FHA Case Number Assignment Request Form
 
 




Broker Info
RLI Loan Number
Broker Company Name
Broker Contact
Loan Officer Name
Phone
Email
EIN
NMLS ID
Borrower Info
Borrower Name
(Last, First MI)
SSN/ TIN
Date of Birth
(MM-DD-YYY)
Borr1  
  
Borr2  
  
Borr3  
  
Borr4  
  
Property Information (must be COMPLETE legal address)
House No  
Unit  
Month/Year Built (MM-YYY)  
Complete Street Name  
City  
State  
Zip Code  
Units  
County  
Property Type  
Loan Type  
Loan Information
Loan Term  
 Purchase   Refinance
If Refinance  Prior FHA   Prior Conventional
Streamline Refinance  Yes   No
Streamline Refinance With Appraisal  Yes   No
If purchase, was this case previously sold as a Real Estate Owned (HUD Previously Sold)  Yes   No
Prior FHA or Prior REO Case Number (i.e. 123-1234567):  
Is this property a Condo  Yes   No
Condo Project Approved  Yes   No
FHA Project ID  
Projected Closed Date