Officers & Owners Information

List all officers directly involved in managing, overseeing, or conducting the FHA business of the applicant. For each entry, select the appropriate category (Individual or Company/Corporation) and complete the section that applies. Designate an Officer in Charge to continue.

List all Individual and Corporate owners, including ownership percentage. Total ownership percentage must equal 100% to continue.

Individual (Officer and/or Owner)

Salutation:
	First	MI	Last
Individual Name			*
Job Title	*
SSN	--*
Officer In Charge
Email	*		Email and Verify Email addresses must be identical
Verify Email	*

Percent Ownership	% *

Company/Corporation (Owner)

Company Name	*
Tax Identification Number	- *

Percent Ownership	% *

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U.S. Department of Housing and Urban Development

451 7th Street, S.W., Washington, DC 20410

T: (202) 402-3815

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