Certified Multifamily Ownership and
Exhibit III-13 Loan History Statement
CERTIFIED MULTIFAMILY OWNERSHIP AND LOAN HISTORY STATEMENT
Property Name: _____________________________________________________________________________
Property Address: ______________________________________________________________________ _____
Key Principal or Principal
and Description of Interest in the
Borrower or Subject Property: ____________________________________________________________
The undersigned certifies that all information provided on this Statement and all attachments hereto are true, complete, and correct to the best
of the undersigned's knowledge.
Attached to this Statement is:
_____ 1. A description of any current bankruptcy or any bankruptcy occurring within the previous 10 years of the
undersigned, or of any entity in which the undersigned owns or has owned a significant interest.
_____ 2. A description of any pending or current litigation or judgments related to: (a) the undersigned's ownership or
operation of any real estate which could materially and adversely impact the undersigned's financial condition, (b)
the undersigned's ownership of a significant interest in any entity, or (c) any entity in which the undersigned owns
a significant interest which could materially and adversely impact the entity's financial condition.
_____ 3. A description of any litigation or judgments in the previous 10 years involving (a) Fannie Mae and the
undersigned, or (b) Fannie Mae and any entity in which the undersigned owns or has owned a significant interest.
_____ 4. An explanation as to the cause and resolution of any delinquencies, defaults, foreclosures, or deeds-in-lieu of
foreclosure occurring during the previous 10 years in connection with loans to the undersigned or entities in which
the undersigned owns or has owned a significant interest.
_____ 5. A listing of all multifamily properties in which the undersigned owns or has owned either the property or a
significant interest in the borrower and for which the mortgage or other security instrument on the property was
purchased by Fannie Mae.
Indicate which attachments are included by checking the appropriate line next to the attachment description. If an attachment is not
applicable, then indicate not applicable ("n/a") on the appropriate line. For purposes of this Statement, "significant interest" means a general
partnership interest, joint venture interest, 25 percent or more limited partnership, or 25 percent or more stock ownership.
Name: ______________________________________ Title: ________________________________________
Signature: ______________________________________ Date: ________________________________________
Recertification: There is no change to undersigned's responses to the above statements.
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