**APPENDIX 4**

**LAND STATUS AND JURISDICTION FORM**

**SECTION 184 INDIAN HOUSING LOAN GUARANTEE PROGRAM**

**HUD, OFFICE OF NATIVE AMERICAN PROGRAMS**

**NOTE TO BORROWERS, TRIBES, AND LENDERS**: *This form is intended as a
model only*. Lenders and/or tribes may elect to use this or any other
complete format to submit information about land type.

**APPLICANT NAME**:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**CO-APPLICANT NAME**:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**LENDER**:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**BORROWER'S** **TRIBE**:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**PROPOSED PROPERTY ADDRESS/LOCATION**:

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**LAND STATUS**:

\_\_\_\_\_ **TRIBAL TRUST LAND** (Attach a copy of a letter or other
document from the tribe indicating the tribe's intention to permit the
applicant to develop this site.)

\_\_\_\_\_ **FEE SIMPLE LAND** (Attach a copy of a map or legal
description indicating that this land is within the IHA operating area.)

\_\_\_\_\_ **ALLOTTED OR INDIVIDUAL TRUST LAND** (Attach a copy of BIA
document indicating that this land is held in trust for the applicant)

**DOES THE TRIBE HAVE A TRIBAL COURT SYSTEM**:

\_\_\_\_\_ YES \_\_\_\_\_ NO

**IF YES, DOES THE TRIBAL COURT SYSTEM HAVE JURISDICTION TO HEAR
FORECLOSURE AND/OR EVICTION CASES FOR THE PROPOSED SITE**:

\_\_\_\_\_ YES \_\_\_\_\_ NO

**SIGNATURE OF TRIBAL OFFICIAL**:

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

SIGNATURE AND PRINTED NAME

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

TITLE

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

NAME OF TRIBE WHERE PROPERTY IS LOCATED

<table>
<colgroup>
<col style="width: 19%" />
<col style="width: 3%" />
<col style="width: 1%" />
<col style="width: 9%" />
<col style="width: 5%" />
<col style="width: 2%" />
<col style="width: 4%" />
<col style="width: 0%" />
<col style="width: 4%" />
<col style="width: 5%" />
<col style="width: 6%" />
<col style="width: 3%" />
<col style="width: 1%" />
<col style="width: 6%" />
<col style="width: 1%" />
<col style="width: 3%" />
<col style="width: 6%" />
<col style="width: 3%" />
<col style="width: 12%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="6"><strong>Mortgage Credit<br />
Analysis Worksheet<br />
Native American Loan Guarantee Program</strong></td>
<td colspan="7"><strong>U.S. Department of Housing<br />
and Urban Development</strong><br />
Office of Public and Indian Housing</td>
<td colspan="6">OMB Approval No. 2577-0200 (exp. 12/31/2001)</td>
</tr>
<tr class="even">
<td colspan="19">See the Public Reporting Burden and Privacy Act
statements on back</td>
</tr>
<tr class="odd">
<td colspan="12">Section 184 Case Number</td>
<td colspan="7"><p>Type of Construction (check one)</p>
<p>Existing Construction Proposed Construction</p></td>
</tr>
<tr class="even">
<td colspan="3">1a. Borrower’s name</td>
<td colspan="4">2a. Social Security Number</td>
<td colspan="3">3a. Age</td>
<td colspan="6">4. Dependents</td>
<td colspan="3" rowspan="2"><p>5. Marital Status</p>
<p>a. Married</p>
<p>b. Separated</p>
<p>c. Unmarried</p></td>
</tr>
<tr class="odd">
<td colspan="3">1b. Co-Borrower’s name</td>
<td colspan="4">2b. Social Security Number</td>
<td colspan="3">3b. Age</td>
<td colspan="2">a. Numbers</td>
<td colspan="4">b. Ages</td>
</tr>
<tr class="even">
<td colspan="2">6a. Mortgage without LG Fee</td>
<td colspan="6">6b. Total LG Fee<br />
(1% of maximum mortgage)</td>
<td colspan="5">6c. Mortgage with LG Fee</td>
<td colspan="6"><p>7.a. Total Closing Costs</p>
<p>b. Less Paid by Seller ______________</p>
<p>c. Borrower’s Closing Costs</p></td>
</tr>
<tr class="odd">
<td>8. Current housing expenses</td>
<td colspan="3">9. Term of loan (years)</td>
<td colspan="4">10. Interest rate (%)</td>
<td colspan="3"><p>11. First-time Homebuyer?</p>
<p> Yes No</p></td>
<td colspan="6"><p>12. Adj. buy-down interest rate</p>
<p>%</p></td>
<td colspan="2">13. Appraised Value</td>
</tr>
<tr class="even">
<td colspan="9"><strong>14. Settlement Requirements/Mortgage
Calculation</strong></td>
<td colspan="5"><strong>16. Debts &amp; Obligations</strong></td>
<td colspan="4"><strong>Monthly Payment</strong></td>
<td><strong>Unpaid Balance</strong></td>
</tr>
<tr class="odd">
<td colspan="5"><blockquote>
<p>a. Contract Sales Price or Construction Cost</p>
</blockquote></td>
<td colspan="4"></td>
<td colspan="5"><blockquote>
<p>a. Total installment debt</p>
</blockquote></td>
<td colspan="4"></td>
<td></td>
</tr>
<tr class="even">
<td colspan="5"><blockquote>
<p>b. Repairs &amp; Improvements</p>
</blockquote></td>
<td colspan="4"></td>
<td colspan="5"><blockquote>
<p>b. Child support, etc.</p>
</blockquote></td>
<td colspan="4"></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="5"><blockquote>
<p>c. Borrower-paid Closing Costs (from line 7c)</p>
</blockquote></td>
<td colspan="4"></td>
<td colspan="5"><blockquote>
<p>c. Other</p>
</blockquote></td>
<td colspan="4"></td>
<td></td>
</tr>
<tr class="even">
<td colspan="5"><blockquote>
<p>d. Sales Concessions (subtract)</p>
</blockquote></td>
<td colspan="4"></td>
<td colspan="5"><blockquote>
<p>d. Total monthly payments</p>
</blockquote></td>
<td colspan="4"></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="5"><blockquote>
<p>e. Acquisition Cost (sum of lines 14a + b + c minus 14d</p>
</blockquote></td>
<td colspan="4"></td>
<td colspan="10"><strong>17. Future Monthly Payments</strong></td>
</tr>
<tr class="even">
<td colspan="5"><blockquote>
<p>f. Multiply Acquisition Cost (line 14e) by</p>
</blockquote></td>
<td colspan="4"></td>
<td colspan="9"><blockquote>
<p>a. Principal &amp; Interest — 1st mortgage</p>
</blockquote></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="5"><blockquote>
<p>0.9775 if greater than $50,000</p>
</blockquote></td>
<td colspan="4"></td>
<td colspan="9"><blockquote>
<p>b Homeowners Association Fee</p>
</blockquote></td>
<td></td>
</tr>
<tr class="even">
<td colspan="5"><blockquote>
<p>0.9875 it $50,000 or less</p>
</blockquote></td>
<td colspan="4"></td>
<td colspan="9"><blockquote>
<p>c. Ground rent</p>
</blockquote></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="5"><blockquote>
<p>g. Mortgage (without LG Fee) (lowest of 14f, 18b, or 18e)</p>
</blockquote></td>
<td colspan="4"></td>
<td colspan="9"><blockquote>
<p>d. Principal &amp; Interest — 2nd mortgage</p>
</blockquote></td>
<td></td>
</tr>
<tr class="even">
<td colspan="5"><blockquote>
<p>h. Required investment (line 14e minus line 14g)</p>
</blockquote></td>
<td colspan="4"></td>
<td colspan="9"><blockquote>
<p>e. Hazard insurance</p>
</blockquote></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="5"><blockquote>
<p>i. Discounts</p>
</blockquote></td>
<td colspan="4"></td>
<td colspan="9"><blockquote>
<p>f. Taxes &amp; special assessments</p>
</blockquote></td>
<td></td>
</tr>
<tr class="even">
<td colspan="5"><blockquote>
<p>j. Prepayable expenses</p>
</blockquote></td>
<td colspan="4"></td>
<td colspan="9"><blockquote>
<p>g. Total mortgage payment</p>
</blockquote></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="5"><blockquote>
<p>k. LG Fee paid in cash</p>
</blockquote></td>
<td colspan="4"></td>
<td colspan="9"><blockquote>
<p>h. Recurring expenses (from line 16d)</p>
</blockquote></td>
<td></td>
</tr>
<tr class="even">
<td colspan="5"><blockquote>
<p>I. Non-Realty and other items (see 14d)</p>
</blockquote></td>
<td colspan="4"></td>
<td colspan="9"><blockquote>
<p>i. Total fixed payment</p>
</blockquote></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="5"><blockquote>
<p>m. Total requirements (sum of lines 14h -14l)</p>
</blockquote></td>
<td colspan="4"></td>
<td colspan="10"><strong>18. Ratios/Residual Income</strong></td>
</tr>
<tr class="even">
<td colspan="5"><blockquote>
<p>n. Amount paid in cash other (explain)</p>
</blockquote></td>
<td colspan="4"></td>
<td colspan="9"><blockquote>
<p>a. Loan—to—value (line 14g ÷ item 13)</p>
</blockquote></td>
<td>. %</td>
</tr>
<tr class="odd">
<td colspan="5"><blockquote>
<p>o. Amount to be paid in cash other</p>
</blockquote></td>
<td colspan="4"></td>
<td colspan="9"><blockquote>
<p>b. Value</p>
</blockquote></td>
<td></td>
</tr>
<tr class="even">
<td colspan="5"><blockquote>
<p>p. Assets available</p>
</blockquote></td>
<td colspan="4"></td>
<td colspan="9"><blockquote>
<p>(item 13) x 0.9775 if greater than $50,000</p>
</blockquote></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="5"><blockquote>
<p>q. 2nd mortgage proceeds (if applicable)</p>
</blockquote></td>
<td colspan="4"></td>
<td colspan="9"><blockquote>
<p>(item 13) x 0.9875 if $50,000 or less</p>
</blockquote></td>
<td>. %</td>
</tr>
<tr class="even">
<td colspan="9"><strong>15. Monthly Effective Income</strong></td>
<td colspan="9"><blockquote>
<p>c. Total fixed payment-to-income (line 17i ÷ line 15f)</p>
</blockquote></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="5"><blockquote>
<p>a. Borrowers base pay</p>
</blockquote></td>
<td colspan="4"></td>
<td colspan="9"><blockquote>
<p>d. Residual Income (l5f x 0.80 – 17g – 16d)</p>
</blockquote></td>
<td></td>
</tr>
<tr class="even">
<td colspan="5"><blockquote>
<p>b. Borrowers other earnings (explain)</p>
</blockquote></td>
<td colspan="4"></td>
<td colspan="9"><blockquote>
<p>e. 150% of FHA Mortgage Limit</p>
</blockquote></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="5"><blockquote>
<p>c. Co-borrowers base pay</p>
</blockquote></td>
<td colspan="4"></td>
<td colspan="10"><strong>19. Borrower Rating</strong> (enter “A” for
acceptable or “R” for reject)</td>
</tr>
<tr class="even">
<td colspan="5"><blockquote>
<p>d. Co-borrowers other earnings (explain)</p>
</blockquote></td>
<td colspan="4"></td>
<td colspan="9"><blockquote>
<p>a. Credit characteristics</p>
</blockquote></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="5"><blockquote>
<p>e. Net income from real estate</p>
</blockquote></td>
<td colspan="4"></td>
<td colspan="9"><blockquote>
<p>b. Adequacy of effective income</p>
</blockquote></td>
<td></td>
</tr>
<tr class="even">
<td colspan="5"><blockquote>
<p>f. Gross monthly income</p>
</blockquote></td>
<td colspan="4"></td>
<td colspan="9"><blockquote>
<p>c. Stability of effective income</p>
</blockquote></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="9" rowspan="7">Remarks: (attach additional paper if
needed)</td>
<td colspan="9"><blockquote>
<p>d. Adequacy of available assets</p>
</blockquote></td>
<td></td>
</tr>
<tr class="even">
<td colspan="10"><strong>20. Contract Sales Price of Property (line
14a)</strong></td>
</tr>
<tr class="odd">
<td colspan="10"><blockquote>
<p>a. 6% of line 20</p>
</blockquote></td>
</tr>
<tr class="even">
<td colspan="10"><blockquote>
<p>b. Total Seller Contribution</p>
</blockquote></td>
</tr>
<tr class="odd">
<td colspan="10"><blockquote>
<p>c. Excess Contribution</p>
</blockquote></td>
</tr>
<tr class="even">
<td colspan="6"><strong>21. Borrower’s CAIVR number</strong></td>
<td colspan="4"><strong>Co-borrower’s CAIVR number</strong></td>
</tr>
<tr class="odd">
<td colspan="10"><p><strong>22. Total Amount of Gifts</strong></p>
<p>$</p></td>
</tr>
</tbody>
</table>

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.
1001,1010,1012; 31 U.S.C. 3729,3802)

+----------------+-----------------------------+-----------------------+
| **Final        | **Underwriters signature &  | **HUD Representatives |
| application    | date**                      | signature & date**    |
| decision**     |                             |                       |
|                | X                           | X                     |
| > Approved     |                             |                       |
| >              |                             |                       |
| > Reject       |                             |                       |
+----------------+-----------------------------+-----------------------+
| Public         |                             |                       |
| reporting      |                             |                       |
| burden for     |                             |                       |
| this           |                             |                       |
| collection of  |                             |                       |
| information is |                             |                       |
| estimated to   |                             |                       |
| average 6      |                             |                       |
| 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.   |                             |                       |
| This agency    |                             |                       |
| may not        |                             |                       |
| collect this   |                             |                       |
| information,   |                             |                       |
| and you are    |                             |                       |
| not required   |                             |                       |
| to complete    |                             |                       |
| this form,     |                             |                       |
| unless it      |                             |                       |
| displays a     |                             |                       |
| currently      |                             |                       |
| valid 0MB      |                             |                       |
| control        |                             |                       |
| number.        |                             |                       |
|                |                             |                       |
| This           |                             |                       |
| information is |                             |                       |
| required by    |                             |                       |
| Section 184 of |                             |                       |
| the Housing    |                             |                       |
| and Community  |                             |                       |
| Development    |                             |                       |
| Act of 1992,   |                             |                       |
| as amended by  |                             |                       |
| Section 701 of |                             |                       |
| the Native     |                             |                       |
| America        |                             |                       |
| Housing        |                             |                       |
| Assistance and |                             |                       |
| Self           |                             |                       |
| -Determination |                             |                       |
| Act of 1996    |                             |                       |
| and            |                             |                       |
| implementing   |                             |                       |
| regulations at |                             |                       |
| 24 CFR Section |                             |                       |
| 1005. HUD has  |                             |                       |
| the authority  |                             |                       |
| to guarantee   |                             |                       |
| loans for the  |                             |                       |
| construction,  |                             |                       |
| acquisition,   |                             |                       |
| or             |                             |                       |
| rehabilitation |                             |                       |
| of 1- to       |                             |                       |
| 4-family homes |                             |                       |
| to be owned by |                             |                       |
| Native         |                             |                       |
| Americans on   |                             |                       |
| restricted     |                             |                       |
| Indian lands.  |                             |                       |
| Mortgage       |                             |                       |
| lenders        |                             |                       |
| (mortgagees)   |                             |                       |
| provide        |                             |                       |
| borrower and   |                             |                       |
| tender         |                             |                       |
| information to |                             |                       |
| HUD for the    |                             |                       |
| guarantee of   |                             |                       |
| the loan.      |                             |                       |
| Responses to   |                             |                       |
| the collection |                             |                       |
| of information |                             |                       |
| are required   |                             |                       |
| to obtain a    |                             |                       |
| benefit. The   |                             |                       |
| information    |                             |                       |
| requested is   |                             |                       |
| considered     |                             |                       |
| sensitive and  |                             |                       |
| is protected   |                             |                       |
| by the Privacy |                             |                       |
| Act.           |                             |                       |
|                |                             |                       |
| Sensitive      |                             |                       |
| Information:   |                             |                       |
| The            |                             |                       |
| information    |                             |                       |
| collected on   |                             |                       |
| this form is   |                             |                       |
| considered     |                             |                       |
| sensitive and  |                             |                       |
| is protected   |                             |                       |
| by the Privacy |                             |                       |
| Act. The       |                             |                       |
| Privacy Act    |                             |                       |
| requires that  |                             |                       |
| these records  |                             |                       |
| be maintained  |                             |                       |
| with           |                             |                       |
| appropriate    |                             |                       |
| a              |                             |                       |
| dministrative, |                             |                       |
| technical, and |                             |                       |
| physical       |                             |                       |
| safeguards to  |                             |                       |
| ensure their   |                             |                       |
| security and   |                             |                       |
| co             |                             |                       |
| nfidentiality. |                             |                       |
| In addition,   |                             |                       |
| these records  |                             |                       |
| should be      |                             |                       |
| protected      |                             |                       |
| against any    |                             |                       |
| anticipated    |                             |                       |
| threats or     |                             |                       |
| hazards to     |                             |                       |
| their security |                             |                       |
| or integrity   |                             |                       |
| which could    |                             |                       |
| result in      |                             |                       |
| substantial    |                             |                       |
| harm,          |                             |                       |
| embarrassment  |                             |                       |
| inconvenience, |                             |                       |
| or unfairness  |                             |                       |
| to any         |                             |                       |
| individual on  |                             |                       |
| whom the       |                             |                       |
| information is |                             |                       |
| maintained.    |                             |                       |
+----------------+-----------------------------+-----------------------+

Line 14d (Subtract Sales Concessions): Refers to seller-paid prepaid
items, personal property items, seller concessions exceeding 6% from
Attachment A, etc. This does not include seller-paid closing costs from
line 7b. This amount should also appear on line 141 to correctly
determine total cash requirements.

