Borrower's Certification and Authorization

Certification

The undersigned, certify the following:

1. I/we have applied for a mortgage loan from Capital Community Bank.  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 downpayment, employment, and income information, and assets and liabilities.  I/we certify that all of the information is true and complete.  I/we made no misrepresentation in the loan application or other documents, nor did I/we omit any pertinent information.

2. I/we understand and agree that Capital Community Bank reserves the right to change the mortgage loan review process 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 Capital Community Bank.  As part of the verification process, Capital Community Bank 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 Capital Community Bank, and to any investor to whom Capital Community Bank may sell my mortgage, and to the mortgage guaranty insurer (if any), 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. Capital Community Bank or any investor that purchases the mortgage, or the mortgage guaranty insurer (if any), may address this authorization to any party named in the loan application.

4. A copy of this authorization may be accepted as an original.

5. Your prompt reply to Capital Community Bank, the investor that purchased the mortgage, or the mortgage guaranty insurer (if any) is appreciated.

6. Mortgage guaranty insurer (if any): _________________________________________