Uniform Residential Loan Application€¦ · Refinance Construction-Permanent Primary Residence...

Uniform Residential Loan ApplicationThis 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", as

applicable. Co-Borrower information must also be provided (and the appropriate box checked) when the income or assets of a person other than the "Borrower"

(including the Borrower's spouse) will be used as a basis for loan qualification or the income or assets of the Borrower's spouse or other person who has community

property rights pursuant 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 personhas community property rights 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 relying on other property located in a community property state as a basis for repayment of the loan.

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

Borrower Co-Borrower

VA Conventional Other (explain): Agency Case Number Lender Case Number

FHA USDA/RuralHousing Service

Amount

$ %

Interest Rate No. of Months Fixed Rate Other (explain):

GPM ARM (type):

Subject Property Address (street, city, state, & ZIP) No. of Units

Legal Description of Subject Property (attach description if necessary) Year Built

Purpose of Loan Purchase Construction Other (explain): Property will be:

Refinance Construction-Permanent Primary Residence Secondary Residence Investment

Complete this line if construction or construction-permanent loan.Year LotAcquired

Original Cost

$

Amount Existing Liens

$

(a) Present Value of Lot

$

(b) Cost of Improvements

$

Total (a+b)

$

Complete this line if this is a refinance loan.YearAcquired

Original Cost

$

Amount Existing Liens

$

Purpose of Refinance Describe Improvements made to be made

Cost: $Title will be held in what Name(s) Manner in which Title will be held Estate will be held in:

Fee SimpleLeasehold (showexpiration date)Source of Down Payment, Settlement Charges and/or Subordinate Financing (explain)

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

Social Security Number Home Phone (incl. area code) DOB (mm/dd/yyyy) Yrs. School

Married (includes registered domestic partners)

Unmarried (includes single, divorced, widowed)

Separated

Dependents (not listed by Co-Borrower)

No.

Ages

Present Address (street, city, state, ZIP/ country) Own Rent No. Yrs.

Mailing Address, if different from Present Address

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

Former Address (street, city, state, ZIP) Own Rent No. Yrs.


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

Social Security Number Home Phone (incl. area code) DOB (mm/dd/yyyy) Yrs. School

Married (includes registered domestic partners)

Unmarried (includes single, divorced, widowed)

Separated

Dependents (not listed by Borrower)

No.

Ages

Present Address (street, city, state, ZIP/ country) Own Rent No. Yrs.

Mailing Address, if different from Present Address



MortgageApplied for:

Amortization Type:

I. TYPE OF MORTGAGE AND TERMS OF LOAN

II. PROPERTY INFORMATION AND PURPOSE OF LOAN

III. BORROWER INFORMATIONBorrower Co-Borrower

Borrower

Co-BorrowerUniform Residential Loan ApplicationFreddie Mac Form 65 7/05 (rev. 6/09) Fannie Mae Form 1003 7/05 (rev. 6/09)

Calyx Form - Loanapp1.frm (11/09)

/ United States / United States

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American Fidelity, NMLS# 226068

IV. EMPLOYMENT INFORMATIONBorrower Co-Borrower

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

Name & Address of Employer Self Employed Yrs. on this job

Yrs. employed in thisline of work/profession

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

Name & Address of Employer Self Employed Dates (from-to)

Monthly Income

$



Monthly Income

$



Monthly Income

$



Monthly Income

$


Name & Address of Employer Self Employed Yrs. on this job

Yrs. employed in thisline of work/profession



Monthly Income

$



Monthly Income

$



Monthly Income

$



Monthly Income

$


V. MONTHLY INCOME AND COMBINED HOUSING EXPENSE INFORMATION

Gross Monthly Income Borrower Co-Borrower Total

Combined MonthlyHousing Expense Present Proposed

Total Total

Base Empl. Income*

Overtime

Bonuses

Commissions

Dividends/Interest

Net Rental Income

Other (before completing,see the notice in "describeother income," below)

Rent

First Mortgage (P&I)

Other Financing (P&I)

Hazard Insurance

Real Estate Taxes

Mortgage Insurance

Other:

$ $ $ $

$

$ $ $ $ $

Homeowner Assn. Dues

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

Describe Other Income Alimony, child support, or separate maintenance income need not be revealed if theBorrower (B) or Co-Borrower (C) does not choose to have it considered for repaying this loan.

Notice:

B/C Monthly Amount

$

Borrower



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VI. ASSETS AND LIABILITIESThis Statement and any applicable supporting schedules may be completed jointly by both married and unmarried Co-borrowers if their assets and liabilities are sufficiently joinedso that the Statement can be meaningfully and fairly presented on a combined basis; otherwise, separate Statements and Schedules are required. If the Co-Borrower sectionwas completed about a non-applicant spouse or other person, this Statement and supporting schedules must be completed by that spouse or other person also.

Completed Jointly Not Jointly

ASSETS Cash or Market ValueDescription

Cash deposit toward purchase held by:

$

List checking and savings accounts below

Name and address of Bank, S&L, or Credit Union

Acct. no. $


Acct. no. $


Acct. no. $

Stocks & Bonds (Companyname/number description)

$

Life insurance net cash value

Face amount: $

$

Subtotal Liquid Assets $

Real estate owned (enter market valuefrom schedule of real estate owned)

$

Vested interest in retirement fund $

Net worth of business(es) owned(attach financial statement)

$

Automobiles owned (make and year) $

Other Assets (itemize) $

Liabilities and Pledged Assets.

Total Assets a. $

LIABILITIES Monthly Payment &Months Left to Pay

Unpaid Balance

List the creditor's name, address and account number for all outstandingdebts, 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.

Name and address of Company $ Payment/Months $

Acct. no.Name and address of Company $ Payment/Months $


Acct. no.

Name and address of Company $ Payment/Months $



Acct. no.

Alimony/Child Support/SeparateMaintenance Payments Owed to:

$

Job-Related Expense (child care, union dues, etc.) $

Total Monthly Payments $

Net Worth(a minus b)

$ Total Liabilities b. $=>

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

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

Type ofProperty

PresentMarket Value

Amount ofMortgages & Liens

GrossRental Income

MortgagePayments

Insurance,Maintenance,Taxes & Misc.

NetRental Income

Totals

$ $ $ $ $ $

$ $ $ $ $ $

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

Alternate Name Creditor Name Account Number

Borrower



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VII. DETAILS OF TRANSACTION VIII. DECLARATIONS

IX. ACKNOWLEDGEMENT AND AGREEMENT

X. INFORMATION FOR GOVERNMENT MONITORING PURPOSES

a. Purchase price $

b. Alterations, improvements, repairs

c. Land (if acquired separately)

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

e. Estimated prepaid items

f. Estimated closing costs

g. PMI, MIP, Funding Fee

h. Discount (if Borrower will pay)

i. Total costs (add items a through h)

j. Subordinate financing

k. Borrower's closing costs paid by Seller

l. Other Credits (explain)

m. Loan amount (exclude PMI, MIP,Funding Fee financed)

n. PMI, MIP, Funding Fee financed

o. Loan amount (add m & n)

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

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

Borrower Co-Borrower

Yes No Yes Noa. Are there any outstanding judgments against you?

b. Have you been declared bankrupt within the past 7 years?

c. Have you had property foreclosed upon or given title or deed in lieu thereofin the last 7 years?

d. Are you a party to a lawsuit?

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

(This would include such loans as home mortgage loans, SBA loans, home improvementloans, educational loans, manufactured (mobile) home loans, any mortgage, financialobligation, bond, or loan guarantee. If "Yes," provide details, including date, name, and address of Lender, FHA or VA case number, if any, and reasons for the action.)

f. 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.

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

h. Is any part of the down payment borrowed?

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

j. Are you a U. S. citizen?

k. Are you a permanent resident alien?

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

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

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

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

Each of the undersigned specifically represents to Lender and to Lender's actual or potential agents, brokers, processors, attorneys, insurers, servicers, successors and assigns andagrees 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 or negligent mis-representation of this information contained in this application may result in civil liability, including monetary damages, to any person who may suffer any loss due to reliance upon anymisrepresentation that I have made on this application, and/or in criminal penalties including, but not limited to, fine or imprisonment or both under the provisions of Title 18, United StatesCode, 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 the property described in this application; (3) theproperty will not be used for any illegal or prohibited purpose or use; (4) all statements made in this application are made for the purpose of obtaining a residential mortgage loan; (5) theproperty will be occupied as indicated in this application; (6) the Lender, its servicers, successors or assigns may retain the original and/or an electronic record of this application, whetheror not the loan is approved; (7) the Lender and its agents, brokers, insurers, servicers, successors and assigns may continuously rely on the information contained in the application, andI am obligated to amend and/or supplement the information provided in this application if any of the material facts that I have represented herein should change prior to closing of theLoan; (8) in the event that my payments on the Loan become delinquent, the Lender, its servicers, successors, or assigns may, in addition to any other rights and remedies that it mayhave relating to such delinquency, report my name and account information to one or more consumer credit reporting agencies; (9) ownership of the Loan and/or administration of the Loanaccount 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 the condition 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 in applicable 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 as effective, 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 purpose through any source, including a source named in this applicationor a consumer reporting agency.

Borrower's Signature Date Co-Borrower's Signature Date

X X

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 creditopportunity, 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 maynot 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 race, youmay 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 basis of visualobservation and 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 the 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 for.)

BORROWER CO-BORROWER

Ethnicity:

Race:

Sex:

Ethnicity:

Race:

Sex:

I do not wish to furnish this information

Hispanic or Latino Not Hispanic or Latino

American Indian orAlaska Native

Asian Black orAfrican American

Native Hawaiian or Other Pacific Islander White

Female Male

I do not wish to furnish this information

Hispanic or Latino Not Hispanic or Latino

American Indian orAlaska Native

Asian Black orAfrican American

Native Hawaiian or Other Pacific Islander White

Female Male

To be Completed by Loan Originator:This information was provided:

In a face-to-face interviewIn a telephone interview

By the applicant and submitted by fax or mailBy the applicant and submitted via e-mail or the internet

Loan Originator's Signature Date

XLoan 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

Uniform Residential Loan ApplicationFreddie Mac Form 65 7/05 (rev. 6/09) Fannie Mae Form 1003 7/05 (rev. 6/09)


Right to Receive Copy of Appraisal I/We have the right to a copy of the appraisal report used in connection with this application for credit. To obtain a copy, I/we must sendCreditor a written request at the mailing address Creditor has provided.Creditor must hear from us no later than ____ days after Creditor notifies me/us about the action takenon this application, or I/we withdraw this application.If you would like a copy of the appraisal report, contact:

90

American Fidelity 1600 Golf Rd Rolling Meadows, IL 60008

American Fidelity(P) 847-517-9900 (F) 847-201-2660 226068

1600 Golf RdRolling Meadows, IL 60008

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Continuation Sheet/Residential Loan Application

Use this continuation sheet if youneed more space to complete theResidential Loan Application.Mark B for Borrower or C forCo-Borrower.

Borrower: Agency Case Number:

Co-Borrower: Lender Case Number:

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 theabove facts as applicable under the provisions of Title 18, United States Code, Section 1001, et seq.

Borrower's Signature: Date Co-Borrower's Signature: Date

X X

VI. ASSETS AND LIABILITIES

ASSETSCash or Market

Value LIABILITIESMonthly Payment &

Months Left to Pay

Unpaid

Balance


Acct. no. $Name and address of Bank, S&L, or Credit Union






Acct. no. $

Name and address of Company $ Payt./Mos. $

Acct. No.Name and address of Company $ Payt./Mos. $






Acct. No.

Uniform Residential Loan ApplicationFreddie Mac Form 65 7/05 (rev. 6/09) Fannie Mae Form 1003 7/05 (rev. 6/09)

Calyx Form - LNAP5AST.FRM (11/09)

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INSTRUCTIONS TO PRINTERSFORM 4506, PAGE 1 of 2MARGINS: TOP 13 mm (1⁄ 2 "), CENTER SIDES. PRINTS: HEAD to HEADPAPER: WHITE WRITING, SUB. 20. INK: BLACKFLAT SIZE: 216 mm (81⁄ 2 ") 3 279 mm (11")PERFORATE: NONE

4506-T Form Request for Transcript of Tax Return

OMB No. 1545-1872

(Rev. January 2008)

© Do not sign this form unless all applicable lines have been completed.Read the instructions on page 2.

Department of the TreasuryInternal Revenue Service

© Request may be rejected if the form is incomplete, illegible, or any requiredline was blank at the time of signature.

First social security number on tax return oremployer identification number (see instructions)

1a

1b

Name shown on tax return. If a joint return, enter the name shown first.

If a joint return, enter spouse’s name shown on tax return

2a

Second social security number if joint tax return

2b

Current name, address (including apt., room, or suite no.), city, state, and ZIP code

3

Form 4506-T (Rev. 1-2008) Cat. No. 37667N

For Privacy Act and Paperwork Reduction Act Notice, see page 2.

7 I.R.S. SPECIFICATIONS TO BE REMOVED BEFORE PRINTING

DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

TLS, have youtransmitted all R text files for this cycle update?

Date

Action

Revised proofsrequested

Date

Signature

O.K. to print

Previous address shown on the last return filed if different from line 3

4

Caution: DO NOT SIGN this form if a third party requires you to complete Form 4506-T, and lines 6 and 9 are blank.

If the transcript or tax information is to be mailed to a third party (such as a mortgage company), enter the third party’s name, address,and telephone number. The IRS has no control over what the third party does with the tax information.

5

6

9

Year or period requested. Enter the ending date of the year or period, using the mm/dd/yyyy format. If you are requesting more than fouryears or periods, you must attach another Form 4506-T. For requests relating to quarterly tax returns, such as Form 941, you must entereach quarter or tax period separately.

Telephone number of taxpayer online 1a or 2a

SignHere

( ) Date Signature (see instructions)

Title (if line 1a above is a corporation, partnership, estate, or trust)

© ©

Signature of taxpayer(s). I declare that I am either the taxpayer whose name is shown on line 1a or 2a, or a person authorized to obtain the taxinformation requested. If the request applies to a joint return, either husband or wife must sign. If signed by a corporate officer, partner,guardian, tax matters partner, executor, receiver, administrator, trustee, or party other than the taxpayer, I certify that I have the authority toexecute Form 4506-T on behalf of the taxpayer.

Spouse’s signature © Date

Tip: Use Form 4506-T to order a transcript or other return information free of charge. See the product list below. You can also call 1-800-829-1040 toorder a transcript. If you need a copy of your return, use Form 4506, Request for Copy of Tax Return. There is a fee to get a copy of your return.

