Request for Verification of Mortgage Loan or Credit Union Privacy Act Notice: This informations oe Used bythe agency colectng a its assignees in detwmining whether you quily 38a prospective mongagor under is program. ity rol be cecoses cts the agency excopt as required and permited by Iaw. You donot have fo provide his inlrmation, but You do net your applcalion fe approval 2a prospective morigagr or borawsr may bs delayed or ojeced. The ilormation requested in rs orm is sultorzedby Tile 38, USC, Chapin 37 (VA) by 12 USC, Section 1701s 59. (L HUD/FEAI: by 42 USC, Section 14520 (1 MUO/CPO): and Tis 42 USO, 1471 et. sag, oF 7 USC, 1921 et sag. USDAVE MHA) Tnetrucions: Lender — Compile ligms 1 trough &. Have appicanfe) comets Pat ld, and ioward areal to Credior named in Pat tom {Shelora7Credtor — Plaza complete Pan ana retin arecy 6 Land froes Pat hem 2 __Thavtormis tobe tranemiied drecty to th lander and ts net bo tranarted through the applant or any other party. Part |= Request To Tare and aess of Wargago HOIde RG UnerV AROS) ] & From (ass ana Rios ofan 3 Landare Na, (Opianat [7 Tatoos oe Vere’ Proper Actress {ecountia Name ot {oan (hecour) amber “EW ane Aaron 0 Aopcarte [5 Sigur a pica) x x Part il - To Be Completed by Mortgagee/Creditor ‘Wa fave received an applicalion fora loan from the above, o whom we understand you have exlended a loan or rent Tn addlion To the information requested below please furnish us with any information you might have that will assist us in processing this loan. 10. ORIGINAL LOAN AMOUNT, ORIGINATION DATE] 11. MONTHLY PAYMENT Includes: Taxes = YES ONO 8. Insurance @ Yes a NO 8. 12. PRESENT LOAN BALANCE DATE OF MATURITY | 18. TYPEOFLOAN (checkone) SS —_— (COFHA [VA [CONVENTIONAL 14, Specity number of late payments in the past 12 months: 15, Isaccountcurrent C}_ yes Ono 16. REMARKS: 7. SIGNATURE OF MORTGAGEE ia, WILE OF MORTGAGEE [7a bare (GENESIS 2000, NC. 160” (800) 82-0508 Farm VON2 (03/88) RETURN DIRECTLY TO LENDER