II. PROPERTY INFORMATION AND PURPOSE OF · 2018-07-27 · V. MONTHLY INCOME AND COMBINED HOUSING...

asThis application is designed to be completed by the applicant(s) with the Lender's assistance. Applicants should complete this form as "Borrower" or "Co-Borrower," (includingthe income or assets of a person other than the "Borrower" applicable. Co-Borrower information must also be provided (and the appropriate box checked) when

rightsor the income or assets of the Borrower's spouse or other person who has community property the Borrower's spouse) will be used as a basis for loan qualification propertypursuant to state law will not be used as a basis for loan qualification, but his or her liabilities must be considered because the spouse or other person has community

relyingrights pursuant to applicable law and Borrower resides in a community property state, the security property is located in a community property state, or the Borrower is on other property state as a basis for repayment of the loan.

LOANI. TYPE OF MORTGAGE AND TERMS OF

loan.Complete this line if construction or construction-permanent

ApplicationUniform Residential Loan

LOANII. PROPERTY INFORMATION AND PURPOSE OF

Mortgage VA Conventional (explain):Other

for:Applied FHA USDA/RuralServiceHousing

6/09Freddie Mac Form 65

Borrower Co-Borrower

4 of

AmortizationType:

RateFixed (explain):Other

GPM (type):ARM

Amount

$

RateInterest

%

MonthsNo. of

EmployedSelf Name & Address of Employer

code)Business Phone (incl.area Position/Title/Type of Business

(from-to)Dates

Monthly Income

$

If employed in current position for less than two years or if currently employed in more than one position, complete the following:

EmployerName & Address of EmployedSelf

code) Business Phone (incl.area Position/Title/Type of Business

UnitsNo. of

BuiltYear

be:Property will Secondary Primary

Investment Residence Residence

loan.Complete this line if this is a refinance

(a+b)Total of (b) Cost of Improvements (a) Present Value of Lot Amount Existing Liens Original Cost Year Lot Acquired

$ $ $ $ $

madeto be made

$Cost:

Name(s)Title will be held in what

(explain)Source of Down Payment, Settlement Charges and/or Subordinate Financing

heldManner in which Title will be Estate will be held in:

Fee Simple

Leaseholddate)(show expiration

applicable)Co-Borrower's Name (include Jr. or Sr. if

Unmarried (include single, Married widowed)divorced,

Separated

applicable)Borrower's Name (include Jr. or Sr. if

)codearea incl. (Home Phone Social Security Number

Co-Borrower)Dependents (not listed by ages no.

Unmarried (include single, Married divorced, widowed)

Separated

Borrower)Dependents (not listed by ages no.

ZIP)Present Address (street, city, state,

Yrs.No. _______ Rent Own

ZIP)Present Address (street, city, state,

Yrs.No. ______ Rent Own

AddressMailing Address, if different from Present

Yrs.No. _______ Rent Own

ZIP)Former Address (street, city, state, ZIP)Former Address (street, city, state,

If residing at present address for less than two years, complete the following:



jobYrs. on this

Yrs. employed in this line of

work/profession



jobYrs. on this

Yrs. employed in this line of work/profession





(from-to)Dates

Monthly Income

$

(from-to)Dates

Monthly Income

$

(from-to)Dates

Monthly Income

$

Yrs.No. ______ Rent Own

ImprovementsDescribe Purpose of Refinance Amount Existing Liens Original Cost Year Acquired

$ $

INFORMATIONIV. EMPLOYMENT

INFORMATIONIII. BORROWER Borrower Co-Borrower

ZIP)Subject Property Address (street, city, state &

necessary)Legal Description of Subject Property (attach description if

Loan Purpose of Purchase Construction (explain):Other

Refinance

NumberLender Case Agency Case Number

6/09Fannie Mae Form 1003

SchoolYrs.

