Borrower And Non-b Borrower And Non-borrowing Spouse Certifications

OMB Control
No. 2502-0611
2502-0611
Control No.
OMB

Public reporting
reporting burden
burden for
Public
this collection
information relating
to the
the U.S.
U.S. Department
Department of
for this
collection of
of information
relating to
of
Housing and
Urban Development
Development (HUD)
(HUD)’s
Performing Loan
Loan Servicing
the Home
Home Equity
Equity
Servicing for
for the
Housing
and Urban
's Performing
Conversion
Mortgage (HECM)
(HECM) is
is estimated
to average
Conversion Mortgage
estimated to
average 0.10
0.10 hours
hours per
per response
response for
for
FHA-approved mortgagees
who service
HECMs and
and the
the HECM
HECM borrowers.
borrowers. This
the
FHA-approved
mortgagees who
service HECMs
This includes
includes the
time for
for reviewing
gathering and
the
time
reviewing instructions,
instructions, searching
searching existing
existing data
data sources,
sources, gathering
and maintaining
maintaining the
data
and completing
the collection
information.
collection of
of information.
data needed,
needed, and
completing and
and reviewing
reviewing the

Send
this burden
burden estimate
this collection
Send comments
comments regarding
regarding this
estimate or
or any
any other
other aspect
aspect of
of this
collection of
of
information,
to reduce
this burden,
burden, to
to the
the Reports
Reports Management
Management Officer,
Officer,
information, including
including suggestions
suggestions to
reduce this
REE, U.S.
U.S. Department
Department of
Housing and
and Urban
Urban Development
Development (HUD),
(HUD), 451
Room
REE,
of Housing
451 7th
7th Street,
Street, SW,
SW, Room
8210,
Washington, DC
DC 20410-5000.
20410-5000. When
When providing
to OMB
8210, Washington,
providing comments,
comments, please
please refer
refer to
OMB
Approval
No. 2502-0611.
2502-0611. HUD
HUD may
and sponsor,
is not
to
Approval No.
may not
not conduct
conduct and
sponsor, and
and aa person
person is
not required
required to
respond
to, aa collection
information unless
unless the
the collection
valid control
respond to,
collection of
of information
collection displays
displays aa valid
control number.
number.
The
information collection
is required
to be
be sent
to the
the Eligible
Eligible Non-Borrowing
Non-Borrowing Spouse
The information
collection is
required to
sent to
Spouse during
during
aa deferral
and payable
under
deferral of
of due
due and
payable status.
status. There
There are
are no
no assurances
assurances of
of confidentiality
confidentiality provided
provided under
this collection.
this
collection.

HECM
Borrower and
and NBS
Certifications
HECM Borrower
NBS Certifications

U.S. Department
Department of
Housing and
and Urban
Urban Development
(HUD)
U.S.
of Housing
Development (HUD)
HOME
EQUITY CONVERSION
CONVERSION MORTGAGE
HOME EQUITY
MORTGAGE (HECM)
(HECM)

BORROWER AND
AND NON-BORROWING
BORROWER
NON-BORROWING SPOUSE
SPOUSE CERTIFICATIONS
CERTIFICATIONS
Use
Use the
the following
following language
language as
as suggested
suggested models
models for
for Borrower
Borrower and/or
and/or NBS
NBS Certifications:
Certifications:

