| IX. ACKNOWLEDGMENT AND AGREEMENT | |||
| The undersigned
specifically acknowledge(s) and agree(s) that: (1) the loan
requested by this application will be secured by a first mortgage or
deed of trust on the property described herein; (2) the property
will not be used for any illegal or prohibited purpose or use; (3)
all statements made in this application are made for the purpose of
obtaining the loan indicated herein; (4) occupation of the property
will be as indicated above; (5) verification or reverification of
any information contained in the application may be made at any time
by the Lender, its agents, successors and assigns, either directly
or through a credit reporting agency, from any source named in this
application, and the original copy of this application will be
retained by the Lender, even if the loan is not approved; (6) the
Lender, its agents, successors and assigns will rely on the
information contained in the application and I/we have a continuing
obligation to amend and/or supplement the information provided in
this application if any of the material facts which I/we have
represented herein should change prior to closing; (7) in the event
my/our payments on the loan indicated in this application become
delinquent, the Lender, its agents, successors and assigns, may in
addition to all their other rights and remedies, report my/our
name(s) and account information to a credit reporting agency; (8) be
transferred to an agent, successor or assign of the Lender with
prior notice to me; (9) the Lender, its agents, successors and
assigns make no representation or warranties, express or implied, to
the Borrower(s) regarding the property, the condition of the
property, or the value of the property. Certification: I/We certify that the information provide in this application is true and correct as of the date set forth opposite my/our signature(s) on this application and acknowledge my/our understanding that any intentional or negligent misrepresentation(s) of the information contained in this application may result in civil liability and/or criminal penalties including, but not limited to, fine or imprisonment or both under the provisions of Title 18, United States Code, Section 1001, et seq. and liability for monetary damages to the Lender, its agents, successors and assigns, insurers and any other person may suffer any loss due to reliance upon any misrepresentation which I/we have made on this application. | |||
| Borrower's
Signature X |
Date | Co-Borrower's
Signature X |
Date |
| X. INFORMATION FOR GOVERNMENT MONITORING PURPOSES | |||
| The following information is requested by the Federal Government for certain types of loans related to a dwelling. In order to monitor the lender's compliance with Equal Credit Opportunity, Fair Housing and Home Mortgage Disclosure laws. You are not required to furnish this information, but are encouraged to do so. The law provides that a lender may neither discriminate on the basis of this information, nor on whether you choose to furnish it. However, if you choose not to furnish it, under Federal regulations this Lender is required to note race and sex on the basis of visual observation or surname. If you do not wish to furnish the above information, please check the box below. Lender must review the above material to assure that the disclosure satisfy all requirements to which the Lender is subject under applicable state law for the particular type of loan applied for. | |||
| BORROWER Race/National Origin: |
CO-BORROWER Race/National Origin: Other (specify) _________________ | ||
| Sex:
|
Sex: | ||
| To be
Completed by Interviewer This application was taken by: |
Interviewer's
Name (print or type)
__________________________________________ __________________________________________ |
Name and Address Interviewer's Employer | |