Application for Approval FHA Lender and/or Ginnie Mae Mortgage-Backed Securities Issuer
U.S. Department of Housing and Urban Development
Federal Housing Administration and
Government National Mortgage Association
OMB Approval No. 2503-0033
(exp. 11/30/2008)
	
Public reporting burden for this collection of information is estimated to average 1 hour 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.
	
The information requested on this form is required by 24 CFR Part 202 and Sec. 306(g) of the National Housing Act or by HUD Handbooks 4060.1 and 5500.3. The information collected assists FHA and Ginnie Mae in determining which lenders should be approved to participate in the FHA single and multifamily insurance programs and/or the Ginnie Mae Mortgage-Backed Securities Program. It is used to help FHA minimize its risk in insuring single-family and multifamily mortgages and Ginnie Mae to minimize its risk. Applicants are not required to respond to this collection of information unless a current OMB approval number is displayed on the form.
	
Privacy Act Statement. Names and Social Security Numbers are requested in order for the Department to obtain positive identification of the applicant’s officers, directors, stockholders and employees who have authority to obligate the applicant. The information requested will be used solely to determine the eligibility of the individuals to participate in the Department’s mortgage insurance programs. The Department is authorized to request this information by Executive Order 9397 and it will not be disclosed outside the Department except as permitted by law. The Social Security Numbers are provided to HUD on a voluntary basis. Failure to provide this information could cause delay in processing of the applications.
	
	
Instructions for Completing Form HUD-11701
Applicants seeking qualification as a FHA-approved lender/mortgagee or loan correspondent under the Title I and/or Title II programs and/or as an approved issuer with the Government National Mortgage Association (“Ginnie Mae”), must complete the appropriate sections of this form.
	
Qualified applicants may obtain one of the following three types of approval:
	
1. FHA Approval Only
Applicants seeking only FHA approval must complete Sections A, B, and C of this form and provide the supplemental information requested. The application fee is nonrefundable and is $1,000 for Title1, Title II, or for both; there is no additional fee if the applicant is already approved for one program. The application and fee must be sent to the appropriate address shown below.
	
2. Ginnie Mae Approval Only
Applicants seeking only Ginnie Mae approval must complete Sections A, B, D or E, and F of this form and provide the supplemental information requested. A nonrefundable application fee of $250 made payable to Ginnie Mae is required at the time of application. The fee is to be included with the application package. The application and fee must be sent to the appropriate address shown below.
	
3. FHA and Ginnie Mae Approval
Applicants seeking both FHA and Ginnie Mae approval must complete Sections A, B, C, D or E, and F of this form and provide the supplemental information requested. Separate fees are to be paid for each program as specified above. The application and fee must be sent to both FHA and Ginnie Mae at the appropriate addresses shown below.
	
4. Conversion of FHA Status
An applicant already approved for Title I or Title II and wishing to convert its status must complete Section A and each changed item in Section C. If there are no changes regarding officers or owners, item 11 in Section A may be omitted. The applicant must submit the application together with the supplemental information to the appropriate address shown below. The nonrefundable conversion fee is $300 for Title I, Title II, or Title I and Title II at the same time and must be sent to the appropriate address shown below.
	
Addresses for Submission of Application and Fee:
	
Applications for FHA approval only, sent by U.S. Mail:
	
U.S. Department of Housing and Urban Development
Lender Approval & Recertification Division
Rm B133 / P3214
451 7th Street, SW
Washington, D.C. 20410-8888
	
Applications for FHA approval only, sent by delivery service:
	
U.S. Department of Housing and Urban Development
Lender Approval & Recertification Division
Suite 3214
490 L’Enfant Plaza East, SW
Washington, D.C. 20024-2118
	
Applications for Ginnie Mae approval only, sent by U.S. Mail:
	
Government National Mortgage Association
451 7th Street, SW
Washington, D.C. 20410-9000
	
Previous editions are obsolete.
Fee for FHA Title I approval or conversion:
	
U.S. Department of Housing and Urban Development
P. O. Box 198608
Atlanta, GA 30384
	
Fee for FHA Title II approval or conversion, or fee for FHA Title I and
Title II approval or conversion:
U.S. Department of Housing and Urban Development
P. O. Box 198619
Atlanta, GA 30384
	
	
Replaces HUD-92001, 92001-D and LD Page i form HUD-11701 (01/2006)
ref. Handbooks 5500.3, Rev. 1 and 4060.1
	
	
	
S
upplemental
	Information to be Submitted to Obtain FHA Title I and/or FHA Title
	II Approval.
	