Construction-Permanent

(MM/DD/YYYY)DOB )codearea incl. (Home Phone Social Security Number SchoolYrs. (MM/DD/YYYY)DOB

AddressMailing Address, if different from Present

722-3498- (800) Distributed by FIPCO®

below):If this is an application for joint credit, Borrower and Co-Borrower each agree that we intend to apply for joint credit (sign

Co-BorrowerBorrower

eFIPCO

INFORMATIONV. MONTHLY INCOME AND COMBINED HOUSING EXPENSE

statements.*Self Employed Borrower(s) may be required to provide additional documentation such as tax returns and financial

IncomeDescribe Other Alimony, child support, or separate maintenance income need not be revealed if the Borrower (B) Notice: loan.or Co-Borrower (C) does not choose to have it considered for repaying this B/C Monthly Amount

$

of 4

soThis Statement and any applicable supporting schedules may be completed jointly by both married and unmarried Co-Borrowers if their assets and liabilities are sufficiently joined wasthat the Statement can be meaningfully and fairly presented on a combined basis; otherwise, separate Statements and Schedules are required. If the Co-Borrower section

also.completed about a non-applicant spouse or other person, this Statement and supporting schedules must be completed about that spouse or other person

List the creditor's name, address and account number for all outstanding.Liabilities and Pledged Assetsdebts, including automobile loans, revolving charge accounts, real estate loans, alimony, child support,stock pledges, etc. Use continuation sheet, if necessary. Indicate by (*) those liabilities, which will besatisfied upon sale of real estate owned or upon refinancing of the subject property.

LIABILITIES &Monthly Payment PayMonths Left to

ASSETS Cash or Market ValueDescription

by:Cash deposit toward purchase held

UnionName and address of Bank, S&L, or Credit

Acct No.


Acct No.


No.Acct


Acct No.

name/numberStocks & Bonds (Company description)

valueLife Insurance net cash

$ Face amount:

Real Estate owned (enter market value owned)from schedule of real estate

Vested interest in retirement fund

year)Automobiles owned (make and

Other Assets (itemize)

belowList checking and savings accounts

$ $ Payment/Months Name and address of Company

no.Acct.


no.Acct.


no.Acct.

Subtotal Liquid Assets

a.Total Assets $ b.Total Liabilities $

MaintenanceAlimony/Child Support/Separate Payments Owed to:

etc.)Job Related Expenses (child care, union dues,

JointlyNot Jointly Completed

LIABILITIESVI. ASSETS AND

PaymentsTotal Monthly

Total Co-Borrower Borrower Gross Monthly Income

Income*Base Empl.

Overtime

Bonuses

Commissions

Dividends/Interest

IncomeNet Rental

Total $ $ $

Monthly Combined ExpenseHousing

Rent $

(P&I)First Mortgage $

(P&I)Other Financing

InsuranceHazard

TaxesReal Estate

InsuranceMortgage

Dues.Homeowner Assn

Other:

Total $ $

Present Proposed

no.Acct.


no.Acct.


no.Acct.


no.Acct.

completing,Other (before "describesee the notice in

below)other income,"

$

$

$

$

$

$

$

$

$

$

$

$

$

$

$

$

$ $ $

ownedNet Worth of business(es) (attach financial statement)

$

Balance Unpaid


Net Worth b)(a minus

6/09Fannie Mae Form 1003 722-3498- (800) Distributed by FIPCO®


of 4

BorrowerNo Yes No Yes

TRANSACTIONVII. DETAILS OF

sheet.)(If additional properties are owned, use continuation Owned Schedule of Real Estate

SignatureCo-Borrower's Date

XSignatureBorrower's Date

pendingProperty Address (enter S if sold, PS if sale or R if rental being held for income)

Totals

If you answer "Yes" to any questions a through i, please use continuationsheet for explanation.

List any additional names under which credit has previously been received and indicate appropriate creditor name(s) and account number(s):

Account NumberCreditor Name Alternate Name

Purchase price a.

Alterations, improvements, repairs b.

Land (if acquired separately) c.

off)Refinance (incl. debts to be paid d.

Estimated prepaid items e.

Estimated closing costs f.

