EFTA Document EFTA01279834

STATUS CERTIFICATION AFFIDAVIT Borrow er(s): Property Address: Lender: Fifth Third Mortgage Company BEFORE ME, the undersigned authority duly authorized to take acknowledgments and administer oaths, on this day personally appeared the undersigned Borrower(s) who, after being duly sworn on oath stated the following: 1. I/We the undersigned Borrower(s) understands that Lender is granting a mortgage loan (the "Loan") based on the representations made in the Loan application given by the Borrower(s) to Lender I/We hereby certify that all statements related to the Loan application, including but not limited to financial. marital, and employment status, have not changed and to my/our knowledge, will not change in the foreseeable future. The statements of fact regarding occupancy of the Property which is being purchased, improved, refinanced or additionally encumbered with the proceeds of the Loan are the same as represented at time of Loan application. 2. If the Property is being purchased by Borrower(s). the funds for down payment and closing costs are being paid from the source stated on the loan application and there is no secondary financing in this transaction that has not been disclosed to the Lender. I/We certify that if my/our Loan application states that other real estate was to be sold, this is to certify that such transaction has taken place and I/we no longer have title to that real estate. 3. If the Property is currently owned by the Borrower(s), I/we certify that there are no delinquent state. county, city, school, water district, utility district or other governmental taxes or assessments due or owing against said Property, and that no tax suit has been filed by any state, county, municipality. water district, utility district or other governmental agency for taxes or assessments levied against Borrower(s) which have not been disclosed in writing to Lender. I/We also certify that there are no unpaid paving assessments or delinquent owner association dues. 4. There are no suits filed by or pending against Borrower(s) in any federal or state court which have not been disclosed in writing to Lender 5. Borrower(s) acknowledges that this Status Certification Affidavit is given as a material inducement to cause Lender to make the Loan to Borrower(s). Borrower(s) also understands that any false statements, misrepresentations or material omissions may result in civil and criminal penalties. The agreements and covenants contained herein shall survive the closing of this Loan transaction. (Borrower) (Date) (Borrower) (Date) (Borrower) (Date) (Borrower) (Date) THE STATE OF FL COUNTY OF PALM BEACH BEFORE ME, the undersigned authority, on this day appeared , known to me to be the person(s) whose name(s) is subscribed to the foregoing instrument, and acknowledged to me that he executed the same for the purposes and consideration therein expressed. GIVEN UNDER MY HAND AND SEAL OF OFFICE, this 10th 2014 day of December Notary Public. State of FL 4- 305 19207).01 %%IP IA ORTOACIE FORMS 7192 ! 19047010420361321! CONFIDENTIAL SDNY_GM_00030279 EFTA_00I 40897 EFTA01279834