	
	S 
		     9.
		 Facilities Evidence 
		 10b.
		 E & O Insurance 
		
upplemental
	Information required to be submitted with form HUD-11701, for
	verifying that an applicant meets FHA Title I and/or Title II
	requirements for lender approval, varies depending on the type of
	institution making application. To determine what additional
	information is required, determine what classification type the
	institution falls under (i.e., Supervised Lender, Non-Supervised
	Lender, Loan Correspondent, Investing Lender, or Governmental
	Institution). The criteria used in determining an institution’s
	classification are the same for both Title I and Title II approvals.
	Title I lender status is covered in HUD Handbook 4700.2. Title II
	lender status is covered in HUD Handbook 4060.1. After determining
	its classification type, provide the information listed under the
	appropriate classification type. Check the appropriate boxes to
	indicate that the required documents have been included with the
	application package. 
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
S
upplemental
	Information to be Submitted to Obtain Ginnie Mae Approval
	
S
upplemental
	information required to be submitted with form HUD-11701 for
	verifying that an applicant meets Ginnie Mae requirements for issuer
	approval. For additional information on the Ginnie Mae I and II
	programs see Handbook 5500.3. All applicants will be approved to
	issue Ginnie Mae I and II single-family securities; however, in
	order to securitize Ginnie Mae II pools or loan packages, applicants
	must also execute form HUD-11709, Master Agreement for Servicer’s
	Principal and Interest Custodial Account, and form HUD-11709, Master
	Agreement for Servicer’s Principal and Interest Custodial
	Account, and form HUD-11709-A, ACH Debit Authorization.
	
Check the appropriate box to indicate that each required document has been included with the application package.
		     3.
		 Certificate of Insurance – Fidelity Bond reflecting adequate
		coverage and proper Ginnie Mae loss payee endorsement 
		     4.
		 Certificate of Insurance – Errors and Omissions reflecting
		adequate coverage and proper Ginnie Mae loss payee endorsement 
		     1.
		 Nonrefundable application fee of $250 
		     2.
		 HUD Form 11702 
		5.
		 Evidence of Quality Control Plan for underwriting, origination,
		and servicing of mortgage loans and secondary marketing. Provide a 
		      copy of quality control findings for the past six months and
		management’s response to those findings. 
		 
		     6.
		 Audited Financial Statements for latest three years (2 copies) 
		     7.
		 Most recent interim financial statement (balance sheet and income
		statement) signed by an officer as true and correct 
		     8.
		 Dollar value of loans to officers/directors/affiliates as of most
		recent financial audit 
		   11.
		 List name(s), address(es), telephone number(s), and contact
		person(s) for mortgage insurance companies, warehouse lenders, and 
		                                                              
		investors for whom the applicant is currently doing business 
		   12.
		 HUD Form 11709 
		   13.
		 HUD Form 11709-A 
		     2.
		 HUD Form 11702
		
		
	
	
	
	
	
	
	
	
			
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
P
revious
	editions are obsolete 
	
	
Replaces HUD-92001, 92001-D and LD form HUD-11701 (01/2006)
Page ii ref. Handbooks 5500.3, Rev. 1 and 4060.1
	
	A
pplication
	for Approval 
	
FHA Lender and/or Ginnie Mae Mortgage-Backed Securities Issuer
U.S. Department of Housing and Urban Development
Federal Housing Administration and
Government National Mortgage Association
OMB Approval No. 2503-0033
(Exp. 11/30/2008)
	
All Applicants are required to complete Sections A and B. Use this form as a cover sheet for your submission.
	