(1)
Unmarried Borrower
(1) Unmarried
Borrower

At
the Mortgagee
Mortgagee must
the following
following certification
from each
Borrower identified
identified
At closing,
closing, the
must obtain
obtain the
certification from
each Borrower
as
unmarried:
as unmarried:
II hereby
that II am
understand that
that my
HECM loan
hereby certify
certify that
am not
not married
married and
and II understand
my HECM
loan does
does not
not contain
contain
aa deferral
to prevent
the displacement
to whom
whom II
deferral of
of due
due and
and payable
payable status
status to
prevent the
displacement of
of any
any spouse
spouse to
may
become legally
the future.
may become
legally married
married in
in the
future.
(2) Married
Married Borrower
with Non-Borrowing
(2)
Borrower with
Non-Borrowing Spouse
Spouse
At
the Mortgagee
Mortgagee must
the appropriate
from any
Borrower
At closing,
closing, the
must obtain
obtain the
appropriate certification
certification from
any married
married Borrower
with aa Non-Borrowing
Non-Borrowing Spouse
as well
well as
the Non-Borrowing
Non-Borrowing Spouse.
with
Spouse as
as from
from the
Spouse.
(a) Borrower
(a)
Borrower Certification:
Certification: Eligible
Eligible Non-Borrowing
Non-Borrowing Spouse
Spouse
The following
certification is
The
following certification
is required
Borrower identified
identified as
to aa
required from
from each
each Borrower
as married
married to
currently
Eligible Non-Borrowing
Non-Borrowing Spouse:
currently Eligible
Spouse:

II hereby
that II am
legally married
married and
and the
the information
information II have
hereby certify
certify that
am currently
currently legally
have provided
provided
with respect
to my
my spouse,
is true
true and
understand that
that
with
respect to
spouse, __________________,, is
and correct.
correct. II understand
my HECM
my
HECM loan
loan contains
to defer
HECM that
that
contains aa provision
provision to
defer due
due and
and payable
payable status
status of
of my
my HECM
may
the displacement
only
may prevent
prevent the
displacement of
of ___________________,, my
my current
current spouse,
spouse, if
if and
and only
if certain
are and
and continue
to be
be met.
understand that
that this
this deferral
will not
be
if
certain conditions
conditions are
continue to
met. II understand
deferral will
not be
available
to any
may marry
the future.
further understand
understand that
that this
this
available to
any other
other person
person II may
marry in
in the
future. II further
safeguard
will only
to __________________,, my
if:
safeguard will
only remain
remain available
available to
my current
current spouse,
spouse, if:
1. ____________________ remains
remainder of
of my
my life;
life;
1.
for the
the remainder
remains my
my spouse
spouse for
2. II have
truthfully disclosed
the name
and age
age of
to the
the
2.
have truthfully
disclosed the
name and
of my
my current
current spouse
spouse to
Mortgagee;
Mortgagee;
3.
3. ____________________ continues
to occupy
the property
HECM as
as
continues to
occupy the
property securing
securing my
my HECM
their
their Principal
Principal Residence;
Residence;
4.
the HECM
HECM Borrower
Borrower continue
to be
be satisfied
after the
the
4. All
All other
other obligations
obligations of
of the
continue to
satisfied after
death
the last
surviving Borrower;
Borrower; and
and
death of
of the
last surviving
5. All
All other
other terms
5.
terms and
and conditions
the HECM
HECM continue
to be
be satisfied
after my
conditions of
of the
continue to
satisfied after
my death.
death.
I/We, the undersigned, certify under penalty of perjury that the information provided above is true
WARNING: Anyone who knowingly submits a false claim or makes a false statement
and correct. WARNING:
statement
is subject to criminal and/or civil penalties, including confinement for up to 5 years, fines, and civil
287, 1001,
U.S.C. §§ 3729,
§§ 287,
1001, 1010,
1010, 1012,
1012, 1014;
1014; 31
31 U.S.C.
3729, 3802)
3802)
and administrative penalties. (18 U.S.C. §§

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11

HECM
Borrower and
and NBS
Certifications
HECM Borrower
NBS Certifications

(b)
Eligible Non-Borrowing
(b) Eligible
Non-Borrowing Spouse
Spouse Certification
Certification

