1. I/we represent that I am/we are currently occupying the property securing the loan as my/our
primary residence. If I am /we are currently occupying the property, I/we also represent that
I/we intend to continue occupying the property as my/our primary residence.
2. Under penalty of perjury, I/we certify that all documents and information that I/we provide to
the Housing Counselor and the Lender/Servicer, including the documents and information
regarding my eligibility for any modification or eligibility for any Foreclosure Mediation
Program, are true and correct and accurately reflect my financial status. My Lender/Servicer
may discuss, obtain and share information about my mortgage and financial situation with
third parties regarding a possible alternative to foreclosure.
3. I/we understand and acknowledge the Lender/Servicer may investigate the accuracy of
my/our statements, may require me/us to provide supporting documentation, and that
knowingly submitting false information may violate state and Federal law.
4. I/we understand that if I/we have intentionally engaged in fraud or misrepresented any fact(s),
or if I/we do not provide all of the required documentation, the Lender/Servicer may refuse to
consider any modification or alternative to foreclosure.
5. I/we certify that I am /we are willing to provide all requested documents and to respond to
Housing Counselor/Mediator/Lender/Servicer communications in a timely manner. I/we
understand that time is of the essence and intentional delays on my/our part could result in
making me/us ineligible for the Foreclosure Mediation Program.
6. I/we understand that negotiations for a possible foreclosure alternative will not constitute a
waiver or defense to my Lender's/Servicer's right to commence or continue any foreclosure or
other collection action.
7. I/we understand that an alternative to foreclosure will only be provided if an agreement has
been approved in writing by my Lender/Servicer.