[Program] Loan Program
Appliance Form

INSTRUCTIONS: This form is only needed on FHA 203K Limited or new construction end loans when:
•	Appliances are included in an FHA 203K Limited Rehabilitation Escrow Account; or
•	Appliances or other personal property are included in new construction and the borrower and/or seller do not sign a Personal Property Addendum to remove the personal property from the purchase agreement.	

Execute the form completely, attach required documentation and retain in the loan file.

Minnesota Housing Loan: [MHFA Loan Number]
Borrower(S)
[Borrower Full Name 1][Before Borrower 2][Borrower Full Name 2][Before Borrower 3][Borrower Full Name 3][Before Borrower 4][Borrower Full Name 4]

Lender Information
[Lender Name]		[Lender Loan Number]	
Lending Partner		Lending Partner Loan #	
				[Loan Number]	
Contact Person		Contact Phone #		Minnesota Housing Loan #	

The transaction includes the following appliances:
√ Documentation attached	Appliance/Personal Property		Cost/Value*	
		$		
		$		
		$		
		$		
		$		
Total Cost/Value	$		

*Attach documentation of the price paid by the borrower. If the borrower paid less than market value, attach documentation of the market value.

The appliances/personal property in the transaction are funded by the following:
A.	Borrower Cash to Close	$		
B.	Minnesota Housing Downpayment and Closing Cost Loan	$	[DPA Loan Amount]	
C.	Other Community Second funds (grants or liens)	$		
	Total non-MRB investment/financing (A+ B+ C)	$		

The total cost/value of the appliances/personal property is less than or equal to the non-MRB investment/financing, and there are no other costs (i.e. non-appliance personal property) ineligible for Minnesota Housing mortgage revenue bond financing.

					
Name of Preparer		Title of Preparer		Date