/ /

/ /

/ /

/ /

Transcript requested. Enter the tax form number here (1040, 1065, 1120, etc.) and check the appropriate box below. Enter only one tax

form number per request. ©

a

b

c

7

8

Return Transcript, which includes most of the line items of a tax return as filed with the IRS. Transcripts are only available for the following returns: Form 1040 series, Form 1065, Form 1120, Form 1120A, Form 1120H, Form 1120L, and Form 1120S.Return transcripts are available for the current year and returns processed during the prior 3 processing years. Most requestswill be processed within 10 business days

Account Transcript, which contains information on the financial status of the account, such as payments made on the account, penaltyassessments, and adjustments made by you or the IRS after the return was filed. Return information is limited to items such as tax liabilityand estimated tax payments. Account transcripts are available for most returns. Most requests will be processed within 30 calendar days

Record of Account, which is a combination of line item information and later adjustments to the account. Available for current yearand 3 prior tax years. Most requests will be processed within 30 calendar days

Verification of Nonfiling, which is proof from the IRS that you did not file a return for the year. Most requests will be processed within 10 business days

Form W-2, Form 1099 series, Form 1098 series, or Form 5498 series transcript. The IRS can provide a transcript that includes data fromthese information returns. State or local information is not included with the Form W-2 information. The IRS may be able to provide this transcript information for up to 10 years. Information for the current year is generally not available until the year after it is filed with the IRS. For example, W-2 information for 2006, filed in 2007, will not be available from the IRS until 2008. If you need W-2 information for retirement purposes, youshould contact the Social Security Administration at 1-800-772-1213. Most requests will be processed within 45 days

Caution: If you need a copy of Form W-2 or Form 1099, you should first contact the payer. To get a copy of the Form W-2 or Form 1099filed with your return, you must use Form 4506 and request a copy of your return, which includes all attachments.

INSTRUCTIONS TO PRINTERSFORM 4506-T, PAGE 2 of 2MARGINS: TOP 13 mm (1⁄ 2 "), CENTER SIDES. PRINTS: HEAD to HEADPAPER: WHITE WRITING, SUB. 20. INK: BLACKFLAT SIZE: 216 mm (81⁄ 2 ") 3 279 mm (11")PERFORATE: NONE

Page 2 Form 4506-T (Rev. 1-2008)

Mail or fax to the“Internal RevenueService” at:

If you filed anindividual returnand lived in: RAIVS Team

Stop 679Andover, MA 05501

978-247-9255

District of Columbia,Maine, Maryland,Massachusetts,New Hampshire,New York,Vermont

RAIVS TeamP.O. Box 47-421Stop 91Doraville, GA 30362

770-455-2335

Alabama, Delaware,Florida, Georgia,North Carolina, Rhode Island,South Carolina,Virginia

RAIVS Team Stop 6716 AUSC Austin, TX 73301

Kentucky, Louisiana,Mississippi,Tennessee, Texas, aforeign country, orA.P.O. or F.P.O.address

If you have comments concerning theaccuracy of these time estimates orsuggestions for making Form 4506-Tsimpler, we would be happy to hear fromyou. You can write to the Internal RevenueService, Tax Products CoordinatingCommittee, SE:W:CAR:MP:T:T:SP, 1111Constitution Ave. NW, IR-6526,Washington, DC 20224. Do not send theform to this address. Instead, see Where tofile on this page.

Privacy Act and Paperwork ReductionAct Notice. We ask for the information onthis form to establish your right to gainaccess to the requested tax informationunder the Internal Revenue Code. We needthis information to properly identify the taxinformation and respond to your request.Sections 6103 and 6109 require you toprovide this information, including yourSSN or EIN. If you do not provide thisinformation, we may not be able toprocess your request. Providing false orfraudulent information may subject you topenalties.

The time needed to complete and fileForm 4506-T will vary depending onindividual circumstances. The estimatedaverage time is: Learning about the lawor the form, 10 min.; Preparing the form,12 min.; and Copying, assembling, andsending the form to the IRS, 20 min.

7 I.R.S. SPECIFICATIONS TO BE REMOVED BEFORE PRINTING

DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

You are not required to provide theinformation requested on a form that issubject to the Paperwork Reduction Actunless the form displays a valid OMBcontrol number. Books or records relatingto a form or its instructions must beretained as long as their contents maybecome material in the administration ofany Internal Revenue law. Generally, taxreturns and return information areconfidential, as required by section 6103.

General Instructions Purpose of form. Use Form 4506-T torequest tax return information. You canalso designate a third party to receive theinformation. See line 5.

Signature and date. Form 4506-T must besigned and dated by the taxpayer listed online 1a or 2a. If you completed line 5requesting the information be sent to athird party, the IRS must receive Form4506-T within 60 days of the date signedby the taxpayer or it will be rejected. Individuals. Transcripts of jointly filedtax returns may be furnished to eitherspouse. Only one signature is required.Sign Form 4506-T exactly as your nameappeared on the original return. If youchanged your name, also sign your currentname. Corporations. Generally, Form 4506-Tcan be signed by: (1) an officer havinglegal authority to bind the corporation, (2)any person designated by the board ofdirectors or other governing body, or (3)any officer or employee on written requestby any principal officer and attested to bythe secretary or other officer.

Partnerships. Generally, Form 4506-Tcan be signed by any person who was amember of the partnership during any partof the tax period requested on line 9. All others. See Internal Revenue Codesection 6103(e) if the taxpayer has died, isinsolvent, is a dissolved corporation, or if atrustee, guardian, executor, receiver, oradministrator is acting for the taxpayer. Where to file. Mail or fax Form 4506-T to

the address below for the state you livedin, or the state your business was in, whenthat return was filed. There are twoaddress charts: one for individualtranscripts (Form 1040 series and FormW-2) and one for all other transcripts. If you are requesting more than onetranscript or other product and the chartbelow shows two different RAIVS teams,send your request to the team based onthe address of your most recent return.

Chart for individualtranscripts (Form 1040 seriesand Form W-2)

RAIVS TeamStop 37106 Fresno, CA 93888

559-456-5876

Alaska, Arizona,California, Colorado,Hawaii, Idaho, Iowa,Kansas, Minnesota,Montana, Nebraska,Nevada, New Mexico,North Dakota,Oklahoma, Oregon,South Dakota, Utah,Washington,Wisconsin, Wyoming RAIVS Team

Stop 6705–B41Kansas City, MO 64999

816-292-6102

Arkansas,Connecticut, Illinois,Indiana, Michigan,Missouri, NewJersey, Ohio,Pennsylvania, West Virginia

Mail or fax to the“Internal RevenueService” at:

RAIVS Team P.O. Box 9941Mail Stop 6734 Ogden, UT 84409

Alabama, Alaska,Arizona, Arkansas,California, Colorado,Florida, Georgia,Hawaii, Idaho, Iowa,Kansas, Louisiana,Minnesota,Mississippi,Missouri, Montana,Nebraska, Nevada,New Mexico, North Dakota,Oklahoma, Oregon, South Dakota,Tennessee, Texas,Utah, Washington,Wyoming, a foreigncountry, or A.P.O. orF.P.O. address Connecticut,Delaware, District ofColumbia, Illinois,Indiana, Kentucky,Maine, Maryland,Massachusetts,Michigan, NewHampshire, NewJersey, New York,North Carolina,Ohio, Pennsylvania,Rhode Island, SouthCarolina, Vermont,Virginia, WestVirginia, Wisconsin

RAIVS TeamP.O. Box 145500Stop 2800 F Cincinnati, OH 45250

859-669-3592

Chart for all other transcripts

Documentation. For entities other thanindividuals, you must attach theauthorization document. For example, thiscould be the letter from the principal officerauthorizing an employee of the corporationor the Letters Testamentary authorizing anindividual to act for an estate.

Line 1b. Enter your employer identificationnumber (EIN) if your request relates to abusiness return. Otherwise, enter the firstsocial security number (SSN) shown on thereturn. For example, if you are requestingForm 1040 that includes Schedule C(Form 1040), enter your SSN.

Routine uses of this information includegiving it to the Department of Justice forcivil and criminal litigation, and cities,states, and the District of Columbia for usein administering their tax laws. We mayalso disclose this information to othercountries under a tax treaty, to federal andstate agencies to enforce federal nontaxcriminal laws, or to federal lawenforcement and intelligence agencies tocombat terrorism.

Tip. Use Form 4506, Request for Copy ofTax Return, to request copies of taxreturns.

Line 6. Enter only one tax form number perrequest.

If you lived in oryour businesswas in:

512-460-2272

801-620-6922

Note. You can also call 1-800-829-1040 torequest a transcript or get moreinformation.

AFFILIATED BUSINESS ARRANGEMENT DISCLOSURE STATEMENT NOTICE

NOT

THERE ARE FREQUENTLY OTHER SETTLEMENT SERVICE PROVIDERS

AVAILABLE WITH SIMILAR SERVICES. YOU ARE FREE TO SHOP AROUND TO DETERMINE THAT

YOU ARE RECEIVING THE BEST SERVICES AND THE BEST RATE FOR THESE SERVICES.

To:

From:

Property:

Date:

This is to give you notice that has a business relationship

with .

The nature of the relationship (and percentage of owner ship interest) is:

.

Because of this relationship, this referral may provide

a financial or other benefit.

[ ] A. Set forth below is the estimated charge or range of charges for the settlement services listed. You arerequired to use the listed provider(s) as a condition for [ ] settlement of your loan on [or] [ ] purchase, sale, orrefinance of the subject property.

Provider and settlement service Charge or range of charges

$

$

$

$

$

$

[ ] B. Set forth below is the estimated charge or range of charges for the settlement services of an attorney, creditreporting agency, or real estate appraiser that we, as your lender, will require you to use, as a condition of yourloan on this property, to represent our interests in the transaction.

Provider and settlement service Charge or range of charges

$

$

$

$

$

$

I/We have read this disclosure form, and understand thatis referring me/us to purchase the above-described settlement service(s) and may receive a financial or other benefitas the result of this referral.

ACKNOWLEDGMENT

Borrower Date Borrower Date

Calyx Form - notice.frm (09/02)

Anti-Steering Disclosure - ARM Loans

Prepared For: Provided By:

Loan Program

Closing Cost Scenario

Lowest

Interest Rate

Lowest

Origination Costs

Lowest Interest Rate

without Risky Features *

Sales Price

Down Payment

Loan Amount

Interest Rate

Term

Due

Interest Only Period

Monthly Payment

Closing Costs

Cash to Close

Origination Fees

Discount Points

Pre-payment Penalties

Balloon Payment

APR

* Risky features refers to loan features such as a prepayment penalty or negative amortization.

In compliance with the anti-steering prohibitions found in Regulation 12 CFR 226.36(e), we are providing youwith this disclosure of loan options. These loan options represent the types of transactions for which you have expressed an interest and are from creditors with whom we regularly conduct business.

By signing below, I acknowledge that I have received a copy of this anti-steering disclosure and that the loan originator has explained these loan options to my satisfaction.

Borrower/Co-Borrower Date

Loan Originator Date

Calyx Form AntiSteer-ARM.frm (04/2011)

American Fidelity

1600 Golf Rd

Rolling Meadows , IL 60008

Ph: 847-517-9900


Anti-Steering Disclosure - Fixed Loans

Prepared For: Provided By:

Loan Program

Closing Cost Scenario

Lowest

Interest Rate

Lowest

Origination Costs

Lowest Interest Rate

without Risky Features *

Sales Price

Down Payment

Loan Amount

Interest Rate

Term

Due

Interest Only Period

Monthly Payment

Closing Costs

Cash to Close

Origination Fees

Discount Points

Pre-payment Penalties

Balloon Payment

APR

* Risky features refers to loan features such as a prepayment penalty or negative amortization.

In compliance with the anti-steering prohibitions found in Regulation 12 CFR 226.36(e), we are providing youwith this disclosure of loan options. These loan options represent the types of transactions for which you have expressed an interest and are from creditors with whom we regularly conduct business.

By signing below, I acknowledge that I have received a copy of this anti-steering disclosure and that the loan originator has explained these loan options to my satisfaction.

Borrower/Co-Borrower Date

Loan Originator Date

Cayx Form AntiSteer-Fixed.frm (04/2011)

American Fidelity

1600 Golf Rd

Rolling Meadows , IL 60008

Ph: 847-517-9900


INITIAL ARM DISCLOSURE STATEMENT

Brokerage Name & Address: Date:

Program Name:

Lender Name:

IMPORTANT LOAN INFORMATION - PLEASE READ CAREFULLY

This program disclosure describes the features of the Adjustable Rate Mortgage (ARM) program you are considering.

You should carefully read this disclosure; and the promissory note, deed of trust or mortgage, any riders, addendums, and all

other supporting documents that you will be asked to sign if you accept an ARM loan ("ARM Loan Documents"). Information

about other ARM programs is available upon request.

ADJUSTABLE RATE MORTGAGE MEANS YOUR PAYMENT MAY CHANGE IN THE FUTUREYou are applying for an ARM loan. This means that your interest rate and monthly payments may change during the life of your ARM

loan. Your monthly payments will increase if the interest rate rises and decrease if it falls. The date or dates on which changes can

occur (referred to in this disclosure as "Change Date") will be specified in the ARM Loan Documents. This ARM loan is based on the

terms and conditions set forth in this disclosure and in the ARM Loan Documents. We have based this disclosure on recent interest

rates, index and margin values, discounts, and fees. Ask us for our current interest rate and margin.

An ARM loan is different from a fixed-rate mortgage loan. For a fixed-rate loan, the monthly payments of principal and interest do not

change during the life of the loan. You should consider carefully which type of loan is best for you.

HOW YOUR INTEREST RATE IS DETERMINED

The Index:

Interest Rate: (check applicable box):

(Applicable if Checked)

(Applicable if Checked) Initial Interest Rate Discount:

(Applicable if Checked) Interest Rate Adjustments:

Your interest rate will be determined by means of an index that may change from time to time.

The interest rate change on this ARM will be based on an interest rate index (referred to in this disclosure as the "Index.")

The Index is

.

Information about the Index is available in/at

.

If the Index is no longer available, we will choose a new index based on comparable information.

Your interest rate is based on

The Index value plus a margin rounded to the nearest ________ percent; or

Other:

Your payment will be based on the interest rate, loan balance, and remaining loan term. A change in the Index generally will

result in a change in the interest rate. The amount that your interest rate may change also may be affected by the Periodic Interest

Rate Cap and the Lifetime Interest Rate Cap, as discussed below. Ask us for our current interest rates and margin.

Interest rate changes are subject to the lender's discretion.

Your loan has an initial interest rate discount, therefore the initial

rate being offered will not be based on the Index plus a margin interest rate formula used to make later adjustments. You should

note, however, that because your initial interest rate will be discounted, your interest rate may increase on the first Change Date

even if the Index remains the same or decreases. Ask us for the amount our ARM loans are currently discounted.

Your loan has "caps" which limit the amount of interest adjustments.

Your interest rate under this ARM loan can change after _____ month(s) and every _____ month(s) thereafter. Your interest rate

cannot increase or decrease more than _______ percentage points at the first adjustment, and ________ percentage points per

subsequent adjustment from the initial interest rate excluding any Buydown ("Periodic Interest Rate Cap"). Your interest rate will

never be greater than ________ ("Lifetime Interest Rate Cap") percentage points above the initial interest rate or lower than ________ .

If applicable, the payment during your loan will be interest only for a period of ______ month(s).

Calyx Form - initarmdisc1.frm (9/10)

American Fidelity Financial Services, Inc.

1600 Golf Road

Rolling Meadows, IL 60008

(P) 800-325-0400 (F) 847-517-9910

American Fidelity Financial Services, Inc., NMLS# 226068

The Initial Interest Rate Discount discussed above will not be taken into account in applying the Periodic Interest Rate Cap or Lifetime

Interest Rate Cap.