PMI, MIP, Funding Fee g.

pay)Discount (if Borrower will h. h)Total costs (add items a through i.

financingSubordinate j.

Borrower's closing costs paid by Seller k.

(explain)Other Credits l.

amountm. Loan financed)(exclude PMI, MIP, Funding Fee

Cash from/to Borrower p. i)(subtract j, k, l & o from

Are there any outstanding judgements against you?

Have you been declared bankrupt within the past 7 years?

Are you presently delinquent or in default on any Federal debt or any otherloan, mortgage, financial obligation, bond, or loan guarantee? If "Yes," give details as described in the preceding question.

Are you obligated to pay alimony, child support, or separate maintenance?

borrowed?Is any part of the down payment

note?Are you a co-maker or endorser on a

Have you had an ownership interest in a property in the last three years?

X

creditThe 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 mayopportunity, 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

race,not discriminate either on the basis of this information, or on whether you choose to furnish it. If you furnish the information, please provide both ethnicity, and race. For basisyou may not check more than one designation. If you do not furnish ethnicity, race, or sex, under Federal regulations, this lender is required to note the information on the

theof visual observation or surname if you have made this application in person. If you do not wish to furnish the information, please check the box below. (Lender must review for.)above material to assure that the disclosures satisfy all requirements to which the Lender is subject under applicable state law for the particular type of loan applied

BORROWER

Sex:

I do not wish to furnish this information

Female

This information was provided:In a face-to-face interview In a telephone interviewBy the applicant and submitted by fax or mailBy the applicant and submitted via e-mail or the Internet

VI. ASSETS AND LIABILITIES (Continued)

DECLARATIONSVIII.

AGREEMENTACKNOWLEDGMENT AND IX.

INFORMATION FOR GOVERNMENT MONITORING PURPOSESX.

6/09Fannie Mae Form 1003

To be Completed by Loan Originator:

Race:

inHave you directly or indirectly been obligated on any loan which resulted foreclosure, transfer of title in lieu of foreclosure, or judgment?

improvement(This would include such loans as home mortgage loans, SBA loans, home financialloans, educational loans, manufactured (mobile) home loans, any mortgage,

andobligation, bond, or loan guarantee. If "Yes," provide details, including date, name action.)address of Lender, FHA or VA case number, if any, and reasons for the

Citizen?Are you a U.S.

alien?Are you a permanent resident

Hispanic or Latino LatinoHispanic or Not or Black

African American orAmerican Indian

Alaska Native Asian

Male

CO-BORROWER

Sex:

I do not wish to furnish this information

Female

Black or AmericanAfrican Asian

Male

Co-Borrower

Have you had property foreclosed upon or given title or deed in lieuthereof in the last 7 years?

lawsuit?Are you a party to a

Do you intend to occupy the property as your primary residence?If "Yes," complete question m below.

a.

b.c.

d.

e.

f.

g.

h.

i.

j.

k.

l.

m.

RentalNet Income

Insurance,Maintenance,

Taxes & Misc. Mortgage

Payments Gross

Rental Income ofAmount

Mortgages & Liens Present

Market Value ofType

Property

$

$ $ $ $ $ $

$ $ $ $ $

jointly(2) How did you hold title to the home – solely by yourself (S), (O)?with your spouse (SP), or jointly with another person

(PR),(1) What type of property did you own – principal residence (IP)?second home (SH), or investment property

PMI, MIP, Funding Fees financed n.

Loan amount (add m & n) o.

