Fillable Printable 26 8084

26 8084

OMB Approved No. 2900-0377

Respondent Burden: 30 minutes

VA FORM

JUN 2006

CLAIM FOR REPURCHASE OF LOAN

(Chapter 37, Title 38, U.S.C., 38 CFR 36.4600)

26-8084

If available, insert the Social Security and/or taxpayer identification

number(s) of all obligors.

This will include any payments remitted to the holder by VA.

Due date of earliest installment not fully satisfied by proper

application of available credits or deposits.

Explain here any advances made to principal since holder purchased

loan from VA and enter total at Item 8G.

Any payments received by the holder after this claim is filed will be

endorsed as appropriate and forwarded to VA.

EXISTING STOCKS OF VA FORM 26-8084, MAR 2001,

WILL BE USED.

Item 4

Item 6A

Item 6H

Item 7

Item 8

1. Executed instrument of reassignment, and/or reconveyance as

prescribed by VA.

2. Instrument evidencing the debt.

3. Security instrument.

4. Title evidence (if any obtained from VA when loan

was purchased).

5. Insurance policies.

6. Any other instruments customarily transferred to a purchaser

incident to the assignment of a loan.

PURSUANT TO 38 CFR 36.4600 ISSUED UNDER CHAPTER 37, TITLE 38, U.S. CODE, THE UNDERSIGNED SUBMITS

CLAIM FOR REPURCHASE OF LOAN AS SET FORTH BELOW.

SUPPORTING DOCUMENTS REQUIRED

7. Receipted tax bill for last period paid.

8. If claimant is an assignee or transferee of the original holder

who purchased this loan from VA, a certified copy of the

instrument of transfer.

9. Statement of account, in duplicate, one certified. This in effect

should be a copy of ledger sheets or equivalent showing amounts

of all debits and credits.

INSTRUCTIONS

NOTE - Use this form when requesting VA to repurchase a

loan under 38 CFR 36.4600. Submit in duplicate.

Signatures are required on the ORIGINAL ONLY. See

below for documents required and Instructions.

CERTIFICATION: The undersigned hereby certifies that the information contained herein is true, accurate and complete, that this is a correct and

valid claim, and that payment therefor has not been received. The undersigned further certifies that it is the owner of the loan identified above.

Federal statutes provide severe penalties for any fraud, intentional misrepresentation or criminal connivance or conspiracy in making any claim upon or against the

Government of the United States, or any department or officer thereof, and obtaining or aiding to obtain the payment or approval of such claim.

1. NAME AND ADDRESS OF HOLDER 2. NAME AND ADDRESS OF OBLIGOR(S)

3. HOLDER’S LOAN NUMBER 4A. OBLIGOR(S) SOCIAL SECURITY NUMBER(S)

4B. OBLIGOR(S) TAXPAYER IDENTIFICATION NUMBER(S) 5. VA LOAN NUMBER

6. SUMMARY OF LOAN ACCOUNT FOLLOWING PURCHASE FROM VA

7. ADVANCES

8. COMPUTATION OF CLAIM FOR REPURCHASE OF VENDEE ACCOUNT

A. TOTAL PAYMENTS

RECEIVED

B. AMOUNT APPLIED TO

TAX & INSURANCE

C. AMOUNT APPLIED

TO INTEREST

D. AMOUNT APPLIED ON

PRINCIPAL

E. LATE CHARGES COLLECTED

F. DATE LAST PAYMENT MADE

G. AMOUNT OF LAST PAYMENT

H. DATE OF FIRST UNCURED DEFAULT

I. INTEREST COLLECTED TO: (Date)

K. INSURANCE PREMIUMS PAID THROUGH (Date)

TYPE PAID THROUGH (Date)

J. TAXES

L. BALANCE IN TAX AND

INSURANCE ACCOUNT

M. PRINCIPAL BALANCE OF LOAN

TOWN OR CITY

COUNTY

OTHER

AMOUNT DATE PURPOSE

ITEM AMOUNT

A. PRINCIPAL BALANCE OF OBLIGOR WHEN LOAN WAS PURCHASED

FROM VA

B. PERCENTAGE OF PAR PAID FOR LOAN

C. AMOUNT PAID FOR LOAN (Not to include any accrued interest. Item 8A X 8B)

D. CREDITS TO PRINCIPAL

E. CREDIT BALANCE IN TAX AND INSURANCE ACCOUNT (Item 6L)

F. SUBTOTAL

G. ADVANCES TO PRINCIPAL

H. UNPAID ACCRUED INTEREST - 38 CFR 36.4600(e)(1) - APPLICABLE ONLY

TO LOANS SOLD AFTER JULY 15, 1970 - USE 365 DAY YEAR BASIS

I. NET AMOUNT CLAIMED UNDER 38 CFR 36.4600(e)

9A. NAME OF CLAIMANT (Type or print) 9B. OFFICIAL SIGNATURE AND TITLE 9C. DATE

THE PAYEE IS ENTITLED, UNDER 38 CFR 36.4600(e), TO

THE PAYMENT OF

AUTHORIZED SIGNATURE DATE

FOR VA

USE ONLY $

$ $ $ $

$ $

NOTE - Please read the Privacy Act and Respondent Burden statements on the

PRIVACY ACT NOTICE: VA will not disclose information collected on this form to any source other than what has been

authorized under the Privacy Act of 1974 or Title 38, Code of Federal Regulations 1.576 for routine uses (e.g., to a member of

Congress inquiring on behalf of a veteran) as identified in the VA system of records, 55VA26, Loan Guaranty Home, Condominium

and Manufactured Home Loan Applicant Records, Specially Adapted Housing Applicant Records, and Vendee Loan Applicant

Records - VA, and published in the Federal Register. Your obligation to respond is mandatory under 38 CFR 36.4600.

RESPONDENT BURDEN: We need this information in order to determine the amount payable under 38 CFR 36.4600. Title 38,

U.S.C. 3710 allows us to ask for this information. We estimate that you will need an average of 30 minutes to review the instructions,

find the information, and complete this form. VA cannot conduct or sponsor a collection of information unless a valid OMB control

number is displayed. You are not required to respond to a collection of information if this number is not displayed. Valid OMB

control numbers can be located on the OMB Internet Page at www.whitehouse.gov/omb/library/OMBINV.VA.EPA.html#VA . If

desired, you can call 1-800-827-1000 to get information on where to send comments or suggestions about this form.