+-----------------------------------+-------------+--------------------+
| **Loan Guarantee Case Number:**   |             | **184 MAXIMUM**    |
|                                   |             |                    |
| **Lender:**                       |             | **MORTGAGE**       |
|                                   |             |                    |
| **Borrower(s):**                  |             | **WORKSHEET FOR**  |
|                                   |             |                    |
| **Property Address (street, city, |             | **REHABILITATION   |
| state and zip code):**            |             | AND**              |
|                                   |             |                    |
|                                   |             | **SINGLE CLOSE     |
|                                   |             | LOANS**            |
+-----------------------------------+-------------+--------------------+
|                                   |             |                    |
+-----------------------------------+-------------+--------------------+
| **ALLOWABLE COSTS FOR             |             |                    |
| REHABILITATION OR SINGLE CLOSE    |             |                    |
| LOANS**                           |             |                    |
+-----------------------------------+-------------+--------------------+
| 1\. Total Costs of Repair or      |             | \$                 |
| Construction (from Specification  |             |                    |
| of Repair or Contractor Work      |             |                    |
| Write-up)                         |             |                    |
+-----------------------------------+-------------+--------------------+
| 2\. Contingency Reserve on Repair |             | \$                 |
| or Construction Cost ( )%         |             |                    |
+-----------------------------------+-------------+--------------------+
| 3\. Inspection Fees ( x \$ per    |             | \$                 |
| inspection) + Title Update Fee (  |             |                    |
| x \$ per draw)                    |             |                    |
+-----------------------------------+-------------+--------------------+
| 4\. Mortgage Payments Escrowed (  |             | \$                 |
| months x \$ ) =                   |             |                    |
+-----------------------------------+-------------+--------------------+
| 5\. **SUB-TOTAL for               |             | \$                 |
| Rehabilitation or Construction    |             |                    |
| Escrow Account (total of 1-4)**:  |             |                    |
+-----------------------------------+-------------+--------------------+
| 6\. Architectural and Engineering |             | \$                 |
| Fees:                             |             |                    |
+-----------------------------------+-------------+--------------------+
| 7\. Permits and other Fees        |             | \$                 |
| (explain in remarks):             |             |                    |
+-----------------------------------+-------------+--------------------+
| **8. SUB-TOTAL for release at     |             | \$                 |
| closing (total of 6 & 7)**:       |             |                    |
+-----------------------------------+-------------+--------------------+
| 9\. TOTAL Rehabilitation or       |             | \$                 |
| Construction Costs (total of 5    |             |                    |
| and 8):                           |             |                    |
+-----------------------------------+-------------+--------------------+

**WHERE TO TRANSFER NUMBERS FROM THE ABOVE WORKSHEET TO THE MORTGAGE
CREDIT ANALYSIS WORKSHEET**:

> [WORKSHEET]{.underline} [MCAW]{.underline}
>
> Line 9 Line l4a

**SECTION 184 LOAN GUARANTEE FIRM COMMITMENT FORM**

U.S. Department of Housing and Urban Development Office of Native
American Programs

+-----------------------------------------------------------------------+
| **General Commitment Conditions**                                     |
|                                                                       |
| **1.** **Maximum Mortgage Amount and Term**: a) Occupant Mortgagors:  |
| Mortgage amount and terms assume satisfactory owner-occupant          |
| mortgagor(s) or qualified fl-IA or Tribe. b) Changes: HUD may, due to |
| a significant negative event affecting The homebuyer's income,        |
| liabilities or credit, change The mortgage amount and term.           |
|                                                                       |
| **2. Validity Period**: This document expires 60 days from The issue  |
| date with an optional 60-day extension at HUD's discretion.           |
|                                                                       |
| **3. Cancellation**: This document may be cancelled alter 60 days     |
| from The date of issuance if construction has not started.            |
|                                                                       |
| **4. Property Standards**: All construction, repairs, or alterations  |
| proposed in the application or on the construction exhibits returned  |
| herewith must equal or exceed applicable codes and HUD requirements.  |
+-----------------------------------------------------------------------+

Section 184 Case Number:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Date issued:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

INST Reference Number:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Expiration Date:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Lender:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Borrower:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Property Address:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_ Purchase Existing \_\_\_\_\_ Rehab Existing \_\_\_\_\_ New
Construction \_\_\_\_\_Purchase & Rehab

\_\_\_\_\_ Manufactured Existing Housing

**COMMITMENT TERMS**

Estimated Value of Property:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Commitment Amount:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Maximum Mortgage Amount: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Loan Term (Years): \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Interest Rate: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Monthly Expense Estimate**:

Insurance \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Taxes and/or lease payment
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Maintenance and repairs
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Heat and utilities \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Condominium community expense
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Total Expenses \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_ Approved \_\_\_\_\_ Rejected by Director, Office of Loan
Guarantee, National ONAP

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Signature Date

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Typed or Printed Name

**COMMITMENT CONDITIONS**

HUD's commitment to guarantee a mortgage on this property is dependent
on the completion of the conditions listed below. HUD does not guarantee
the work done to comply with the conditions. Estimated Remaining
Economic Life of this property is \_\_\_\_ years. This property \_\_\_
is \_\_\_is not eligible for maximum financing (maximum loan-to-value
ratio mortgage). Describe commitment conditions below:

Form HUD 53037

**SECTION 184 LOAN GUARANTEE FIRM COMMITMENT FORM**

U.S. Department of Housing and Urban Development Page 2 of 2

Office of Native American Programs

**LANGUAGE TO BE INCLUDED IN THE SALES CONTRACT**

If you signed your sales contract prior to receiving this statement of
appraised value, the sales contract must include, or be changed to
include, the following language:

It is expressly agreed that notwithstanding any other provisions of This
contract, the purchaser shall not be obligated to complete the purchase
of the property described herein or to incur any penalty by forfeiture
of earnest money deposits or otherwise unless The mortgagee has
delivered to the purchaser a written statement issued by the Assistant
Secretary for Native American Programs setting forth The appraised value
of The property of not less than \$ \_\_\_\_\_\_which statement the
mortgagee hereby agrees to deliver to the purchaser promptly after such
appraised value statement is made available to the mortgagee. The
purchaser shall, however, have the privilege and option of proceeding
with consummation of the contract without regard to The amount of The
appraised valuation. The appraised valuation is arrived at to determine
the maximum mortgage the Department of Housing and Urban Development
(HUD) will guarantee. HUD does not warrant the value or the condition of
the property. The purchaser should satisfy himself/herself that the
price and condition of the property are acceptable.

**[Amount to be Borrowed]{.underline}**: When you borrow to buy a home,
you pay interest and other charges which add to your cost. A larger down
payment will result in a smaller mortgage. Borrow as little as you .need
and repay in the shortest time.

**ADVICE TO HOMEBUYERS**

**[Prepaid Items]{.underline}**: These are charges that normally will be
paid at closing and are recurring in nature. They include such items as
funds for real estate taxes and hazard insurance. The amount of these
items will vary depending upon the closing date. No estimate is provided
with this statement.

**[Escrow Account]{.underline}**: This is a special account that your
lender will keep on your behalf to save the necessary funds to pay
certain future bills. Your mortgage payment will include, in addition to
an amount for interest and principal, amounts to cover such items as
property taxes and hazard insurance. These charges are collected in
advance so that your lender will have enough money in the account to
apply the charge when it comes due. Generally, 1/12 of the next year's
estimated charges will be the amount collected with each of your monthly
mortgage payments. Bear in mind that in most communities, taxes and
other operating costs are increasing. The estimates should give some
idea of what you can extract the costs to be at the beginning, in some
areas, the estimate of taxes may also include charges such as sewer
charges, garbage collection fee, water rates, etc.

**Loan Guarantee Fee (LGF)**: The amount for guaranteeing your mortgage.
The LGF may be financed into your mortgage.

**Estimated Monthly Expenses**: These are costs associated with
homeownership which HUD believes the homeowners will have to pay when
living in the property. Two examples of 'estimated monthly expenses' are
fire insurance and taxes, which are paid to your lender each month as
pan of your mortgage payment. These are put into your escrow account.

**Other Costs of Homeownership**: Utilities are usually paid monthly to
whomever provides the service. Also, you should save a certain amount
each month to cover repair and maintenance costs which will come up
while you own your home.

**Late Payments**: If you do not pay your mortgage payment within 15
days from the last day of the month, you can be charged a penalty. This
may be four cents for each dollar of your payment.

**New Construction**: After specifications are accepted by HUD before
construction, the builder is required to warrant that the house
substantially conforms to approved plans and specifications. This
warranty is for one year following the date on which title is
transferred to the original buyer or the date on which the house was
first lived in, whichever happens first. If, during the warranty period,
you notice defects for which you believe the builder is responsible, ask
the builder in writing to fix them. You cannot expect the builder to fix
damage caused by ordinary wear and tear or by poor maintenance.

Form HUD 53037

**U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT**

**OFFICE OF NATIVE AMERICAN PROGRAMS**

***IMPORTANCE OF HOME INSPECTIONS***

*HUD DOES NOT WARRANT THE VALUE OR THE CONDITION OF A HOME*

**HUD's Office of Native American Programs requires the lender to have
an appraiser determine the value of the property which you are
purchasing, it is an estimate only and is used to determine the amount
of mortgage which HUD will guarantee and if the condition of the
property makes it eligible for HUD mortgage guarantee. The appraisal,
however, is [not]{.underline} a guarantee that the property is free of
defects.**

**As the purchaser, [YOU]{.underline} should carefully examine the
property or have it inspected by a qualified home inspection company to
make sure that the condition is acceptable to you. You should do this
before you sign the sales contract or make the contract contingent on
the inspection. If repairs are needed, you may negotiate with the owner
about having the faults corrected.**

**There is no requirement that you hire an inspector. If you choose to,
the cost of the inspection up to \$300 may be included in our mortgage
loan. Names of home inspection companies can be found in the yellow
pages of your telephone directory under the heading, "Home Inspection
Services", or your Tribe or Housing Authority may have a listing of
these companies.**

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Borrower(s) Signature

**CONSTRUCTION LOAN AGREEMENT**

This Agreement is made this \_\_\_\_\_ day of\_\_\_\_\_\_\_\_\_\_,
20\_\_\_\_, between \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ (Borrower) and
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ (Lender) to
establish the conditions under which the Lender will advance proceeds of
a loan to be used to purchase and construct the property described
below. The property is located on the Reservation of
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
(Tribe) State of \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ and/or is
describe as:

1\. The loan will be in the principal sum of
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Dollars (\$) to be advanced
by Lender to Borrower as provided in this agreement and will be secured
by a mortgage or deed of trust (Mortgage), which will be a first lien on
the property.

2\. Payments required under the mortgage or deed of trust must be made
by the Borrower on the date specified, even though the proposed
construction may not be completed or the property may not be suitable
for occupancy, on the anticipated date.

3\. The Lender intends to request the Assistant Secretary for Public and
Indian Housing (Assistant Secretary) to guarantee the loan under the
provisions of Section 184 of the Housing and Community Development Act
of 1992; therefore, Borrower agrees to conform to, and to cause the unit
to be constructed in conformance with, all requirements of HUD.

4\. The Lender will place funds allocated to construction, contingency
reserve, mortgage payments and fees totaling \$\_\_\_\_\_\_\_\_\_\_\_\_)
in a secured interest bearing account, trust or escrow for the benefit
of the Borrower (hereafter "escrowed funds"). The income earned on the
escrowed funds will be paid upon issuance of the Final Release Notice or
such earlier time as agreeable to the Lender. If the Borrower should
default under the mortgage or deed of trust, funds in the interest
bearing account trust, or escrow that have not been approved for
disbursement shall be applied to the unpaid balance of the loan.

> Lender shall release the escrow funds by check, payable to the
> Borrower and the contractor or other appropriate payee who performed
> the work and supplied the materials in connection with this Agreement.
> The funds shall not be released until a Draw Request signed by both
> the Mortgagor and contractor, and, except for a possible payment for
> materials and shipping, an executed Compliance Inspection Report (Form
> HUD-92051) are approved by the Mortgagee. The Final Release of the
> escrow funds is to take place only after the final acceptance of work
> by local or tribal jurisdiction.
>
> The Lender or HUD may determine that additional compliance inspections
> are required throughout the construction period to ensure that the
> work is progressing in a satisfactory manner. However release of funds
> is not authorized on this type of inspection. The Borrower or builder
> is responsible for paying the inspection fee. The Lender may require a
> property inspection if there have been no draw requests for more than
> 30 days.
>
> If a Mortgage Payment Reserve is established in the escrow account,
> the Lender may draw from the account to make the monthly mortgage
> payments provided the dwelling has not been occupied and/or the Final
> Release Notice has not been issued.

5\. The amount specified in paragraph 1 includes the contingency
reserve. If the contingency reserve or any part thereof is not used, the
remaining balance will be applied as a partial prepayment of the loan,
if the contingency reserve is part of the mortgage. However, such
prepayment will not extend or postpone the due date of any monthly
installment due under the note, nor change the amount of such
installments. If the Borrower, (or other person, organization or agency)
put his or her own money into the contingency reserve account then the
Borrower can be refunded the money remaining in the account after the
issuance of the Final Release Notice.

6\. The Borrower will complete all construction on the property in
accordance with the architectural exhibits as accepted by the Lender
and/or HUD.

7\. Changes in the architectural exhibits must be approved by HUD prior
to the beginning of construction. Construction must be 100 percent
complete on each change order item before release of any monies.

8\. Borrower will cause all improvements to be made in a workmanlike
manner and in accordance with all applicable statutes and regulations.
All licenses, permits and privileges required by local or tribal
governmental authorities to construct the property will be obtained by
the Borrower or his/her contractor.

9\. Representatives of the Lender and HUD shall have the right to enter
upon the property at all times during the period of construction and on
completion of construction to determine whether the work conforms with
this agreement and to determine the amount of the Construction Escrow
Account to be released by the Lender.

10\. Borrower will furnish such records, contracts, bills and other
documents relating to the property and the construction as the Lender or
HUD may require.

11\. Without prior, written consent of the Lender, no materials,
equipment fixtures, or any part of construction financed with this loan
shall be purchased or installed subject to conditional sales contracts,
security agreements or lease agreements. In addition, no right may be
reserved or accrued to anyone to remove or repossess any item, or to
consider it as personal property.

12\. The Borrower shall cause either this instrument or the construction
contract to be filed in the public or tribal records, if the effect of
recording will be to relieve the mortgage property from mechanic's and
material men's liens. Before any advance under this agreement, the
Lender may require the Borrower to obtain acknowledgement of payment and
releases of lien from the contractor and all subcontractors and material
men dealing directly with the principal contractor. These releases shall
cover the period down to the date covered by the last advance, and
concurrently with the final payment for the entire project. Such
acknowledgements and releases shall be in the form required by local,
tribal or state lien laws and shall cover all work done, labor performed
and materials (including equipment and fixtures) furnished for the
project.

13\. Borrower shall cause work to begin within 30 days following the
date of this agreement. Borrower shall have work completed within
\_\_\_\_ months following the date of this agreement. Work shall be
performed with reasonable diligence; therefore, work is never to cease
for more than 30 consecutive days. Should Borrower fail to comply with
these terms, the Lender may refuse to make further payments under this
agreement. Any funds remaining in the Construction Escrow Account shall
be applied as a prepayment to the mortgage.

14\. In the event any Stop Notices, Notices to Withhold, Mechanic's
Liens, or claims of liens are filed against the property, the Lender,
after five (5) days' notice to the undersigned of its intention to do
so, may pay any or all such liens or claims, or may contest the validity
of any of them, paying all costs and expenses of contesting the same.

15\. Failure of the Borrower to perform under the terms of this
Construction Escrow Account shall make the loan amount, at the option of
the Lender, due and payable.

16\. The borrower acknowledges receipt of the accepted architectural
exhibits that are incorporated into this agreement which copies are
maintained by the Lender and in the HUD Program Office of Native
American Programs.

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Borrower(s) Signature(s) Date

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Lender Signature Date

**CONSTRUCTION LOAN RIDER**

THIS CONSTRUCTION LOAN RIDER is made this \_\_\_\_\_\_\_\_\_\_ day of,
20\_\_ and is incorporated into and shall be deemed to amend and
supplement the Mortgage, Deed of Trust or Security Deed (Security
Instrument) of the same date given by the undersigned (Borrower) to
secure Borrower's Note (Note) to

(lender) of the same date and covering the property described in the
Security Instrument and located at:

(property address)

ADDITIONAL COVENANTS. In addition to the covenants and agreements made
in the Security Instrument, Borrower and Lender further covenant and
agree as follows:

A. All replacements and additions, and Borrower's interest in the
Construction Escrow Account established in connection with this Security
Instrument shall be covered by this Security Instrument.

B. Loan proceeds are to be advanced for the construction of the premises
in accordance with the Construction Loan Agreement dated
\_\_\_\_\_\_\_\_\_\_\_,20\_\_\_, between the borrower and lender. This
agreement is incorporated by reference and made a part of this mortgage.
No advances shall be made unless approved by the Assistant Secretary of
Public and Indian Housing, Department of Housing and Urban Development.

C. If the construction is not properly completed, performed with
reasonable diligence, or is discontinued at any time except for strikes
or lockouts, the lender is vested with full authority to take the
necessary steps to protect the construction and the property from harm,
continue existing contracts or enter into necessary contracts to
complete the construction. All sums expended for such protection shall
be added to the principal indebtedness, and be secured by the mortgage
and be due and payable on demand with interest as set out in the note.

D. If the borrower fails to make any payment or to perform any other
obligation under the loan, including the commencement progress, and
completion provisions of the Construction Loan Agreement, and such
failure continues for a period of 30 days, the loan shall, at the option
of the lender, be in default.

BY SIGNING BELOW, Borrower accepts and agrees to the terms of the
covenants contained in this Construction Loan Rider.

> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Borrower
> Signature/Date

**SINGLE CLOSE**

**184 APPLICANT ACKNOWLEDGEMENT**

I/We, the undersigned, do hereby acknowledge and understand that at the
time of the loan closing of HUD 184 Guaranteed Construction/Permanent
Loan, for which I/we have applied to \_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
(lender), the proceeds designated for the construction, including a
contingency reserve in the amount of \$\_\_\_\_\_\_\_\_\_\_\_\_
(received form the borrower/loan proceeds), are to be placed in an
interest bearing escrow account.

If there are unused contingency funds, mortgage payments or inspection
fees in the Construction Escrow Account after the Final Release is
processed,
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_ (lender), in compliance with HUD regulations, *must* apply
those funds to prepay the mortgage principal, provided those items are a
part of the mortgage.

The net income (interest) earned by the Construction Escrow Account will
be (1) paid to me/us or (2) applied to prepay the mortgage principal
upon the completion of construction. This account is not, nor shall it
be treated as an escrow for the paying of real estate taxes, insurance
premiums, delinquent notes, ground rents, or assessments.

I/We hereby request that
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_(lender),
after final inspection is satisfactorily complete and the final release
has been processed, will:

> Pay the net interest income directly to me/us.
>
> Apply the net interest income directly to the mortgage principal
> balance for an equal amount of principal reduction.
>
> Other:

I/We further acknowledge, that if required to protect the priority of
the Security Instrument, that
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
(lender) may retain the holdback, for a period not to exceed 35 days (or
the time period to required by law to file a lien, whichever is longer),
to ensure compliance with state lien waiver laws or other state or
tribal requirements. A copy of the final inspection report and Final
Release Notice will be provided to me/us.

I/We further understand that the Appraiser and Inspectors obligation is
to assist the lender in determining the eligibility of the property for
HUD guarantee purposes only and that I/we are responsible to determine
the soundness of the property before and after construction, including
value, cost estimates and the ability of the contractor to complete the
construction in a satisfactory workman like manner in compliance with
all accepted exhibits and local codes and ordinances.

> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ (DATE)
>
> Applicant Signature
>
> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ (DATE)
>
> Co-Applicant Signature

**WAIVER OF CONTINGENCY RESERVE**

**(under \$7,500 only)**

I/We the undersigned do hereby acknowledge and understand that the
Section 184 Guaranteed Rehabilitation Loan for

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

(Borrower) (Co-Borrower)

does not include a contingency reserve for unforeseen circumstances
during the construction/rehabilitation period. We further understand the
construction/rehabilitation must be completed as the property was
appraised and that any cost of unforeseen expenses will not be the
responsibility of The U.S. Department of Housing and Urban Development
(HUD).