Ethnicity: Ethnicity:

orNative Hawaiian IslanderOther Pacific

White

Hispanic or Latino LatinoHispanic or Not

orNative Hawaiian IslanderOther Pacific

White

orAmerican Indian Alaska Native

Each of the undersigned specifically represents to Lender and to Lender's actual or potential agents, brokers, processors, attorneys, insurers, servicers, successors and assignsand agrees and acknowledges that: (1) the information provided in this application is true and correct as of the date set forth opposite my signature and that any intentional ornegligent misrepresentation of this information contained in this application may result in civil liability, including monetary damages, to any person who may suffer any loss due toreliance upon any misrepresentation that I have made on this application, and/or in criminal penalties including, but not limited to, fine or imprisonment or both under theprovisions of Title 18, United States Code, Sec. 1001, et seq.; (2) the loan requested pursuant to this application (the "Loan") will be secured by a mortgage or deed of trust on theproperty described in this application; (3) the property will not be used for any illegal or prohibited purpose or use; (4) all statements made in this application are made for thepurpose of obtaining a residential mortgage loan; (5) the property will be occupied as indicated in this application; (6) the Lender, its servicers, successors or assigns may retainthe original and/or an electronic record of this application, whether or not the Loan is approved; (7) the Lender and its agents, brokers, insurers, servicers, successors, and assignsmay continuously rely on the information contained in the application, and I am obligated to amend and/or supplement the information provided in this application if any of thematerial facts that I have represented herein should change prior to closing of the Loan; (8) in the event that my payments on the Loan become delinquent, the Lender, itsservicers, successors or assigns may, in addition to any other rights and remedies that it may have relating to such delinquency, report my name and account information to one ormore consumer credit reporting agencies; (9) ownership of the Loan and/or administration of the Loan account may be transferred with such notice as may be required by law; (10)neither Lender nor its agents, brokers, insurers, servicers, successors or assigns has made any representation or warranty, express or implied, to me regarding the property or thecondition or value of the property; and (11) my transmission of this application as an "electronic record" containing my "electronic signature," as those terms are defined inapplicable federal and/or state laws (excluding audio and video recordings), or my facsimile transmission of this application containing a facsimile of my signature, shall be aseffective, enforceable and valid as if a paper version of this application were delivered containing my original written signature.

Acknowledgement. Each of the undersigned hereby acknowledges that any owner of the Loan, its servicers, successors and assigns, may verify or reverify any informationcontained in this application or obtain any information or data relating to the Loan, for any legitimate business purpose through any source, including a source named in thisapplication or a consumer reporting agency.

Race:

722-3498- (800) Distributed by FIPCO® 6/09Freddie Mac Form 65

Loan Originator's Signature

Loan Originator's Name (print or type)

Loan Origination Company's Name

Loan Originator Identifier

Loan Origination Company Identifier

Loan Originator's Phone Number (including area code)

Loan Origination Company's Address

DateX

APPLICATIONSHEET / RESIDENTIAL LOAN CONTINUATION youUse this continuation sheet if theneed more space to complete

Application.Residential Loan forC or for Borrower BMark

Co-Borrower.

Borrower:

Co-Borrower:

Number:Agency Case

Number:Lender Case

I/We fully understand that it is a Federal crime punishable by fine or imprisonment, or both, to knowingly make any false statements concerning any of seq.the above facts as applicable under the provisions of Title 18, United States Code, Section 1001, et

of 4

XX

SignatureCo-Borrower's DateSignatureBorrower's Date

6/09Fannie Mae Form 1003 722-3498- (800) Distributed by FIPCO®


–

Demographic Information Addendum. This section asks about your ethnicity, sex, and race.

Demographic Information of Borrower

The purpose of collecting this information is to help ensure that all applicants are treated fairly and that the housing needs of communities and neighborhoods are being fulfilled. For residential mortgage lending, Federal law requires that we ask applicants for their demographic information (ethnicity, sex, and race) in order to monitor our compliance with equal credit opportunity, fair housing, and home mortgage disclosure laws. You are not required to provide this information, but are encouraged to do so. You may select one or more designations for "Ethnicity" and one or more designations for "Race." The law provides that we may not discriminate on the basis of this information, or on whether you choose to provide it. However, if you choose not to provide the information and you have made this application in person, Federal regulations require us to note your ethnicity, sex, and race on the basis of visual observation or surname. The law also provides that we may not discriminate on the basis of age or marital status information you provide in this application. If you do not wish to provide some or all of this information, please check below.