	
	 
Section
	A. General Information
 
	
1a. Corporate Name
	
	
	
	
1b. DBA (if applicable)
	
	
	
	
3. Geographic Address of Home Office (must be physical address)
Attention (Use a title, not an individual’s name)
	
	
	
Street Address
	
 
	    
	
	 
	   City
		State		Zip Code
	 
	   County
2a. Phone (include area code and extension)
	
Ext.
	
	
2b. FAX (include area code)
	
	
	
	
2c. E-mail
	
	
	
5a. Contact Person for this application
	
	
	
5b. Contact Phone Number and extension for this application
	
 
	                                                             Ext.
6a. Contact FAX Number and area code for this application
	
	
	
	
	
	
4. Mailing Address Check if same as Geographic
Attention (Use a title, not an individual’s name)
	
	
Street Address/ P.O. Box
	
 
	    
	
City State Zip Code
	
	
	
	
6b. Contact E-Mail Address for this application
	
	
	
	
	
7. Date of Charter
	
	
	
	
8. Under Laws of the State of (if applicable)
	
	
	 
	 
	
9. Program Approval(s) Requested 10. Minority/Women-Owned Business (Optional)
	 
	    FHA
	Title I 
(Property
	Improvement Loans/Manufactured Housing Loans)
	    	                 FHA
	Title I Conversion	                Minority-Owned
	 
	    FHA
	Title II (Mortgage Loans)                        FHA Multifamily   
			                 FHA Title II Conversion                
	Women-Owned
	 
	    Ginnie
	Mae Single-Family		   Ginnie Mae Multifamily				
	               Minority-Owned/Women-Owned
 
		
1
1.
	Institution Type    					              12. Applicant Taxpayer
	Identifying Number	              13. Fiscal Year End
	
 
	     Credit
	Union			   Bank			       (9 digits)				      (month)
 
	     Savings
	Bank			   Savings and Loan
 
	     Mortgage
	Co./Finance Co.
	1
4.
	 All Applicants must
	provide
	the information below for all officers, along with owners having a
	25% or greater ownership interest in the applicant. If additional
	space is needed, use a separate sheet. Please indicate which officer
	is in charge of the day-to-day operations of the applicant by
	checking the box provided.     
	
 
	                         
	
O
fficer/Owner
	Name			Title (if applicable)			Social Security Number	        %
	Ownership
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
	
P
revious
	editions are obsolete.
	
Replaces HUD-92001, 92001-D and LD form HUD-11701 (01/2006) Page 1 of 3 ref. Handbooks 5500.3, Rev. 1 and 4060.1
	
 
	      Section B.  History
	and Business Status
	
P
lease
	check the appropriate answer for each question below. If any of the
	questions require a “Yes” answer, provide an explanation
	on a separate sheet.
	
Yes No
	1
.	Is
	the applicant the subject of any assessments or con-         
	tingent liabilities not disclosed in its financial statements?
	2
.
		Has the applicant or any of its principals, officers,   individuals
	serving on the Board of Directors, or individuals acting as
	authorized signatories, ever been, or are any presently suspended,
	terminated, debarred, sanctioned, fined, convicted, denied approval,
	or refused a license by any Federal, State, or local government
	agency, or a government-related entity, where the action is related
	to the responsibilities that are commensurate with those of the
	financial services industry?
	
	
	3
.	Is
	the applicant or any of its principals, officers, individuals
	serving on its Board of Directors, individuals acting as authorized
	signatories, or employees currently involved in a proceeding or
	subject to an investigation that could result, or has resulted, in
	suspension, fine, or disbarment by a Federal, State, or local
	government agency, conviction in a criminal matter, bankruptcy or
	denial of fidelity insurance or mortgagee’s errors and
	omissions insurance coverage?
Yes No
	4
.
		Have any mortgage insurance companies, secondary marketing agencies
	or warehouse lenders, or broker/dealers denied the applicant
	approval in the three previous fiscal years being reported? Provide
	the date and reasons for each denial.
 