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Borrower/Date Co-Borrower/Date

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Lender/Date

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Construction/Rehabilitation Contractor (if applicable)/Date

**CONTINGENCY RELEASE LETTER**

184 Case No.:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Property Address:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

To: Mortgagee

We have received and reviewed your request for release of
\$\_\_\_\_\_\_\_\_\_\_\_\_\_\_, the contingency reserve for the subject
184 mortgage. Your request is approved/disapproved, of the amount of
\$\_\_\_\_\_\_\_\_.

> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ (DATE)
>
> Director, Loan Guarantee
>
> Program ONAP

**FINAL RELEASE NOTICE**

184 Case No.:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Property Address:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

To: Mortgagee

We have reviewed the final inspection of the construction of the subject
property.

Based on our findings and the documentation in the file, you are hereby
authorized to release the final draw along with the holdback. However,
if it is required to protect the priority of the Security Instrument,
the hold back may be retained for a period not to exceed 35 days (or the
time period required by law to file a first lien, whichever is longer),
to ensure compliance with state lien waiver laws or other state or
tribal requirements.

The mortgage must be prepaid in the amount of
\$\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_, which represents the balance of the
contingency reserve, mortgage payment reserve, inspection fees or other
miscellaneous fees that were financed and not approved for release.

> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ (DATE)
>
> Director, Loan Guarantee
>
> Program ONAP

**MORTGAGOR'S LETTER OF COMPLETION**

To: Lender

RE: 184 Case No.:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Lender's Loan No.:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Property Address:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

The construction, as outlined in the Construction Loan Agreement
(including architectural exhibits), has been completed in a workmanlike
manner to my/our satisfaction to the above mentioned property.

I/We request that the Final Inspection by the HUD approved inspector and
the Final Release of funds from the Construction Escrow Account be made
after you receive an acceptable Final Compliance Inspection Report.

I/We understand that you, the lender, if required to protect the
priority of the Security Instrument, may retain any "Holdback" reserve
hinds for a period of not more than thirty-five (35) days or a longer
time period allowable by state laws to ensure against any liens
resulting from the construction of the home on the subject property.
However, at the earliest possible date, I/we request any such funds be
released as is appropriate.

This request also directs you to properly distribute the funds in the
Construction Escrow Account that represent the balance of the
Contingency Reserve, Mortgage Payment Reserve, and inspection fees and
other miscellaneous fees (if applicable) that were not used.

> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
> (DATE)
>
> Borrower(s) Signature

**RIDER FOR SECTION 184 MORTGAGE**

**(LEASEHOLD)**

THIS RIDER FOR SECTION 184 MORTGAGE is made this \_\_\_\_\_\_\_\_\_day
of \_\_\_\_\_\_, 20\_\_\_ and is incorporated into and shall be deemed
to amend and supplement the Mortgage, Deed of Trust or Security Deed
("Security Instrument") of the same date given by the undersigned
("Borrower") to secure Borrower's Note ("Note") to
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_ ("Lender") of the same date and covering the
property described in the Security Instrument and located at:

\[Property Address\]

ADDITIONAL COVENANTS. In addition to the covenants and agreements made
in the Security Instrument, Borrower and Lender further covenant and
agree as follows:

> A. The interests of the Borrower in the property described above were
> created by a lease agreement from
> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
> as lessor dated \_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_, 20\_\_\_\_. Any
> reference to the "Property" shall be construed as referring only to
> the interest of Borrower created by such lease or any replacement
> lease (as applicable).
>
> B. If the Security Instrument is assigned to the Secretary of Housing
> and Urban Development ("Secretary"), any foreclosure proceeding may
> take place in a tribal court, Federal district court, or other court
> of competent jurisdiction or non-judicially, if applicable. Section
> 184 of the Housing and Community Development Act grants to any such
> court the jurisdiction to convey to the Secretary the remaining life
> of a lease on the property and to order eviction of the delinquent
> Borrower.
>
> C. Any purchaser at foreclosure sale other than the Secretary must
> receive the written consent of the lessor or, if lessor is not an
> Indian tribe, the tribe of which lessor is a member. The purchaser
> shall receive a lease for the remaining term of the existing lease
> unless the tribe consents to an assumption of the existing lease.
>
> D. This Security Instrument may be assumed, subject to credit approval
> by the Lender/HUD and the consent of the tribe to an assumption of the
> existing lease or the grant of the new lease. Assumption shall not
> cause any adjustment of the interest rate.
>
> E. A sale of property subject to the Security Instrument without an
> assumption of the Security Instrument may be made if a new lease for
> the remaining term of the existing lease is granted.

BY SIGNING BELOW, Borrower accepts and agrees to the terms and covenants
in this Rider for Section 184 Mortgage.

> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ (SEAL)

Borrower

> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ (SEAL)

Borrower

**RIDER FOR SECTION 184 MORTGAGE**

**FEE SIMPLE PROPERTY ONLY**

THIS RIDER FOR SECTION 184 MORTGAGE on FEE SIMPLE PROPERTY ONLY (not
Trust or Allotted Land) is made this \_\_\_\_\_\_ day of
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_20\_\_\_\_\_ and is incorporated into and
shall be deemed to amend and supplement the Mortgage, Deed of Trust or
Security Deed ("Security Instrument") of the same date given by the
undersigned ("Borrower") to secure Borrower's Note to
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_ ("Lender") of the same date and covering the
property described in the Security Instrument and located at:

ADDITIONAL COVENANTS. In addition to the covenants and agreements made
in the Security Instrument. Borrower and Lender further covenant and
agree as follows:

1\. If the Security Instrument is assigned to the Secretary of Housing
and Urban Development ('Secretary"), any foreclosure proceeding may take
place in a tribal court, Federal district court, or other court of
competent jurisdiction or non-judicially, if applicable.

2\. This security instrument may be assumed, subject to credit approval
by the Lender/HUD. Assumption shall not cause any adjustment of the
interest rate.

3\. Any and all foreclosure proceedings pertaining to the Security
Instrument and any judgments arising from such proceedings are subject
to the provisions of Section 184 of the Housing and Community
Development Act of 1992, as amended, or any successor Act, and any
regulations promulgated thereunder, as well as the applicable provisions
of the foreclosure laws of the court of competent jurisdiction, if
applicable.

BY SIGNING BELOW, Borrower accepts and agrees to the terms and covenants
in this Rider for a Section 184 Mortgage for the Fee Simple Property.

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

(Seal) BORROWER (Seal) BORROWER

**RIDER FOR SECTION 184**

**INDIVIDUAL ALLOTTED TRUST LAND**

**(NO LEASE)**

THIS RIDER FOR SECTION 184 MORTGAGE is made this \_\_\_\_\_\_\_\_\_day
of \_\_\_\_\_\_, 20\_\_\_\_\_\_, and is incorporated into and shall be
deemed to amend and supplement the Mortgage, Deed of Trust or Security
Deed ("Security Instrument") of the same date given by the undersigned
("Borrower") to secure Borrower's Note ("Note") to
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
("Lender") of the same date and covering the property described in the
Security Instrument and located at:

(PROPERTY ADDRESS)

ADDITIONAL COVENANTS. In addition to the covenants and agreements made
in the Security Instrument, Borrower and Lender further covenant and
agree as follows:

A.  If the Security Instrument is assigned to the Secretary of Housing
    and Urban Development ("Secretary"), any foreclosure proceeding may
    take place in a tribal court, Federal district court, or other court
    of competent jurisdiction or non-judicially, if applicable. Section
    184 of the Community Housing and Development Act grants to any such
    court the jurisdiction to convey the property to the Secretary and
    to order eviction of the delinquent Borrower. In the event of
    foreclosure, the land shall not be removed from trust or restricted
    status except upon application to the Secretary of the Interior or
    his duly authorized representative.

```{=html}
<!-- -->
```
B.  The mortgagee or the Secretary shall not sell, transfer or otherwise
    dispose of or alienate the property except to an eligible tribal
    member, the Indian tribe, or the Indian housing authority or TDHE
    servicing the Indian tribe.

```{=html}
<!-- -->
```
C.  This Security Instrument may be assumed, subject to credit approval
    by the Lender/HUD by any eligible tribal member, the Indian tribe,
    or the Indian housing authority or TDHE servicing the Indian tribe.
    Assumption shall not cause any adjustment of the interest rate.

BY SIGNING BELOW, Borrower accepts and agrees to the terms and covenants
in this Rider for Section 184 Mortgage.