The
from each
Eligible Non-Borrowing
Non-Borrowing Spouse
The following
following certification
certification is
is required
required from
each currently
currently Eligible
Spouse
of aa HECM
of
HECM Borrower:
Borrower:
that II am
legally married
to _______________,, aa HECM
HECM
II hereby
hereby certify
certify that
am currently,
currently, legally
married to
Borrower, and
the information
is true
true and
and correct.
understand that
that
Borrower,
and the
information provided
provided about
about me
me is
correct. II understand
my
HECM contains
to prevent
my spouse’s
spouse's HECM
contains aa deferral
deferral of
of due
due and
and payable
payable status
status to
prevent my
my
displacement
from the
the property
the death
the last
Borrower under
under
displacement from
property following
following the
death of
of the
last surviving
surviving Borrower
my
HECM, but
but only
if:
only if:
my spouse’s
spouse's HECM,
1. II remain(ed)
1.
the legal
the HECM
HECM Borrower,
Borrower, identified
identified above,
the
remain(ed) the
legal spouse
spouse of
of the
above, for
for the
remainder
[their] life;
life;
remainder of
of [their]
2.
The HECM
2. The
HECM Borrower,
Borrower, identified
identified above,
truthfully disclosed
above, and
and II truthfully
disclosed my
my name
name and
and
age
to the
the Mortgagee;
Mortgagee;
age to
my Principal
3.
to occupy
the property
HECM as
Principal
3. II continue
continue to
occupy the
property securing
securing my
my spouse’s
spouse's HECM
as my
Residence;
Residence;
4. All
other obligations
obligations of
4.
All other
the HECM
HECM Borrower
Borrower continue
to be
be satisfied
the
of the
continue to
satisfied after
after the
and
death
the last
last surviving
surviving Borrower;
Borrower; and
death of
of the
5.
All other
terms and
and conditions
of the
the HECM
HECM continue
to be
be satisfied
the
5. All
other terms
conditions of
continue to
satisfied after
after the
death
the last
last surviving
surviving Borrower.
Borrower.
death of
of the

I/We, the
the undersigned,
undersigned, certify
under penalty
that the
the information
above is
is true
true
I/We,
certify under
penalty of
of perjury
perjury that
information provided
provided above
and correct.
WARNING: Anyone
who knowingly
false claim
false statement
and
correct. WARNING:
Anyone who
knowingly submits
submits aa false
claim or
or makes
makes aa false
statement
is subject
to criminal
including confinement
for up
up to
to 55 years,
years, fines,
fines, and
and civil
civil
is
subject to
criminal and/or
and/or civil
civil penalties,
penalties, including
confinement for
administrative penalties.
penalties. (18
§§ 287,
1001, 1010,
1010, 1012,
1012, 1014;
1014; 31
31 U.S.C.
and administrative
(18 U.S.C.
U.S.C. §§
287, 1001,
U.S.C. §§ 3729,
3729, 3802)
3802)
and
(c)
Borrower Certification:
(c) Borrower
Certification: Ineligible
Ineligible Non-Borrowing
Non-Borrowing Spouse
Spouse
The following
following certification
The
from each
Borrower identified
as married
married to
to an
certification is
is required
required from
each Borrower
identified as
an
Ineligible
Non-Borrowing Spouse:
Ineligible Non-Borrowing
Spouse:

II hereby
that II am
am currently
married, that
that the
the information
information II have
hereby certify
certify that
currently legally
legally married,
have provided
provided
with respect
to my
is true
true and
and correct,
with
respect to
my spouse,
spouse, ________________,, is
correct, and
and my
my spouse
spouse is
is not
not
eligible
and cannot
become eligible
for aa Deferral
Deferral Period
Period for
the following
following reason:
eligible and
cannot become
eligible for
for the
reason:
____ My
My spouse
the property
the HECM
HECM as
their Principal
Principal
as their
spouse does
does not
not occupy
occupy the
property securing
securing the
Residence. My
My spouse’s
Principal Residence
Residence is:
is:
Residence.
spouse's current
current Principal
_______________________________________________________________________.
referenced in
II understand
understand that
that because
because my
is ineligible,
ineligible, the
the Deferral
Deferral Period
Period referenced
in my
my
my spouse
spouse is
HECM will
will not
to prevent
the displacement
HECM
not defer
defer due
due and
and payable
payable status
status to
prevent the
displacement of
of
______________,, my
any other
marry in
in the
the future.
future. II
my current
current spouse,
spouse, or
or any
other person
person II may
may marry
acknowledge
that were
were my
spouse eligible
Deferral Period,
Period, the
the maximum
maximum equity
equity
acknowledge that
my spouse
eligible for
for aa Deferral
. [I
available
to me
under the
the HECM
HECM loan
would be
be $_________.
[I understand
understand that
that because
because
available to
me under
loan would
$
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2