Ask us for our current adjustments and overall rate limitations.

HOW YOUR PAYMENTS ARE DETERMINED

NOTICE OF INTEREST RATE AND PAYMENT CHANGES

HOW YOUR PAYMENT CAN CHANGE

Frequency of Payment Changes:

(Applicable if Checked)

(Applicable if Checked) Initial Minimum Payment Rate Option:

(Applicable if Checked) Payment Rate Changes:

(Applicable if Checked):

Limitations on Interest Rate Payment Changes (Check all applicable boxes, if any):

Your initial monthly payment of principal and interest will be determined based on the interest rate, loan term, and balance when

your loan is closed. Your payment will be set to amortize the loan over a period of ______ months.

Based on increases or decreases in the Index, payment amounts under this ARM loan can

change after _____ month(s) and every _____ month(s) thereafter. However, your monthly payment amount could change more

frequently if there is a change in the taxes, assessments, insurance premiums, or other charges required to be made into an

escrow or impound account.

Your monthly payment amount could also change more frequently if, as a result of unpaid interest

being added to your loan balance, the maximum principal balance exceeds _______% of the original loan balance.

Your ARM loan has an initial minimum payment rate

option; the initial payment rate will be based on _____________________________________________________________

for a period of _____ month(s). If applicable, the payment during this Initial Minimum Payment Rate Option period will be

interest only for a period of _____ month(s). The minimum (or limited) payment may be less than the amount of interest

due that month and may not reduce the amount you owe on your mortgage. If you choose this option, the amount of any interest

you do not pay will be added to the principal of the ARM loan, increasing the amount you owe and your future monthly payments,

and will increase the amount of interest you will pay over the life of the ARM loan. If any of your ARM loan payments is not

sufficient to cover the interest due, the difference will be added to your loan amount.

Your ARM loan has payment adjustments. Your payment will not

increase or decrease by more than ________ percentage points every _______ month(s). Because your payment is limited or

capped to a percentage of _______, your ARM loan will be recast, or re-amortized at or before month ______ and will re-amortize

again or stop recasting at month ______. When the ARM loan is recast, it will re-amortize the ARM loan's monthly payment if

negative amortization has occurred so the ARM loan will be paid off within the original loan term. If negative amortization does

occur, the maximum principal balance cannot increase more than ________% of the original loan amount. If the maximum

balance is reached, the ARM loan will immediately re-amortize and the ARM loan's monthly payment will be re-calculated in order

to pay off the ARM loan within the original loan term. The minimum (or limited) payment may be less than the amount of interest

due that month and may not reduce the amount you owe on your mortgage. The amount of any interest you do not pay will be

added to the principal of the ARM loan, increasing the amount you owe and your future monthly payments, and will increase the

amount of interest you will pay over the life of the ARM loan. If any of your ARM loan payments is not sufficient to cover the

interest due, the difference will be added to your loan amount.

Your periodic payments will not fully amortize your loan and you will be required to make a single

payment of the periodic payment plus the remaining unpaid balance at the end of the loan term.

You will be notified at least annually if interest rate changes occur. When an interest rate change will also involve a change in your

monthly payment, you will be notified in writing (at least 25 calendar days, but not more than 120 calendar days) before the payment at

the new level is due. The notice will indicate the adjusted payment amount, interest rate, Index value, and the outstanding loan balance

at the time.

Your payment can change every ______ month(s) based on change in the loan term, interest rate, or loan balance. For example, on a

$10,000 ______ month(s) loan with an initial interest rate of ________% in effect as of ___________, the maximum amount

that the interest rate can rise under this program is ________ percentage points, to _______ %, and the monthly payment can rise from

first-year payment of $ ________ to a maximum of $ _______ in the ______ year. To see what your payments would be, divide your

mortgage amount by $10,000; then multiple the monthly payment by that amount. For example, the monthly payment for a mortgage

amount of $60,000 would be: $60,000 divided by $10,000 = 6; 6 x $ ________ = $ _________ per month.



IMPORTANT LOAN INFORMATION

PREPAYMENT: (check applicable box)

DEMAND FEATURE: (check applicable box)

This description is for informational purposes only and does not constitute a commitment on the part of the Lender to

provide financing. The ARM Loan Documents will control the terms of the ARM loan; therefore, you should become familiar

with and understand the provisions of these documents. Upon execution of the ARM Loan Documents, both you and the

Lender will become bound by the terms of the ARM Loan Documents.

Borrower Acknowledgement

This ARM loan program does (or) does not have a pre-payment penalty.

If you are paying more than your regularly scheduled payment, you must notify us as to how you want the funds applied.

This loan program does (or) does not include a demand feature.

If a demand feature applies, the lender may demand full repayment of a mortgage for any reason.

If this program disclosure has not fully answered your questions concerning the ARM loan program you are considering, please ask your

Mortgage Representative for additional information.

I/we acknowledge receipt of this disclosure and further acknowledge that this disclosure was completed in full prior to its receipt.

I/we also acknowledge receipt of the handbook entitled, "Consumer Handbook of Adjustable Rate Mortgages."

Borrower Date

Borrower Date



BORROWER INFORMATION DOCUMENT

This document is being provided to you pursuant to the Residential Mortgage License Act of 1987 and Rules promulgated thereunder (38 Ill. Adm. Code 1050). The purpose of this document is to set forth those exhibits and materials you should receive or be receiving in connection with your residential mortgage loan application with American Fidelity Financial Services, Inc., holder of License 4222 and regulated by the State of Illinois, Division of Banking, under the aforesaid Act.

Situations may arise that could affect the processing of the loan but that may not be known by American Fidelity Financial Services, Inc. at the time the application was taken. Examples of such situations include, but are not limited to 1) An appraisal value different from that estimated by the borrower; 2) Credit obligations the borrower fails to report; 3) A change in the borrower's financial circumstances that would result in his or her ineligibility for the loan; or 4) A material change or discontinuation of a loan program by an investor or other entity, such as the U.S. Department of Housing and Urban Development, the Veterans' Administration or a private investor.

The following documents will be furnished to the borrower if applicable.

1) Settlement Cost Booklet – For purchase loan transactions 2) Good Faith Estimate of Costs 3) Loan Application 4) Mortgage Escrow Account Act 5) Consumer Handbook on Adjustable Rate Mortgages

Upon request, the borrower shall be furnished the following documents:

1) A sample note and mortgage that will be executed if the loan applied for is approved. 2) A sample copy of the commitment letter 3) A general description of underwriting standards that will be considered in evaluating the

application.

LOAN BROKERAGE DISCLOSURE STATEMENT

American Fidelity Financial Services, Inc. does not make loans and actual funds are provided by another entity that may affect availability of funds.

American Fidelity Financial Services, Inc. an Illinois corporation is the name that is licensed under the Residential Mortgage License Act of 1987. We were previously American Federal Financial Services, Inc.

American Fidelity Financial Services, Inc. brokers loans to various lenders.

RIGHT TO RECEIVE APPRAISAL

American Fidelity Financial Services, Inc. shall provide to the borrower with a copy of all appraisals. American Fidelity Financial Services, Inc. shall provide a complete copy of any appraisal, including any appraisal generated using the Automated Valuation Model, obtained by the lender for use in underwriting the residential mortgage loan within 3 business days of receipt by the licensee, but in no event less than 24 hours prior to the day of closing. The appraisal may be sent via first class mail, commercial carrier, by facsimile or by e-mail, if the borrower has supplied an e-mail address.

The undersigned does hereby acknowledge receipt of all of the above applicable documents as of the __________ day of _______________, 20_____.

______________________________________ ______________________________________ (BORROWER SIGNATURE) (CO-BORROWER SIGNATURE)

NOTICE TO THE HOME LOAN APPLICANTCREDIT SCORE INFORMATION DISCLOSURE

APPLICANT(S) NAME AND ADDRESS LENDER NAME AND ADDRESS (ORIGINATOR):

In connection with your application for a home loan, the lender must disclose to you the score that a consumer reporting agencydistributed to users and the lender used in connection with your home loan, and the key factors affecting your credit scores.

The credit score is a computer-generated summary calculated at the time of the request and based on information a consumer reportingagency or lender has on file. The scores are based on data about your credit history and payment patterns. Credit scores are importantbecause they are used to assist the lender in determining whether you will obtain a loan. They may also be used to determine whatinterest rate you may be offered on the mortgage. Credit scores can change over time, depending on your conduct, how your credithistory and payment patterns change, and how credit-scoring technologies change.

Because the score is based on information in your credit history, it is very important that you review the credit related information that isbeing furnished to make sure it is accurate. Credit records may vary from one company to another.

If you have questions about your credit score or the credit information that is furnished to you, contact the consumer reporting agencyat the address and telephone number provided with this notice, or contact the lender, if the lender developed or generated the credit score. The consumer reporting agency plays no part in the decision to take any action on the loan application and is unable to provide you with specific reasons for the decision on a loan application.

If you have questions concerning the terms of the loan, contact the lender.

The consumer reporting agencies listed below provided a credit score that was used in connection with your home loan application.

Consumer Reporting Agency Borrower: Co-Brw:

Model Used:

Range of Possible Scores

to

Score: Created:

Factors

Score: Created:

Factors

page 1 of 2Calyx Form - csid1.frm (11/07)

American Fidelity

1600 Golf Rd


(P) 847-517-9900, (F) 847-201-2660

Experian

P.O. Box 9701

Allen, TX 75013

(P)888-397-3742


Consumer Reporting Agency Borrower: Co-Brw:

Model Used:


to

Score: Created:

Factors

Score: Created:

Factors

Model Used:


to

Score: Created:

Factors

Score: Created:

Factors

I/We have received a copy of this disclosure.

Applicant Date Applicant Date

page 2 of 2Calyx Form - csid2.frm (11/07)

TransUnion

P.O. Box 1000

Chester, PA 19022

(P)800-888-4213

Equifax

P.O. Box 740241

Atlanta, GA 30374

(P)800-685-1111


DISCLOSURE NOTICESDate:

Applicant(s): Property Address:

AFFIDAVIT OF OCCUPANCYApplicant(s) hereby certify and acknowledge that, upon taking title to the real property described above, their occupancy

status will be as follows:

Primary Residence - Applicant(s)shall occupy, establish, and use the Property as Applicant(s) principal residence within 60 days after closing and shall continue to occupy the Property as Applicant(s) principal residence for at least one year after the date of occupancy, unless Lender otherwise agrees in writing, which consent shall not be unreasonably withheld, or unless extenuating circumstances exist which are beyond Borrower’s control.

Secondary Residence - To be occupied by Applicant(s) at least 15 days yearly, as second home (vacation, etc.),while maintaining principal residence elsewhere. [Please check this box if you plan to establish it as your primaryresidence at a future date (e.g., retirement)].

Investment Property - Not owner occupied. Purchased as an investment to be held or rented.

The Applicant(s) acknowledge it is a federal crime punishable by fine or imprisonment, or both, to knowingly make any falsestatement concerning this loan application as applicable under the provisions of Title 18, United States Code, Section 1014.

APPLICANT SIGNATURE CO-APPLICANT SIGNATURE

ANTI-COERCION STATEMENT

The insurance laws of this state provide that the lender may not require the applicant to take insurance through anyparticular insurance agent or company to protect the mortgaged property. The applicant, subjected to the rules adopted bythe Insurance Commissioner, has the right to have the insurance placed with an insurance agent or company of his choice, provided the company meets the requirement of the lender. The lender has the right to designate reasonable financialrequirements as to the company and the adequacy of the coverage.I have read the foregoing statement, or the rules of the Insurance Commissioner relative hereto, and understand my rightsand privileges and those of the lender relative to the placing of such insurance.I have selected the following agencies to write the insurance covering the property described above:

Insurance Company Name Agent

Agent's Address Agent's Telephone Number


FAIR CREDIT REPORTING ACTAn investigation will be made as to the credit standing of all individuals seeking credit in this application. The nature and scopeof any investigation will be furnished to you upon written request made within a reasonable period of time. In the event of creditdenial due to an unfavorable consumer report, you will be advised of the identity of the Consumer Reporting Agency making suchreport and of your right to request within sixty (60) days the reason for the adverse action, pursuant to provisions of section 615(b)of the Fair Credit Reporting Act.


FHA LOANS ONLY

IF YOU PREPAY YOUR LOAN ON OTHER THAN THE REGULAR INSTALLMENT DATE, YOU MAY BE ASSESSED INTEREST CHARGES UNTIL THE END OF THAT MONTH.

GOVERNMENT LOANS ONLY

RIGHT TO FINANCIAL PRIVACY ACT OF 1978 - This is a notice to you as required by the Right to Financial Privacy Act of 1978 that the Department of Housing and Urban Development or Department of Veterans Affairs has a right of access to financial records held by a financialinstitution in connection with the consideration of administration of assistance to you. Financial records involving your transaction will be available to the Department of Housing and Urban Development or Department of Veterans Affairs without further notice or authorization but will not be disclosed or released to another Government agency or Department without your consent except as required or permitted by law.


Calyx Form - disnot.frm (9/10)


AMERICAN FIDELITY FINANCIAL SERVICES, INC. Illinois Residential Mortgage Licensee

1600 Golf Road, Suite 1200 Rolling Meadows, IL 60008

Phone: (800) 325-0400 | Fax: (847) 517-9910 | [email protected]

DOCUMENTATION REQUIRED TO OBTAIN FINANCING

Certain documentation will be required from the borrower(s) in order to obtain any given mortgage program. To help ensure that the following lock agreement (shown below) will not expire, please send the following information as soon as possible.

DATE DATE REQUIRED REQUESTED RECEIVED

_____ 2 PAYSTUBS FOR EACH BORROWER 0-30 DAYS OLD………..__________ __________ _____ PAST 2 YEARS W2 FORMS…………………………………………………__________ __________ _____ PAST 2 YEARS 1040 FORMS WITH ALL SCHEDULES……………__________ __________ _____ 1ST MORTGAGE NOTE……………………………………………………….__________ __________ _____ 1ST AND 2ND MORTGAGE STATEMENT……………………………….__________ __________ _____ HOMEOWNER’S INSURANCE…………………………………………….__________ __________ _____ PAST 3 MONTH’S BANK STATEMENTS………………………………__________ __________ _____ SOCICAL SECURITY AWARD LETTER………………………………….__________ __________ _____ PENSION AWARD LETTER…………………………………………………__________ __________ _____ RENTAL LEASE AGREEMENT…………………………………………….__________ __________ _____ CURRENT PROFIT AND LOSS STATEMENT………………………..__________ __________ _____ BANKRUPTCY DISCHARGE PAPERS…………………………………..__________ __________ _____ HUD1 (SETTLEMENT STATEMENT) PRIOR MORTGAGES….__________ __________ _____ DRIVER’S LICENSE & SOCIAL SEC. CARD ALL BORROWERS__________ __________

LOCK / FLOAT DISCLOSURE

Date:__________ Time:__________

Pricing Options

This is a brief overview of the options we can offer for your loan. Please read, indicate your selection, and sign. Make certain that you understand the option you have chosen. Do not hesitate to ask questions.