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Borrower

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Borrower

+-----------------------------+----+-------+---+----------------------+
| **Transmittal for**         | ** |       |   | 0MB Approval No.     |
|                             | U. |       |   | 2577-0200 (exp.      |
| **Loan Guarantee Fee**      | S. |       |   | 12/31/2001)          |
| (LGF)                       | De |       |   |                      |
|                             | pa |       |   |                      |
| **Native American Loan      | rt |       |   |                      |
| Guarantee Program**         | me |       |   |                      |
|                             | nt |       |   |                      |
|                             | of |       |   |                      |
|                             | H  |       |   |                      |
|                             | ou |       |   |                      |
|                             | si |       |   |                      |
|                             | ng |       |   |                      |
|                             | a  |       |   |                      |
|                             | nd |       |   |                      |
|                             | U  |       |   |                      |
|                             | rb |       |   |                      |
|                             | an |       |   |                      |
|                             | D  |       |   |                      |
|                             | ev |       |   |                      |
|                             | el |       |   |                      |
|                             | op |       |   |                      |
|                             | me |       |   |                      |
|                             | nt |       |   |                      |
|                             | ** |       |   |                      |
|                             |    |       |   |                      |
|                             | Of |       |   |                      |
|                             | fi |       |   |                      |
|                             | ce |       |   |                      |
|                             | of |       |   |                      |
|                             | Pu |       |   |                      |
|                             | bl |       |   |                      |
|                             | ic |       |   |                      |
|                             | a  |       |   |                      |
|                             | nd |       |   |                      |
|                             | In |       |   |                      |
|                             | di |       |   |                      |
|                             | an |       |   |                      |
|                             | H  |       |   |                      |
|                             | ou |       |   |                      |
|                             | si |       |   |                      |
|                             | ng |       |   |                      |
+-----------------------------+----+-------+---+----------------------+
| 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. This agency    |    |       |   |                      |
| may not collect this        |    |       |   |                      |
| information, and you are    |    |       |   |                      |
| not required to complete    |    |       |   |                      |
| this form, unless it        |    |       |   |                      |
| displays a currently valid  |    |       |   |                      |
| 0MB control number.         |    |       |   |                      |
|                             |    |       |   |                      |
| This information is         |    |       |   |                      |
| required by Section 184 of  |    |       |   |                      |
| the Housing and Community   |    |       |   |                      |
| Development Act of 1992, as |    |       |   |                      |
| amended by Section 701 of   |    |       |   |                      |
| the Native American Housing |    |       |   |                      |
| Assistance and              |    |       |   |                      |
| Self-Determination Act of   |    |       |   |                      |
| 1996 and implementing       |    |       |   |                      |
| regulations at 24 CFR       |    |       |   |                      |
| Section 1005. HUD has the   |    |       |   |                      |
| authority to guarantee      |    |       |   |                      |
| loans for the construction, |    |       |   |                      |
| acquisition, or             |    |       |   |                      |
| rehabilitation of 1- to     |    |       |   |                      |
| 4-family homes to be owned  |    |       |   |                      |
| by Native Americans on      |    |       |   |                      |
| restricted Indian lands.    |    |       |   |                      |
| Mortgage lenders            |    |       |   |                      |
| (mortgagees) provide        |    |       |   |                      |
| borrower and lender         |    |       |   |                      |
| information to HUD for the  |    |       |   |                      |
| guarantee of the loan.      |    |       |   |                      |
| Responses to the collection |    |       |   |                      |
| of information are required |    |       |   |                      |
| to obtain a benefit. The    |    |       |   |                      |
| information requested does  |    |       |   |                      |
| not lend itself to          |    |       |   |                      |
| confidentiality.            |    |       |   |                      |
+-----------------------------+----+-------+---+----------------------+
| This transmittal shall be   |    |       |   |                      |
| prepared by the remitting   |    |       |   |                      |
| mortgagee to accompany all  |    |       |   |                      |
| LGF payments sent to HUD.   |    |       |   |                      |
|                             |    |       |   |                      |
| Incomplete and/or           |    |       |   |                      |
| inaccurate data may delay   |    |       |   |                      |
| endorsement of the 184 case |    |       |   |                      |
| involved.                   |    |       |   |                      |
|                             |    |       |   |                      |
| **Mail all transmittals to: |    |       |   |                      |
| HUD c/o Processing Center,  |    |       |   |                      |
| PC Box 198353, Atlanta, GA  |    |       |   |                      |
| 30384-8353.**               |    |       |   |                      |
+-----------------------------+----+-------+---+----------------------+
| **Part 1 Lender             |    | **Ins |   |                      |
| Information**               |    | truct |   |                      |
|                             |    | ions: |   |                      |
| 1a. Reason for Payment      |    | Part  |   |                      |
|                             |    | 1     |   |                      |
| > Initial Fee on a          |    | L     |   |                      |
| > Additional Fee Late       |    | ender |   |                      |
| > Charge/                   |    | Inf   |   |                      |
| >                           |    | ormat |   |                      |
| > new loan on an            |    | ion** |   |                      |
| > underpayment Interest     |    |       |   |                      |
|                             |    | 1a.   |   |                      |
|                             |    | Check |   |                      |
|                             |    | the   |   |                      |
|                             |    | a     |   |                      |
|                             |    | pprop |   |                      |
|                             |    | riate |   |                      |
|                             |    | bo    |   |                      |
|                             |    | x(es) |   |                      |
|                             |    | to    |   |                      |
|                             |    | ind   |   |                      |
|                             |    | icate |   |                      |
|                             |    | the   |   |                      |
|                             |    | pu    |   |                      |
|                             |    | rpose |   |                      |
|                             |    | of    |   |                      |
|                             |    | the   |   |                      |
|                             |    | tr    |   |                      |
|                             |    | ansmi |   |                      |
|                             |    | ttal. |   |                      |
|                             |    |       |   |                      |
|                             |    | 1b.   |   |                      |
|                             |    | Enter |   |                      |
|                             |    | the   |   |                      |
|                             |    | name  |   |                      |
|                             |    | of    |   |                      |
|                             |    | the   |   |                      |
|                             |    | remi  |   |                      |
|                             |    | tting |   |                      |
|                             |    | Le    |   |                      |
|                             |    | nder. |   |                      |
|                             |    |       |   |                      |
|                             |    | 1c.   |   |                      |
|                             |    | Enter |   |                      |
|                             |    | the   |   |                      |
|                             |    | remi  |   |                      |
|                             |    | tting |   |                      |
|                             |    | Len   |   |                      |
|                             |    | der's |   |                      |
|                             |    | ID    |   |                      |
|                             |    | nu    |   |                      |
|                             |    | mber. |   |                      |
|                             |    | The   |   |                      |
|                             |    | LGF   |   |                      |
|                             |    | stat  |   |                      |
|                             |    | ement |   |                      |
|                             |    | of    |   |                      |
|                             |    | ac    |   |                      |
|                             |    | count |   |                      |
|                             |    | confi |   |                      |
|                             |    | rming |   |                      |
|                             |    | re    |   |                      |
|                             |    | ceipt |   |                      |
|                             |    | of    |   |                      |
|                             |    | the   |   |                      |
|                             |    | funds |   |                      |
|                             |    | will  |   |                      |
|                             |    | be    |   |                      |
|                             |    | sent  |   |                      |
|                             |    | to    |   |                      |
|                             |    | the   |   |                      |
|                             |    | re    |   |                      |
|                             |    | lated |   |                      |
|                             |    | ad    |   |                      |
|                             |    | dress |   |                      |
|                             |    | in    |   |                      |
|                             |    | HUD's |   |                      |
|                             |    | rec   |   |                      |
|                             |    | ords. |   |                      |
+-----------------------------+----+-------+---+----------------------+
| 1b. Lender's Name (print)   |    |       |   |                      |
+-----------------------------+----+-------+---+----------------------+
| 1c. Lender Number (10       |    |       |   |                      |
| digits)                     |    |       |   |                      |
+-----------------------------+----+-------+---+----------------------+
| 1d. Name of Person to be    |    |       | 1 |                      |
| contacted regarding this    |    |       | e |                      |
| payment                     |    |       | . |                      |
|                             |    |       | P |                      |
|                             |    |       | h |                      |
|                             |    |       | o |                      |
|                             |    |       | n |                      |
|                             |    |       | e |                      |
|                             |    |       | N |                      |
|                             |    |       | u |                      |
|                             |    |       | m |                      |
|                             |    |       | b |                      |
|                             |    |       | e |                      |
|                             |    |       | r |                      |
|                             |    |       | ( |                      |
|                             |    |       | i |                      |
|                             |    |       | n |                      |
|                             |    |       | c |                      |
|                             |    |       | l |                      |
|                             |    |       | u |                      |
|                             |    |       | d |                      |
|                             |    |       | e |                      |
|                             |    |       | a |                      |
|                             |    |       | r |                      |
|                             |    |       | e |                      |
|                             |    |       | a |                      |
|                             |    |       | c |                      |
|                             |    |       | o |                      |
|                             |    |       | d |                      |
|                             |    |       | e |                      |
|                             |    |       | & |                      |
|                             |    |       | e |                      |
|                             |    |       | x |                      |
|                             |    |       | t |                      |
|                             |    |       | e |                      |
|                             |    |       | n |                      |
|                             |    |       | s |                      |
|                             |    |       | i |                      |
|                             |    |       | o |                      |
|                             |    |       | n |                      |
|                             |    |       | ) |                      |
+-----------------------------+----+-------+---+----------------------+
| **Part 2 Mortgage Data**    |    | **Ins |   |                      |
|                             |    | truct |   |                      |
| 2a. 184 Case Number (10     |    | ions: |   |                      |
| digits, 3 + 7)              |    | Part  |   |                      |
|                             |    | 2 LGF |   |                      |
|                             |    | Mor   |   |                      |
|                             |    | tgage |   |                      |
|                             |    | D     |   |                      |
|                             |    | ata** |   |                      |
|                             |    |       |   |                      |
|                             |    | 2a.   |   |                      |
|                             |    | Enter |   |                      |
|                             |    | the   |   |                      |
|                             |    | 184   |   |                      |
|                             |    | Case  |   |                      |
|                             |    | N     |   |                      |
|                             |    | umber |   |                      |
|                             |    | ass   |   |                      |
|                             |    | igned |   |                      |
|                             |    | by    |   |                      |
|                             |    | HUD.  |   |                      |
|                             |    |       |   |                      |
|                             |    | 2b.   |   |                      |
|                             |    | Enter |   |                      |
|                             |    | the   |   |                      |
|                             |    | cl    |   |                      |
|                             |    | osing |   |                      |
|                             |    | date  |   |                      |
|                             |    | of    |   |                      |
|                             |    | the   |   |                      |
|                             |    | mort  |   |                      |
|                             |    | gage. |   |                      |
|                             |    |       |   |                      |
|                             |    | 2c.   |   |                      |
|                             |    | Check |   |                      |
|                             |    | the   |   |                      |
|                             |    | box   |   |                      |
|                             |    | indic |   |                      |
|                             |    | ating |   |                      |
|                             |    | the   |   |                      |
|                             |    | n     |   |                      |
|                             |    | umber |   |                      |
|                             |    | of    |   |                      |
|                             |    | pay   |   |                      |
|                             |    | ments |   |                      |
|                             |    | in    |   |                      |
|                             |    | the   |   |                      |
|                             |    | mort  |   |                      |
|                             |    | gage. |   |                      |
|                             |    |       |   |                      |
|                             |    | 2d.   |   |                      |
|                             |    | Enter |   |                      |
|                             |    | the   |   |                      |
|                             |    | mor   |   |                      |
|                             |    | tgage |   |                      |
|                             |    | am    |   |                      |
|                             |    | ount. |   |                      |
|                             |    |       |   |                      |
|                             |    | 2e.   |   |                      |
|                             |    | Enter |   |                      |
|                             |    | the   |   |                      |
|                             |    | pe    |   |                      |
|                             |    | rcent |   |                      |
|                             |    | of    |   |                      |
|                             |    | LGF   |   |                      |
|                             |    | fina  |   |                      |
|                             |    | nced, |   |                      |
|                             |    | e.g.  |   |                      |
|                             |    | 0% or |   |                      |
|                             |    | 100%  |   |                      |
|                             |    |       |   |                      |
|                             |    | 2f.   |   |                      |
|                             |    | Enter |   |                      |
|                             |    | the   |   |                      |
|                             |    | borro |   |                      |
|                             |    | wer's |   |                      |
|                             |    | loan  |   |                      |
|                             |    | n     |   |                      |
|                             |    | umber |   |                      |
|                             |    | of    |   |                      |
|                             |    | the   |   |                      |
|                             |    | borro |   |                      |
|                             |    | wer's |   |                      |
|                             |    | last  |   |                      |
|                             |    | name. |   |                      |
|                             |    | HUD   |   |                      |
|                             |    | will  |   |                      |
|                             |    | in    |   |                      |
|                             |    | clude |   |                      |
|                             |    | this  |   |                      |
|                             |    | i     |   |                      |
|                             |    | nform |   |                      |
|                             |    | ation |   |                      |
|                             |    | on    |   |                      |
|                             |    | the   |   |                      |
|                             |    | LGF   |   |                      |
|                             |    | stat  |   |                      |
|                             |    | ement |   |                      |
|                             |    | of    |   |                      |
|                             |    | ac    |   |                      |
|                             |    | count |   |                      |
|                             |    | to    |   |                      |
|                             |    | a     |   |                      |
|                             |    | ssist |   |                      |
|                             |    | mortg |   |                      |
|                             |    | agees |   |                      |
|                             |    | in    |   |                      |
|                             |    | mat   |   |                      |
|                             |    | ching |   |                      |
|                             |    | state |   |                      |
|                             |    | ments |   |                      |
|                             |    | to    |   |                      |
|                             |    | the   |   |                      |
|                             |    | a     |   |                      |
|                             |    | pprop |   |                      |
|                             |    | riate |   |                      |
|                             |    | mor   |   |                      |
|                             |    | tgage |   |                      |
|                             |    | file. |   |                      |
+-----------------------------+----+-------+---+----------------------+
| 2b. Closing Date (mm/dd/yy) |    |       |   |                      |
+-----------------------------+----+-------+---+----------------------+
| 2c. Terms in Months         |    |       |   |                      |
|                             |    |       |   |                      |
| \(1\) 1 to 215 months LG    |    |       |   |                      |
| Fee                         |    |       |   |                      |
|                             |    |       |   |                      |
| \(2\) 216 to 264 months     |    |       |   |                      |
| Financed?                   |    |       |   |                      |
|                             |    |       |   |                      |
| \(3\) 265 to 300 months Yes |    |       |   |                      |
|                             |    |       |   |                      |
| \(4\) over 300 months No    |    |       |   |                      |
+-----------------------------+----+-------+---+----------------------+
| 2d. Mortgage Amount         |    |       |   |                      |
|                             |    |       |   |                      |
| \$                          |    |       |   |                      |
+-----------------------------+----+-------+---+----------------------+
| 2e. Percentage of the LGF   |    |       |   |                      |
| Financed                    |    |       |   |                      |
|                             |    |       |   |                      |
| \%                          |    |       |   |                      |
+-----------------------------+----+-------+---+----------------------+
| 2f. Borrower's Loan Number  |    |       |   |                      |
| of Last name                |    |       |   |                      |
+-----------------------------+----+-------+---+----------------------+
| **Part 3 Loan Guarantee Fee |    | **Ins |   |                      |
| Data**                      |    | truct |   |                      |
|                             |    | ions: |   |                      |
| 3a. Fee Amount for Mortgage |    | Part  |   |                      |
|                             |    | 3 LGF |   |                      |
| \$                          |    | D     |   |                      |
|                             |    | ata** |   |                      |
|                             |    |       |   |                      |
|                             |    | 3a.   |   |                      |
|                             |    | Enter |   |                      |
|                             |    | the   |   |                      |
|                             |    | LGF   |   |                      |
|                             |    | due   |   |                      |
|                             |    | HUD   |   |                      |
|                             |    | as    |   |                      |
|                             |    | shown |   |                      |
|                             |    | on    |   |                      |
|                             |    | form  |   |                      |
|                             |    | H     |   |                      |
|                             |    | UD-1, |   |                      |
|                             |    | Settl |   |                      |
|                             |    | ement |   |                      |
|                             |    | State |   |                      |
|                             |    | ment, |   |                      |
|                             |    | or if |   |                      |
|                             |    | a     |   |                      |
|                             |    | pplic |   |                      |
|                             |    | able, |   |                      |
|                             |    | the   |   |                      |
|                             |    | addit |   |                      |
|                             |    | ional |   |                      |
|                             |    | LGF   |   |                      |
|                             |    | being |   |                      |
|                             |    | remi  |   |                      |
|                             |    | tted. |   |                      |
|                             |    |       |   |                      |
|                             |    | 3b. A |   |                      |
|                             |    | 4%    |   |                      |
|                             |    | late  |   |                      |
|                             |    | c     |   |                      |
|                             |    | harge |   |                      |
|                             |    | shall |   |                      |
|                             |    | be    |   |                      |
|                             |    | paid  |   |                      |
|                             |    | if    |   |                      |
|                             |    | the   |   |                      |
|                             |    | LGF   |   |                      |
|                             |    | is    |   |                      |
|                             |    | not   |   |                      |
|                             |    | exp   |   |                      |
|                             |    | ected |   |                      |
|                             |    | to    |   |                      |
|                             |    | reach |   |                      |
|                             |    | HUD   |   |                      |
|                             |    | w     |   |                      |
|                             |    | ithin |   |                      |
|                             |    | 15    |   |                      |
|                             |    | days  |   |                      |
|                             |    | of    |   |                      |
|                             |    | the   |   |                      |
|                             |    | cl    |   |                      |
|                             |    | osing |   |                      |
|                             |    | date  |   |                      |
|                             |    | en    |   |                      |
|                             |    | tered |   |                      |
|                             |    | in    |   |                      |
|                             |    | item  |   |                      |
|                             |    | 2b.   |   |                      |
|                             |    | Enter |   |                      |
|                             |    | 4% of |   |                      |
|                             |    | the   |   |                      |
|                             |    | Net   |   |                      |
|                             |    | LGF   |   |                      |
|                             |    | shown |   |                      |
|                             |    | in    |   |                      |
|                             |    | item  |   |                      |
|                             |    | 3a.   |   |                      |
|                             |    |       |   |                      |
|                             |    | 3c.   |   |                      |
|                             |    | In    |   |                      |
|                             |    | add   |   |                      |
|                             |    | ition |   |                      |
|                             |    | to    |   |                      |
|                             |    | the   |   |                      |
|                             |    | late  |   |                      |
|                             |    | ch    |   |                      |
|                             |    | arge, |   |                      |
|                             |    | daily |   |                      |
|                             |    | int   |   |                      |
|                             |    | erest |   |                      |
|                             |    | shall |   |                      |
|                             |    | be    |   |                      |
|                             |    | paid  |   |                      |
|                             |    | on    |   |                      |
|                             |    | the   |   |                      |
|                             |    | Net   |   |                      |
|                             |    | LGF   |   |                      |
|                             |    | (item |   |                      |
|                             |    | 3a)   |   |                      |
|                             |    | from  |   |                      |
|                             |    | the   |   |                      |
|                             |    | cl    |   |                      |
|                             |    | osing |   |                      |
|                             |    | date  |   |                      |
|                             |    | if    |   |                      |
|                             |    | the   |   |                      |
|                             |    | LGF   |   |                      |
|                             |    | pa    |   |                      |
|                             |    | yment |   |                      |
|                             |    | is    |   |                      |
|                             |    | not   |   |                      |
|                             |    | exp   |   |                      |
|                             |    | ected |   |                      |
|                             |    | to    |   |                      |
|                             |    | reach |   |                      |
|                             |    | HUD   |   |                      |
|                             |    | w     |   |                      |
|                             |    | ithin |   |                      |
|                             |    | 30    |   |                      |
|                             |    | days  |   |                      |
|                             |    | of    |   |                      |
|                             |    | the   |   |                      |
|                             |    | cl    |   |                      |
|                             |    | osing |   |                      |
|                             |    | date. |   |                      |
|                             |    | Use   |   |                      |
|                             |    | the   |   |                      |
|                             |    | cu    |   |                      |
|                             |    | rrent |   |                      |
|                             |    | value |   |                      |
|                             |    | of    |   |                      |
|                             |    | Fe    |   |                      |
|                             |    | deral |   |                      |
|                             |    | funds |   |                      |
|                             |    | rate  |   |                      |
|                             |    | (publ |   |                      |
|                             |    | ished |   |                      |
|                             |    | ann   |   |                      |
|                             |    | ually |   |                      |
|                             |    | in    |   |                      |
|                             |    | the   |   |                      |
|                             |    | Fe    |   |                      |
|                             |    | deral |   |                      |
|                             |    | Regi  |   |                      |
|                             |    | ster) |   |                      |
|                             |    | to    |   |                      |
|                             |    | co    |   |                      |
|                             |    | mpute |   |                      |
|                             |    | the   |   |                      |
|                             |    | int   |   |                      |
|                             |    | erest |   |                      |
|                             |    | due.  |   |                      |
|                             |    |       |   |                      |
|                             |    | 3d.   |   |                      |
|                             |    | Enter |   |                      |
|                             |    | the   |   |                      |
|                             |    | total |   |                      |
|                             |    | of    |   |                      |
|                             |    | items |   |                      |
|                             |    | 3a    |   |                      |
|                             |    | plus  |   |                      |
|                             |    | 3b    |   |                      |
|                             |    | plus  |   |                      |
|                             |    | 3c.   |   |                      |
|                             |    | This  |   |                      |
|                             |    | a     |   |                      |
|                             |    | mount |   |                      |
|                             |    | must  |   |                      |
|                             |    | equal |   |                      |
|                             |    | the   |   |                      |
|                             |    | a     |   |                      |
|                             |    | mount |   |                      |
|                             |    | of    |   |                      |
|                             |    | the   |   |                      |
|                             |    | c     |   |                      |
|                             |    | heck. |   |                      |
|                             |    | An    |   |                      |
|                             |    | indiv |   |                      |
|                             |    | idual |   |                      |
|                             |    | check |   |                      |
|                             |    | is    |   |                      |
|                             |    | req   |   |                      |
|                             |    | uired |   |                      |
|                             |    | for   |   |                      |
|                             |    | each  |   |                      |
|                             |    | form  |   |                      |
|                             |    | HUD-5 |   |                      |
|                             |    | 3038. |   |                      |
|                             |    | **Do  |   |                      |
|                             |    | not   |   |                      |
|                             |    | co    |   |                      |
|                             |    | mbine |   |                      |
|                             |    | rem   |   |                      |
|                             |    | ittan |   |                      |
|                             |    | ces** |   |                      |
+-----------------------------+----+-------+---+----------------------+
| 3b. Late Charge Due (4% of  |    |       |   |                      |
| 3a)                         |    |       |   |                      |
|                             |    |       |   |                      |
| \$                          |    |       |   |                      |
+-----------------------------+----+-------+---+----------------------+
| 3c. Interest Due            |    |       |   |                      |
|                             |    |       |   |                      |
| \$                          |    |       |   |                      |
+-----------------------------+----+-------+---+----------------------+
| 3d. Total Amount of Check   |    |       |   |                      |
| (3a plus 3b plus 3c)        |    |       |   |                      |
|                             |    |       |   |                      |
| \$                          |    |       |   |                      |
+-----------------------------+----+-------+---+----------------------+
|                             |    |       |   |                      |
+-----------------------------+----+-------+---+----------------------+
| Form HUD-53038 (10/94)      |    |       |   |                      |
+-----------------------------+----+-------+---+----------------------+

<table>
<colgroup>
<col style="width: 16%" />
<col style="width: 11%" />
<col style="width: 4%" />
<col style="width: 15%" />
<col style="width: 0%" />
<col style="width: 13%" />
<col style="width: 1%" />
<col style="width: 1%" />
<col style="width: 11%" />
<col style="width: 1%" />
<col style="width: 3%" />
<col style="width: 16%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="5"><strong>Indian Loan Guarantee Certificate</strong></td>
<td colspan="7"><p><strong>U.S. Department of Housing and Urban
Development</strong></p>
<p>Office of Public and Indian Housing</p></td>
</tr>
<tr class="even">
<td>1. 184 Case Number</td>
<td colspan="2">2. Amortization Plan:</td>
<td colspan="2">3. LTV Ratio</td>
<td colspan="3">4. Living Units:</td>
<td colspan="3">5. Borrower Type</td>
<td>6. Control Number:</td>
</tr>
<tr class="odd">
<td colspan="2">7. Name of Borrower (last, first, MI):</td>
<td colspan="2">8. Social Security Number:</td>
<td colspan="3">9. Mortgage Amount:</td>
<td colspan="2"><p>10. Interest rate:</p>
<p>%</p></td>
<td colspan="3">11. Monthly Payment (P&amp;I)</td>
</tr>
<tr class="even">
<td colspan="2">12. Name of Co-Borrower (last, first, MI)’</td>
<td colspan="2">13. Social Security Number:</td>
<td colspan="2">14. Maturity Date:</td>
<td colspan="4">15. First Payment</td>
<td colspan="2">16. Endorsement Date:</td>
</tr>
<tr class="odd">
<td colspan="12">17. Address of Property:</td>
</tr>
<tr class="even">
<td colspan="5">18. Lender’s Name, Address, &amp; ID Number:</td>
<td colspan="7"><p>Endorsed for guarantee when signed below by an
authorized agent of the Assistant Secretary for Public and Indian
Housing.</p>
<p>A copy of this certificate must accompany any claim for guarantee
benefits submitted to HUD.</p>
<p><strong>X</strong></p></td>
</tr>
<tr class="odd">
<td colspan="12"><p>This certificate, when endorsed above by an
authorized agent of the Assistant Secretary for Public and Indian
Housing, is evidence of guarantee of the mortgagee loan described herein
under the Section 184 of the Housing and Community Development Act of
1992 (P.L. 102550) and regulations of the U.S. Department of Housing and
Urban Development published in Code of the Federal Regulations (24 CFR
1005).</p>
<p><strong>Sensitive Information: The information colt acted on flits
form is considered sensitive and is protected by the Privacy Act Th.
Privacy Act requires that these records be maintained with appropriate
administrative, technical, and physical safeguards to ensure their
security and confidentially. In addition, these records should be
protected against any anticipated threats or hazards to their security
or integrity which could result in substantial harm, embarrassment,
inconvenience, or unfairness to any individual on whom the Information
is maintained.</strong></p></td>
</tr>
<tr class="even">
<td colspan="12">form HUD-53039 (10/94)</td>
</tr>
<tr class="odd">
<td colspan="12">form HUD-53039 (10/94)</td>
</tr>
</tbody>
</table>

**SAMPLE DRAW REQUEST** U.S. Department of Housing and Urban Development

Section 184 Indian Housing Loan Guarantee Program

Borrowers Name & Property Address:

Lenders Name & Address:

This Draw Number Date:

  ----------------------------------------------------------------------------------
  Construction Item            Total     Previous   Request   Total of   Accepted
                               Escrow    Draw (1)   for This  Column (1) Amounts Due
                                                    Draw (2)  & (2)      
  ---------------------------- --------- ---------- --------- ---------- -----------
  Well                                                                   
  Drilling/Permits/Equipment                                             

  Excavation/Site Preparation                                            

  Foundation/Slab                                                        

  Modular Delivered                                                      

  Affixed to Foundation                                                  

  Foundation Damp Proofed                                                

  Backfilled                                                             

  Septic                                                                 

  Plumbing Hookup                                                        

  Electrical Hookup                                                      

  Heating System                                                         

  Finished Grading                                                       

  Finished Landscaping                                                   

  Exterior steps/porches/decks                                           

  Gutters/Downspouts                                                     

  Driveway/Walkway                                                       

  Appliances                                                             

  Masonry                                                                

  Siding                                                                 

  Roof                                                                   

  Shutters                                                               

  Paint (exterior/interior)                                              

  Caulking                                                               

  Fencing                                                                

  Grading                                                                

  Windows                                                                

  Weather Stripping                                                      

  Doors (Exterior/Interior)                                              

  Partition Walls                                                        

  Plaster/Drywall                                                        

  Decorating                                                             

  Wood Trim                                                              

  Stairs                                                                 

  Closets                                                                

  Wood Floors                                                            

  Finished Floors                                                        

  Ceramic Tile                                                           

  Bath Accessories                                                       

  Insulation                                                             

  Cabinetry                                                              

  Appliances                                                             

  Basements                                                              

  Cleanup                                                                

  Miscellaneous                                                          

  Other                                                                  

  TOTAL:                                                                 
  ----------------------------------------------------------------------------------

  --------------------------------------- ----------------- --------------
                                          This Draw         Totals to Date

  Total From Above                                          

  Less 10% Holdback                                         

  Net Amount Due to Borrower                                
  --------------------------------------- ----------------- --------------

This Draw Request is submitted for payment. All completed work has been
done in a workman like manner. I/We understand that a 10% holdback will
not be released until all work is completed and it's determined that no
mechanic's and materialman's liens have been placed on the property.

