Request for Verification of Gift/Gift Letter - Part I - Request and Part II - To be Completed by Donor

Sep 15, 2026

A USDA Rural Housing Service gift verification form for monetary gifts intended to support a home purchase. The lender completes items 1–7 and the applicants complete item 8, then the form is transmitted directly to the donor. The donor completes Part II by providing gift amount, phone number, relationship to the applicant, and a statement and signature confirming no repayment is expected. Includes donor instructions and a Privacy Act statement describing authorization, voluntary disclosure, and routine disclosures.

LanguageEnglish

CategoryForms

FormatPDF

Pages2

Reading Time1 min

AccessFree to download

REQUEST FOR VERIFICATION OF GIFT/GIFT LETTER

Part I - Request

Part II - To be Completed by Donor

PRIVACY ACT STATEMENT TO REFERENCES

United States Department of AgricultureRural Housing Service # REQUEST FOR VERIFICATION OF GIFT/GIFT LETTER Instructions:Lender-Complete items 1 through 7.Have applicants complete item 8.Forward directly to donor listed in item 1.Donor-Please complete items 9 through 12 as applicable and return directly to lender named in item 2.The form is to be transmitted directly to the donor and is not to be transmitted through the applicant or any other party. ## PartI-Request | 1.To(Name and Address of Donor) | | 2.From(Name and Address of Lender) | | | | --- | --- | --- | --- | --- | | 3.Signature of Lender | 4.Title | | 5.Date | 6.Loan Number(Optional) | | | | | | | | 7.Name and Address of Applicant(s) | | 8.Signature of Applicants | | | | | | X | | | | | | X | | | We have been advised that you are the donor of a monetarygift to the aplicant(s)for the purpose of a home purchase.Please complete PartII below. ## Part Ⅱ-To be Completed by Donor | 9.Dollar Amount of Gift | 10.Donor's Phone Number | 11.Relationship to Applicant | | --- | --- | --- | | | | | 12.Donor's Statement and SignatureI state that no repayment of this gift is expected. (Signature) Date: According to the Paperwork Reduction Act of 1995,no persons are required to respond to a collection of information unless it displays a valid OMBcontrol number.The valid OMB control number for this information collection is 0575-0172.The time required to complete this information collectionis estimated to average 5 minutes per response,including the time for reviewing instructions,searching existing data sources,gathering and maintainingthe data needed,and completing and reviewing the collection of information. (Signature) UNITED STATES DEPARTMENT OF AGRICULTURERural Development # PRIVACY ACT STATEMENT TO REFERENCES Rural Development is authorized by the Consolidated Farm and Rural Development Act(7 U.S.C.1921 et.seq.);and Title V of the Housing Act of 1949,as amended(42 U.S.C.1471 et.seq.),to solicit theinformation requested. Disclosure of the information requested is voluntary.However,information provided is of considerablevalue to Agencies in determining the repayment ability of individuals and their eligibility for Agencyprograms.There willbe no consequences to you ifyou do not provide the information requested. Your name,and the information you provide,willbe released to the applicant at the applicant's request.Some information will be available to any requester under the provisions of the Freedom of Information Act. The information you provide may be referred to another agency,whether Federal,State,local or foreign,charged with the responsibility of investigating or prosecuting a violation of law,or of enforcing or implementing the statute,rule,regulation or order issued pursuant thereto,ofany record within this system wheninformation available indicates a violation oflaw,whether civil,criminal or regulatory in nature,and whetherarising by general statute or particular program statute,or by rule,regulation or order issued pursuant thereto. Rural Development is a Equal OpportunityLender.Complaints of discrimination based on race,sex,religion,national origin or marital status should be sent to:Secretary of Agriculture.Washington D.C.20250

FAQs

Who completes Part I of the Request for Verification of Gift/Gift Letter?

The lender completes items 1 through 7, and the applicants complete item 8. The lender then forwards the form directly to the donor listed in item 1.

What information does the donor provide in Part II?

In Part II, the donor enters the dollar amount of the gift, donor phone number, relationship to the applicant, and signs a statement confirming no repayment of the gift is expected.

Does the Privacy Act statement require respondents to provide information?

Disclosure is voluntary, and there are no consequences if the information requested is not provided. The statement explains authorization to solicit information and how it may be used or disclosed.

Sep 15, 2026

Uploaded by Caleb Sterling