SAMS1106c Invoice Transmittal Continuation

Single Family Acquired Asset
Management System (SAMS)

Invoice Transmittal Continuation

U.S. Department of Housing
and Urban Development
Office of Housing
Federal Housing Commissioner

Instructions: This form must be attached to a completed form SAMS-1106. Send completed form to local HUD HOC, Attn: M&M Contractor GTR/GTM.
Note: Item numbers correspond to form SAMS-1106

Place M & M's Stamp Here, If applicable

1. System Generated Transmittal Number

6. Payee's NAID

7. Payee's Name

11. Invoice No. 12. Invoice Date

13. PO/CO/WO

14. Description

Total number of invoices for this page

15. PC 16. FHA Case Number

17. AMT. Per PC

Subtotal for this page

18. Invoice Total

$

To the best of my knowledge, all the information stated herein, as well as any information provided in the accompaniment herewith, is true and accurate.
Warning: HUD will prosecute false claims and statements. Conviction may result in criminal and/or civil penalties. (18 U.S.C. 1001, 1010, 1012; 31 U.S.C. 3729, 3802)
19. Preparer's Signature & Title (M&M Contractor/Closing Agent/SF REO staff)

22. Date signed (mm/dd/yyyy)

X

Previous edition is obsolete

form SAMS-1106-C (3/99)
ref Handbook 4310.5