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

General Contractor Date Borrower(s) Date

The mortgagee is authorized to release the following funds
\$\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Lender Date

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Inspector Date

**CONSTRUCTION WORK ORDER**

SPECIFICATION OF REPAIRS

+-----------------------------------+-----------------------------------+
| Applicant's Name                  | Contact Name                      |
| \_\_                              | \_\_\_\_\_                        |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ | \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ | _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |
|                                   |                                   |
| Property Address                  | Contact Phone No.                 |
| \_\_                              | \_                                |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ | \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ | _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |
|                                   |                                   |
| City                              | Best Time to Call                 |
| \                                 | \_\_                              |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ | \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |
| State \_\_\_\_\_\_\_\_\_\_\_\_\_  | _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |
| Zip \_\_\_\_\_\_\_                |                                   |
+-----------------------------------+-----------------------------------+
| Loan Guarantee No.                | Contractor's Name                 |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ | \_                                |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ | \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |
|                                   | _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |
| Mtg. Co. Loan No.                 |                                   |
| \_\_                              | Address                           |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ | \_\_\_\_\_\_\_\_\_                |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ | \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |
|                                   | _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |
| Estimated Number of Mos. Needed   |                                   |
| to Complete Work \_\_\_\_\_\_     | City                              |
|                                   | \                                 |
|                                   | _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |
|                                   | State \_\_\_\_\_\_\_\_\_\_\_ Zip  |
|                                   | \_\_\_\_\_\_\_\_\_                |
|                                   |                                   |
|                                   | Telephone No.                     |
|                                   | \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_    |
|                                   | License No.                       |
|                                   | \_\_\_\_\_\_\_\_\_\_\_\_          |
+-----------------------------------+-----------------------------------+
| Assigned Appraiser                | Assigned Plan Reviewer            |
| \_                                | \_\_\_\_\_\_\_\_\_\_\_\_\_\       |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ | _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |                                   |
|                                   | Telephone No.                     |
| Telephone No.                     | \_\_\_\_                          |
| \_\_\_\_                          | \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ |
| \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\ | _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |
| _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |                                   |
+-----------------------------------+-----------------------------------+

***STEP-BY-STEP PROCEDURES***

1\. Each line must be addressed by either filling in the information or
entering "NONE" in the "SUBTOTAL" section. (Print or Type)

2\. Description of Materials. HUD Form 92005 needs to be used listing
all materials. For items such as: kitchen cabinets, appliances, heating
and air condition, etc., make and model number.

3\. Inspection report from a qualified architect, engineer or inspection
service.

4\. Set of architectural plans should be attached for new construction.
They must show the property address and the borrower's name. Floor plan,
building section, elevations and plot plan needs to be included.)

5\. Transfer the costs to draw request form for each construction draw.

6\. The sales contract should be attached, indicating that the loan is
contingent upon HUD 184 loan approval.

7\. If Owner performs any of the work other than painting and cleaning,
a letter detailing his/her qualifications to perform the work is
necessary, (normally three years full time employment as a building
trades employee). Homeowner may not be reimbursed for labor.

8\. Definitions of Abbreviations:

> Linear Feet = LF Each = EA Square Feet = SF Square Yard = SY Lump Sum
> = LS

1\. MASONRY

  ------------------- ----------- -------- --------- ----------- -------------------------------
                      **Unit.**   **\$     **Qty**   **Total**   **Describe the work to be
                                  Cost**                         done**

  Point brick work    SF                                         

  Stucco              SF                                         

  Build brick wall    SF                                         

  Build masonry,      SF                                         
  brick or stone                                                 
  chimney                                                        
  ------------------- ----------- -------- --------- ----------- -------------------------------

This portion of the work will be done by: (initial one) \_\_\_\_\_ Owner
\_\_\_\_\_ Contractor \_\_\_\_\_ Subcontractor

\_\_\_\_\_ Required Repair \_\_\_\_\_ Permit Necessary

See Description of Materials Form HUD 92005 See Item No.
\_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

COMMENTS: SUB-TOTAL SECTION NO. 1 \$\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

2\. SIDING

  ------------------- ----------- -------- --------- ----------- -------------------------------
                      **Unit.**   **\$     **Qty**   **Total**   **Describe the work to be
                                  Cost**                         done**

  Replace defective   SF                                         
  siding                                                         

  Replace defective   LF                                         
  facia (REDWOOD)                                                

  Replace defective   SF                                         
  soffit                                                         
  ------------------- ----------- -------- --------- ----------- -------------------------------

This portion of the work will be done by: (initial one) \_\_\_\_\_ Owner
\_\_\_\_\_ Contractor \_\_\_\_\_ Subcontractor

\_\_\_\_\_ Required Repair \_\_\_\_\_ Permit Necessary

See Description of Materials Form HUD 92005 See Item No.
\_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

COMMENTS: SUB-TOTAL SECTION NO. 2 \$\_\_\_\_\_\_\_\_\_\_\_\_

3\. GUTTERS & DOWNSPOUTS

  --------------------- ----------- -------- --------- ----------- --------------------------
                        **Unit.**   **\$     **Qty**   **Total**   **Describe the work to be
                                    Cost**                         done**

  Replace gutters &     LF                                         
  downspouts MINIMUM R6                                            
  GA                                                               

  Clean gutters & open  LS                                         
  downspouts                                                       
  --------------------- ----------- -------- --------- ----------- --------------------------

This portion of the work will be done by: (initial one) \_\_\_\_\_ Owner
\_\_\_\_\_ Contractor \_\_\_\_\_ Subcontractor

\_\_\_\_\_ Required Repair \_\_\_\_\_ Permit Necessary

See Description of Materials Form HUD 92005 See Item No.
\_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

COMMENTS: SUB-TOTAL SECTION NO. 3 \$\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

4\. ROOF

  ------------------- ----------- -------- --------- ----------- -------------------------------
                      **Unit.**   **\$     **Qty**   **Total**   **Describe the work to be
                                  Cost**                         done**

  Install a new built SF                                         
  up roof, with new                                              
  metal gravel stops                                             

  Install 240#        SF                                         
  Sealtab asphalt                                                
  shingles on all                                                
  roofs with a 3:12                                              
  pitch or greater                                               

  Remove old roofing  SF                                         
  (if more than 2                                                
  layers)                                                        
  ------------------- ----------- -------- --------- ----------- -------------------------------

This portion of the work will be done by: (initial one) \_\_\_\_\_ Owner
\_\_\_\_\_ Contractor \_\_\_\_\_ Subcontractor

\_\_\_\_\_ Required Repair \_\_\_\_\_ Permit Necessary

See Description of Materials Form HUD 92005 See Item No.
\_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

COMMENTS: SUB-TOTAL SECTION NO. 4 \$\_\_\_\_\_\_\_\_\_\_\_\_

5\. SHUTTERS

  ------------------- ----------- -------- --------- ----------- -------------------------------
                      **Unit.**   **\$     **Qty**   **Total**   **Describe the work to be
                                  Cost**                         done**

  Install shutters at Pair                                       
  windows                                                        
  ------------------- ----------- -------- --------- ----------- -------------------------------

This portion of the work will be done by: (initial one) \_\_\_\_\_ Owner
\_\_\_\_\_ Contractor \_\_\_\_\_ Subcontractor

\_\_\_\_\_ Required Repair \_\_\_\_\_ Permit Necessary

See Description of Materials Form HUD 92005 See Item No.
\_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

COMMENTS: SUB-TOTAL SECTION NO. 5 \$\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

6\. EXTERIORS

  ------------------- ----------- -------- --------- ----------- -------------------------------
                      **Unit.**   **\$     **Qty**   **Total**   **Describe the work to be
                                  Cost**                         done**

  Remove defective,   LF                                         
  buckled wood                                                   
  members                                                        

  Provide a           SF                                         
  structurally sound                                             
  porch floor,                                                   
  properly finished                                              

  Replace existing    SF                                         
  porch with masonry                                             
  steps and stoops                                               

  Provide ornamental  LF                                         
  iron or wood                                                   
  railing or parts                                               

  Provide wood deck   SF                                         
  with foundation                                                
  finished                                                       
  ------------------- ----------- -------- --------- ----------- -------------------------------

This portion of the work will be done by: (initial one) \_\_\_\_\_ Owner
\_\_\_\_\_ Contractor \_\_\_\_\_ Subcontractor

\_\_\_\_\_ Required Repair \_\_\_\_\_ Permit Necessary

See Description of Materials Form HUD 92005 See Item No.
\_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

COMMENTS: SUB-TOTAL SECTION NO. 6 \$\_\_\_\_\_\_\_\_\_\_\_\_

7\. WALKS

  ------------------- ----------- -------- --------- ----------- -------------------------------
                      **Unit.**   **\$     **Qty**   **Total**   **Describe the work to be
                                  Cost**                         done**

  Install new         SF                                         
  concrete walks                                                 
  (Minimum 36" W)                                                

  Install concrete    LF                                         
  steps (Minimum 36"                                             
  W)                                                             
  ------------------- ----------- -------- --------- ----------- -------------------------------

This portion of the work will be done by: (initial one) \_\_\_\_\_ Owner
\_\_\_\_\_ Contractor \_\_\_\_\_ Subcontractor

\_\_\_\_\_ Required Repair \_\_\_\_\_ Permit Necessary

See Description of Materials Form HUD 92005 See Item No.
\_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

COMMENTS: SUB-TOTAL SECTION NO. 7 \$\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

8\. DRIVEWAYS

  ------------------- ----------- -------- --------- ----------- -------------------------------
                      **Unit.**   **\$     **Qty**   **Total**   **Describe the work to be
                                  Cost**                         done**

  Remove old driveway SF                                         
  and apron                                                      

  Install blacktop    SF                                         
  drive min. 2" over                                             
  existing drive and                                             
  apron                                                          

  Install new         SF                                         
  concrete driveway                                              
  min 4" and apron                                               
  with wire mesh                                                 
  Control Joints                                                 
  every 10'                                                      
  ------------------- ----------- -------- --------- ----------- -------------------------------

This portion of the work will be done by: (initial one) \_\_\_\_\_ Owner
\_\_\_\_\_ Contractor \_\_\_\_\_ Subcontractor

\_\_\_\_\_ Required Repair \_\_\_\_\_ Permit Necessary

See Description of Materials Form HUD 92005 See Item No.
\_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

COMMENTS: SUB-TOTAL SECTION NO. 8 \$\_\_\_\_\_\_\_\_\_\_\_\_

9\. PAINT --- EXTERIOR

  ------------------- ----------- -------- --------- ----------- -------------------------------
                      **Unit.**   **\$     **Qty**   **Total**   **Describe the work to be
                                  Cost**                         done**

  Scrape, sand smooth LS                                         
  and paint a minimum                                            
  two coats good                                                 
  quality paint at                                               
  all exterior                                                   
  woodwork and metal.                                            
  All old, defective                                             
  paint to be removed                                            
  in accordance with                                             
  lead-based paint                                               
  removal procedures                                             
  ------------------- ----------- -------- --------- ----------- -------------------------------

This portion of the work will be done by: (initial one) \_\_\_\_\_ Owner
\_\_\_\_\_ Contractor \_\_\_\_\_ Subcontractor

\_\_\_\_\_ Required Repair \_\_\_\_\_ Permit Necessary

See Description of Materials Form HUD 92005 See Item No.
\_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

COMMENTS: SUB-TOTAL SECTION NO. 9 \$\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

10\. CAULKING

  ------------------- ----------- -------- --------- ----------- -------------------------------
                      **Unit.**   **\$     **Qty**   **Total**   **Describe the work to be
                                  Cost**                         done**

  Caulk all windows   EA                                         
  and door frames                                                

  Caulk cracks in     EA                                         
  concrete flatwork                                              
  with silicone                                                  
  ------------------- ----------- -------- --------- ----------- -------------------------------

This portion of the work will be done by: (initial one) \_\_\_\_\_ Owner
\_\_\_\_\_ Contractor \_\_\_\_\_ Subcontractor

\_\_\_\_\_ Required Repair \_\_\_\_\_ Permit Necessary

See Description of Materials Form HUD 92005 See Item No.
\_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

COMMENTS: SUB-TOTAL SECTION NO. 10 \$\_\_\_\_\_\_\_\_\_\_\_\_

11\. FENCING

  ------------------- ----------- -------- --------- ----------- -------------------------------
                      **Unit.**   **\$     **Qty**   **Total**   **Describe the work to be
                                  Cost**                         done**

  Install new fencing LF                                         

  Reset existing      LS                                         
  fencing                                                        
  ------------------- ----------- -------- --------- ----------- -------------------------------

This portion of the work will be done by: (initial one) \_\_\_\_\_ Owner
\_\_\_\_\_ Contractor \_\_\_\_\_ Subcontractor

\_\_\_\_\_ Required Repair \_\_\_\_\_ Permit Necessary

See Description of Materials Form HUD 92005 See Item No.
\_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

COMMENTS: SUB-TOTAL SECTION NO. 11 \$\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

12\. GRADING

  ------------------- ----------- -------- --------- ----------- -------------------------------
                      **Unit.**   **\$     **Qty**   **Total**   **Describe the work to be
                                  Cost**                         done**

  Remove debris from  LS                                         
  yards finish earth;                                            
  then grade and seed                                            
  Minimum 6" fall in                                             
  first 10' away from                                            
  building                                                       
  ------------------- ----------- -------- --------- ----------- -------------------------------

This portion of the work will be done by: (initial one) \_\_\_\_\_ Owner
\_\_\_\_\_ Contractor \_\_\_\_\_ Subcontractor

\_\_\_\_\_ Required Repair \_\_\_\_\_ Permit Necessary

See Description of Materials Form HUD 92005 See Item No.
\_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

COMMENTS: SUB-TOTAL SECTION NO. 12 \$\_\_\_\_\_\_\_\_\_\_\_\_

13\. WINDOWS

  -------------------- ----------- -------- --------- ----------- ---------------------------
                       **Unit.**   **\$     **Qty**   **Total**   **Describe the work to be
                                   Cost**                         done**

  Install new          EA                                         
  replacement windows                                             

  Replace rotted or    EA                                         
  defective sash                                                  

  Replace rotted or    EA                                         
  defective sill                                                  

  Replace basement     EA                                         
  windows                                                         

  Replace              EA                                         
  cracked/broken glass                                            

  Replace missing      EA                                         
  glazing putty                                                   

  Repair/replace       EA                                         
  missing screens                                                 
  -------------------- ----------- -------- --------- ----------- ---------------------------

This portion of the work will be done by: (initial one) \_\_\_\_\_ Owner
\_\_\_\_\_ Contractor \_\_\_\_\_ Subcontractor

\_\_\_\_\_ Required Repair \_\_\_\_\_ Permit Necessary

See Description of Materials Form HUD 92005 See Item No.
\_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

COMMENTS: SUB-TOTAL SECTION NO. 13 \$\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

14\. WEATHERSTRIPPING

  ------------------- ----------- -------- --------- ----------- -------------------------------
                      **Unit.**   **\$     **Qty**   **Total**   **Describe the work to be
                                  Cost**                         done**

  Install new         LF                                         
  weatherstripping at                                            
  all exterior doors                                             

  Weatherstrip all    EA                                         
  windows                                                        

  Install metal       EA                                         
  interlocking                                                   
  thresholds at                                                  
  exterior doors                                                 
  ------------------- ----------- -------- --------- ----------- -------------------------------

This portion of the work will be done by: (initial one) \_\_\_\_\_ Owner
\_\_\_\_\_ Contractor \_\_\_\_\_ Subcontractor

\_\_\_\_\_ Required Repair \_\_\_\_\_ Permit Necessary

See Description of Materials Form HUD 92005 See Item No.
\_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

COMMENTS: SUB-TOTAL SECTION NO. 14 \$\_\_\_\_\_\_\_\_\_\_\_\_

15\. DOORS --- EXTERIOR

  ------------------- ----------- -------- --------- ----------- -------------------------------
                      **Unit.**   **\$     **Qty**   **Total**   **Describe the work to be
                                  Cost**                         done**

  Install 1-3/4"      EA                                         
  exterior doors                                                 

  Install three (3)   EA                                         
  new door butts                                                 
  (Brand)                                                        

  Install exterior    LF                                         
  door trim                                                      

  Install new lockset EA                                         
  (Brand and Series)                                             
  ------------------- ----------- -------- --------- ----------- -------------------------------

This portion of the work will be done by: (initial one) \_\_\_\_\_ Owner
\_\_\_\_\_ Contractor \_\_\_\_\_ Subcontractor

\_\_\_\_\_ Required Repair \_\_\_\_\_ Permit Necessary

See Description of Materials Form HUD 92005 See Item No.
\_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

COMMENTS: SUB-TOTAL SECTION NO. 15 \$\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

16\. DOORS --- INTERIOR

  -------------------- ----------- -------- --------- ----------- --------------------------
                       **Unit.**   **\$     **Qty**   **Total**   **Describe the work to be
                                   Cost**                         done**

  Replace defective    EA                                         
  doors                                                           

  Replace new doors    EA                                         
  with new locksets                                               

  Install lockset      EA                                         
  where missing or                                                
  malfunctioning                                                  

  Readjust all doors   EA                                         
  for proper closing                                              

  Install bedroom      EA                                         
  closet doors                                                    

  Install bi-fold      EA                                         
  doors                                                           

  Install trim around  EA                                         
  doors                                                           
  -------------------- ----------- -------- --------- ----------- --------------------------

This portion of the work will be done by: (initial one) \_\_\_\_\_ Owner
\_\_\_\_\_ Contractor \_\_\_\_\_ Subcontractor

\_\_\_\_\_ Required Repair \_\_\_\_\_ Permit Necessary

See Description of Materials Form HUD 92005 See Item No.
\_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

COMMENTS: SUB-TOTAL SECTION NO. 16 \$\_\_\_\_\_\_\_\_\_\_\_\_

17\. PARTITION

  ------------------- ----------- -------- --------- ----------- -------------------------------
                      **Unit.**   **\$     **Qty**   **Total**   **Describe the work to be
                                  Cost**                         done**

  Framing of new      SF                                         
  walls and                                                      
  partitions (Do not                                             
  include drywall                                                
  costs)                                                         
  ------------------- ----------- -------- --------- ----------- -------------------------------

This portion of the work will be done by: (initial one) \_\_\_\_\_ Owner
\_\_\_\_\_ Contractor \_\_\_\_\_ Subcontractor

\_\_\_\_\_ Required Repair \_\_\_\_\_ Permit Necessary

See Description of Materials Form HUD 92005 See Item No.
\_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

COMMENTS: SUB-TOTAL SECTION NO. 17 \$\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

18\. PLASTER/DRYWALL (to U.S. Gypsum Standards)

  ------------------- ----------- -------- --------- ----------- -------------------------------
                      **Unit.**   **\$     **Qty**   **Total**   **Describe the work to be
                                  Cost**                         done**

  Patch all defective LS                                         
  plaster/ drywall to                                            
  match existing wall                                            
  or ceiling finish                                              

  Install new drywall SF                                         
  ------------------- ----------- -------- --------- ----------- -------------------------------

This portion of the work will be done by: (initial one) \_\_\_\_\_ Owner
\_\_\_\_\_ Contractor \_\_\_\_\_ Subcontractor

\_\_\_\_\_ Required Repair \_\_\_\_\_ Permit Necessary

See Description of Materials Form HUD 92005 See Item No.
\_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

COMMENTS: SUB-TOTAL SECTION NO. 18 \$\_\_\_\_\_\_\_\_\_\_\_\_

19\. DECORATING

  -------------------- ----------- -------- --------- ----------- ----------------------------
                       **Unit.**   **\$     **Qty**   **Total**   **Describe the work to be
                                   Cost**                         done**

  Paint all interior   LS                                         
  walls & trim (all                                               
  old, defective paint                                            
  to be removed in                                                
  accordance with lead                                            
  paint removal                                                   
  procedures) (2 coats                                            
  primer and finish)                                              

