Mail To:

Department of Housing & Urban Development
HUD Mortgage Insurance Lists
P.O. Box 9500
Springfield, VA 22151

Enter The State Listing Abbreviations
I wish to order the following listings. FEE*

HUD-________________________ ______

HUD-________________________ ______

HUD-________________________ ______

HUD-________________________ ______

HUD-________________________ ______

HUD-________________________ ______

Value of order / Handling
$10.00 or less / $2.00
$10.01 - $50.00 / $4.00
$50.01 - $100.00 / $8.00
over $100.00 / $8.00

Handling Fee ____
Total ____

Method of Payment - payable to HUD: Check One
__ Certified Or Cashier's Check __ Money Order
(no personal checks or cash)

PURCHASER INFORMATION:

______________________________
Name

______________________________
Co. Name / Organization (if applicable)

______________________________
Address

______________________________

______________________________
City / State / Zip

______________________________
Telephone (including area code)

*The Fee Covers Only Document Search And Duplication Costs And Is Not A Charge For Merchandise. Therefore, The Fee Is Non-Refundable.

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