Ethnicity: Check one or moreHispanic or Latino

Mexican Puerto Rican CubanOther Hispanic or Latino Print origin:

For example: Argentinean, Colombian, Dominican, Nicaraguan, Salvadoran, Spaniard, and so on.

Not Hispanic or LatinoI do not wish to provide this information

SexFemaleMale I do not wish to provide this information

Race: Check one or moreAmerican Indian or Alaska Native – Print name of enrolled or principal tribe: Asian

Asian Indian Chinese FilipinoJapanese Korean VietnameseOther Asian – Print race:For example: Hmong, Laotian, Thai, Pakistani, Cambodian, and so on.

Black or African AmericanNative Hawaiian or Other Pacific Islander

Native Hawaiian Guamanian or Chamorro Samoan Other Pacific Islander – Print race:

For example: Fijian, Tongan, and so on. WhiteI do not wish to provide this information

To Be Completed by Financial Institution (for application taken in person):

Was the ethnicity of the Borrower collected on the basis of visual observation or surname? NO YESWas the sex of the Borrower collected on the basis of visual observation or surname? NO YESWas the race of the Borrower collected on the basis of visual observation or surname? NO YES

The Demographic Information was provided through:

Face-to-Face Interview (includes Electronic Media w/ Video Component) Telephone Interview Fax or Mail Email or Internet

Borrower Name:Uniform Residential Loan Application Freddie Mac Form 65 • Fannie Mae Form 1003 Revised 09/2017 EFM1003DADDM Rev 11/17 Distributed by FIPCO® - (800) 722-3498

eFIPCO

APPRNO (2/14)© 2014 Wisconsin Bankers Association/Distributed by FIPCO®

NOTICE OF RIGHT TO RECEIVE COPY OF APPRAISAL

To Mortgage Loan Applicant(s):

Application Dated

We may order an appraisal to determine the property’s value and charge you for this appraisal. We will promptly give you a copy of any appraisal, even if your loan does not close.

You can pay for an additional appraisal for your own use at your own cost.

Additional Provisions:

)noitazinagrO fo epyT(

EAPPRNO Rev. 5/2016

*01092014%842*

Jackson County Bank8 Main Street, PO Box 490Black River Falls, WI 54615

xSignature

xSignature

FACT ACT ADDENDUM TO UNIFORM RESIDENTIAL LOAN APPLICATION

Applicants:

This Addendum supplements and is made a part of the attached Uniform Residential LoanApplication.

We acknowledge that income from medical insurance, disability or wage continuation insuranceneed not be revealed in the description of other income on page 2 of the Uniform ResidentialLoan Application unless we choose to have it considered as a basis for repaying this loan.

DatedSignatureApplicant

SignatureCo-Applicant

1003 FACT (3/06)

© 2006 Wisconsin Bankers Association / Distributed by FIPCO®

11823

The extent to which parties may verify, reverify or obtain any information or data relating to theLoan according to the Acknowledgement on page 3 of the Uniform Residential Loan Applicationmay be limited by applicable Federal Law.

eFIPCO

Borrower(s) AddressLender Name and

Date NumberLoan

forThe undersigned authorize Lender to attach to this form or a copy of this form, one or more of a FNMA form of Request thisVerification of Employment, or Deposit or Rent or Mortgage Account, and agree that my signature, or a copy of my signature on theform, shall constitute my signature upon such attachment and authorize verification of the attachment, the same as if

document.undersigned had signed the attachment as an original oris understood that a copy of this form will also serve as an authorization. If the loan closes, the undersigned authorize that all It

audit.part of the application information may be verified as part of a post closing

Borrower

Borrower

Borrower

Borrower

Date

Date

Date

Date

AUTHORIZATIONBORROWER SIGNATURE

eFIPCO

HAZARD INSURANCE REQUIREMENTS

An insurance policy may take several weeks to procure and, accordingly, you should not delay contacting the appropriate providers. THE FAILURE TO PROCURE A POLICY AND PROVIDE IT TO YOUR LENDER MAY DELAY THE LOAN CLOSING.