  Removal all existing SF                                         
  wallpaper                                                       

  Wallpaper walls      SF                                         
  -------------------- ----------- -------- --------- ----------- ----------------------------

This portion of the work will be done by: (initial one) \_\_\_\_\_ Owner
\_\_\_\_\_ Contractor \_\_\_\_\_ Subcontractor

\_\_\_\_\_ Required Repair \_\_\_\_\_ Permit Necessary

See Description of Materials Form HUD 92005 See Item No.
\_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

COMMENTS: SUB-TOTAL SECTION NO. 19 \$\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

20\. WOOD TRIM

  -------------------- ----------- -------- --------- ----------- ----------------------------
                       **Unit.**   **\$     **Qty**   **Total**   **Describe the work to be
                                   Cost**                         done**

  Replace all cracked, LF                                         
  broken, mismatched                                              
  trim, jambs, etc.                                               

  Remove all unused    EA                                         
  hinges, curtain rod                                             
  hangers, nails,                                                 
  screws, etc.                                                    

  Replace all wood     LF                                         
  trim at interior                                                
  door units, base,                                               
  shoe & other trim                                               

  Replace defective    SF                                         
  wall paneling                                                   
  -------------------- ----------- -------- --------- ----------- ----------------------------

This portion of the work will be done by: (initial one) \_\_\_\_\_ Owner
\_\_\_\_\_ Contractor \_\_\_\_\_ Subcontractor

\_\_\_\_\_ Required Repair \_\_\_\_\_ Permit Necessary

See Description of Materials Form HUD 92005 See Item No.
\_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

COMMENTS: SUB-TOTAL SECTION NO. 20 \$\_\_\_\_\_\_\_\_\_\_\_\_

21\. STAIRS

  ------------------- ----------- -------- --------- ----------- -------------------------------
                      **Unit.**   **\$     **Qty**   **Total**   **Describe the work to be
                                  Cost**                         done**

  Replace bad         LF                                         
  basement treads,                                               
  and risers                                                     

  Replace main        LF                                         
  stairs, treads &                                               
  risers                                                         

  Replace broken      LF                                         
  and/or missing                                                 
  baluster                                                       

  Provide hand rails, LF                                         
  etc.                                                           

  Install new stairs  LS                                         
  at basement                                                    

  Install new stairs  LS                                         
  ------------------- ----------- -------- --------- ----------- -------------------------------

This portion of the work will be done by: (initial one) \_\_\_\_\_ Owner
\_\_\_\_\_ Contractor \_\_\_\_\_ Subcontractor

\_\_\_\_\_ Required Repair \_\_\_\_\_ Permit Necessary

See Description of Materials Form HUD 92005 See Item No.
\_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

COMMENTS: SUB-TOTAL SECTION NO. 21 \$\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

22\. CLOSETS

  ------------------- ----------- -------- --------- ----------- -------------------------------
                      **Unit.**   **\$     **Qty**   **Total**   **Describe the work to be
                                  Cost**                         done**

  Install shelves     LF                                         

  Install clothing    LF                                         
  rods                                                           
  ------------------- ----------- -------- --------- ----------- -------------------------------

This portion of the work will be done by: (initial one) \_\_\_\_\_ Owner
\_\_\_\_\_ Contractor \_\_\_\_\_ Subcontractor

\_\_\_\_\_ Required Repair \_\_\_\_\_ Permit Necessary

See Description of Materials Form HUD 92005 See Item No.
\_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

COMMENTS: SUB-TOTAL SECTION NO. 22 \$\_\_\_\_\_\_\_\_\_\_\_\_

23\. WOOD FLOORS

  ------------------- ----------- -------- --------- ----------- -------------------------------
                      **Unit.**   **\$     **Qty**   **Total**   **Describe the work to be
                                  Cost**                         done**

  Replace all         SF                                         
  defective flooring,                                            
  holes in floors,                                               
  etc. with wood                                                 
  flooring to match                                              
  existing floors                                                

  Sand, fill &        SF                                         
  refinish wood                                                  
  floors                                                         

  Install new         SF                                         
  hardwood floors                                                
  ------------------- ----------- -------- --------- ----------- -------------------------------

This portion of the work will be done by: (initial one) \_\_\_\_\_ Owner
\_\_\_\_\_ Contractor \_\_\_\_\_ Subcontractor

\_\_\_\_\_ Required Repair \_\_\_\_\_ Permit Necessary

See Description of Materials Form HUD 92005 See Item No.
\_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

COMMENTS: SUB-TOTAL SECTION NO. 23 \$\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

24\. FINISHED FLOORS

  ------------------- ----------- -------- --------- ----------- -------------------------------
                      **Unit.**   **\$     **Qty**   **Total**   **Describe the work to be
                                  Cost**                         done**

  Install vinyl                                                  
  asbestos tile or                                               
  sheet goods w/1/4"                                             
  underlayment                                                   

  Kitchen:            SY                                         

  Bath:               SY                                         

  Install carpet &    SY                                         
  pad                                                            
  ------------------- ----------- -------- --------- ----------- -------------------------------

This portion of the work will be done by: (initial one) \_\_\_\_\_ Owner
\_\_\_\_\_ Contractor \_\_\_\_\_ Subcontractor

\_\_\_\_\_ Required Repair \_\_\_\_\_ Permit Necessary

See Description of Materials Form HUD 92005 See Item No.
\_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

COMMENTS: SUB-TOTAL SECTION NO. 24 \$\_\_\_\_\_\_\_\_\_\_\_\_

25\. CERAMIC TILE

  -------------------- ----------- -------- --------- ----------- ---------------------------
                       **Unit.**   **\$     **Qty**   **Total**   **Describe the work to be
                                   Cost**                         done**

  Install ceramic tile SF                                         
  wainscot in bathroom                                            
  area for shower                                                 
  height                                                          

  Install ceramic tile SF                                         
  floor                                                           

  Install Marlite      SF                                         
  wainscot above                                                  
  bathtub area for                                                
  shower height                                                   

  Replace defective    SF                                         
  tile in bath                                                    

  Replace defective    SF                                         
  tile in vestibule                                               

  Replace defective    SF                                         
  tile in kitchen                                                 
  -------------------- ----------- -------- --------- ----------- ---------------------------

This portion of the work will be done by: (initial one) \_\_\_\_\_ Owner
\_\_\_\_\_ Contractor \_\_\_\_\_ Subcontractor

\_\_\_\_\_ Required Repair \_\_\_\_\_ Permit Necessary

See Description of Materials Form HUD 92005 See Item No.
\_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

COMMENTS: SUB-TOTAL SECTION NO. 25 \$\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

26\. BATH ACCESSORIES

  ------------------- ----------- -------- --------- ----------- -------------------------------
                      **Unit.**   **\$     **Qty**   **Total**   **Describe the work to be
                                  Cost**                         done**

  Replace medicine    EA                                         
  cabinet in bath                                                

  Install paper       EA                                         
  holder                                                         

  Install towel bar   EA                                         

  Install soap dish   EA                                         

  Install grab bar in EA                                         
  tub/shower                                                     
  ------------------- ----------- -------- --------- ----------- -------------------------------

This portion of the work will be done by: (initial one) \_\_\_\_\_ Owner
\_\_\_\_\_ Contractor \_\_\_\_\_ Subcontractor

\_\_\_\_\_ Required Repair \_\_\_\_\_ Permit Necessary

See Description of Materials Form HUD 92005 See Item No.
\_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

COMMENTS: SUB-TOTAL SECTION NO. 26 \$\_\_\_\_\_\_\_\_\_\_\_\_

27\. PLUMBING

  ------------------- ----------- -------- --------- ----------- -------------------------------
                      **Unit.**   **\$     **Qty**   **Total**   **Describe the work to be
                                  Cost**                         done**

  Install new hot &   LF                                         
  cold water piping                                              

  Install 30 gal.     EA                                         
  (min) glass-lined                                              
  gas hot water                                                  
  heater (52 gallon                                              
  if electric)                                                   

  Install new kitchen EA                                         
  sink                                                           

  Install 3-piece     LS                                         
  bathroom with                                                  
  shower over tub                                                

  Install laundry     EA                                         
  tray with faucet                                               

  Replace washers at  EA                                         
  faucets                                                        

  Replace defective   LF                                         
  sewer lines                                                    

  Replace defective   EA                                         
  faucets                                                        

  Replace lead pipes  LF                                         
  ------------------- ----------- -------- --------- ----------- -------------------------------

This portion of the work will be done by: (initial one) \_\_\_\_\_ Owner
\_\_\_\_\_ Contractor \_\_\_\_\_ Subcontractor

\_\_\_\_\_ Required Repair \_\_\_\_\_ Permit Necessary

See Description of Materials Form HUD 92005 See Item No.
\_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

COMMENTS: SUB-TOTAL SECTION NO. 27 \$\_\_\_\_\_\_\_\_\_\_\_\_

28\. ELECTRICAL

  ------------------- ----------- -------- --------- ----------- -------------------------------
                      **Unit.**   **\$     **Qty**   **Total**   **Describe the work to be
                                  Cost**                         done**

  Install 100 amp     LS                                         
  service                                                        

  Replace all frayed  LS                                         
  exterior wire from                                             
  service to main &                                              
  into ext. panel box                                            

  Install new wall    EA                                         
  switches                                                       

  Install new         EA                                         
  lighting fixtures                                              
  (describe)                                                     

  Install new         EA                                         
  exterior lighting                                              

  Replace wall        EA                                         
  receptacles                                                    

  Install three (3)   EA                                         
  way switch                                                     

  Install smoke       EA                                         
  detector(s)                                                    

  Bath exhaust fan(s) EA                                         

  Install GFCI        EA                                         
  outlets                                                        

  Install new wiring  LF                                         
  ------------------- ----------- -------- --------- ----------- -------------------------------

This portion of the work will be done by: (initial one) \_\_\_\_\_ Owner
\_\_\_\_\_ Contractor \_\_\_\_\_ Subcontractor

\_\_\_\_\_ Required Repair \_\_\_\_\_ Permit Necessary

See Description of Materials Form HUD 92005 See Item No.
\_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

COMMENTS: SUB-TOTAL SECTION NO. 28 \$\_\_\_\_\_\_\_\_\_\_\_\_

29\. HEATING

  ---------------------- ----------- -------- --------- ----------- --------------------------
                         **Unit.**   **\$     **Qty**   **Total**   **Describe the work to be
                                     Cost**                         done**

  Install new Gas        EA                                         
  forced-warm air                                                   
  furnace                                                           

  Install new hot water  EA                                         
  boiler                                                            

  Install automatic      EA                                         
  flow-control valve                                                

  Install temperature    EA                                         
  control valve at                                                  
  boiler                                                            

  Install heat supply    LS                                         
  outlet in each room                                               

  Install heat (FWA)     EA                                         
  grills                                                            
  ---------------------- ----------- -------- --------- ----------- --------------------------

This portion of the work will be done by: (initial one) \_\_\_\_\_ Owner
\_\_\_\_\_ Contractor \_\_\_\_\_ Subcontractor

\_\_\_\_\_ Required Repair \_\_\_\_\_ Permit Necessary

See Description of Materials Form HUD 92005 See Item No.
\_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

COMMENTS: SUB-TOTAL SECTION NO. 29 \$\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

30\. INSULATION

  ------------------------ ----------- -------- --------- ----------- --------------------------
                           **Unit.**   **\$     **Qty**   **Total**   **Describe the work to be
                                       Cost**                         done**

  Install crawl space      SF                                         
  R-\_\_\_\_\_ Exterior                                               
  walls or joists                                                     

  Install Attic            SF                                         
  R-\_\_\_\_\_\_\_\_\_\_                                              

  Install R-13 batts in    SF                                         
  exterior walls                                                      

  Install 6 mil vapor      SF                                         
  barrier in crawl space                                              
  ------------------------ ----------- -------- --------- ----------- --------------------------

This portion of the work will be done by: (initial one) \_\_\_\_\_ Owner
\_\_\_\_\_ Contractor \_\_\_\_\_ Subcontractor

\_\_\_\_\_ Required Repair \_\_\_\_\_ Permit Necessary

See Description of Materials Form HUD 92005 See Item No.
\_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

COMMENTS: SUB-TOTAL SECTION NO. 30 \$\_\_\_\_\_\_\_\_\_\_\_\_

31\. CABINETRY

  ------------------- ----------- -------- --------- ----------- -------------------------------
                      **Unit.**   **\$     **Qty**   **Total**   **Describe the work to be
                                  Cost**                         done**

  Base cabinets       LF                                         

  Kitchen countertops LS                                         

  Wall cabinets       LF                                         

  Vanities            EA                                         

  Vanity              LS                                         
  countertop(s)                                                  
  ------------------- ----------- -------- --------- ----------- -------------------------------

This portion of the work will be done by: (initial one) \_\_\_\_\_ Owner
\_\_\_\_\_ Contractor \_\_\_\_\_ Subcontractor

\_\_\_\_\_ Required Repair \_\_\_\_\_ Permit Necessary

See Description of Materials Form HUD 92005 See Item No.
\_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

COMMENTS: SUB-TOTAL SECTION NO. 31 \$\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

32\. APPLIANCES\*

  ------------------- ----------- -------- --------- ----------- -------------------------------
                      **Unit.**   **\$     **Qty**   **Total**   **Describe the work to be
                                  Cost**                         done**

  Range               EA                                         

  Refrigerator        EA                                         

  Dishwasher          EA                                         

  Disposal            EA                                         

  Range Hood Fan      EA                                         
  ------------------- ----------- -------- --------- ----------- -------------------------------

This portion of the work will be done by: (initial one) \_\_\_\_\_ Owner
\_\_\_\_\_ Contractor \_\_\_\_\_ Subcontractor

\_\_\_\_\_ Required Repair \_\_\_\_\_ Permit Necessary

See Description of Materials Form HUD 92005 See Item No.
\_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

COMMENTS: SUB-TOTAL SECTION NO. 32 \$\_\_\_\_\_\_\_\_\_\_\_\_

33\. BASEMENTS

  ----------------------- ----------- -------- --------- ----------- --------------------------
                          **Unit.**   **\$     **Qty**   **Total**   **Describe the work to be
                                      Cost**                         done**

  Install a min 4" thick  SF                                         
  concrete floor with 6 x                                            
  6 10/10 mesh and                                                   
  control joints every                                               
  400 sq ft                                                          

  Fur out walls           SF                                         

  Install new sump pump & EA                                         
  pit                                                                

  Replace damaged joists  EA                                         

  Termite treatment/dry   LS                                         
  rot infestation                                                    
  ----------------------- ----------- -------- --------- ----------- --------------------------

This portion of the work will be done by: (initial one) \_\_\_\_\_ Owner
\_\_\_\_\_ Contractor \_\_\_\_\_ Subcontractor

\_\_\_\_\_ Required Repair \_\_\_\_\_ Permit Necessary

See Description of Materials Form HUD 92005 See Item No.
\_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

COMMENTS: SUB-TOTAL SECTION NO. 33 \$\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

34\. CLEANUP

  ---------------------- ----------- -------- --------- ----------- --------------------------
                         **Unit.**   **\$     **Qty**   **Total**   **Describe the work to be
                                     Cost**                         done**

  Remove debris from                                                
  property exterior                                                 

  Remove debris from                                                
  property interior                                                 
  including crawlspace                                              
  and attic                                                         

  Broom clean floors,                                               
  clean ALL windows                                                 

  Clean all plumbing,                                               
  fixtures & appliances                                             
  ---------------------- ----------- -------- --------- ----------- --------------------------

This portion of the work will be done by: (initial one) \_\_\_\_\_ Owner
\_\_\_\_\_ Contractor \_\_\_\_\_ Subcontractor

\_\_\_\_\_ Required Repair \_\_\_\_\_ Permit Necessary

See Description of Materials Form HUD 92005 See Item No.
\_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

COMMENTS: SUB-TOTAL SECTION NO. 34 \$\_\_\_\_\_\_\_\_\_\_\_\_

**35. MISCELLANEOUS**

Describe any main dwelling materials, equipment or construction liens
not shown elsewhere; or to provide additional information where The
space provided was inadequate. (Always reference by item number to
correspond to number used on this form.)

This portion of the work will be done by: (initial one) \_\_\_\_\_ Owner
\_\_\_\_\_ Contractor \_\_\_\_\_ Subcontractor

\_\_\_\_\_ Required Repair \_\_\_\_\_ Permit Necessary

See Description of Materials Form HUD 92005 See Item No.
\_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

COMMENTS: SUB-TOTAL SECTION NO. 35 \$\_\_\_\_\_\_\_\_\_\_\_\_

RECAP OF SUBTOTALS

+------------+---------+------------+-------+---------------+-------+
| 1\.        | \$      | 18\.       | \$    | 35\.          | \$    |
| Masonry    |         | Plast      |       | Miscellaneous |       |
|            |         | er/Drywall |       |               |       |
+------------+---------+------------+-------+---------------+-------+
| 2\. Siding | \$      | 19\.       | \$    | Subtotal      | \$    |
|            |         | Decorating |       | Construction  |       |
|            |         |            |       | Costs         |       |
+------------+---------+------------+-------+---------------+-------+
| 3\.        | \$      | 20\. Wood  | \$    | 36\.          |       |
| Gutters &  |         | Trim       |       | ALLOWABLE     |       |
| Downspouts |         |            |       | FEES          |       |
+------------+---------+------------+-------+---------------+-------+
| 4\. Roof   | \$      | 21\.       | \$    | > Consultant  | \$    |
|            |         | Stairs     |       | > Fee         |       |
+------------+---------+------------+-------+---------------+-------+
| 5\.        | \$      | 22\.       | \$    | > Plan Review | \$    |
| Shutters   |         | Closets    |       | > Fee         |       |
+------------+---------+------------+-------+---------------+-------+
| 6\.        | \$      | 23\. Wood  | \$    | > Supp Orig   | \$    |
| Exteriors  |         | Floors     |       | > Fee         |       |
+------------+---------+------------+-------+---------------+-------+
| 7\. Walks  | \$      | 24\.       | \$    | > Prop Insp   | \$    |
|            |         | Finished   |       | > (4x50)      |       |
|            |         | floors     |       |               |       |
+------------+---------+------------+-------+---------------+-------+
| 8\.        | \$      | 25\.       | \$    | > I/C Disb    | \$    |
| Driveways  |         | Ceramic    |       | > (4x50)      |       |
|            |         | tile       |       |               |       |
+------------+---------+------------+-------+---------------+-------+
| 9\. Paint  | \$      | 26\. Bath  | \$    | > Building    | \$    |
| (exterior) |         | a          |       | > Permits     |       |
|            |         | ccessories |       |               |       |
+------------+---------+------------+-------+---------------+-------+
| 10\.       | \$      | 27\.       | \$    | >             | \$    |
| Caulking   |         | Plumbing   |       | Architectural |       |
|            |         |            |       | > -- Engineer |       |
+------------+---------+------------+-------+---------------+-------+
| 11\.       | \$      | 28\.       | \$    | > Subtotal    | \$    |
| Fencing    |         | Electrical |       | > (#36)       |       |
+------------+---------+------------+-------+---------------+-------+
| 12\.       | \$      | 29\.       | \$    | 37\. 10-20    | \$    |
| Grading    |         | Heating    |       | Percent       |       |
|            |         |            |       | Contingency   |       |
+------------+---------+------------+-------+---------------+-------+
| 13\.       | \$      | 30\.       | \$    | 38\. Monthly  | \$    |
| Windows    |         | Insulation |       | Payment       |       |
|            |         |            |       | Reserve       |       |
+------------+---------+------------+-------+---------------+-------+
| 14\.       | \$      | 31\.       | \$    | 39\. Discount | \$    |
| Weathe     |         | Cabinetry  |       | on Const.     |       |
| rstripping |         |            |       |               |       |
+------------+---------+------------+-------+---------------+-------+
| 15\. Doors | \$      | 32\.       | \$    | > Total Cost  | \$    |
| (exterior) |         | Appliances |       | > of          |       |
|            |         |            |       | > Allowable   |       |
|            |         |            |       | > Fees        |       |
+------------+---------+------------+-------+---------------+-------+
| 16\. Doors | \$      | 33\.       | \$    |               |       |
| (interior) |         | Basements  |       |               |       |
+------------+---------+------------+-------+---------------+-------+
| 17\.       | \$      | 34\.       | \$    | > GRAND TOTAL | \$    |
| Partition  |         | Cleanup    |       |               |       |
| Walls      |         |            |       |               |       |
+------------+---------+------------+-------+---------------+-------+

Signature and Date (Purchaser):
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**X\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**X**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Signature and Date (Contractor):
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**X**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Signature and Date (Fee Inspector):

**X\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**90 OR MORE DAYS DELINQUENT NOTICE**

LOAN GUARANTEE NO. \_\_\_\_\_\_\_\_ BORROWER
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

SSN \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

CO-BORROWER \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

SSN \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

PROPERTY STREET NO.
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

PROPERTY STREET NAME
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

PROPERTY CITY NAME
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

PROPERTY STATE NAME
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

PROPERTY ZIP CODE
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

LENDER LOAN NO. \_\_\_\_\_\_\_ OUI DATE \_\_\_\_\_\_\_ UNPAID BALANCE
\_\_\_\_\_\_

MORTGAGE STATUS/DATE\* \_\_\_\_\_\_\_\_\_\_ FIRST PAYMENT DUE DATE
\_\_\_\_\_\_\_\_\_

OCCUPANCY STATUS
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

LENDER \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ ID \#
\_\_\_\_\_\_\_\_\_\_ PHONE \_\_\_\_\_\_\_\_\_\_\_

SERVICING OFFICE \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\* See Status of Mortgage Codes

**STATUS OF MORTGAGE CODES**

A.  **90 or more Days Delinquent**. The case is 90 or more days
    delinquent, but no action is reported under codes B through G of
    this section. Also, when this code is used, enter the date (MMYY)
    the case is reported for the first time.