Commit

_____ We will commit to fund a loan amount of __________ at the price and rate in effect at the time of application provided the loan disburses within _____ days of application and loan is approved by investor with whom the loan is locked. Lock expires on _______________.

RATE: _____ PRICE: _____ TERM: _____ Circle one: FIXED RATE / ADJUSTABLE RATE

At Market

_____ No commitment is made for either rate or price. The rate and price in effect the day of closing will be charged, unless the loan is prior committed. Loan products may change during the time a loan is not locked. As such, the rate, term, and closing costs may be dramatically different at time of closing if a loan is not locked until the closing date. Reverse mortgages typically cannot be locked until the date of closing and the above “At Market” disclosure applies.

________________________________ ________________________________ Borrower Date Co-Borrower Date

________________________________ LOAN ORIGINATOR’S Signature Date

EQUAL CREDIT OPPORTUNITY ACT The federal equal credit opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national origin, sex, marital status, age (provided the applicant has the capacity to enter into a binding contract); because all or part of the applicant’s income derives from any public assistance program; or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. The federal Agency that administers compliance with this law concerning this company is the Federal Trade Commission, Pennsylvania and 6th Street N.W., Washington, DC 20580. We are required to disclose to you that you need not disclose income from alimony, child support or separate maintenance payment if you choose not to do so. Having made this disclosure to you, we are permitted to inquire if any of the income shown on you application is derived from such a source and to consider the likelihood of consistent payment as we do with any income on which you are relying to qualify for the loan which you are applying

Borrowers' Certification and Authorization CERTIFICATION The Undersigned certify the following: 1. I/We have applied for a mortgage loan from American Fidelity Financial Services, Inc. In applying for the loan, I/We completed a loan application containing various information on the purpose of the loan, the amount and source of the down payment, employment and income information, and the assets and liabilities. I/We certify that all of the information is true and complete. I/We made no misrepresentations in the loan application or other documents, nor did I/We omit any pertinent information. 2. I/We understand and agree that American Fidelity Financial Services, Inc. reserves the right to change the mortgage loan review processes to a full documentation program. This may include verifying the information provided on the application with the employer and/or the financial institution. 3. I/We fully understand that it is a Federal crime punishable by fine or imprisonment, or both, to knowingly make any false statements when applying for this mortgage, as applicable under the provisions of Title 18, United States Code, Section 1014. AUTHORIZATION TO RELEASE INFORMATION To Whom It May Concern: 1. I/We have applied for a mortgage loan from American Fidelity Financial Services, Inc. As part of the application process, American Fidelity Financial Services, Inc. and the mortgage guaranty insurer (if any), may verify information contained in my/our loan application and in other documents required in connection with the loan, either before the loan is closed or as part of its quality control program. 2. I/We authorize you to provide to American Fidelity Financial Services, Inc. and to any investor to whom American Fidelity Financial Services, Inc. may sell my mortgage, any and all information and documentation that they request. Such information includes, but is not limited to, employment history and income; bank, money market and similar account balances; credit history; and copies of income tax returns. 3. American Fidelity Financial Services, Inc. or any investor that purchases the mortgage may address this authorization to any party named in the loan application. 4. A copy of this authorization may be accepted as an original. _________________________________ _________________________________ Borrower Signature Date Social Security Number _________________________________ _________________________________ Co-Borrower Signature Date Social Security Number

HUD/VA Addendum to Uniform Residential Loan Application OMB Approval No. VA: 2900-0144HUD: 2502-0059 (exp (2/28/2014))

Part I - Identifying Information (mark the type of application)

1. VA Application forHome Loan Guaranty

HUD/FHA Application for Insuranceunder the National Housing Act

2. Agency Case No: (include any suffix) 3. Lender's Case No. 4. Section of the Act(for HUD cases)

5. Borrower's Name & Present Address (include zip code)

6. Property Address (including name of subdivision, lot & block no. & zip code)

7. Loan Amount (include the UFMIP iffor HUD or Funding Fee if for VA)

$

8. Interest Rate

%

9. Proposed Maturity

yrs. mos.

10. Discount Amount(only if borrower ispermitted to pay)

11. Amount of UpFront Premium

$

12a. Amount of MonthlyPremium

$ /mo.

12b.Term of MonthlyPremium

months

13. Lender's I.D. Code 14. Sponsor/Agent I.D. Code

15. Lender's Name & Address (include zip code) 16. Name & Address of Sponsor/Agent

17. Lender's Telephone Number

Type or Print all entries clearly

VA: The veteran and the lender hereby apply to the Secretary of Veterans Affairs for Guaranty of the loan described here under Section 3710,Chapter 37, Title 38, United States Code, to the full extent permitted by the veteran's entitlement and severally agree that the Regulationspromulgated pursuant to Chapter 37, and in effect on the date of the loan shall govern the rights, duties, and liabilities of the parties.

18. First TimeHomebuyer ?

a. Yes

b. No

19. VA Only:

7)Construct Home (proceeds to be paid out duringconstruction)

8) Finance Co-op Purchase

Title will be Vested in:

Veteran

Veteran & Spouse

Other (Specify):

20. Purpose of Loan (blocks 9 - 12 are for VA loans only)

1) Purchase Existing Home Previously Occupied

2) Finance Improvements to Existing Property

3) Refinance (Refi.)

4) Purchase New Condo. Unit

5) Purchase Existing Condo. Unit

6) Purchase Existing Home Not Previously Occupied

9) Purchase Permanently Sited Manufactured Home

10) Purchase Permanently Sited Manufactured Home & Lot

11) Refi. Permanently Sited Manufactured Home to Buy Lot

12) Refi. Permanently Sited Manufactured Home/Lot Loan

Part II - Lender's Certification21. The undersigned lender makes the following certifications to inducethe Department of Veterans Affairs to issue a certificate of commitmentto guarantee the subject loan or a Loan Guaranty Certificate under Title38, U. S. Code, or to induce the Department of Housing and UrbanDevelopment - Federal Housing Commissioner to issue a firm commit-ment for mortgage insurance or a Mortgage Insurance Certificateunder the National Housing Act.A. The loan terms furnished in the Uniform Residential Loan Application

and this Addendum are true, accurate and complete.B. The information contained in the Uniform Residential Loan Application

and this Addendum was obtained directly from the borrower by anemployee of the undersigned lender or its duly authorized agentand is true to the best of the lender's knowledge and belief.

C. The credit report submitted on the subject borrower (andco-borrower, if any) was ordered by the undersigned lender or itsduly authorized agent directly from the credit bureau which preparedthe report and was received directly from said credit bureau.

D. The verification of employment and verification of deposits wererequested and received by the lender or its duly authorized agentwithout passing through the hands of any third persons and are trueto the best of the lender's knowledge and belief.

E. The Uniform Residential Loan Application and this Addendum weresigned by the borrower after all sections were completed.

F. This proposed loan to the named borrower meets the income and creditrequirements of the governing law in the judgment of the undersigned.

G. To the best of my knowledge and belief, I and my firm and itsprincipals: (1) are not presently debarred, suspended, proposed fordebarment, declared ineligible, or voluntarily excluded from coveredtransactions by any Federal department or agency; (2) have not, withina three-year period preceding this proposal, been convicted of or hada civil judgment rendered against them for (a) commission of fraud ora criminal offense in connection with obtaining, attempting to obtain,or performing a public (Federal, State or local) transaction or contractunder a public transaction; (b) violation of Federal or State antitruststatutes or commission of embezzlement, theft, forgery, bribery,falsification or destruction of records, making false statements, orreceiving stolen property; (3) are not presently indicted for or otherwisecriminally or civilly charged by a governmental entity (Federal, State orlocal) with commission of any of the offenses enumerated in paragraphG(2) of this certification; and (4) have not, within a three-year periodpreceding this application/proposal, had one or more public transactions(Federal, State or local) terminated for cause or default.

Items "H" through "J" are to be completed as applicable for VA loans only.H. The names and functions of any duly authorized agents who developed on behalf of the lender any of the information or supporting credit data submitted are as

follows:

Name & Address Function (e.g., obtained information on the Uniform Residential LoanApplication, ordered credit report, verifications of employment, deposits, etc.)

If no agent is shown above, the undersigned lender affirmatively certifies that all information and supporting credit data were obtained directly by the lender.

I. The undersigned lender understands and agrees that it is responsible for the omissions, errors, or acts of agents identified in item H as to the functionswith which they are identified

J. The proposed loan conforms otherwise with the applicable provisions of Title 38, U.S. Code, and of the regulations concerning guaranty or insurance of loansto veterans.

Signature of Officer of Lender Title of Officer of Lender Date (mm/dd/yyyy)

Part III - Notices to Borrowers. Public reporting burden for this collection of information is estimated to average 6 minutes per response, including the time forreviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Thisagency may not conduct or sponsor, and a person is not required to respond to, a collection information unless that collection displays a valid OMB control numbercan be located on the OMB Internet page at http://www.whitehouse.gov/omb/library/OMBINV.LIST.OF.AGENCIES.html#LIST_OF_AGENCIES.Privacy Act Information. The information requested on the Uniform Residential Loan Application and this Addendum is authorized by 38 U.S.C. 3710 (if for DVA)and 12 U.S.C. 1701 et seq. (if for HUD/FHA). The Debt Collection Act of 1982, Pub. Law 97-365, and HUD's Housing and Community Development Act of 1987, 42U.S.C. 3543, require persons applying for a federally insured or guaranteed loan to furnish his/her social security number (SSN). You must provide all the requestedinformation, including your SSN. HUD and/or VA may conduct a computer match to verify the information you provide. HUD and/or VA may disclose certaininformation to Federal, State, and local agencies when relevant to civil, criminal, or regulatory investigations and prosecutions. It will not otherwise be disclosed orreleased outside of HUD or VA, except as required and permitted by law. The information will be used to determine whether you qualify as a mortgagor. Anydisclosure of information outside VA or HUD/FHA will be made only as permitted by law. Failure to provide any of the requested information, including SSN, may

VA Form 26-1802aform HUD-92900-A (09/2010)page 1

Calyx Form - fhavaa1.frm (04/11)


result in disapproval of your loan application. This is notice to you as required by the Right to Financial Privacy Act of 1978 that VA or HUD/FHA has a right of accessto financial records held by financial institutions in connection with the consideration or administration of assistance to you. Financial records involving yourtransaction will be available to VA and HUD/FHA without further notice or authorization but will not be disclosed or released by this institution to another GovernmentAgency or Department without your consent except as required or permitted by law. Caution. Delinquencies, defaults, foreclosures and abuses of mortgage loans involvingprograms of the Federal Government can be costly and detrimental to your credit, now and in the future. The lender in this transaction, its agents and assigns as well as theFederal Government, its agencies, agents and assigns, are authorized to take any and all of the following actions in the event loan payments become delinquent on themortgage loan described in the attached application: (1) Report your name and account information to a credit bureau; (2) Assess additional interest and penalty chargesfor the period of time that payment is not made; (3) Assess charges to cover additional administrative costs incurred by the Government to service your account; (4) Offsetamounts owed to you under other Federal programs; (5) Refer your account to a private attorney, collection agency or mortgage servicing agency to collect the amount due,foreclose the mortgage, sell the property and seek judgment against you for any deficiency; (6) Refer your account to the Department of Justice for litigation in the courts;(7) If you are a current or retired Federal employee, take action to offset your salary, or civil service retirement benefits; (8) Refer your debt to the Internal Revenue Service foroffset against any amount owed to you as an income tax refund; and (9) Report any resulting written-off debt of yours to the Internal Revenue Service as your taxable income.All of these actions can and will be used to recover any debts owed when it is determined to be in the interest of the lender and/or the Federal Government to do so.

Part IV - Borrower Consent for Social Security Administration to Verify Social Security NumberI authorize the Social Security Administration to verify my Social Security number to the Lender identified in this document and HUD/FHA, through a computer matchconducted by HUD/FHA.I understand that my consent allows no additional information from my Social Security records to be provided to the Lender, and HUD/FHA and that verification of mySocial Security number does not constitute confirmation of my identity. I also understand that my Social Security number may not be used for any other purpose thanthe one stated above, including resale or redisclosure to other parties. The only other redisclosure permitted by this authorization is for review purposes to ensure thatHUD/FHA complies with SSA's consent requirements.

I am the individual to whom the Social Security number was issued or that person's legal guardian. I declare and affirm under the penalty of perjury that the informationcontained herein is true and correct. I know that if I make any representation that I know is false to obtain information from Social Security records, I could be punishedby a fine or imprisonment or both.This consent is valid for 180 days from the date signed, unless indicated otherwise by the individual(s) named in this loan application.

Read consent carefully. Review accuracy of social security number(s) and birth dates provided on this application.Signature(s) of Borrower(s) Date signed Signature(s) of Co-Borrower(s) Date signed

/ / / /Part V - Borrower Certification22. Complete the following for a HUD/FHA Mortgage

22 a. Do you own or have you sold other real estate within the past60 months on which there was a HUD / FHA mortgage? Yes No

Is it to be sold?

Yes No

22 b. Sales Price

$

22 c. Original Mortgage Amt

$

22 d. Address

22 e. If the dwelling to be covered by this mortgage is to be rented, is it a part of, adjacent or contiguous to any project subdivision or group of concentratedrental properties involving eight or more dwelling units in which you have any financial interest? Yes No If "Yes" give details.

22 f. Do you own more than four dwellings? Yes No If "Yes" submit form HUD-92561.

23. Complete for VA - Guaranteed Mortgage. Have you ever had a VA home loan? Yes No

24. Applicable for Both VA & HUD. As a home loan borrower, you will be legally obligated to make the mortgage payments called for by your mortgage loan contract.The fact that you dispose of your property after the loan has been madewill not relieve you of liability for making these payments. Payment of the loanin full is ordinarily the way liability on a mortgage note is ended. Some home buyers have the mistaken impression that if they sell their homes when theymove to another locality, or dispose of it for any other reasons, they are no longer liable for the mortgage payments and that liability for these payments is solelythat of the new owners. Even though the new owners may agree in writing to assume liability for your mortgage payments, this assumption agreement will notrelieve you from liability to the holder of the note which you signed when you obtained the loan to buy the property. Unless you are able to sell the property to abuyer who is acceptable to VA or to HUD/FHA and who will assume the payment of your obligation to the lender, you will not be relieved from liability to repay anyclaim which VA or HUD/FHA may be required to pay your lender on account of default in your loan payments.The amount of any such claim payment will bea debt owed by you to the Federal Government. This debt will be the object of established collection procedures.

25. I, the Undersigned Borrower(s) Certify that:

(1) I have read and understand the foregoing concerning my liability on theloan and Part III Notices to Borrowers.

(2) Occupancy: (for VA only -- mark the applicable box)(a) I now actually occupy the above-described property as my home orintend to move into and occupy said property as my home within areasonable period of time or intend to reoccupy it after the completion ofmajor alterations, repairs or improvements.

(b) My spouse is on active military duty and in his or her absence, I occupyor intend to occupy the property securing this loan as my home.

(c) I previously occupied the property securing this loan as my home. (forinterest rate reductions)

(d) While my spouse was on active military duty and unable to occupy theproperty securing this loan, I previously occupied the property that issecuring this loan as my home. (for interest rate reduction loans)

Note: If box 2b or 2d is checked, the veteran's spouse must also sign below.