	
5. Has the applicant been subject to any past or present action by HUD, VA, Fannie Mae, Freddie Mac, or other government-related entity to indemnify the entity against loss?
	6.	
Is
	the applicant currently subject to regulatory or supervisory action
	by any regulatory agency? Regulatory actions include, but are not
	limited to, supervisory agreements, cease and desist orders, notices
	of determination, memoranda of understanding, unresolved audits, and
	investigations. Supervisory actions include, but are not limited to,
	the appointment of a trustee, conservator, or managing agent.
	
	
7. Has the applicant or any owner, principal, or managing executive been involved, through ownership or otherwise, with a previously defaulted Ginnie Mae issuer(s)?
ection
	C: FHA Title I and Title II only                                    
	    
	
	 
1.
	Premium Address
	 Check
	if same as:           Geographic         Mailing		
	       
	
 
	        Attention
	(Use a title, not an individual’s name)	
	
 
	       Street
	Address/ P.O. Box											           
	
City State Zip Code
2. Payee Address Must be completed for all FHA applications
 
	      Attention (Use a title,
	not an individual’s name)	
	
Street Address/ P.O. Box
 
	      
	
City State Zip Code
	
3. CHUMS Address Check if same as: Geographic Mailing Premium Payee
 
	       Attention (Use a title,
	not an individual’s name)
	
Street Address/ P.O. Box
City State Zip Code
	
	4. Endorsement Address
	Check if same as:     Geographic       Mailing      Premium     
	Payee      CHUMS
 
	       Attention (Use a title,
	not an individual’s name)
	
Street Address/ P.O. Box
City State Zip Code
	
8
.
	 Sponsor Home Office Lender/Mortgagee ID  10. Origination/Service 		
	                  (HUD use)
(10 digits)
	
	
9
.
	 Applicant Taxpayer Identifying Number		Title I   Property
	Improvement
(9 digits) Manufactured Housing
Title II 1-4 Family Mortgages
Multifamily Mortgages
 
	5. Lender/Mortgagee Type     
	6. Institution Type        
	
	
 
	       Government       
		Federal
State
Local
	
		
Supervised * Credit Union
(not Loan Correspondent) Bank
Savings Bank
	
		Savings
	& Loan
 
	       Non-supervised		Insurance
	Company                                     
	
(not Loan Correspondent) Mortgage Co./
F
inance
	Co.
 
	       Loan
	Correspondent	Mortgage Co./
(Supervised/Non-supervised) Finance Co.
 
	      			Supervised Loan
 
	       			Correspondent *
 
	       Investing
	Mortgagee	For-Profit
 
	                                                  Not-for-Profit
 
	       Reserved
	
 
	       Service
	Provider	Service Provider
Servicing Agent
 
	5. Lender/Mortgagee          
	6. Institution Type
Type Code (HUD use) (HUD use)
	
 
	       
	
* 7. Examined and Supervised 7. Examined
 
	         Federal Reserve
	System	            and
	Super-
Federal Deposit Insurance Corp. vised Code
Office of Thrift Supervision (HUD use)
National Credit Union Admin.
 
	         Other (specify)
 
11.
	Fiscal Year End (month)
	
 
12.
	Financial Statement Date (HUD use)
	
 
13a.
	Title I Home Office Lender ID, if prior approval
(10 digits)
	
13b. Title II Home Office Mortgagee ID, if prior
approval (10 digits)
	
	
	
	
	R
eplaces
	HUD-92001, 92001-D and LD	                                          
	         					    form HUD-11701 (07/2005)
Page 2 of 3 ref. Handbooks 5500.3, Rev. 1 and 4060.1
 
       FHA Certification
The undersigned agrees to comply with the provisions of the HUD regulations and the requirements of the Secretary of HUD.
I certify that I am authorized to execute this application on behalf of the applicant.
	