B.  **Foreclosure Started**. Enter the date the first legal action is
    taken to foreclose (for example, the filing of a complaint or the
    publication of notice of sale)

C.  **Foreclosure Completed**. The forced sale of the mortgaged
    property, either by court or other prescribed method, occurred. Also
    enter the date (MMYY) of sale. Continue to report the case in this
    status until you report it under Code D of this section.

D.  **Property Conveyed to HUD**. The deed was filed for record to HUD
    after completion of foreclosure. Also enter date (MMYY) of action.
    **Do not report case again**.

E.  **Assignment Completed**. The assignment of mortgage was filed for
    record to HUD. Also enter date (MMYY) of filing. **Do not report
    case again**.

F.  **Paid to less than 90 days delinquent**. Also enter the date (MMYY)
    when delinquency was reduced to less than 90 days.

G.  **Reinstated by mortgagor (who retains ownership)**. Also enter the
    date (MMYY) when reinstated to current status. **Do not report case
    in future reports unless it returns to 90 days + delinquency
    status**.

H.  **Reinstated by assumptor**. Also enter the date (MMYY) when the
    assumption took place. **Do not report case in future reports unless
    it returns to 90 days + delinquency status.**

I.  **Paid in full**. Also enter the date (MMYY) when loan was paid in
    full. **Do not report case again.**

J.  **Servicing transferred or sold to another mortgagee**. Also enter
    the date (MMYY) when loan was paid in full. **Do not report case
    again.**

# 

Consult legal counsel prior to using any documents

# SELF-HELP AGREEMENT

(Single Close)

  -----------------------------------------------------------------------
  Borrower's Name(s): 184 Case No.

  Property Address: City: State: Zip:

  Telephone Number: Work: ( ) Home: ( )
  -----------------------------------------------------------------------

I hereby certify that I have the time, skills, the tools, and the
resolve to complete all items identified on the plans and specifications
and work writeup to be completed by me in a professional and timely
manner. The quality of the workmanship and materials will be at or above
those specified in the work writeup and plans/specifications. Should the
quality of the work and/or the materials be unacceptable to the lender
approved inspector, I agree that the work will be redone and/or the
materials replaced at my own cost.

I further certify that I have, on my own, reviewed the plans and
specifications and the cost estimates and that I have made contact with
various contractors and/or subcontractors for those portions of the
construction job that are necessary to let out for contract. I have
personally made an investigation of my selected contractor's
workmanship, capacity to complete my job in a timely manner, and have on
my own, selected the contractor(s) who will complete the construction of
this project. I understand that if my contractor's costs increase over
and above this initially approved amount, and if increases will not be
covered by executed and approved change orders with funding from my
contingency account, I have the funds necessary to pay the contractor
and complete the job.

I further agree that I will furnish such excess funds directly to the
lender to be placed in the contingency reserve account for my use. I
agree that these funds will remain irrevocably committed to this project
and may not be withdrawn for any other purposes. Upon the completion of
this project, any funds remaining in this contingency reserve account
will be returned to me if I placed the funds into the account,
otherwise, the money will be paid down on the mortgage principal or used
to make additional improvements to the property.

I further certify that I will complete this job within the contract
period as set forth in the Construction Loan Agreement. I understand
that for all payments a 10 percent holdback (retainage) will be withheld
and will be returned after final completion after the Lender determines
that no liens will be placed on the property.

I further certify that I will provide paid receipts and lien waivers for
specific identifiable items when requested by the lender. I understand
that I can only request a draw inspection for the actual cost of
construction and that any savings can be used to make further
improvements to the property.

I further certify that NO ESCROWED FUNDS WILL BE USED TO PAY FOR
MATERIALS STORED ON SITE OR IN ANY OTHER LOCATION, except for purchase
orders for kitchen/bath cabinetry and finish flooring. I agree that
disbursement of any monies may be made only AFTER the work has been
installed, completed, inspected, and approved by the inspector.

I agree that if I make any changes to the work write-up document as
approved and made a part of the Construction Loan Agreement, I will
secure a written and approved change order PRIOR TO THE CHANGE, using
form HUD 92577. I understand that any work completed prior to the
acceptance of the change order will be at my own risk and that I may
have to pay for the work out of my own funds.

I will secure all required (City/State/County/Tribal) permits prior to
starting construction and to hold HUD and the Lender harmless for all
actions of myself and my contractor, subcontractors and/or suppliers on
this job. I also understand that all payment(s) are subject to
inspection and approval by the approved inspector.

I agree to obtain a Hazard Insurance Policy to insure against fire,
windstorm, hail and other extended coverage (also known as Builders Risk
Policy, HO, Rental Dwelling Insurance Policy) in the amount equal to or
greater than the total of all financing sources and have provided or
will provide a copy of the insurance policy and paid receipt to the
Lender. I also agree to obtain a Liability Policy if the above listed
policies do not provide such coverage for injury, death, etc. to other
(non worker) persons who may enter onto the job site.

I also agree to obtain a Certificate of Insurance of any
subcontractor(s) for workman's compensation, which at a minimum will
provide liability coverage for any persons working at this project.

I now wish to proceed with this job on my own as above described and in
compliance with the accepted architectural exhibits. I agree to secure
proper insurance verification from all contractors and/or subcontractors
and I further certify that all contracts are strictly between myself and
my contractors, subcontractors, and/or suppliers, and I hereby hold HUD
and the Lender harmless from any problems whatsoever that might develop
between myself and my contractors, subcontractors, and/or suppliers. If
I wish further assurances and/or warranties from the workmen or the
suppliers, I will secure them prior to payout.

Signed as of the Date Shown Below:

Borrower: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Co-Borrower \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Witness: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Date:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

# BORROWER/CONTRACTOR AGREEMENT

(SAMPLE DOCUMENT) **Loan No. \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

Borrower's Name(s): Case No.:

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Property Address:

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Borrower's Phone: Home: ( ) Work: ( )

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Contractor's Name:

State of: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ License No:
\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Address:

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Phone: ( )

**THIS AGREEMENT,** made this date,
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_, between the above mentioned
Homeowner (Owner) and Contractor, is for the construction or
rehabilitation of the property, indicated above, that has been approved
for a loan under the Section 184 Program. The Owner shall pay the
contractor the sum of \$ \_\_\_\_\_\_\_\_\_\_\_\_\_ for completion of
the work, including all sales tax due by law, together with increases or
decreases in the contract price as may be approved in writing by the
Lender. The work will begin within 30 days of loan closing with the
Lender, and will be completed by
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_, unless delayed
beyond the Contractor's control. The General Provisions listed below are
made a part of this agreement. The contract documents consist of the
architectural exhibits listed in the Construction Loan Agreement between
the Owner and the Lender, or as described below (or on an attached
sheet):

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Owner(s) Signature(s) and Date Contractor's Signature and Date

**1. Contract Documents:** This Agreement includes all general
provisions, special provisions, and architectural exhibits that were
accepted by the Lender. Work not covered by this agreement will not be
required unless it is required by reasonable inference as being
necessary to produce the intended result. By executing this Agreement,
the contractor represents that he/she has visited the site and
understands local conditions, including state and local building
regulations and conditions under which the work is to be performed.

**2. Owner:** Unless otherwise provided for in the Agreement, the owner
will secure and pay for necessary easements, exceptions from zoning
requirements, or other actions that must precede the approval of permits
for this project. If owner fails to do so then this contract is void. If
the contractor fails to correct defective work or persistently fails to
carry out the work in accordance with the agreement of general
provisions, the owner may order the contractor in writing to stop such
work, or a part of the work, until the cause for the order has been
eliminated.

**3. Contractor:** The contractor will supervise and direct the work,
and the work of all subcontractors if any. He/she will use the best
skill and attention and will be solely responsible for all construction
methods and materials and for coordinating all portions of the work.
Unless otherwise specified in the Agreement, the contractor will provide
and/or pay for all labor, materials, equipment, tools, machinery,
transportation, and other goods, facilities, and services necessary for
the proper execution and completion of the work. The contractor will
maintain order and discipline among all employees and will not assign
anyone unfit for the task. The contractor warrants to the owner that all
materials and equipment incorporated are new and that all work will be
of good quality and free of defects or faults. The contractor will pay
for building permits, other permits, fees, inspections and licenses
necessary for completion of the work unless otherwise specified herein.
The contractor will indemnify and hold harmless the owner from and
against all claims, damages, losses expenses, legal fees or other costs
arising or resulting from the contractor's performance of the work, or
provisions of this section. The contractor will comply with all rules,
regulations, laws, ordinances and order of any public authority of HUD's
Inspector's bearing on the performance of the work. The contractor is
responsible for and indemnifies the owner against acts and omissions of
employees, subcontractors and their employees, or others performing the
work under this Agreement with the contractor. The contractor will
provide shop drawings, samples, product data or other information
provided for in this Agreement, where necessary.

**4. Subcontractor:** Selected by the contractor, except that the
contractor will not employ any subcontractor to whom the owner may have
a reasonable objection, nor will the contractor be required by the owner
to employ any subcontractor to whom the contractor has a reasonable
objection.

**5. Work by Owner or Other Contractor:** The owner reserves the right
to perform work related to the project, but which is not a part of this
Agreement, and to award separate contracts in connection with other
portions of the project not detailed in this Agreement. All contractors
and subcontractors will be afforded reasonable opportunity for the
storage of materials and equipment by the owner and by each other. Any
costs arising by defective or ill-timed work will be borne by the
responsible party.

**6. Binding Arbitration:** Claims or disputes relating to the Agreement
or General Provisions will be resolved by the Construction Industry
Arbitration Rules of the American Arbitration Association (AAA) unless
both parties mutually agree to other methods. The notice of the demand
for arbitration must be filed in writing with the other party to this
Agreement and with the AAA and must be made in a reasonable time after
the dispute has arisen. The award rendered by the arbitration(s) will be
considered final and judgment will be entered upon it in accordance with
applicable law in any court having jurisdiction thereof.

**7. Clean Up and Trash Removal:** The contractor will keep the owner's
residence free from waste or rubbish resulting from the work. All waste,
rubbish, tools, construction materials and machinery will be removed
promptly after completion of the work by the contractor.

**8. Time:** With respect to the scheduled completion of the work, time
is of the essence. If the contractor is delayed at anytime in the
progress of the work by change orders, fire, labor disputes, acts of God
or other causes beyond the contactor's control, the completion schedule
for the work or affected parts of the work may be extended by the same
amount of time caused by the delay. The contractor must begin work no
later than 30 days after loan closing and will not cease work for more
than 30 consecutive days.

**9. Payments and Completion:** Payments may be withheld because of: (1)
defective work not remedied; (2) failure of contractor to make proper
payments to subcontractors, workers or suppliers; (3) persistent failure
to carry out work in accordance with this Agreement or these general
conditions, or (4) legal claims. The final payment will be due after
complete release of any and all liens arising out of the contract or
submission of receipts or other evidence of payment covering all
subcontractors or suppliers who could file such a lien. The contractor
agrees to indemnify the owner against such liens and will refund all
monies, including costs and reasonable attorney's fees, paid by the
owner in discharging the debt. A 10 percent holdback is required by the
lender to assure the work has been properly completed and there are no
liens on the property.

**10. Protection of Property and Persons:** The contractor is
responsible for initiating, maintaining and supervising all necessary or
required safety programs. The contractor must comply with all applicable
laws, regulations, ordinances, orders or laws of federal, state, county
or local governments. The contractor will indemnify the owner for all
property loss or damage to the owner caused by his/her employees or
his/her direct or sub tier subcontractors.

**11. Insurance:** The contractor will purchase and maintain such
insurance necessary to protect from claims under workers compensation
and from any damage to the owners(s) property resulting from the conduct
of this contract.

**12. Changes in the Contract:** The owner may order changes, additions,
or modifications (using form HUD 92577) without invalidating the
contract. Such changes must be in writing and signed by the owner and
accepted by the lender and HUD. Not all change order requests may be
accepted by the lender, therefore, the contractor proceeds at their own
risk if work is completed without an accepted change order.

**13. Correction of Deficiencies:** The contractor must correct promptly
any work of his/her own or his/her subcontractors found to be defective
or not complying with the terms of the contract.

**14. Warranty:** The contractor will provide a one-year warranty on all
labor and materials used in the construction or rehabilitation of the
property. This warranty must extend one year from the date of completion
of the contract or longer if prescribed by law unless otherwise
specified by other terms of this contract. Disputes will be resolved
through the Construction Industry Arbitration Rules of the American
Arbitration Association.

**15. Termination:** If the owner fails to make a payment under the
terms of this Agreement, through no fault of the contractor, the
contractor may, upon ten working days written notice to the owner, and
if not satisfied, terminate this Agreement. The owner will be
responsible for paying the contractor for all work completed.

If the contractor fails to or neglects to carry out the terms of the
contract, the owner, after ten working days written notice to the
contractor, may terminate this Agreement. The owner may finish the job
by whatever reasonable method the owner deems expedient. If the cost of
completion exceeds the contract balance, the difference, as well as
reasonable attorney's fees if necessary, will be paid to the owner by
the contractor.

# NOTICE OF SERVICING LENDER CHANGE

Loan Guarantee No.
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Mortgagor \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Co-Mortgagor
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Property Street Address
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

City/State/Zip Code
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Previous Lender Name
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

> Address \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

New Servicing Lender Name
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

> Address \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
>
> Phone No. \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
>
> Lender No.
> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
>
> Loan No. \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Date Servicing Acquired
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**BORROWER INFORMATION PACKET COVER LETTER**

Dear Mr. And Mrs. Borrower:

We want to help you save your home. If the reason for your failure to
pay your mortgage was due to a temporary situation that will soon be
corrected, we may be able to work with you to arrange for repayment on
terms you can afford. Or, we may be able to work out another alternative
acceptable to you. Please call \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_- at
\_\_\_\_\_\_\_\_\_\_\_ as soon as possible to pursue this option (TDD
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_).

We have enclosed the pamphlet "Saving Your Home" which describes methods
to assist you in bringing your mortgage current. The pamphlet also
addresses other alternative to foreclosure. Foreclosure is the legal
means that we may use to take ownership of your home if you do not make
your mortgage payments.

Your mortgage payments of \$\_\_\_\_\_\_\_\_\_\_\_ plus late charges of
\$\_\_\_\_\_\_\_\_\_\_\_\_\_\_ for the months of \_\_\_\_\_\_ and
\_\_\_\_\_\_ are past due. If these payments are not received by
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_, you could lose your home. If you have
already mailed the payments, please accept our thanks.

Prior to contacting us, you should contact a HUD-approved housing
counseling agency. A list of agencies is enclosed. A counselor will
review your financial situation. The counselor may be able to suggest
how you can arrange to pay the overdue payment(s) and make timely
mortgage payments in the future. The counselor will also discuss other
available options. You may also want to contact your tribe for any
assistance they can provide.

We want to help you save your home. Please read the pamphlet carefully.
It could assist you in preventing foreclosure.