(3) Mark the applicable box (not applicable for Home Improvement or Refi-nancing Loan) I have been informed that ($ ) is:

the reasonable value of the property as determined by VA or;

the statement of appraised value as determined by HUD/FHA.

Note: If the contract price or cost exceeds the VA "Reasonable Value"or HUD/FHA "Statement of Appraised Value" mark either item (a) or item(b), whichever is applicable.

(a) I was aware of this valuation when I signed my contract and I havepaid or will pay in cash from my own resources at or prior to loan closing a sum equal to the difference between the contract purchase price orcost and the VA or HUD/FHA established value.

I do not and will not have outstanding after loan closing any unpaidcontractual obligation on account of such cash payment;

(b) I was not aware of this valuation when I signed my contract but haveelected to complete the transaction at the contract purchase price or cost.I have paid or will pay in cash from my own resources at or prior to loanclosing a sum equal to the difference between contract purchase price orcost and the VA or HUD/FHA established value. I do not and will not haveoutstanding after loan closing any unpaid contractual obligation on accountof such cash payment.

(4) Neither I, nor anyone authorized to act for me, will refuse to sell or rent, afterthe making of a bona fide offer, or refuse to negotiate for the sale or rental of,or otherwise make unavailable or deny the dwelling or property covered byhis/her loan to any person because of race, color, religion, sex, handicap,familial status or national origin. I recognize that any restrictive covenant onthis property relating to race, color, religion, sex, handicap, familial status ornational origin is illegal and void and civil action for preventive relief may bebrought by the Attorney General of the United States in any appropriate U.S.District Court against any person responsible for the violation of theapplicable law.

(5) All information in this application is given for the purpose of obtaining a loanto be insured under the National Housing Act or guaranteed by the Depart-ment of Veterans Affairs and the information in the Uniform Residential LoanApplication and this Addendum is true and complete to the best of myknowledge and belief. Verification may be obtained from any source namedherein.

(6) For HUD Only (for properties constructed prior to 1978) I have receivedinformation on lead paint poisoning. Yes Not Applicable

(7) I am aware that neither HUD/FHA nor VA warrants the condition orvalue of the property.

Signature(s) of Borrower(s) -- unless this application is fully completed. Read the certifications carefully & review accuracy of this application.Do not sign

Signature(s) of Borrower(s) Date signed Signature(s) of Co-Borrower(s) Date signed

/ / / /X X

VA Form 26-1802aform HUD-92900-A (09/2010)

( Borrowers Must Sign Both Parts IV & V ) Federal statutes provide severe penalties for any fraud, intentional misrepresentation, or criminal connivance or conspiracy purposed toinfluence the issuance of any guaranty or insurance by the VA Secretary or the HUD/FHA Commissioner.

page 2

Calyx Form - fhavaa2.frm (04/11)


Direct Endorsement Approval for a HUD/FHA-Insured Mortgage U.S. Department of Housingand Urban Development

Part I - Identifying Information (mark the type of application) 2. Agency Case No. (include any suffix) 3. Lender's Case No. 4. Section of the Act(for HUD cases)

1. HUD/FHA Application for Insuranceunder the National Housing Act

5. Borrower's Name & Present Address (include zip code) 7. Loan Amount (include the UFMIP)

$

8. Interest Rate

%

9. Proposed Maturity

yrs. mos.

10. Discount Amount(only if borrower ispermitted to pay)

11. Amount of UpFront Premium

$

12a. Amount ofMonthly Premium

$ /mo.

12b. Term ofMonthly Premium

months

6. Property Address (including name of subdivision, lot & block no. & zip code)

14. Sponsor/Agent I.D. Code13. Lender's I.D. Code

15. Lender's Name & Address (include zip code) 16. Name & Address of Sponsor/Agent

17. Lender's Telephone NumberType or Print all entries clearly

SponsoredOriginations

Name of Loan Origination Company Tax ID of Loan Origination Company NMLS ID of Loan Origination Company

Approved: Approved subject to the additional conditions stated below, if any.

Date Mortgage Approved Date Approval Expires

Modified &Approvedas follows:

Loan Amount (include UFMIP)

$

Interest Rate

%

Proposed Maturity

yrs. mos.

Monthly Payment

$

Amount of UpFront Premium

$

Amount of MonthlyPremium

$

Term of MonthlyPremium

months

Additional Conditions:

If this is proposed construction, the builder has certified compliance with HUD requirements on form HUD-92541.

If this is new construction, the lender certifies that the property is 100% complete (both on site and off site improvements) and the property meetsHUD's minimum property standards and local building codes.

Form HUD-92544, Builder's Warranty is required.

The property has a 10-year warranty.

Owner-Occupancy Not required (item (b) of the Borrower's Certificate does not apply).

The mortgage is a high loan-to-value ratio for non-occupant mortgagor in military.

Other: (specify)

This mortgage was rated as an "accept" or "approve" by FHA's Total Mortgage Scorecard. As such, the undersigned representative of the mortgagee

certifies to the integrity of the data supplied by the lender used to determine the quality of the loan, that a Direct Endorsement Underwriter reviewed

the appraisal (if applicable) and further certifies that this mortgage is eligible for HUD mortgage insurance under the Direct Endorsement program.

I hereby make all certifications required for this mortgage as set forth in HUD Handbook 4000.4

Mortgagee Representative:

This mortgage was rated as a “refer” by FHA's Total Mortgage Scorecard, and/or was manually underwritten by a Direct Endorsement

underwriter. As such, the undersigned Direct Endorsement underwriter certifies that I have personally reviewed the appraisal report (if

applicable), credit application, and all associated documents and have used due diligence in underwriting this mortgage. I find that this

mortgage is eligible for HUD mortgage insurance under the Direct Endorsement program and I hereby make all certifications required for

this mortgage as set forth in HUD Handbook 4000.4

Direct Endorsement Underwriter DE's CHUMS ID Number

The Mortgagee, its owners, officers, employees or directors do do not have a financial interest in or arelationship, by affiliation or ownership, with the builder or seller involved in this transaction.

formVA Form

HUD-92900-A (09/2010)26-1802a

page 3Calyx Form - fhavaa3.frm (04/11)


Borrower's Certificate The undersigned certifies that:

(a) I will not have outstanding any other unpaid obligations contracted in connection with the mortgage transaction or the purchase of the

said property except obligations which are secured by property or collateral owned by me independently of the said mortgagedproperty, or obligations approved by the Commissioner;

(b) One of the undersigned intends to occupy the subject property, (note: this item does not apply if owner-occupancy is not required

by the commitment);(c) All charges and fees collected from me as shown in the settlement statement have been paid by my own funds, and no other

charges have been or will be paid by me in respect to this transaction;(d) Neither I, nor anyone authorized to act for me, will refuse to sell or rent, after the making of a bona fide offer, or refuse to negotiate

for the sale or rental of or otherwise make unavailable or deny the dwelling or property covered by this loan to any person because ofrace, color, religion, sex, handicap, familial status or national origin. I recognize that any restrictive covenant on this property relatingto race, color, religion, sex, handicap, familial status or national origin is illegal and void and any such covenant is hereby specificallydisclaimed. I understand that civil action for preventative relief may be brought by the Attorney General of the United States in anyappropriate U.S. District Court against any person responsible for a violation of this certificate.

Borrower'(s) Signature(s) & Date

Lender's Certificate The undersigned certifies that to the best of its knowledge:

(a) The statements made in its application for insurance and in this Certificate are true and correct;

(b) The conditions listed above or appearing in any outstanding commitment issued under the above case number have been fulfilled;(c) Complete disbursement of the loan has been made to the borrower, or to his/her creditors for his/her account and with his/her consent;(d) The security instrument has been recorded and is a good and valid first lien on the property described;

(e) No charge has been made to or paid by the borrower except as permitted under HUD regulations;(f) The copies of the credit and security instruments which are submitted herewith are true and exact copies as executed and filed for

record;

(g) It has not paid any kickbacks, fee or consideration of any type, directly or indirectly, to any party in connection with this transactionexcept as permitted under HUD regulations and administrative instructions.

I, the undersigned, as authorized representative of , mortgageeat this time of closing of this mortgage loan, certify that I have personally reviewed the mortgage loan documents, closing statements,

application for insurance endorsement, and all accompanying documents. I hereby make all certifications required for this mortgage asset forth in HUD Handbook 4000.4.

Lender's Name Note: If the approval is executed by an agent in

the name of lender, the agent must enter thelender's code number and type.

Title of Lender's Officer

Signature of Lender's Officer Date

Code Number (5 digits) Type

Calyx Form - fhavaa4.frm (04/11) page 4 form HUD-92900-A (09/2010)

VA Form 26-1802a

American Fidelity


NOTICE TO HOMEOWNER

File No.:Property Address :

Assumption of HUD/FHA-Insured MortgagesRelease of Personal Liability

You are legally obligated to make the monthly payments required by your mortgage (deed of trust) and promissorynote.

The Department of Housing and Urban Development (HUD) has acted to keep investors and noncreditworthypurchasers from acquiring one- to four-family residential properties covered by certain FHA-insured mortgages.There are minor exceptions to the restriction on investors: loans to public agencies and some nonprofitorganizations, Indian tribes or servicepersons; and loans under special mortgage insurance programs for propertysold by HUD, rehabilitation loans or refinancing of insured mortgages. Your lender can advise you if you areincluded in one of these exceptions.

HUD will therefore direct the lender to accelerate this FHA-insured mortgage loan if all or part of the property issold or transferred to a purchaser or recipient (1) who will not occupy the property as his or her principalresidence, or (2) who does occupy the property but whose credit has not been approved in accordance with HUDrequirements. This policy will apply except for certain sales or transfers where acceleration is prohibited by law.

When a loan is accelerated, the entire balance is declared ''immediately due and payable." Since HUD will notapprove the sale of the property covered by this mortgage to an investor or to a person whose credit has not beenapproved, you, the original homeowner, would remain liable for the mortgage debt even though the title to theproperty might have been transferred to the new buyer.

Even if you sell your home by letting an approved purchaser (that is, a creditworthy owner-occupant) assume yourmortgage, you are still liable for the mortgage debt unless you obtain a release from liability from your mortgagelender. FHA-approved lenders have been instructed by HUD to prepare such a release when an original homeownersells his or her property to a creditworthy purchaser who executes an agreement to assume and pay the mortgagedebt and thereby agrees to become the substitute mortgagor. The release is contained in FormHUD-92210-1, (''Approval of Purchaser and Release of Seller"). You should ask for it if the mortgage lender doesnot provide it to you automatically when you sell your home to a creditworthy owner-occupant purchaser whoexecutes an agreement to assume personal liability for the debt. When this form is executed, you are no longerliable for the mortgage debt.

You must sign and date this notice as indicated, return one copy to your lender as proof of notification and keep one copy for your records.

Applicant Date

Applicant Date

* Instruction to lender : A copy of this notice must be given to the mortgagor(s) on or before the date of settlement.You should retain asigned copy in the origination file.

CALYX Form Nothom.frm 9/99


INFORMED CONSUMER CHOICE DISCLOSURE NOTICE

Borrower(s): Property Addr:

Loan Number:

______________________________

______________________________

______________________________

______________________________

______________________________

In addition to an FHA-insured mortgage, you may also qualify for other mortgage products offered by your lender. To assure that youare aware of possible choices in financing, your lender has prepared a comparison of the typical costs of alternative conventional mortgageproduct(s) below, using representative loan amounts and costs (the actual loan amounts and associated costs shown below will vary from your own mortgage loan transaction). You should study the comparison carefully, ask questions, and determine which product is best foryou. The information provided below was prepared as of

Neither your lender nor FHA warrants that you actually qualify for any mortgage loan offered by your lender. This notice is provided to identify the key differences between these mortgage products offered by your lender. This disclosure is not a contract and does notconstitute loan approval. Actual mortgage approval can only be made following a full underwriting analysis by your mortgage lender.

1

2

3

4

5

6

7

8

9

10

Sales Price

Mortgage Amount

(with Up-front Mortgage Insurance Premium)

Closing Costs

Down Payment Needed

Interest Rate and Term of Loan in Years

Monthly Payment (principal and interest only)

Loan-to-Value

Monthly Mortgage Insurance Premium (first year) *

Maximum # of Years of Monthly Insurance Premium Payments

Up-front Mortgage Insurance Premium (if applicable) **

(Included in Mortgage Amount, line 2)

FHA Mortgage Insurance Premium Information:

* Monthly mortgage insurance premiums are calculated on the average annual principal balance, i.e., as the amount you owe on the loandecreases each year, so does the amount of the monthly premium.

** Based on an up-front mortgage insurance premium rate of %.

If you paid an up-front mortgage insurance premium, you will also be charged a monthly mortgage insurance premium until theloan-to-value ratio of your mortgage reaches 78 percent of the sales price or appraised value of your home, whichever was lowerinitial(provided that premiums are paid for at least five years). You will reach 78 percent loan-to-value threshold in one of two ways: Throughnormal amortization as you make your monthly payments, or by paying additional principal on the mortgage. Your lender can adviseyou on when the mortgage will reach the 78 percent level through normal amortization.

If you have a 15-year mortgage and make a downpayment in excess of 10 percent, you will not have to make monthly mortgageinsurance premiums. You will also reach the 78 percent loan-to-value threshold earlier than on longer term mortgages and may not haveto pay monthly mortgage insurance premiums for the full five years.

You are required to make these payments on your FHA-insured loan unless you refinance or the mortgage is otherwise paid in full.

I/We have received a copy of this disclosure.

Borrower

Borrower

Date

Date

Calyx Form - ccdisc.frm(3/09)

FHA Financing 203(b) FixedRate

Conventional Financing97% w/Mtg Insurance

100,000

97,750

99,216

2,000

4,250

7.00 % / 30 yrs

660.00

97.75 %

39.94

14 yrs

1,466

100,000

97,000

2,000

5,000

7.00 % / 30 yrs

645.00

97.00 %

76.63

13 yrs

1.5


Important Notice to Homebuyers U.S. Department of Housingand Urban Development

Office of Housing - FederalHousing Commissioner

OMB Approval No. 2502-0059(Expires 02/28/2014)

You must read this entire document at the time you apply for the loan.Return one copy to lender as proof of notification and keep one copy for your records.

Condition of Property

The property you are buying is not HUD/FHA approved and HUD/FHA does not warrant the condition or the valueof the property. An appraisal will be performed to estimate the value of the property, but this appraisal does not guarantee that the house is free of defects. You should inspect the property yourself very carefully or hire aprofessional inspection service to inspect the property for you.

Interest Rate and Discount Points

HUD does not regulate the interest rate or the dis-count points that may be paid by you or the seller or otherthird party. You should shop around to be sure you aresatisfied with the loan terms offered and with the servicereputation of the lender you have chosen.

The interest rate, any discount points and the length oftime the lender will honor the loan terms are all negoti-ated between you and the lender.

The seller can pay the discount points, or a portionthereof, if you and the seller agree to such an arrange-ment.

