Single Family Registration

ACKNOWLEDGMENT AND AGREEMENT: THIS IS NOT AN APPLICATION FOR CREDIT OR A MORTGAGE LOAN. I/We certify that the above information is correct as of the date set forth. I understand that any intentional or negligent misrepresentation(s) of this information may result in civil liability and /or criminal penalties. A faxed copy of this signed document is also acceptable for any legal purpose. I/We understand Owner is not a mortgage broker however, Owner may or may not submit this and other documents to a licensed mortgage company that offers B/C credit lending. If I/We cannot qualify, then Owner may finance at his sole discretion. Verification or re-verification of any information contained in this document may be made at any time by any potential lender, its agents, successors and assigns, either directly or through a credit-reporting agency.