Sincerely,

ABC Mortgage Company

Enclosures:

List of Housing Counseling Agencies

**HUD Pamphlet PA-426-H**

<table>
<colgroup>
<col style="width: 25%" />
<col style="width: 1%" />
<col style="width: 1%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 1%" />
<col style="width: 1%" />
<col style="width: 3%" />
<col style="width: 4%" />
<col style="width: 1%" />
<col style="width: 6%" />
<col style="width: 8%" />
<col style="width: 5%" />
<col style="width: 3%" />
<col style="width: 12%" />
<col style="width: 12%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="2" rowspan="3"><p><strong>Environmental Assessment and
Compliance Findings for the Related Laws</strong></p>
<p>RMS: HI-00487R</p></td>
<td colspan="10" rowspan="3"><strong>U.S. Department of Housing and
Urban Development</strong></td>
<td colspan="2">1. Project Number:</td>
<td colspan="3"></td>
</tr>
<tr class="even">
<td colspan="2">HUD Program:</td>
<td colspan="3"></td>
</tr>
<tr class="odd">
<td colspan="2">2. Date Received</td>
<td colspan="3"></td>
</tr>
<tr class="even">
<td colspan="17"><strong>Findings and Recommendations</strong> are to be
prepared <strong>after the</strong> environmental analysis is completed.
complete items 1 through 15 as appropriate for all projects. For
projects requiring an environmental assessment, also complete Parts A
and B. For projects categorically excluded under 24 CFR 50.20, complete
Part A. Attach notes and source documentation that support the
findings.</td>
</tr>
<tr class="odd">
<td colspan="10">3. Project Name and Location: (Street, City, County,
State)</td>
<td colspan="7">4. Applicant Name and Address (Street, City, State, Zip
Code)</td>
</tr>
<tr class="even">
<td colspan="3"><p>5. Multifamily Elderly Other</p>
<p>(if Other, explain)</p></td>
<td colspan="10"><p>6. Number of: _________ Dwelling Units</p>
<p>_____ Buildings _____ Stories _____ Acres</p></td>
<td colspan="4"><p>7. Displacement: No Yes</p>
<p>(if Yes, explain)</p></td>
</tr>
<tr class="odd">
<td colspan="10"><p>8. New Construction Rehabilitation Other</p>
<p>(if Other, explain)</p></td>
<td colspan="7" rowspan="3"><p>10. Planning Findings: Is the project in
compliance or conformance with the following plans?</p>
<p>Local Zoning: Yes No Not Applicable</p>
<p>Coastal Zone: Yes No Not Applicable</p>
<p>Air Quality (SIP): Yes No Not Applicable</p>
<p>Explain any “No” answer: ______________________________</p>
<p>Are there any unresolved conflicts concerning No Yes</p>
<p>the use of the site (if Yes, explain)</p></td>
</tr>
<tr class="even">
<td colspan="10"><p>9. Has an environmental report (Federal, State,</p>
<p>or local) been used in completing this form? No Yes</p>
<p>(if Yes, identify)</p></td>
</tr>
<tr class="odd">
<td colspan="10"><p>11. Environmental Finding: (check one)</p>
<p> Categorical exclusion is made in accordance with § 50.20 or</p></td>
</tr>
<tr class="even">
<td colspan="17"><p> Environmental Assessment and a Finding of No
Significant Impact (FONSI) is made in accordance with § 50.33 or</p>
<p> Environmental Assessment and a Finding of Significant Impact is
made, and an Environmental Impact Statement is required in accordance
with §§ 50.33(d) and 50.41.</p></td>
</tr>
<tr class="odd">
<td colspan="12"> Project is recommended for approval (List any
conditions and requirements)</td>
<td colspan="5"> Project is recommended for rejection (State
reasons):</td>
</tr>
<tr class="even">
<td colspan="7">12. Preparer: (signature</td>
<td colspan="4">Date:</td>
<td colspan="5">13. Supervisor: (signature)</td>
<td>Date</td>
</tr>
<tr class="odd">
<td colspan="17"><p>14. Comments by Environmental Clearance Officer
(ECO):</p>
<p>required for projects over 200 lots/units)</p></td>
</tr>
<tr class="even">
<td colspan="15"><blockquote>
<p>ECO: (signature)</p>
<p><strong>X</strong></p>
</blockquote></td>
<td colspan="2">Date:</td>
</tr>
<tr class="odd">
<td colspan="17">15. Comments (if any) by HUD Approving Official:</td>
</tr>
<tr class="even">
<td colspan="15"><blockquote>
<p>HUD Approving Official: (signature)</p>
<p><strong>X</strong></p>
</blockquote></td>
<td colspan="2">Date:</td>
</tr>
<tr class="odd">
<td colspan="17"><p>form <strong>HUD-4128</strong> (10/96)</p>
<p>ref. Handbook 1390.2</p></td>
</tr>
<tr class="even">
<td colspan="17"></td>
</tr>
<tr class="odd">
<td colspan="17"><strong>Part A. Compliance Findings for §50.4 Related
Laws and Authorities</strong></td>
</tr>
<tr class="even">
<td colspan="3" rowspan="2">§ 50.4 Laws and Authorities</td>
<td colspan="5">Project is in Compliance</td>
<td colspan="9" rowspan="2">Source Documentation and Requirements for
Approval</td>
</tr>
<tr class="odd">
<td colspan="2">Yes</td>
<td colspan="3">No</td>
</tr>
<tr class="even">
<td colspan="3">16. Coastal Barrier Resources</td>
<td colspan="2"></td>
<td colspan="3"></td>
<td colspan="9"></td>
</tr>
<tr class="odd">
<td colspan="3">17. Floodplain Management<br />
(24 CFR Part 55)</td>
<td colspan="2"></td>
<td colspan="3"></td>
<td colspan="9"></td>
</tr>
<tr class="even">
<td colspan="3">18. Historic Preservation<br />
(36 CFR Part 800)</td>
<td colspan="2"></td>
<td colspan="3"></td>
<td colspan="9"></td>
</tr>
<tr class="odd">
<td colspan="3"><p>19. Noise Abatement</p>
<p>(24 CFR Part 51 Subpart B)</p></td>
<td colspan="2"></td>
<td colspan="3"></td>
<td colspan="9"></td>
</tr>
<tr class="even">
<td colspan="3"><p>20. Hazardous Operations</p>
<p>(24 CFR Part 51 Subpart C)</p></td>
<td colspan="2"></td>
<td colspan="3"></td>
<td colspan="9"></td>
</tr>
<tr class="odd">
<td colspan="3"><p>21. Airport Hazards</p>
<p>(24 CFR Part 51 Subpart D)</p></td>
<td colspan="2"></td>
<td colspan="3"></td>
<td colspan="9"></td>
</tr>
<tr class="even">
<td colspan="3"><p>22. Protection of Wetlands</p>
<p>(E.O. 11990)</p></td>
<td colspan="2"></td>
<td colspan="3"></td>
<td colspan="9"></td>
</tr>
<tr class="odd">
<td colspan="3">23. Toxic Chemicals &amp; Radioactive Materials
(§ 50.3(i))</td>
<td colspan="2"></td>
<td colspan="3"></td>
<td colspan="9"></td>
</tr>
<tr class="even">
<td colspan="3">24. Other § 50.4 authorities (e.g., endangered species,
sole source aquifers, farmlands protection, flood insurance,
environmental justice)</td>
<td colspan="2"></td>
<td colspan="3"></td>
<td colspan="9"></td>
</tr>
<tr class="odd">
<td colspan="17"><strong>Part B. Environmental/Program
Factors</strong></td>
</tr>
<tr class="even">
<td rowspan="2">Factors</td>
<td colspan="8"><p>Anticipated</p>
<p>Impact/Deficiencies</p></td>
<td colspan="8" rowspan="2">Source Documentation and Requirements for
Approval</td>
</tr>
<tr class="odd">
<td colspan="3">None</td>
<td colspan="2">Minor</td>
<td colspan="3">Major</td>
</tr>
<tr class="even">
<td>25. Unique Natural Features and Areas</td>
<td colspan="3"></td>
<td colspan="2"></td>
<td colspan="3"></td>
<td colspan="8"></td>
</tr>
<tr class="odd">
<td>26. Site Suitability, Access, and Compatibility with surrounding
development</td>
<td colspan="3"></td>
<td colspan="2"></td>
<td colspan="3"></td>
<td colspan="8"></td>
</tr>
<tr class="even">
<td>27. Soil Stability, Erosion, and Drainage</td>
<td colspan="3"></td>
<td colspan="2"></td>
<td colspan="3"></td>
<td colspan="8"></td>
</tr>
<tr class="odd">
<td>28 Nuisances and Hazards (natural and built)</td>
<td colspan="3"></td>
<td colspan="2"></td>
<td colspan="3"></td>
<td colspan="8"></td>
</tr>
<tr class="even">
<td>29. Water Supply / Sanitary Sewers</td>
<td colspan="3"></td>
<td colspan="2"></td>
<td colspan="3"></td>
<td colspan="8"></td>
</tr>
<tr class="odd">
<td>30. Solid Waste Disposal</td>
<td colspan="3"></td>
<td colspan="2"></td>
<td colspan="3"></td>
<td colspan="8"></td>
</tr>
<tr class="even">
<td>31. Schools, Parks, Recreation, and Social Services</td>
<td colspan="3"></td>
<td colspan="2"></td>
<td colspan="3"></td>
<td colspan="8"></td>
</tr>
<tr class="odd">
<td>32. Emergency Health Care, Fire and Police Services</td>
<td colspan="3"></td>
<td colspan="2"></td>
<td colspan="3"></td>
<td colspan="8"></td>
</tr>
<tr class="even">
<td>33. Commercial/Retail and Transportation</td>
<td colspan="3"></td>
<td colspan="2"></td>
<td colspan="3"></td>
<td colspan="8"></td>
</tr>
<tr class="odd">
<td>34. Other</td>
<td colspan="3"></td>
<td colspan="2"></td>
<td colspan="3"></td>
<td colspan="8"></td>
</tr>
<tr class="even">
<td colspan="17"></td>
</tr>
</tbody>
</table>

form **HUD-4128** (10/96)

ref. Handbook 1390.2

***"Existing Construction"***

**ENVIRONMENTAL REVIEW RECORD**

**COMPLIANCE WITH 24 CFR 58.6**

**[FLOOD DISASTER PROTECTION ACT]{.underline}**

1.  Is the project located within a Special Flood Hazard Area as mapped
    by the Federal Emergency Management Agency (FEMA)? \_\_\_\_\_\_Yes
    \_\_\_\_\_\_No

```{=html}
<!-- -->
```
2.  If the project site has not been mapped by FEMA, is it in a flood
    prone area as determined by another qualified source?

Source
Documentation:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

If the answer to either question 1 or 2 is yes, the project cannot
proceed unless flood insurance is obtained through the National Flood
Insurance Program.

Insurance Policy Number: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**[COASTAL BARRIER IMPROVEMENT ACT]{.underline}**

1.  Is the project located within a designated coastal resource area?
    \_\_\_\_Yes\_\_\_\_No

NOTE: There are no coastal barriers along the Pacific coast.

**[RUNWAY CLEAR ZONE/CLEAR ZONE]{.underline}**

1.  Does the project involve the sale or acquisition of existing
    property within an FAA-designated runway clear zone?

\_\_\_\_\_Yes \_\_\_\_\_No

Source
documentation:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

If yes, responsibility entity must advise the buyer of existing
conditions/implications and a disclaimer signed by owner must be
attached.

**PREPARED
BY:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
DATE:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

***"New Construction - 1-4 Units on one Site***

***or 5 or more units on scattered site (2000 ft)"***

**STATUTORY WORKSHEET**

[Use this worksheet only for HUD projects which are Categorically
Excluded per 24 CFR Section 58.35(a).]{.underline}

**24 CFR §58.5 STATUTES, EXECUTIVE ORDERS & REGULATIONS**

**PROJECT NAME and DESCRIPTION -** Include all contemplated actions
which logically are either geographically or functionally part of the
project:

This project is determined to be categorically excluded according to:
\[Cite section(s)\]\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**DIRECTIONS** - Write **"A"** in the Status Column when the project, by
its nature, does not affect the resources under consideration; OR write
**"B"** if the project triggers formal compliance consultation
procedures with the oversight agency, or requires mitigation (see
Statutory Worksheet Instructions). Compliance documentation must contain
verifiable source documents and relevant base data. Attach reviews,
consultations, special studies as needed.

**[Compliance Factors:]{.underline}**

Statutes, Executive Orders, and Status

Regulations listed at 24 CFR §58.5 A / B Compliance Finding and
Documentation

+---------------------------+-----+------------------------------------+
| **Historic Preservation** |     |                                    |
|                           |     |                                    |
| \[36 CFR Part 800\]       |     |                                    |
+---------------------------+-----+------------------------------------+
| **Floodplain Management** |     |                                    |
|                           |     |                                    |
| \[24 CFR 55, Executive    |     |                                    |
| Order 11988\]             |     |                                    |
+---------------------------+-----+------------------------------------+
| **Wetland Protection**    |     |                                    |
|                           |     |                                    |
| \[Executive Order 11990\] |     |                                    |
+---------------------------+-----+------------------------------------+
| **Coastal Zone Management |     |                                    |
| Act**                     |     |                                    |
|                           |     |                                    |
| \[Sections 307(c), (d)\]  |     |                                    |
+---------------------------+-----+------------------------------------+
| **Sole Source Aquifers**  |     |                                    |
|                           |     |                                    |
| \[40 CFR 149\]            |     |                                    |
+---------------------------+-----+------------------------------------+
| **Endangered Species      |     |                                    |
| Act**                     |     |                                    |
|                           |     |                                    |
| **\[50 CFR 402\]**        |     |                                    |
+---------------------------+-----+------------------------------------+
| **Wild and Scenic Rivers  |     |                                    |
| Act**                     |     |                                    |
|                           |     |                                    |
| \[Sections 7(b), and      |     |                                    |
| (c)\]                     |     |                                    |
+---------------------------+-----+------------------------------------+
| **Clean Air Act -**       |     |                                    |
| \[Sections 176(c), (d),   |     |                                    |
| and 40 CFR 6, 51, 93\]    |     |                                    |
+---------------------------+-----+------------------------------------+

+---------------------------+-----+------------------------------------+
| **Farmland Protection     |     |                                    |
| Policy Act**              |     |                                    |
|                           |     |                                    |
| \[7 CFR 658\]             |     |                                    |
+---------------------------+-----+------------------------------------+
| **Environmental Justice** |     |                                    |
|                           |     |                                    |
| \[Executive Order 12898\] |     |                                    |
+---------------------------+-----+------------------------------------+
| **HUD ENVIRONMENTAL       |     |                                    |
| STANDARDS**               |     |                                    |
|                           |     |                                    |
| Noise Abatement and       |     |                                    |
| Control                   |     |                                    |
|                           |     |                                    |
| \[24 CFR 51B\]            |     |                                    |
+---------------------------+-----+------------------------------------+
| Explosive and Flammable   |     |                                    |
| Operations                |     |                                    |
|                           |     |                                    |
| \[24 CFR 51C\]            |     |                                    |
+---------------------------+-----+------------------------------------+
| **Toxic Chemicals and     |     |                                    |
| Radioactive**             |     |                                    |
|                           |     |                                    |
| Materials \[HUD Notice    |     |                                    |
| 79-33\]                   |     |                                    |
+---------------------------+-----+------------------------------------+
| **Airport Clear Zones and |     |                                    |
| Accident**                |     |                                    |
|                           |     |                                    |
| Potential Zones \[24 CFR  |     |                                    |
| 51D\]                     |     |                                    |
+---------------------------+-----+------------------------------------+

DETERMINATION:

( ) This project converts to Exempt, per Section 58.34(a)(12), because
it does not require any mitigation for compliance with any listed
statutes or authorities, nor requires any formal permit or license
(Status \"A\" has been determined in the status column for all
authorities); **Funds may be drawn down** for this (now) EXEMPT project;
OR

( ) This project cannot convert to Exempt because one or more
statutes/authorities require consultation or mitigation. Complete
consultation/mitigation requirements, publish NOI/RROF and obtain
Authority to Use Grant Funds (HUD 7015.16) per Section 58.70 and 58.71
before drawing down funds; OR

( ) The unusual circumstances of this project may result in a
significant environmental impact. This project requires preparation of
an Environmental Assessment (EA). Prepare the EA according to 24 CFR
Part 58 Subpart E.

PREPARER SIGNATURE:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
DATE:

PREPARER NAME:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

RESPONSIBLE ENTITY OFFICIAL / SIGNATURE:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

NAME, TITLE:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
DATE: \_\_\_\_\_\_\_\_\_

**USE OF STANDARD FHA FORMS**

**FOR THE SECTION 184 PROGRAM**

Where possible, this guide has made use of standard Fl-IA or Public and
Indian Housing forms. However, some of the information required in some
of the FHA or PH-I forms is not applicable to the Section 184 Program.
When completing the standard FHA or PIH forms please refer to the
following annotations.

**Form HUD 92900-A, Addendum to Uniform Residential Loan Application**

-   Where the form states HUD/FHA the form is understood to apply to
    HUD's Section 184 Program, operated under the Office of Native
    American Programs.

-   Boxes 7 and 11, include the one-time loan guarantee fee rather than
    MIP.

-   Box 12, leave blank \-- Section 184 does not require annual MIIP
    payments.

-   Box 20, options 3, 11, and 12 are not permitted under Section 184.

-   Page 4, Lender's Certificate, the application is for a loan
    guarantee and certifications under this part apply to compliance
    with the Section 184 statute, regulation, and guidebook.

**Form HUD 51000, Schedule of Amounts for Contract Payments**

-   Under the section entitled "Project Name and Location", please write
    the name and address of the borrower. Ignore the section entitled
    "Project Number".

**Form HUD 5372, Construction Progress Schedule**

-   [In general]{.underline} where this form states public housing
    authority, it is understood to mean the borrower under the Section
    184 Program.

-   In box 1, place the name of the borrower.

-   In box 5, place the property address.

-   Leave box 6 blank.

-   Under the section entitled "Approved by", please sign as the lender.

**Form HUD 51001, Periodic Estimate for Partial Payment**

-   [In general]{.underline} where this form states public housing
    authority, it is understood to mean the borrower under the Section
    184 Program.

-   In the box entitled "Public Housing Agency", place the name of the
    borrower.

**Form HUD 92300, Mortgagor's Assurance of Completion**

-   Where the document states Mortgage Insurance Certificate, the form
    is understood to refer to the Loan Guarantee Certificate.

-   Where the document refers to the FHA Commissioner, the document is
    understood to refer to the Assistant Secretary for Public and Indian
    Housing.

-   Leave the box entitled "FHA case number" blank.

**Form HUD 92577, Request for Acceptance of Changes in Approved Drawings
and Specifications**

-   Where the document refers to the FHA Commissioner, the document is
    understood to refer to the Assistant Secretary for Public and Indian
    Housing.

**Form HUD 92561, Borrower's Contract with Respect to Hotel and
Transient Use of Property**

-   Where the document states HUD insurance or refers to sections of FHA
    regulation or statute, the form is understood to apply to a
    HUD-guaranteed loan under the Section 184 Program and its applicable
    statute and regulations.

**Form HUD 51004, Summary of Materials Stored**

-   In the box entitled "Public Housing Agency", place the name of the
    borrower.

**Form HUD 51003, Schedule of Materials Stored**

-   In the box entitled "Public Housing Agency", place the name of the
    borrower.

**Form HUD 54111, Request for Insurance Endorsement**

-   Where the form states HUD/FHA the form is understood to apply to
    HUD's Section 184 Program, operated under the Office of Native
    American Programs.

-   Leave boxes 3, 4, 5, 30, and 38 blank.

-   Box 7, option 7 is not permitted under Section 184

**Form HUD 92541, Builder's Certification**

-   Where the document states HUD-insured, it is understood to apply to
    a HUD-guaranteed loan under Section 184.

-   Where the document states HUD insurance or refers to sections of FHA
    regulation or statute, the form is understood to apply to a
    HUD-guaranteed loan under the Section 184 Program and its applicable
    statute and regulations.

**Form HUD 92051, Compliance Inspection Report**

-   Where the document states FHA-insured, it is understood to apply to
    a HUD-guaranteed loan under Section 184.

**Form HUD 92544, Warranty of Completion of Construction**

-   Where the document states HUD insurance or refers to sections of FHA
    regulation or statute, the form is understood to apply to a
    HUD-guaranteed loan under the Section 184 Program and its applicable
    statute and regulations.

Where the document refers to the FHA Commissioner, the document is
understood to refer to the Assistant Secretary for Public and Indian
Housing.