06MFNTgF
Old
.*
466

IIIIIIII

944NDEYOPI

HECM
Borrower and
and NBS
Certifications
HECM Borrower
NBS Certifications

, which
aa Deferral
Deferral Period
Period will
will not
apply, II am
able to
to access
which represents
not apply,
am able
access $_________,
$
represents more
more
1
equity
than II otherwise
would have
been able
to draw
under the
the HECM.V
HECM.] II acknowledge
equity than
otherwise would
have been
able to
draw under
acknowledge
that
that it
it is
is solely
to the
the ineligibility
ineligibility of
my spouse
that the
the access
to $__________
is
solely due
due to
of my
spouse that
access to
$
is
being made
made available
to me.
me. II further
further understand
understand that
that my
lender is
is relying
my lender
relying on
on my
my
being
available to
of my
my spouse
spouse in
in making
making this
loan in
certification
to the
the factual
factual ineligibility
ineligibility of
this HECM
HECM loan
in the
the
certification to
amount
the loan
further acknowledge
that this
this information
is
amount identified
identified in
in the
loan agreement.
agreement. II further
acknowledge that
information is
material
to the
the origination
this loan
loan and
the insurance
this HECM
HECM by
by the
the
material to
origination of
of this
and the
insurance of
of this
Department of
Housing and
Urban Development
Development -- Federal
Federal Housing
Housing Administration.
Administration.
Department
of Housing
and Urban

I/We, the
the undersigned,
undersigned, certify
under penalty
that the
the information
above
I/We,
certify under
penalty of
of perjury
perjury that
information provided
provided above
is true
true and
and correct.
WARNING: Anyone
who knowingly
false claim
is
correct. WARNING:
Anyone who
knowingly submits
submits aa false
claim or
or makes
makes aa
false statement
is subject
to criminal
including confinement
for up
up to
to 55
confinement for
false
statement is
subject to
criminal and/or
and/or civil
civil penalties,
penalties, including
civil and
administrative penalties.
penalties. (18
§§ 287,
1001, 1010,
1010, 1012,
1012,
years, fines,
fines, and
and administrative
(18 U.S.C.
U.S.C. §§
287, 1001,
years,
and civil
1014;
U.S.C. §§ 3729,
3729, 3802)
3802)
1014; 31
31 U.S.C.
(d) Ineligible
Ineligible Non-Borrowing
Certification
(d)
Non-Borrowing Spouse
Spouse Certification
The following
certification is
The
following certification
is required
Non-Borrowing Spouse
required from
from each
each Ineligible
Ineligible Non-Borrowing
Spouse of
of aa
HECM Borrower:
Borrower:
HECM

