-----------------------------------------------------------------------
  **EDI INFORMATION REQUEST**

  *(Read definitions and instructions in Appendix B at*
  http://www.hud.gov/offices/hsg/comp/edi/edi.cfm *before completing
  form)*
  -----------------------------------------------------------------------

*Check the mortgage insurance application this information applies to
(Check transaction type and standards version).*

+-----------------------+-----------------------+-----------------------+
| Claims (TS            | Defaults (TS 264/824) | MRC/Terminations (TS  |
| 260/820/824)          |                       | 266/824)              |
|                       | *(Check only one)*    |                       |
| *(Check only one)*    |                       | *(Check only one)*    |
|                       | Standards Version     |                       |
| Standards Version     | 004040                | Standards Version     |
| 004040                |                       | 004040                |
|                       | Standards Version     |                       |
| Standards Version     | 004010                | Standards Version     |
| 004010                |                       | 004010                |
|                       | Standards Version     |                       |
| Standards Version     | 003032                | Standards Version     |
| 003032                |                       | 003042                |
+-----------------------+-----------------------+-----------------------+

Complete the following:

  -------------- -------------------------------- ----------- ------- -- ----- ------- ------- --
  Organization                                    HUD                                          
  Name                                            Mortgagee                                    
                                                  ID                                           

  Contact Name                                    Phone                                        

  Address                                                                                      

  City                                            State                  Zip                   

  Email                                                                                        

  Date that you                                                                                
  would like to                                                                                
  start sending                                                                                
  Production                                                                                   
  Data:                                                                                        
  (mm/dd/yyyy)                                                                                 

                                                                                               
  -------------- -------------------------------- ----------- ------- -- ----- ------- ------- --

Complete this section if using a Service Bureau to send and receive EDI
transactions:

  -------------- ------------------------------ ------- ------- ----- ------- --
  Service Bureau                                                              
  Name                                                                        

  Contact Name                                  Phone                         

  Address                                                                     

  City                                          State           Zip           

  Email                                                                       
  -------------- ------------------------------ ------- ------- ----- ------- --

Complete this section if using a VAN to send and receive EDI
transactions:

  -------------- ------------------------------ -------------------------
  Name of VAN:                                  

  -------------- ------------------------------ -------------------------

For Inbound document submission to HUD: Please fill-in the values for
ISA05, ISA06, and GS02 in the appropriate row.

+---+------+--------+--------+---------+---------+--------+---+---------+
| * |      | **ISA  | **ISA  | **ISA   | **ISA   | **G    |   | **      |
| * |      | Se     | Se     | Rec     | R       | roup** |   | Group** |
| T |      | nder** | nder** | eiver** | eceiver |        |   |         |
| r |      |        |        |         | ISA08** | **     |   | **R     |
| a |      | *      | **I    | **Qual  |         | Sender |   | eceiver |
| n |      | *Quali | SA06** | ifier** |         | ID**   |   | ID**    |
| s |      | fier** |        |         |         |        |   |         |
| a |      |        |        | **      |         | **     |   | *       |
| c |      | **I    |        | ISA07** |         | GS02** |   | *GS03** |
| t |      | SA05** |        |         |         |        |   |         |
| i |      |        |        |         |         |        |   |         |
| o |      |        |        |         |         |        |   |         |
| n |      |        |        |         |         |        |   |         |
| S |      |        |        |         |         |        |   |         |
| e |      |        |        |         |         |        |   |         |
| t |      |        |        |         |         |        |   |         |
| * |      |        |        |         |         |        |   |         |
| * |      |        |        |         |         |        |   |         |
+---+------+--------+--------+---------+---------+--------+---+---------+
|   | **TS | **     | **     | **ZZ**  | **99996 | **     |   | **99996 |
|   | 2    |     ** |     ** |         | 09999** |     ** |   | 09999** |
|   | 60** |        |        |         |         |        |   |         |
+---+------+--------+--------+---------+---------+--------+---+---------+
|   | **TS | **     | **     | **ZZ**  | **99996 | **     | * | **99996 |
|   | 2    |     ** |     ** |         | 09999** |     ** | * | 09999** |
|   | 64** |        |        |         |         |        | D |         |
|   |      |        |        |         |         |        | * |         |
|   |      |        |        |         |         |        | * |         |
+---+------+--------+--------+---------+---------+--------+---+---------+
|   | **TS | **     | **     | **ZZ**  | **99996 | **     | * | **99996 |
|   | 2    |     ** |     ** |         | 09999** |     ** | * | 09999** |
|   | 66** |        |        |         |         |        | T |         |
|   |      |        |        |         |         |        | * |         |
|   |      |        |        |         |         |        | * |         |
+---+------+--------+--------+---------+---------+--------+---+---------+

To be completed by HUD after approval:

  -------------------------------------------------- ----------- ----------
  ***D******ate Trading Partner can begin sending    **     **   
  EDI Production Data: (mm/dd/yyyy)***                           

  -------------------------------------------------- ----------- ----------

+----------------+-----------------------------------------------------+
| **Return this  | **By FAX to HUD EDI Help Desk (301) 731-1384**      |
| form:**        |                                                     |
|                | **As an attachment by E-Mail to**                   |
|                | EDI.Help.Desk@hud.gov                               |
|                |                                                     |
|                | **If you have any questions call 1-800-HUD-4EDI     |
|                | (1-800-483-4334)**                                  |
+----------------+-----------------------------------------------------+