Lenders may agree to guarantee or "lock-in" the loan

terms for a definite period of time (i.e., 15, 30, 60 days,etc.) or may permit your loan to be determined by futuremarket conditions, also known as "floating". Lendersmay require a fee to lock in the interest rate or the termsof the loan, but must provide a written agreement cover-ing a minimum of 15 days before the anticipated closing.Your agreement with the lender will determine the de-gree, if any, that the interest rate and discount pointsmay rise before closing.

If the lender determines you are eligible for the mort-gage, your agreement with the seller may require you tocomplete the transaction or lose your deposit on theproperty.

Don't Commit Loan FraudIt is important for you to understand that you are requiredto provide complete and accurate information whenapplying for a mortgage loan.

Do not falsify information about your income or as-sets.

Disclose all loans and debts (including money thatmay have been borrowed to make the downpayment).

Do not provide false letters-of-credit, cash-on-handstatements, gift letters or sweat equity letters.

Do not accept funds to be used for your downpaymentfrom any other party (seller, real estate salesperson,builder, etc.).

Do not falsely certify that a property will be used foryour primary residence when you are actually going touse it as a rental property.

Do not act as a "strawbuyer" (somebody who pur-chases a property for another person and then transferstitle of the property to that person), nor should you give thatperson personal or credit information for them touse in any such scheme.

Do not apply for a loan by assuming the identityof another person.

Do not sign an incomplete or blank document;that is, one missing the name and address of therecipient and/or other important identifying infor-mation.

Penalties for Loan Fraud: Federal laws provide se-vere penalties for fraud, misrepresentation, or con-spiracy to influence wrongly the issuance of mortgageinsurance by HUD. You can be subject to a possibleprison term and fine of up to $10,000 for providing falseinformation. Additionally, you could be prohibited fromobtaining a HUD-insured loan for an indefinite period.

Report Loan Fraud: If you are aware of any fraud inHUD programs or if an individual tries to persuade youto make false statements on a loan application, youshould report the matter by calling your nearest HUDoffice or the HUD Regional Inspector General, or call theHUD Hotline on 1 (800) 347-3735.

Warning: It is a crime to knowingly make false state-ments to the United States Government on this or anysimilar form. Penalties upon conviction can include afine and imprisonment. For details see: Title 18 U.SCode Section 1001 and Section 1010.

Discrimination

If you believe you have been subject to discrimination because of race, color, religion, sex, handicap, familial status,or national origin, you should call HUD's Fair Housing & Equal Opportunity Complaint Hotline: 1 (800) 669-9777.

Page 1 of 2Previous editions are obsoleteCalyx Form - H92900b1.frm (04/11)

form HUD-92900-B (12/2004)ref. Handbooks 4150.1 & 4155.1


About Prepayment

This notice is to advise you of the requirements thatmust be followed to accomplish a prepayment of yourmortgage, and to prevent accrual of any interest afterthe date of prepayment.

You may prepay any or all of the outstanding indebted-ness due under your mortgage at any time, withoutpenalty. However, to avoid the accrual of interest onany prepayment, the prepayment must be received onthe installment due date (the first day of the month) if thelender stated this policy in its response to a request fora payoff figure.

Otherwise, you may be required to pay interest on theamount prepaid through the end of the month. The lendercan refuse to accept prepayment on any date otherthan the installment due date.

FHA Mortgage Insurance Information

Who may be eligible for a refund?

Premium Refund: You may be eligible for a refund ofa portion of the insurance premium if you paid anupfront mortgage insurance premium at settlement andare refinancing with another FHA mortgage.

Review your settlement papers or check with yourmortgage company to determine if you paid an upfrontpremium.

Exceptions

Assumptions: When a FHA insured loan is assumedthe insurance remains in force (the seller receives norefund). The owner(s) of the property at the time theinsurance is terminated is entitled to any refund.

FHA-to-FHA Refinance: When a FHA insured loan isrefinanced, the refund from the old premium may beapplied toward the upfront premium required for the newloan.

How are Refunds Determined?The FHA Commissioner determines how much of theupfront premium is refunded when loans are terminated.Refunds are based on the number of months the loan isinsured.

Monthly Insurance Premiums

If you paid an upfront mortgage insurance premium,you will also be charged a monthly mortgage insurancepremium until the loan-to-value of your mortgagereaches 78 percent of the initial sales price or ap-praised value of your home, whichever was lower(provided that premiums are paid for at least fiveyears). You will reach the 78 percent loan-to-valuethreshold in one of two ways: Through normal amortiza-tion as you make your monthly payments, or by payingadditional principal on the mortgage. Your lender canadvise you on when the mortgage will reach the 78percent loan-to-value threshold. If you were notcharged an upfront premium, you will pay the monthlypremium for the life of the mortgage.

Important: The rules governing the eligibility for premium refunds are based on thefinancial status of the FHA insurance fund and are subject to change.

SI USTED HABLA ESPANOL Y TIENE DIFICULTAD LEYENDO O HABLANDO INGLES, POR FAVOR LLAME AESTE NUMERO TELEFONICO 800.697.6967.

You, the borrower(s), must be certain that you understand the transaction. Seek professional advice if youare uncertain.

Acknowledgment: I acknowledge that I have read and received a copy of this notice at the time of loan application. Thisnotice does not constitute a contract or binding agreement. It is designed to provide current HUD/FHA policy regardingrefunds.

Signature & Date Signature & Date

Signature & Date Signature & Date

X X

X X

Previous editions are obsoleteCalyx Form - H92900b2.frm (03/05)

form HUD-92900-B (12/2004)ref. Handbooks 4150.1 & 4155.1Page 2 of 2


ESTIMATED CLOSING DATE 45-60 DAYS.

801 Loan Origination Fee % $ ACCOUNT TO BE PAID AMOUNT TO BE PAID

802 Loan Discount Fee % $

803 Appraisal Fee $

804 Credit Report $

805 Lender's Fee $

808 Processing Fee to AFFSI $

809 Courier Fee to AFFSI $

810 Underwriting Fee to AFFSI $

811 Commitment Fee to AFFSI $

812 $

813 $

901 Interest from

to / day $

1001 Hazard Insurance Premium

months at $ / month $

1002 Mortgage Insurance


1004 County Property Taxes


1005 Annual Assessments


1108 Title Insurance $

1201 Recording Fees $

1400 Total Estimated Settlement Charges $

EST. MONTHLY PMT.: PPD. INT & ESCROWS: ANNUAL AMOUNT:

P & I $ Ppd. Interest $ R. E. Taxes $ 1400 Total Estimated

R.E. Taxes $ R.E. Taxes $ Hazard Ins. $ Settlement Charges: $

Hazard Ins. $ Hazard Ins. $ Mtg Ins. $ Less: Prepaid

Mtg Ins. $ Mtg Ins. $ Other $ interest and escrows: $

Other $ Other $ = Other Estimated

Total Pmt $ Total Ppds. $ Settlement Charges: $

AGREEMENT

Applicant Signature Date Applicant Signature Date

Applicant Signature Date Authorized Official Date

500.00

You acknowledge you have received a copy of the HUD Special Information Booklet "Settlement Costs", if your application is to purchase

residential real property and the Lender will take a first lien on the property. If for any reason the loan you have applied for does not close, and if

permitted by applicable law, you agree to reimburse the mortgage broker for any and all costs incurred to process your application including but

not limited to origination, processing, courier, underwriting, commitment, appraisal, credit report, survey and title insurance fees. These estimates

are provided pursuant to the Real Estate Settlement Procedures Act of 1974, as amended (RESPA). Additional information can be found in the HUD

Special Information Booklet.

at $

250.00

200.00

YSP 3% (paid by bank to broker)

50.00

ANALYSIS OF SETTLEMENT CHARGES:

The information provided below reflects estimates of the charges which you are likely to incur at the settlement of your loan. The fees listed are

estimates - the actual charges may be more or less. Your transaction may not involve a fee for every item listed. The numbers listed beside the

estimates generally correspond to the numbered lines contained in the HUD-1 or HUD-1A settlement statement which you will be receiving at

settlement. The HUD-1 or HUD-1A settlement statement will show you the actual cost for items paid at settlement.

GOOD FAITH ESTIMATE OF BORROWER'S SETTLEMENT COSTSPROVIDED BY: AMERICAN FIDELITY FINANCIAL SERVICES, INC.

5001 NEWPORT, ROLLING MEADOWS, ILLINOIS 60008

ILLINOIS ESCROW ACCOUNT DISCLOSURE AGREEMENT

The mortgage agreement that you have entered into has an escrow account provision. In this escrow account one-twelfth (1/12th) of your yearly property tax and one-twelfth (1/12th) of your yearly hazard insurance premium will be deposited monthly from your mortgage payment. Each year this account will be analyzed to assure that the proper dollar amount is being collected each month from your mortgage payment to pay the current year’s property tax bill and the current year’s hazard insurance premium. The Lender will review the two most recent property tax bills and the most recent hazard insurance premium for your property and compare these with the funds held in your escrow account for that purpose. If it is determined that an increase in your monthly escrow payment is needed, you will receive written notification from the Mortgage Lender within thirty (30) days prior to the date of such increase. This notification will contain the Mortgage Lender’s calculation method of the new escrow figure. I (We) hereby acknowledge receipt of the aforementioned disclosure. ______________________________ ______________________________ Borrower Date ______________________________ ______________________________ Borrower Date

(765 ILCS 910/) Mortgage Escrow Account Act.

(765 ILCS 910/1) (from Ch. 17, par. 4901) Sec. 1. This Act shall be known as the "Mortgage Escrow Account Act". (Source: P.A. 79-625.) (765 ILCS 910/2) (from Ch. 17, par. 4902) Sec. 2. As used in this Act, unless the context requires otherwise: (a) "Escrow Account" means any account established by the mortgage lender in conjunction with a mortgage loan on a residence, into which the borrower is required to make regular periodic payments and out of which the lender pays the taxes on the property covered by the mortgage. (b) "Borrower" means the person obligated under the mortgage loan. (c) "Mortgage Lender" means any bank, savings bank, savings and loan association, credit union, mortgage banker, or other institution, association, partnership, corporation or person who extends the loan of monies for the purpose of enabling another to purchase a residence or who services the loan, including successors in interest of the foregoing. (d) "Escrow-like Arrangement" means any arrangement the intent of which is to serve the same purposes as an escrow account but which does not require the formal establishment of an account. (Source: P.A. 94-50, eff. 1-1-06.) (765 ILCS 910/3) (from Ch. 17, par. 4903) Sec. 3. Escrow Accounts or escrow-like arrangements established after the effective date of this Act in conjunction with mortgage agreements for single-family owner occupied residential property are hereby declared separate and distinct transactions from mortgages and, hence, subject to the laws and regulations of this State. (Source: P.A. 79-625.) (765 ILCS 910/4) (from Ch. 17, par. 4904) Sec. 4. On or after the effective date of this Act, each mortgage lender in conjunction with the granting or servicing of a mortgage on a single-family owner occupied residential property, shall comply with the provisions of this Act. (Source: P.A. 94-50, eff. 1-1-06.) (765 ILCS 910/5) (from Ch. 17, par. 4905) Sec. 5. When the mortgage is reduced to 65% of its original amount by payments of the borrower, timely made according to the provisions of the loan agreement secured by the mortgage, and the borrower is otherwise not in default on the loan agreement, the mortgage lender must notify the borrower that he may terminate such escrow account or that he may elect to continue it until he requests a termination thereof, or until the mortgage is paid in full, whichever occurs first. (Source: P.A. 79-625.) (765 ILCS 910/6) (from Ch. 17, par. 4906) Sec. 6. In lieu of the mortgage lender establishing an escrow account or an escrow-like arrangement, a borrower may pledge an interest bearing time deposit with the mortgage lender in an amount sufficient to secure the payment of anticipated taxes. (Source: P.A. 84-232.) (765 ILCS 910/6.5) Sec. 6.5. Homeownership preservation program. (a) For purposes of this Section, "Homeownership Preservation Program" means (1) a program that is expressly intended to assist

homeowners by refinancing or restructuring existing mortgage obligations either (i) to avoid default or foreclosure, or both, or (ii) to lower interest rates, and that is sponsored by a federal, state, or local government authority or a non-profit organization; or

(2) a lender-sponsored program that is expressly

intended to assist homeowners by restructuring existing mortgage obligations to avoid default or foreclosure, or both.

"Subprime Mortgage Lender" means a mortgage lender that has, for at least 2 of the prior 3 reporting years, reported the rate spread, as required under 12 C.F.R. § 203.4(a)(12), for at least 75% of the loans reported by the mortgage lender in the Loan/Application Register filed in compliance with the

federal Home Mortgage Disclosure Act, 12 U.S.C. 2801 et seq., and implementing Regulation C, 12 C.F.R. 201 et seq. (b) Section 6 shall not apply: (1) to a mortgage loan made by a subprime mortgage

lender in compliance with the requirements for higher-priced mortgage loans established in Regulation Z 12 C.F.R. Part 226, issued by the Board of Governors of the Federal Reserve System to implement the federal Truth in Lending Act, whether or not the mortgage loan is a higher-priced mortgage loan, provided that:

(A) for loans that are not higher-priced mortgage

loans, the escrow account must be terminated upon the borrower's request at no cost to the borrower; and

(B) for loans that are higher-priced mortgage

loans, the escrow account must be terminated upon the borrower's request at no cost to the borrower on terms no stricter than the following conditions:

(i) the escrow termination requirements

established in Regulation Z are satisfied;

(ii) the borrower has maintained a

satisfactory payment history (no payments more than 30 days late) for the 12 months prior to the mortgage lender's receipt of the borrower's termination request; and

(iii) the borrower has reimbursed the

mortgage lender for any escrow advances or escrow deficiencies existing at the time of the borrower's termination request.

(2) to a refinance or modification made by a subprime

mortgage lender under a homeownership preservation program that requires establishment of an escrow account as a condition or requirement of the refinance or modification, provided that the escrow account must be terminated upon the borrower's request at no cost to the borrower on terms no stricter than the following conditions:

(A) termination is permitted under the terms of

the government or non-profit sponsored homeownership preservation program, if applicable, and the borrower complies with all conditions or requirements for termination established by or allowed under such program;

(B) the borrower has maintained a satisfactory

payment history (no payments more than 30 days late) for the 12 months prior to the mortgage lender's receipt of the borrower's termination request; and

(C) the borrower has reimbursed the mortgage

lender for any escrow advances or escrow deficiencies existing at the time of the borrower's termination request.

Termination may not be denied for failure to reimburse escrow advances or escrow deficiencies under item (iii) of subparagraph (B) of paragraph (1) of subsection (b), or subparagraph (C) of paragraph (2) of subsection (b) if the borrower claims, in writing, that there is an error with such advances or deficiencies. In such case, the lender must terminate the escrow account if all other conditions of termination are satisfied; however, such termination will not alter or affect any other rights of the mortgage lender or the borrower with respect to the collection of such escrow advances or escrow deficiencies. (Source: P.A. 96-854, eff. 12-31-09.) (765 ILCS 910/7) (from Ch. 17, par. 4907) Sec. 7. The borrower shall not have the right to terminate any such arrangement under Section 5 in conjunction with mortgages insured, guaranteed, supplemented, or assisted by the State of Illinois or the federal government that require an escrow arrangement for their continuation. (Source: P.A. 79-625.) (765 ILCS 910/8) (from Ch. 17, par. 4908) Sec. 8. If after terminating an escrow arrangement under the conditions of this Act, the borrower does not furnish to the lender sufficient evidence of payment of the taxes when due on the residence covered by the mortgage with respect to which the escrow arrangement was established, the lender, after taking reasonably good faith steps to verify nonpayment, may, within thirty days after such payment is due, establish or reestablish an escrow arrangement notwithstanding the provisions of this Act. (Source: P.A. 79-625.) (765 ILCS 910/9) (from Ch. 17, par. 4909) Sec. 9. Failure of any mortgage lender operating within this State to comply with the provisions of this Act shall entitle the borrower to actual damages in a court action.