 
	            
	
Section D. Ginnie Mae I and/or II Applicants (Fannie Mae and/or Freddie Mac Approved)
	
	
1. FHA Mortgagee Number (if applicable)
	
	
	
	
	
	
2. Fannie Mae Seller/Servicer Number(s)
	
	
	
	
	
	
	
	
3. FHLMC Seller/Servicer Number(s)
	
	
	
	
	
	
	
4. Total Dollar Amount of Mortgage Servicing Portfolio
	 
		(Servicing)			
		    (Sub-servicing) $			
		    $ $
	
	
	
	
5. On a separate sheet, please provide a description of any restrictions on the applicant’s activities that have been imposed by Fannie Mae and/or Freddie Mac. Please also provide a copy of the applicant’s annual eligibility certification report and the most recent compliance report from Fannie Mae and/or Freddie Mac.
For those applicants applying for approval in Ginnie Mae’s multifamily program, provide eligibility certification of multifamily approval by Fannie Mae and/or Freddie Mac.
F
or
		those applicants who are not approved for Fannie Mae’s and/or
		Freddie Mac’s multifamily program, provide two resumes
		showing the relevant experience in multifamily origination and
		servicing for the past ten years.
	
	
	
 
	      Section
	E. Ginnie Mae I and/or II Applicants (No Fannie Mae or Freddie Mac
	Approval)
	
	
FHA Mortgagee Number: (If applicable)
	
	
	
	
	
On a separate sheet, please provide a brief description of the applicant’s history. Please include operating and business plans.
	
	
3. On a separate sheet, please provide the following: Mortgage loan operations and volume of originations segregated by loan type (i.e., conventional, FHA/VA, RHS) during the last three years for single-family residential and multifamily loans.
	
	
4. On a separate sheet, please list investors, number of loans and dollar amount for whom the applicant services mortgages (sub-servicing is to be identified and broken out separately using the same format).
	
	
	
	
O
n
		a separate sheet, please list investors to whom the applicant sells
		mortgages.
	
O
n
		a separate sheet, please list at least four resumes (minimum of
		three full-time officers and one full-time employee) for the key
		officers and employees of the applicant. The resume must show the
		employee’s name, Social Security Number, date of birth, and
		the relevant experience pertaining to the mortgage banking
		industry. Please include each employee’s employment history
		for the past ten years by name of the employer, date, title,
		supervisor, and a brief description of the duties,
		responsibilities, and accomplishments. Each resume must also
		include an original signature and date.
	 
	     Section
	F. Ginnie Mae Certifications (All Ginnie Mae Applicants)
	
	
	
1. The financial statements submitted to Ginnie Mae are complete and accurate statements of the applicant's financial condition.
	
	
2. To the best of its knowledge and belief, the information and data contained herein are true and correct. Further, it is the opinion of the undersigned that it has powers and authority sufficient to act as an issuer of Ginnie Mae mortgage-backed securities.
	
3. Each applicant warrants that while the application is pending action by Ginnie Mae, the applicant will notify Ginnie Mae in writing of a change in any material factor that could affect the application decision.
	
	
4. Agreements: The undersigned applicant by submitting this application agrees to issue and administer Ginnie Mae mortgage-backed securities and service pooled mortgages in accordance with Section 306(g) of the National Housing Act, its applicable regulations; and the applicable “Government National Mortgage Association Mortgage-Backed Securities Guide” (Ginnie Mae I: Ginnie Mae II: Handbook 5500.3).
All Applicants are required to sign and date the application.
pplicant												Date
	
	
Signature (must be original) Name (printed or typed)
	
	
						
	       Title (must be President, Vice President, Partner, or
	Managing Member)
	
	A
pproved
	   (HUD Use Only)								      Title I ID Number
U.S. Department of Housing and Urban Development,
	
	      Director, Office of Lender Activities and Program Compliance	
By: (Signature of Director, Lender Approval and Recertification Division) Title II ID Number
	
	
Date
	
	
	R
eplaces
	HUD-92001, 92001-D and LD	                                          
	         					    form HUD-11701 (01/2006)
Page 3 of 3 ref. Handbooks 5500.3, Rev. 1 and 4060.1
| File Type | application/msword | 
| File Title | Commitment to Guarantee | 
| Author | Dianne Cooperman | 
| Last Modified By | h05385 | 
| File Modified | 2007-05-01 | 
| File Created | 2007-05-01 |