II hereby
that II am
legally married
married to
to _______________,, aa HECM
HECM
hereby certify
certify that
am currently
currently legally
Borrower, and
and the
the information
information provided
about me
is true
true and
understand that
that
Borrower,
provided about
me is
and correct.
correct. II understand
the Deferral
Deferral Period
Period contained
in my
spouse’s HECM
HECM will
will not
and payable
the
contained in
my spouse's
not defer
defer due
due and
payable
status
to prevent
the property
the death
the last
status to
prevent my
my displacement
displacement from
from the
property following
following the
death of
of the
last
surviving
Borrower because
because II am
become eligible
Deferral
surviving Borrower
am not
not eligible
eligible and
and cannot
cannot become
eligible for
for aa Deferral
Period
for the
Period for
the following
following reason:
reason:
____ II do
the property
the HECM
HECM as
as my
Principal Residence.
Residence. My
My
do not
not occupy
occupy the
property securing
securing the
my Principal
Principal
Principal Residence
Residence is:
is:
_______________________________________________________________________.
II understand
understand that
that because
because II am
am ineligible,
ineligible, the
the Deferral
Deferral Period
Period referenced
spouse’s
referenced in
in my
my spouse's
HECM loan
is inapplicable
will not
to
HECM
loan documents
documents is
inapplicable and
and will
not defer
defer due
due and
and payable
payable status
status to
prevent
acknowledge that
that were
were II eligible
the maximum
prevent my
my displacement.
displacement. II acknowledge
eligible the
maximum equity
equity
available
to my
to access
under the
the HECM
HECM loan
would be
be $_________.
[I
available to
my spouse
spouse to
access under
loan would
$
[I
understand that
that because
because II am
am ineligible
ineligible for
for the
the Deferral
Deferral Period,
Period, my
is able
to
understand
my spouse
spouse is
able to
access
which represents
more equity
than my
would have
, which
represents more
equity than
my spouse
spouse otherwise
otherwise would
have
access $_________,
$
been able
able to
to draw
under their
their HECM.]2
HECM.]2 II acknowledge
that it
it is
is solely
solely due
to my
been
draw under
acknowledge that
due to
my
ineligibility
that access
access to
to this
this equity
is being
being made
to my
ineligibility that
equity is
made available
available to
my spouse.
spouse. II further
further
understand that
that my
spouse’s lender
is relying
to my
understand
my spouse's
lender is
relying on
on my
my certification
certification to
my factual
factual
ineligibility
making this
this HECM
HECM in
in the
the amount
amount identified
in the
the loan
loan agreement.
ineligibility in
in making
identified in
agreement. II
further
acknowledge that
that this
this information
information is
material to
to the
the origination
this loan
and
further acknowledge
is material
origination of
of this
loan and
11

Mortgagees
insert this
in cases
Spouse is
Mortgagees should
should insert
this text
text in
cases where
where the
the Ineligible
Ineligible Non-Borrowing
Non-Borrowing Spouse
is younger
younger than
than the
the Borrower.
Borrower.

22

Mortgagees
insert this
in cases
Spouse is
Mortgagees should
should insert
this text
text in
cases where
where the
the Ineligible
Ineligible Non-Borrowing
Non-Borrowing Spouse
is younger
younger than
than the
the Borrower.
Borrower.

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3

HECM
Borrower and
and NBS
Certifications
HECM Borrower
NBS Certifications

the insurance
this mortgage
by the
the Department
Department of
Housing and
Urban Development
Development -the
insurance of
of this
mortgage by
of Housing
and Urban
Federal
Federal Housing
Housing Administration.
Administration. II consent
to my
gaining access
to this
this equity
consent to
my spouse
spouse gaining
access to
equity
because II acknowledge
and II certify
that II am
and cannot
become eligible
for
eligible for
because
acknowledge and
certify that
am not
not eligible
eligible and
cannot become
aa Deferral
Deferral Period.
Period.
I/We,
the undersigned,
undersigned, certify
under penalty
that the
the information
information provided
is
I/We, the
certify under
penalty of
of perjury
perjury that
provided above
above is
true and
and correct.
WARNING: Anyone
who knowingly
false claim
true
correct. WARNING:
Anyone who
knowingly submits
submits aa false
claim or
or makes
makes aa false
false
statement
is subject
to criminal
including confinement
for up
up to
to 55 years,
years,
statement is
subject to
criminal and/or
and/or civil
civil penalties,
penalties, including
confinement for
civil and
administrative penalties.
penalties. (18
§§ 287,
1001, 1010,
1010, 1012,
1012, 1014;
1014; 31
31
fines, and
and civil
and administrative
(18 U.S.C.
U.S.C. §§
287, 1001,
fines,
3729, 3802)
U.S.C. §§ 3729,
3802)
U.S.C.

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44