Instructions for Form RD 3560-31

IDENTITY OF INTEREST DISCLOSURE/QUALIFICATION CERTIFICATE

This form is to be used for Multi-Family Housing Loans to record the qualifications of

Identity of Interest (IOI) entities.

Fld Name / Item No.	Instruction
Item 1	Insert loan applicant/borrower name.
Item 2	Information on applicant/borrower project.
Item 3	Print applicant/borrower name.
Item 4	Insert date executed by applicant/borrower.
Item 5	Signature of applicant/borrower.
Item 6	Insert name of entity that has IOI with loan applicant, e.g., contractor, subcontractor, supplier, or management agent.
Item 7	Insert Address, Telephone Number, Taxpayer Information Number, Number of Full-Time Employees, Part-Time Employees, and Number of Years in Business on entity listed in Item 6.
Item 8	Insert Name of personnel responsible for completion of the contracted work of entity listed in Item 6.
Item 9	Insert Name, Address, Home Phone Number, Social Security Number, Years in Business, Training, and License(s) held (include numbers) of Principal of IOI Entity listed in Item 6.
Item 10	Insert Name, Address and Telephone Number of Licensing Agencies to persons listed in Item 9.
Item 11	Insert percent of compensation received by person listed in Item 9.
Item 12	Disclose any criminal convictions or debarment from Local, State or Federal Government Programs of person listed in Item 9.
Item 13	Disclose any Current or Pending Legal Actions Against the Company or any of its Principals listed in Item 6.
Item 14	Attach Fee Schedule for all Companies listed in Item 6.
Item 15	Signature of IOI entity principal.
Item 16	Insert Date this Form is signed.