Part 1 – HOMEOWNERS INSURANCE

Your lender and FHA/VA/FNMA/WHEDA/RURAL DEVELOPMENT have basic, minimum hazard insurance requirements related to your home mortgage, which are described below:

1. Coverage must be at least fire and extended coverage with a “special form” coverage endorsement, i.e. fire only – DP1 or

DF 1, homeowners policy – HO1. The insurance must not limit or exclude from coverage (in whole or in part) windstorm, hurricane, hail damages, or any other perils that are normally included under an extended coverage endorsement.

2. The amount of insurance coverage must be at least equal the lesser of (1) 100% of the insurable value of the improvements as established by the property insurer; or (2) the unpaid balance of the mortgage, with a replacement cost endorsement to compensate for the full amount of damage or loss to improvements.

3. Acceptable proofs of coverage include: Evidence/Certificates of Insurance, Binders, Declaration Pages, and Policies. The term of a binder may not exceed 90 days.

4. Properties being improved or rehabilitated are subject to the same standards of coverage as noted in paragraph number two. This means that if necessary, following completion of the repair or rehabilitation work, you may need to increase your insurance coverage. Further, for properties being improved or rehabilitated, additional premiums may be required for sub-par properties. Once you have completed the improvements or rehabilitation, you should contact your insurance agent to see if you can or should change your coverage and your premium. The coverage must also properly reflect your actual occupancy of the property.

5. Changes in federal or state laws or regulations, or other changed circumstances, may require your lender to modify its insurance requirements to include additional types or amounts of coverage. In such an event your lender will notify you prior to the effective date of any additional coverage so that you may purchase such required coverage. If you fail to purchase such required coverage, your lender may do so on your behalf and, in such event, your lender will bill you for the insurance premium for such coverage.

Part 11 - FLOOD INSURANCE

Flood insurance must be purchased on any improved real estate that is located in an area that has been identified by FEMA (the Federal Emergency Management Agency) as a Special Flood Hazard Area. If your home is located in a Special Flood Hazard Area, you must purchase adequate flood insurance. The determination that your home is in a Special Flood Hazard Area may be made at the time of loan origination or at any time during the term of your loan.

1. You must purchase flood insurance only with respect to improvements located in Special Flood Hazard Areas (SFHA)

designated by FEMA on its Flood Hazard Boundary Maps and Flood Insurance Rate Maps, and whose Zone designations are e.g. with out limitation, A, AO, AH, A1-30, AE, A99, AR, AR/A1-30, AR/AE, AR/AO, ARAH, AR/A, VO, or v1-30, VE or V. “Improvement means your home and other structures, such as your garage, that are given value in determining the appraised value of your property. You are not required to purchase flood insurance unless some portion of the improvements is located in a SFHA. As to improvements located wholly outside of a SFHA and whose Zone designations are B, C, X or D, flood insurance is not mandatory. However, your lender may require flood insurance on properties located in zones B, C, X and D, bearing in mind that historically a significant level of all flood losses has occurred in these zones. In addition, your lender may require flood insurance even if the home that is security for the loan in located outside of a SFHA.

2. The amount of coverage must be equal to the lesser of (1) the minimum amount required, under the terms of the coverage, to compensate for any damage or loss on a replacement cost basis (or the unpaid principal balance of the loan, if replacement cost coverage is not available for the type of dwelling insured); or, (2) the maximum insurance available under the appropriate NFIP.

3. Even if flood insurance is not mandatory, you may want to consider purchasing flood insurance now or at a later date. 4. Your lender can require you to purchase flood insurance at any time during the term of the loan. In addition, changes in

federal or sate laws or regulations, or other changed circumstances, may require your lender to modify its insurance requirements to include additional types or amounts of coverage. For example, your lender may require additional coverage when a community coverts from FEMA’s Emergency program to the Regular Program. Your lender will notify you prior to the date that any additional coverage is required.