(Source: P.A. 79-625.) (765 ILCS 910/10) (from Ch. 17, par. 4910) Sec. 10. The provisions of this Act shall not be applicable to a mortgage lender using the capitalization method of accounting for receipt of payments for taxes. The capitalization method shall mean crediting such tax payments directly to the loan principal upon receipt and increasing the loan balance when the taxes are paid. (Source: P.A. 79-625.) (765 ILCS 910/11) (from Ch. 17, par. 4911) Sec. 11. Notice of the requirements of the Act shall be furnished in writing to the borrower at the date of closing. (Source: P.A. 79-625.) (765 ILCS 910/12) (from Ch. 17, par. 4912) Sec. 12. This Act takes effect on January 1, 1976. (Source: P.A. 79-625.) (765 ILCS 910/15) Sec. 15. Notice of tax payments. (a) When any mortgage lender pays the property tax from an escrow account, the mortgage lender must give the borrower written notice of the following, within 45 business days after the tax payment: (1) the date the taxes were paid; (2) the amount of taxes paid; and (3) the permanent index number, mortgage account

number, address of the property, or other property description that is used for assessment and taxation purposes under the Property Tax Code.

(b) The notice required in subsection (a) may be included

on or with other documents, notices, or statements provided to the borrower. If more than one borrower is obligated on the loan, only one borrower who is primarily liable on the loan need be given notice. Notice may be delivered, mailed, or transmitted by any usual means of communication.

(c) Notwithstanding the requirements in subsection (a), a

mortgage lender that provides notice at least annually to a borrower in the manner provided in subsection (b) of a means of communication for the borrower to access the information set forth in subsection (a) by telephone, facsimile, e-mail, Internet access, or other means of communication, is deemed to be in compliance with subsection (a).

(Source: P.A. 94-50, eff. 1-1-06; 94-883, eff. 1-1-07.)

The undersigned hereby acknowledges receipt of copy of Act.

_________________________________________ _________________________________________ Borrower Date Borrower Date

INTENT TO PROCEED WITH APPLICATION

Loan Number:

Originator:

Applicant(s):

Property Address:

You have applied for a mortgage loan covered by the Real Estate Settlement Procedures Act (RESPA) (12 U.S.C.

2601 et seq.). In accordance with RESPA, you were given a Good Faith Estimate. However, if you do not express

intent to continue with your application on or before ______________________, the loan originator is no longer

bound by the Good Faith Estimate.

By signing below, I/we express intent to continue with the application for which a Good Faith Estimate was

issued on ___________.

Date Date

CALYX Form Intent.frm 09/10

American Fidelity

1600 Golf Rd


847-517-9900



5001 NEWPORT ROLLING MEADOWS IL 60008

LOAN BROKERAGE AGREEMENT

This document is being provided to you pursuant to the Illinois Residential Mortgage License Act of 1987 and the rules promulgated in connection therewith. Upon request, a copy of this agreement will be made available to the borrower(s) who have signed below (“borrower(s)”) or the borrower's attorney for review prior to signing For a period of ninety (90) days, American Federal Financial Services, Inc. (herein referred to as American Federal) will have the exclusive right to negotiate a mortgage loan for the borrower(s). The borrower(s) does also hereby agree not to make application for this loan elsewhere. The borrower(s) will keep all credit accounts up to date and all mortgages paid up to date within thirty (30) days of the due date. This loan will be negotiated with a bank, mortgage company, finance company, or any other financial institution that American Federal believes will offer the undersigned an attractive program given the borrower(s) particular circumstances.

The loan terms are as follows: AMOUNT OF LOAN:

NUMBER OF MONTHS:

INTEREST RATE:

MONTHLY PAYMENT: In consideration for services provided by American Federal the borrower(s) do(es) agree to pay out of the loan proceeds as a brokers fee to American Federal. The borrower(s) also agrees to pay points as a service charge to the lender. Loan charges such as title insurance, recording fees, attorney fees, closing fees, broker’s fee and service charge fee (points) will be deducted from the loan proceeds. If American Federal is unable to get this loan approved, the customer will not be obligated to pay any of the closing costs. When the subject property for the mortgage loan has been inspected by an appraiser, the borrower(s) shall pay, immediately, to the appraiser the full amount of the appraisal which shall be no more than $ . If, for any reason, the appraiser is not paid at the time of the appraisal inspection, the borrower(s) will be liable for the full amount of the appraisal and all costs of collection including reasonable attorney fees. Initial here: ______ ______. To obtain this loan for the borrower(s), American Federal does hereby agree to take the borrower(s) residential mortgage loan application, determine credit worthiness and find an appropriate lender to fund this loan under the terms mentioned above. American Federal will also do all necessary processing (including ordering appraisals, titles, payoff letters, verifications of employment, mortgage history, deposits, and loans, verifying homeowners insurance, setting up closing, etc.). The borrower(s) do(es) hereby agree to cooperate with American Federal and any proposed lender, appraiser, or title company that American Federal shall select. During the processing of this mortgage loan, the borrower(s) do(es) hereby acknowledge that there are situations or conditions which could materially affect the amounts applied for due to details which could not be known by American Federal at the time of signing this Loan Brokerage Agreement. Examples of such situation or conditions may include, but not be limited to, an appraised value different from that estimated by the borrower(s) or credit obligations which the borrower(s) fail(s) to report. It is agreed to and acknowledged by the Borrower that the lenders or investors whose loan products the Broker distributes generally provide their loan products to the Broker at a wholesale rate. The retail price offered by the Broker to a borrower – i.e. interest rate, total points and fees – will include the Broker’s compensation. In some cases, the Broker may be paid all of its compensation by either a borrower or a lender. Alternatively, the Broker may be paid a portion of its compensation by both a borrower and a lender. If American Federal makes false or misleading statements, the borrower(s) may upon written notice: 1) Void the agreement, 2) Recover monies paid to the broker for which no services have been performed, 3) Recover actual costs, including attorney fees for enforcing the borrower(s) rights under this Loan Brokerage Agreement. The undersigned expressly acknowledges and understands that this Loan Brokerage Agreement cannot be cancelled for a period of ninety (90) days. During this period, if the borrower(s) decide(s) to cancel this Loan Brokerage Agreement, or if a loan commitment can not be obtained due to the borrower's failure to comply with this Agreement, the borrower(s) do(es) expressly understand that the broker’s fee and all costs of collection, including reasonable attorney's fees shall be due and payable immediately. A loan fee, including fees detailed in this Loan Brokerage Agreement, may be collected by American Federal even if a loan does not close if: 1) Either the fee was provided for in the loan commitment accepted in writing by the borrower or the fee was disclosed in the Loan Brokerage Agreement provided to a borrower pursuant to applicable regulations and signed by the borrower, and a loan commitment was obtained by American Federal consistent with the Loan Brokerage Agreement; and 2) The borrower withdraws the loan application; or the borrower has made a material misrepresentation on the loan application; or the borrower has failed to provide documentation necessary to the processing or closing of the loan. The Borrower(s) does hereby agree to all terms and conditions of this agreement on the day of , 20 . ____________________________________________ ____________________________________________ BORROWER'S Signature CO-BORROWER'S Signature ____________________________________________ ____________________________________________ AMERICAN FEDERAL FINANCIAL SERVICES, INC. Loan Originator Registration Number LOAN OFFICER'S Signature Rev. 11/24/06


1600 GOLF ROAD ROLLING MEADOWS IL 60008

LOAN BROKERAGE AGREEMENT

This document is being provided to you pursuant to the Illinois Residential Mortgage License Act of 1987 and the rules promulgated in connection therewith. Upon request, a copy of this agreement will be made available to the borrower(s) who have signed below (“borrower(s)”) or the borrower's attorney for review prior to signing For a period of ninety (90) days, American Fidelity Financial Services, Inc. (herein referred to as American Fidelity) will have the exclusive right to negotiate a mortgage loan for the borrower(s). The borrower(s) does also hereby agree not to make application for this loan elsewhere. The borrower(s) will keep all credit accounts up to date and all mortgages paid up to date within thirty (30) days of the due date. This loan will be negotiated with a bank, mortgage company, finance company, or any other financial institution that American Fidelity believes will offer the undersigned an attractive program given the borrower(s) particular circumstances.

The loan terms are as follows: AMOUNT OF LOAN: __________________

NUMBER OF MONTHS: __________________

INTEREST RATE: __________________

MONTHLY PAYMENT: __________________ In consideration for services provided by American Fidelity the borrower(s) do(es) agree to pay out of the loan proceeds as a brokers fee to American Fidelity. The borrower(s) also agrees to pay points as a service charge to the lender. Loan charges such as title insurance, recording fees, attorney fees, closing fees, broker’s fee and service charge fee (points) will be deducted from the loan proceeds. If American Fidelity is unable to get this loan approved, the customer will not be obligated to pay any of the closing costs. When the subject property for the mortgage loan has been inspected by an appraiser, the borrower(s) shall pay, immediately, to the appraiser the full amount of the appraisal which shall be no more than $ . If, for any reason, the appraiser is not paid at the time of the appraisal inspection, the borrower(s) will be liable for the full amount of the appraisal and all costs of collection including reasonable attorney fees. Initial here: ______ ______. To obtain this loan for the borrower(s), American Fidelity does hereby agree to take the borrower(s) residential mortgage loan application, determine credit worthiness and find an appropriate lender to fund this loan under the terms mentioned above. American Fidelity will also do all necessary processing (including ordering appraisals, titles, payoff letters, verifications of employment, mortgage history, deposits, and loans, verifying homeowners insurance, setting up closing, etc.). The borrower(s) do(es) hereby agree to cooperate with American Fidelity and any proposed lender, appraiser, or title company that American Fidelity shall select. During the processing of this mortgage loan, the borrower(s) do(es) hereby acknowledge that there are situations or conditions which could materially affect the amounts applied for due to details which could not be known by American Fidelity at the time of signing this Loan Brokerage Agreement. Examples of such situation or conditions may include, but not be limited to, an appraised value different from that estimated by the borrower(s) or credit obligations which the borrower(s) fail(s) to report. It is agreed to and acknowledged by the Borrower that the lenders or investors whose loan products the Broker distributes generally provide their loan products to the Broker at a wholesale rate. The retail price offered by the Broker to a borrower – i.e. interest rate, total points and fees – will include the Broker’s compensation. In some cases, the Broker may be paid all of its compensation by either a borrower or a lender. Alternatively, the Broker may be paid a portion of its compensation by both a borrower and a lender. If American Fidelity makes false or misleading statements, the borrower(s) may upon written notice: 1) Void the agreement, 2) Recover monies paid to the broker for which no services have been performed, 3) Recover actual costs, including attorney fees for enforcing the borrower(s) rights under this Loan Brokerage Agreement. The undersigned expressly acknowledges and understands that this Loan Brokerage Agreement cannot be cancelled for a period of ninety (90) days. During this period, if the borrower(s) decide(s) to cancel this Loan Brokerage Agreement, or if a loan commitment can not be obtained due to the borrower's failure to comply with this Agreement, the borrower(s) do(es) expressly understand that the broker’s fee and all costs of collection, including reasonable attorney's fees shall be due and payable immediately. A loan fee, including fees detailed in this Loan Brokerage Agreement, may be collected by American Fidelity even if a loan does not close if: 1) Either the fee was provided for in the loan commitment accepted in writing by the borrower or the fee was disclosed in the Loan Brokerage Agreement provided to a borrower pursuant to applicable regulations and signed by the borrower, and a loan commitment was obtained by American Fidelity consistent with the Loan Brokerage Agreement; and 2) The borrower withdraws the loan application; or the borrower has made a material misrepresentation on the loan application; or the borrower has failed to provide documentation necessary to the processing or closing of the loan. The Borrower(s) does hereby agree to all terms and conditions of this agreement on the day of , 20___. ____________________________________________ ____________________________________________ BORROWER'S Signature CO-BORROWER'S Signature ____________________________________________ ____________________________________________ AMERICAN FIDELITY FINANCIAL SERVICES, INC. Loan Originator Registration Number LOAN OFFICER'S Signature Rev. 11/24/06

Exhibit B for Wholesale Loan Applications Dates 1/1/2010 and After 1

This Mortgage Broker Fee Agreement and Disclosure (“Agreement”) is by and between American Fidelity

2. YOUR MORTGAGE LOAN You are currently applying for a mortgage loan in the amount of $If your actual loan amount is different, then the dollar amount of any fee that is based on a percentage of the loan amount may increase if the loan amount

If this box is checked, the form has been amended. All amendments must be initialed by borrower,or a new agreement must be completed.

Signature: Signature:

Date: Date:

Broker Name: American Fidelity By: Signature:(Printed Name)

Date:

(Must be completed)

increases, or decrease if the loan amount decreases. The fees in this Agreement are for broker services only and do not include other closing costs or credits from us or other parties for non-broker related services.

3. BROKER FEES: Depending on the loan program you select and subject to applicable legal requirements, our fees may be paid by you directly or indirectly, or a combination of both. For the portion of our fees paid directly, you will pay our fees from your own funds at or prior to the loan closing. For the portion of our fees paid indirectly, you may elect to include our fees in your loan amount and pay us at closing out of your loan proceeds. In addition, you may pay our fees by electing to pay the mortgage lender a higher interest. When you elect to pay a higher interest rate, the mortgage lender will provide you with a credit which will be applied against and reduce your settlement charges, including our fees. Paying our fees directly versus indirectly may result in a lower interest rate. We have discussed these fee payment options with you. In addition to our fees, estimates of other fees you will pay in connection with your loan will be shown on your Good Faith Estimate. Once your interest rate is locked and your loan amount and terms are finalized, we will be able to tell you the exact amount of all fees.

Mortgage Broker Fee Agreement and Disclosure

(Must be completed)

(Must be completed)

CREDIT FOR SETTLEMENT COSTS FROM THE MORTGAGE LENDER IN EXCHANGE FOR YOUR SELECTED INTEREST RATE – This will be reflected as a credit to you on Block 2 of your Good Faith Estimate:

MAXIMUM BROKER FEE (1) – All fees that are paid to us for arranging your loan with a mortgage lender. This amount is included in the “Our origination charge” of Block 1 of your Good Faith Estimate. The “Our origination charge” amount represents the total sum of all origination charges and fees for your loan from the mortgage broker, mortgage lender and other third parties, as applicable.

Amount

NOTE: You may not be charged any fee, other than a reasonable credit report fee (if applicable), prior to (i) receiving your Good Faith Estimate from us, (ii) expressing your intent to proceed with the loan transaction and (iii) receiving the initial disclosures from the mortgage lender.

