MIDWESTERN EQUITY TITLE INSURANCE COMPANY
PROPERTY OWNER(S) LIEN AFFIDAVIT
LENDER:
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OWNER(S):
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{{ $lienAffidavitDt['lender_loans_data']->primary_borrower_last_name }}
PROPERTY ADDRESS:
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{{ $lienAffidavitDt['lender_loans_data']->property_city }},
{{ $lienAffidavitDt['lender_loans_data']['property_state_data']->short_code }} -
{{ $lienAffidavitDt['lender_loans_data']->property_zip }}
1. The owner(s) listed above is
(are) the sole owner(s) of property:
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2. Title to this residence is held
as:
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3. Residential
Occupancy:
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4. The only liens against this residence are as
follows:
| Lender or Other Lien Holder |
Balance
|
| First Lien |
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$
{{ number_format($lienAffidavitDt->first_lien_amount, 2) }} |
| Second Lien |
{{ $lienAffidavitDt->second_lien_name }} |
$
{{ number_format($lienAffidavitDt->second_lien_amount, 2) }} |
| Other Lien(s) |
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$
{{ number_format($lienAffidavitDt->other_lien_amount, 2) }} |
5.
|
Please initial correct response below |
Yes
|
No
|
| All real estate
taxes and assessments are paid in full. |
{{ $lienAffidavitDt->real_estate_taxes_are_paid == 'Yes' ? 'Yes' : '' }} |
{{ $lienAffidavitDt->real_estate_taxes_are_paid == 'No' ? 'No' : '' }} |
| This Property is
free of State and Federal tax liens. |
{{ $lienAffidavitDt->federal_tax_liens == 'Yes' ? 'Yes' : '' }} |
{{ $lienAffidavitDt->federal_tax_liens == 'No' ? 'No' : '' }} |
| This Property is
free of Judgements. |
{{ $lienAffidavitDt->property_of_judgements == 'Yes' ? 'Yes' : '' }} |
{{ $lienAffidavitDt->property_of_judgements == 'No' ? 'No' : '' }} |
|
Has owner filed bankruptcy in the past 90 days? |
{{ $lienAffidavitDt->filed_bankruptcy == 'Yes' ? 'Yes' : '' }} |
{{ $lienAffidavitDt->filed_bankruptcy == 'No' ? 'No' : '' }} |
|
Does this property have a reverse mortgage? |
{{ $lienAffidavitDt->reverse_mortgage == 'Yes' ? 'Yes' : '' }} |
{{ $lienAffidavitDt->reverse_mortgage == 'No' ? 'No' : '' }} |
This Affidavit is given to induce {{ $lienAffidavitDt['lender_loans_data']['lender_data']->institution_name }}
(Lender) to make the loan. We (I) state that the above information is true and complete and understand that
any intentional or negligent misrepresentation (s) of the information contained in this Affidavit 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 Lender, its agents, successors and assigns, insurers, and any other person who may suffer any
loss in reliance upon any misrepresentations when made in this Affidavit.
Signature of Owner's Spouse if Not Owner:
| Subscribed and sworn to before me this |
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|
day of |
|
,
20{{ $lienAffidavitDt->subscribed_sworn_date }} |
|
{{ $lienAffidavitDt->subscribed_sworn_year }}
|
| State
of: |
{{ $lienAffidavitDt->state_code }}
|
County
of: |
{{ $lienAffidavitDt->county_id }}
|
My
comission expires: |
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|
Original for Loan File
Copy for Borrower
Borrower(s)
:
{{ $lienAffidavitDt['lender_loans_data']->primary_borrower_first_name }}
{{ $lienAffidavitDt['lender_loans_data']->primary_borrower_last_name }}
Financial Institution:
{{ $lienAffidavitDt['lender_loans_data']['lender_data']->institution_name != null ? $lienAffidavitDt['lender_loans_data']['lender_data']->institution_name : '--' }}
Property Address:
{{ $lienAffidavitDt['lender_loans_data']->property_address }},
{{ $lienAffidavitDt['lender_loans_data']->property_city }},
{{ $lienAffidavitDt['lender_loans_data']['property_state_data']->short_code }} -
{{ $lienAffidavitDt['lender_loans_data']->property_zip }}
Application No#:
{{ $lienAffidavitDt['lender_loans_data']->application_no }}
Loan Amount:
$
{{ number_format($lienAffidavitDt['lender_loans_data']->loan_amount, 2) }}
Effective Date:
{{ date('m/d/Y', strtotime($lienAffidavitDt['lender_loans_data']->created_at)) }}
Loan Term:
{{ $lienAffidavitDt['lender_loans_data']->loan_term }}
POSSIBLE HOME EQUITY LIEN PROTECTOR (HELP) COVERAGE IN LIEU OF TITLE SEARCH
This loan may qualify for the Home Equity Lien Protector coverage which
protects the lender against losses due to impairments to the title on fixed term equity loans and equity lines
of credit. Please refer to the Master Policy on file for all benefit or eligibility questions.
If this is a covered loan, the following items MUST be in the loan file at all
times:
______
Copy of Credit Report
______
Original of Property Owner(s) Affidavit
______
Copy of Property Tax Bill or First Mortgage or
Deed
NO COVERAGE WILL BE IN FORCE UNLESS THE PREMIUM IS PAID AND THE LOAN APPEARS ON THE MONTHLY REPORT SUBMITTED TO
MIDWESTERN EQUITY TITLE INSURANCE COMPANY.
Form No. 01 (1/01)
Midwestern Equity Title Insurance Company
800-678-0329