5. If at the time of loan origination or at any time during the term of the loan your lender determines that the improvements are located in a Special Flood Hazard Area and you do not have adequate flood insurance, it will notify you that you must obtain adequate flood insurance, at your expense. If you fail to purchase or maintain flood insurance within 45 days of receiving such notice, your lender may purchase adequate flood insurance on your behalf and at your expense, and will bill you for the cost of premiums and fees it incurs in purchasing the flood insurance. Any amounts paid by your lender will become an additional obligation secured under your loan.

6. A flood insurance policy must be issued by the NFIP or meet the following requirements: (1) the insurer must be properly licensed to do business where the property is located; (2) the policy must include an endorsement which requires the insurer to give insured and the lender written notice of cancellation or nonrenewal at least 30 days prior to the effective date of cancellation or nonrenewal; and (3) the policy should guarantee that the flood insurance coverage is at least as broad as the coverage offered by the NFIP policies.

Part 111 – GENERAL

1. Unless a higher maximum amount is required by law, the maximum dwelling deductible for homeowners/fire insurance and flood insurance may not exceed the higher of $1,000 or 1% of the face amount of the dwelling coverage. With regard to wind/hurricane coverage, the maximum deductible may not exceed the higher of $2,000 or 2% of the face amount of the dwelling coverage.

2. Your lender will accept multi-year and/or continuous policies. 3. The loss payable clause must read: Jackson County Bank and/or its assigns as their interest may appear (A.T.I.M.A.). Mail

to Jackson County Bank, PO Box 490, Black River Falls, WI 54615. If mail is forwarded by means of overnight mail, use the following address: Jackson County Bank, 8 Main Street, Black River Falls, WI 54615.

4. Important Note: If you are purchasing a home, the seller’s Insurance policy does not automatically transfer to you.

The seller’s insurance policy is not and typically does not become your policy until you take certain steps and you obtain the approval of the seller’s insurance company. It is your responsibility to take all necessary and appropriate steps to obtain the benefits of the existing insurance policy, or to acquire a new policy. This responsibility is yours, and continues even if you are receiving an assignment of the seller’ escrow funds.

5. If you fail to maintain or provide evidence of the required insurance, your lender may purchase insurance at your expense to protect the Lender’s interest in the property; such insurance may or may not protect your interests. We will bill you for the insurance. Insurance obtained by Jackson County Bank may be more expensive that, and may not provide the same coverage as, insurance you could obtain on your own. Any amounts paid by our lender will become an additional obligation secured under your loan. You may cancel insurance purchased by us, but only after providing us with evidence that you have obtained insurance coverage in the amounts and types required in our agreement.

THE REQUIREMENTS BELOW RELATE TO LOANS FOR WHICH THE LENDER MAINTAINS

AN ESCROW ACCOUNT FOR PAYMENT OF PROPERTY INSURANCE PREMIUMS.

1. You are responsible for ensuring that the Insurance Company sends a bill to your lender at least 30 days in advance of the

policy renewal date. If your lender does not receive the bill on or before the renewal date, your lender may obtain the required insurance on your behalf and you will be charged for the insurance premium as explained above.

2. Invoices for payment must indicate the total premium to be paid for the insurance coverage of only the mortgaged property. 3. Your lender will escrow all premiums and fees for flood insurance, if an escrow has already been established for taxes, other

insurance premiums, or other fees or charges.

BY SIGNING BELOW, I ACKNOWLEDGE THAT I HAVE READ AND UNDERSTOOD THE FOLLOWING, AND I ACKNOWLEDGE RECEIPT OF A COPY OF THIS FORM.

FLOOD INSURANCE CERTIFICATION

If the property I am purchasing is not in a Special Flood Hazard Area as defined in Part 11 above, flood insurance is not mandatory. I am aware that the possibility of flood damage may still exist and in event of damage from a flood there may be no government or lender assistance. If the property is located in Zone B, I understand that flood insurance is not mandatory but is available and I may purchase flood insurance now or at a later date. I am also aware that the purchase of flood insurance may be required by law at a later date by virtue of the community being included in a remapping by FEMA which results in the mortgaged property then being located in a Special Flood Hazard Area. I will be notified of any such remapping. If I do not obtain flood insurance, the lender will obtain such insurance on my behalf, as explained above.

