete items 6A and 6B.
6A. Are you now on active military duty?                                            For VA Use Only
                                                                                    Date Certificate of Veterans Status issued
       Yes                     No
6B. Were you on active military duty on the day following the date
                                                                                    Discharge or Separation Papers Returned to:
           Yes                  No

I Certify That the statements herein are true to the best of my knowledge and belief.
7. Signature of Veteran                                                                                                          8. Date




Important Instructions: If the Certificate is to be sent to the veteran, the complete mailing address should be shown in item 11. If it is desired that the certificate
be sent to other than the veteran, the name and address of such person or firm should be shown in Item 11. Items 9 and 10 need be completed only when
the certificate is being sent to other than the veteran.
                                                                             Do Not Detach


Transmittal of Certificate of Veteran Status
9. Name and Service Number/Social Security Number of Veteran                                                           10. File Reference




The discharge or separation papers returned herewith will not be required again unless requested.                      For VA Use Only
11. Return To:                                                                                                         Date


                                                                                                                       Enclosures
                                                                                                                                   Certificate of Veteran Status
                                                                                                                                   Discharge or Separation Papers
                                                                                                                                   Other (Specify)




Replaces form FHA-2950, which may be used until supply is exhausted                                                                                  form HUD-92950     (9/93)
Calyx Form - rfcovs.frm (11/97)                                                                                                                      VA FORM 26-8261a (9/93)

				
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