, a mortgage broker (“we,” “us,” “our”) and the Borrower(s) who sign(s) below (“you,” “your”). This Agreement discloses and governs the overall fees that will be paid to your mortgage broker for the origination of your loan.

Borrower: Co-Borrower:

YOUR ADJUSTED BROKER FEE – The portion of our fees that will be paid by you to us directly after applying the above credit of the mortgage lender, if applicable. This amount is included in the “Your Adjusted Origination Charges” of Block A of your Good Faith Estimate. The “Your Adjusted Origination Charges” amount represents the total sum difference of Box 1 and Box 2 of your Good Faith Estimate:

By signing below, you acknowledge that:(i) You have received an initial Good Faith Estimate within three (3) business days of the mortgage loan application date and you intend to proceed with the loan transaction.(ii) The Agreement has been explained to you and you understand it. (iii) You have not been charged any fees, other than a reasonable credit fee (if applicable), prior to entering into this Agreement(iv) You voluntarily enter into this Agreement and agree to the fees above.(v) The fees above are based on current market rates and your current loan request.

(1) In Wisconsin, this fee shall constitute a “broker administration fee.” In Iowa, this fee shall constitute a “broker administration fee.” In all other states, this fee shall constitute a broker origination fee.

1. OUR SERVICES: A mortgage broker charges fees to arrange a loan from a mortgage lender who will fund the loan. As your mortgage broker, we will assist you in obtaining a loan, but we do not offer the products of all mortgage lenders, and so we cannot guarantee you the lowest price or best loan terms available. Be sure that you understand and are satisfied with the mortgage loan product and terms we arrange for you. By signing below, you request us to arrange a mortgage loan from a mortgage lender and you agree to the fees listed below for our services.

MORTGAGE LOAN ORIGINATION AGREEMENT(Warning to Broker: The content of this form may vary depending upon the state in which it is used.)

You agree to enter into this Mortgage Loan OriginationAgreement with as an independent contractor to apply for aresidential mortgage loan from a participating lender with which we from time to time contract upon suchterms and conditions as you may request or a lender may require. You inquired into mortgage financing with

onWe are licensed as a "Mortgage Broker" under

SECTION 1. NATURE OF RELATIONSHIP. In connection with this mortgage loan:

* We are acting as an independent contractor and not as your agent.

* We will enter into separate independent contractor agreements with various lenders.

* While we seek to assist you in meeting your financial needs, we do not distribute the productsof all lenders or investors in the market and cannot guarantee the lowest price or best termsavailable in the market.

SECTION 2. OUR COMPENSATION. The lenders whose loan products we distribute generallyprovide their loan products to us at a wholesale rate.

* The retail price we offer you - your interest rate, total points and fees - will include ourcompensation.

* In some cases, we may be paid all of our compensation by either you or the lender. For example, in some cases, if you would rather pay a lower interest rate, you may pay higher up-front points and fees.

* Also, in some cases, if you would rather pay less up front, you may be able to pay a higher interest rate in which case we will be paid directly by the lender.

We also may be paid by the lender based on (i) the value of the Mortgage Loan or related servicingrights in the market place or (ii) other services, goods or facilities performed or provided by us to thelender.

By signing below, the mortgage loan originator and mortgage loan applicant(s) acknowledge receipt of a copy of this signed Agreement.

MORTGAGE LOAN ORIGINATOR

Company Name

Address

City, State, Zip

Phone/Fax

Broker or Authorized Agent Signature Date

APPLICANT(S)

Applicant Name(s)

Address

City, State, Zip

Borrower Signature Date

Co-Borrower Signature Date

Calyx Form MLOA.FRM (06/11)

American Fidelity

American Fidelity

American Fidelity

1600 Golf Rd


847-517-9900 / 847-201-2660


MORTGAGE SERVICING DISCLOSURE STATEMENT NOTICE TO FIRST LIEN MORTGAGE LOAN APPLICANTS: THE RIGHT TO COLLECT YOUR MORTGAGE LOAN PAYMENTS MAY BE TRANSFERRED. FEDERAL LAW GIVES YOU CERTAIN RELATED RIGHTS. IF YOUR LOAN IS MADE, SAVE THIS STATEMENT WITH YOUR LOAN DOCUMENTS, SIGN THE ACKNOWLEDGMENT AT THE END OF THIS STATEMENT ONLY IF YOU UNDERSTAND ITS CONTENTS. Because you are applying for a mortgage loan covered by the Real Estate Settlement Procedures Act (RESPA) (12 U.S.C. §2601 et seq.) you have certain rights under that Federal law. This statement tells you about those rights. It also tells you what the chances are that the servicing for this loan may be transferred to a different loan servicer. “Servicing” refers to collecting your principal, interest and escrow account payments, if any. If your loan servicer changes, there are certain procedures that must be followed. This statement generally explains those procedures. Transfer Practices and Requirements If the servicing of your loan is assigned, sold, or transferred to a new servicer, you must be given written notice of that transfer. The present loan servicer must send you notice in writing of the assignment, sale, or transfer of the servicing not less than 15 days before the effective date of the transfer. The new loan servicer must also send you notice within 15 days after the effective date of the transfer. The present servicer and the new servicer may combine this information in one notice, so long as the notice is sent to you 15 days before the effective date of transfer. The 15 day period is not applicable if a notice of prospective transfer is provided to you at settlement. The law allows a delay in the time (not more than 30 days after a transfer) for servicers to notify you, upon the occurrence of certain business emergencies. Notices must contain certain information. They must contain the effective date of the transfer of the servicing of your loan to the new servicer, and the name, address, and toll-free or collect call telephone number of the new servicer, and toll-free or collect call telephone numbers of a person or department for both your present servicer and your new servicer to answer your questions. During the 60-day period following the effective date of the transfer of the loan servicing, a loan payment received by your old servicer before its due date may not be treated by the new loan servicer as late, and a late fee may not be imposed on you. Complaint Resolution Section 6 of RESPA (12 U.S.C. §2605) gives you certain consumer rights, whether or not your loan servicing is transferred. If you send a “qualified written request” to your servicer, your servicer must provide you with a written acknowledgment within 20 Business Days of receipt of your request. A “qualified written request” is a written correspondence, other than notice on a payment coupon or other payment medium supplied by the servicer, which includes your name and account number, and the information regarding your request. Not later than 60 Business Days after receiving your request, your servicer must make any appropriate corrections to your account, or must provide you with a written clarification regarding any dispute. During this 60 Business Day period, your servicer may not provide information to a consumer reporting agency concerning any overdue payment related to such period or qualified written request. A Business Day is any day in which the offices of the business entity are open to the public for carrying on substantially all of its business functions. Damages and Costs Section 6 of RESPA also provides for damages and costs for individuals or classes of individuals in circumstances where servicers are shown to have violated the requirements of that Section. Servicing Transfer Estimates The following is the best estimate of what will happen to the servicing of your mortgage loan: We may assign, sell, or transfer the servicing of your loan while the loan is outstanding. We haven’t decided yet whether or not to sell your loan. If we do sell it, we will also transfer the servicing of your loan to the purchaser. If we decide not to sell your loan, we will retain the right to service your loan and we will subcontract the processing of your payments to another company. We have previously assigned, sold or transferred the servicing of federally related mortgage loans. For all the first lien mortgage loans that we make in the 12-month period after your mortgage loan is funded, we estimate that we will assign, sell, or transfer 100% of the mortgage servicing. This is only our best estimate and it is not binding. Business conditions or other circumstances may affect our future transferring decisions. Acknowledgment of Mortgage Loan Applicant I/we have read this disclosure form, and understand its contents, as evidenced by my/our signature(s) below. I/we understand that this acknowledgment is a required part of the mortgage loan application. Applicant’sSignature Date Co-Applicant’sSignature Date

PATRIOT ACT INFORMATION FORM Loan Number: __________________________ To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that identifies every customer. When applying for a loan, applicants will be asked for their name, address, date of birth, and other information that will allow lenders to identify them. Applicants will also be asked to show their driver's license or other identifying documents. COMPLETION OF THIS FORM IS REQUIRED IN ORDER TO COMPLY WITH THE PATRIOT ACT. A COPY OF THIS COMPLETED FORM MUST BE PLACED IN THE LOAN FILE. Required Information: Borrower Name: _____________________________________ Co-Borrower Name: _____________________________________ Borrower Date of Birth: _____________________________________ Borrower Tax Payer ID/SSN: _____________________________________ Co-Borrower Date of Birth: _____________________________________ Co-Borrower Tax Payer ID/SSN: _____________________________________ Borrower Current Physical Address: _____________________________________ Co-Borrower Current Physical Address: _____________________________________ Method Of Identification For Borrower (Only One Form Of Verification Is Required): (1) Driver’s License: State _______ # _______________ Issue Date: _______ Expir. Date: _______ (2) Passport: # _______________ Country: __________ Issue Date: _______ Expir. Date: _______ (3) Military ID: Country: __________ Expir. Date: _______ (4) State ID: # _______________ Issue Date: _______ Expir. Date: _______ (5) Green Card: Country: __________ #: ____________________ Expir. Date: _______ (6) Immigration Card: Country: __________ # _______________ Expir. Date: _______ (7) Gov’t ID (Visa): #_______________ Expir. Date: _______ Gov’t Branch: _______________ Method Of Identification For Co-Borrower (Only One Form Of Verification Is Required): (1) Driver’s License: State _______ # _______________ Issue Date: _______ Expir. Date: _______ (2) Passport: # _______________ Country: __________ Issue Date: _______ Expir. Date: _______ (3) Military ID: Country: __________ Expir. Date: _______ (4) State ID: # _______________ Issue Date: _______ Expir. Date: _______ (5) Green Card: Country: __________ #: ____________________ Expir. Date: _______ (6) Immigration Card: Country: __________ # _______________ Expir. Date: _______ (7) Gov’t ID (Visa): #_______________ Expir. Date: _______ Gov’t Branch: _______________ Resolution Of Any Discrepancy: _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ I/we acknowledge that I/we received a copy of this disclosure. _________________________________ _________________________________ Applicant Date Applicant Date _________________________________ Mortgage Representative Date

IMPORTANT NOTICE TO ALL BORROWERSUSA PATRIOT ACT, SECTION 326

Certification of IdentificationFederal Law requires all financial institutions to obtain, verify and record information that identifies each person upon opening an account or applying for a mortgage

Any of the following forms of identification may be used to verify identity:

Driver’s License Government PassportU.S. Military ID Resident Alien IDU.S. Department of State ID Social Security CardFederal Employer ID

Important: Please take note – Information listed below must be exactly as indicated on the document.

______________________________ _____________________________Borrower Co-Borrower

______________________________ _____________________________Form of Identification Form of Identification

______________________________ _____________________________Identification Number Identification Number

______________________________ _____________________________Place of Issuance Place of Issuance

______________________________ _____________________________Date of Birth Date of Birth

______________________________ _____________________________Date of Issue Date of Issue

______________________________ _____________________________Date of Expiration Date of Expiration

I certify that I have personally viewed and accurately recorded the information from the documents identified above, and have reasonably confirmed the identity of the applicant(s)

________________________________________________ ___________________Signed by Loan Officer or Originator Date

Printed Name____________________________________

Borrower Signature Date Co-Borrower Signature Date

IMPORTANT NOTICE TO ALL BORROWERSUSA PATRIOT ACT, SECTION 326

Certification of IdentificationFederal Law requires all financial institutions to obtain, verify and record information that identifies each person upon opening an account or applying for a mortgage

Any of the following forms of identification may be used to verify identity:

Driver’s License Government PassportU.S. Military ID Resident Alien IDU.S. Department of State ID Social Security CardFederal Employer ID

Important: Please take note – Information listed below must be exactly as indicated on the document.

______________________________ _____________________________Borrower Co-Borrower

______________________________ _____________________________Form of Identification Form of Identification

______________________________ _____________________________Identification Number Identification Number

______________________________ _____________________________Place of Issuance Place of Issuance

______________________________ _____________________________Date of Birth Date of Birth

______________________________ _____________________________Date of Issue Date of Issue

______________________________ _____________________________Date of Expiration Date of Expiration

I certify that I have personally viewed and accurately recorded the information from the documents identified above, and have reasonably confirmed the identity of the applicant(s)

________________________________________________ ___________________Signed by Loan Officer or Originator Date

Printed Name____________________________________

FACTSWhat DoesWith Your Personal Information?

Financial companies choose how they share your personal information. Federal law gives consumersthe right to limit some but not all sharing. Federal law also required us to tell you how we collect,share, and protect your personal information. Please read this notice carefully to understand what we do.

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

All financial companies need to share customers' personal information to run their everyday business. In thesection below, we list the reasons financial companies can share their customers' personal information; the reasons

Reasons we can share your personal information Can you limit this sharing?

For our everyday business purposes --

For our marketing purposes --

For joint marketing with other financial companies

For our affiliates' everyday business purposes --

For our affiliates' everyday business purposes --

For our affiliates to market to you

For nonaffiliates to market to you

such as to process your transactions, maintainyour account(s), responds to court orders and legalinvestigations, or report to credit bureaus

to offer our products and services to you

information about your transactions and experiences

information about your creditworthiness

Please note:

If you are a new customer, we can begin sharing your informationWhen you are no longer our customer, we continue to share your information as described in this notice.

However, you can contact us at any time to limit our sharing.

Why?

What?

How?

To limitour sharing

Questions?

Calyx Form - Privacy1_LimitSharing.frm (01/2011)

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American Fidelity Financial Services, Inc. DoRev. 07/11

• Social Security Number and Income• account balances and payment history• credit history and credit scores

American Fidelity Financial Services, Inc. chooses to share; and whether you can limit this sharing.

Does American Fidelity FinancialServices, Inc. share?

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

• Call 800-325-0400 - our menu will prompt you through your choice(s)

30 days from the date we sent this notice.

• Call 800-325-0400 or go to http://www.illinoisrates.com


Who we are

Who is providing this notice?

What we do

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

We collect your personal information, for example, when you

Why can't I limit all sharing? Federal law gives you the right to limit only

• sharing for affiliates' everday business purposes - information about yourcreditworthiness

• affiliates from using your information to market to you• sharing for nonaffiliates to market to you

State Laws and individual companies may give you additional rights tolimit sharing.

Definitions

Affiliates Companies related by common ownership or control. They can be financial andnonfinancial companies.

Nonaffiliates Companies not related by common ownership or control. They can be financial andnonfinancial companies.

Joint marketing A formal agreement between nonaffiliated financial companies that together marketfinancial products or services to you.

Calyx Form - Privacy2_NoOptOut.frm (01/2011)

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American Fidelity Financial Services, Inc.1600 Golf RoadRolling Meadows, IL 60008

How does American Fidelity Financial Services, Inc. protect my personal information?

Your privacy is of the highest importance to American Fidelity Financial Services, Inc. Although information may be shared, every effort is used to protect your information from unathorized use.

How does American Fidelity Financial Services, Inc. collect my personal information?

American Fidelity Financial Services, Inc. has no affiliates.

• American Fidelity Financial Services, Inc. does not share with nonaffiliates so they can market to you.

• American Fidelity Financial Services, Inc. doesn't jointly market.


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