BORROWER’S RIGHT TO CHOOSE INSURANCE COMPANY AND AGENT

Federal and state law provides that I have the right to select the Insurance Company agent of my own choice to provide the required property insurance. My lender may not require me to purchase insurance through any particular insurance company or insurance agent as a condition to obtaining a loan, providing the company meets the lender’s reasonable requirements as to the financia l standing of the insurance company and the adequacy of the coverage. I understand my rights to select the insurance company and insurance agent of my choice, and I have made my selection freely and without coercion by my lender. _______________________________________________ _________________ Applicant Date _______________________________________________ _________________ Co-applicant Date

J:\Real Estate Dept\FORMS\FED VA\HOME LOAN PACKAGE\HAZARD INSURANCE REQUIREMENTS.doc

Financial companies choose how they share your personal information. Federal law givesconsumers the right to limit some but not all sharing. Federal law also requires us to tellyou how we collect, share, and protect your personal information. Please read this noticecarefully to understand what we do.

personal information to run theirAll financial companies need to share everyday business. In the section below, we list the reasons financial companies

personal information; the reasons can share their

FACTS

Why?

How?

such as to process your transactions, maintainyour account(s), respond to court orders andlegal investigations, or report to credit bureaus

For our marketing purposes -

For joint marketing with other financial companies

For our affiliates' everyday business purposes -information about your transactions and experiences

For nonaffiliates to market to you

information about your creditworthiness

For our everyday business purposes -

to offer our products and services to you

For our affiliates' everyday business purposes -

or go toCall Questions?

The types of personal information we collect and share depend on the product or serviceyou have with us. This information can include:

and Social Security number andand

our customer, we continue to share your information as describedno longerWhen you arein this notice.

What?

Reasons we can share your personal information Can you limitthis sharing?

PrivNotice4.1010Distributed by FIPCO® - (800)-722-3498

Rev.

eFIPCO

7/2018

WHAT DOES JACKSON COUNTY BANK DO WITH YOUR PERSONAL INFORMATION?

Account BalancesIncomeCredit History

Assets Employment Information

customers'

customers'Jackson County Bank chooses to share; and whether you can limit this sharing.

Does Jackson CountyBank share?

Yes No

No We don't share

Yes No

No We don't share

No We don't share

No We don't share

866-331-3664 www.jacksoncountybank.com

Federal law gives you the right to limit only sharing for affiliates' everyday business

about your creditworthiness purposes--informationaffiliates from using your information to market to yousharing for nonaffiliates to market to you

State laws and individual companies may give you additionalrights to limit sharing.

We collect your personal information, for example, when youoror

Why can't I limit all sharing?

What we do

Who we are

Who is providing this notice?

To protect your personal information from unauthorized accessand use, we use security measures that comply with federal law.These measures include computer safeguards and secured filesand buildings.

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Other important information

Affiliates

Joint Marketing

Nonaffiliates

DefinitionsCompanies related by common ownership or control. They canbe financial and nonfinancial companies.

Companies not related by common ownership or control. Theycan be financial and nonfinancial companies.

A formal agreement between nonaffiliated financial companiesthat together market financial products or services to you.

EPRIV4 rev, 6/2013

Jackson County Bank

How does Jackson County Bank protect mypersonal information?

How does Jackson County Bank collect mypersonal information? Open an Account Provide Your Mortgage Information

Apply for a Loan Give Us Your Contact InformationGive Us Your Income Information

We also collect your personal information from others, such ascredit bureaus, affiliates, or other companies.

Jackson County Bank does not share with our affiliates

Jackson County Bank does not share with nonaffiliates so theycan market to you.

Our joint marketing partners include investment companies.

II. PROPERTY INFORMATION AND PURPOSE OF · 2018-07-27 · V. MONTHLY INCOME AND COMBINED HOUSING...

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