BY SUBMITTING THIS FORM, I CERTIFY THAT THE SERVICES SELECTED ABOVE WERE ACTUALLY PERFORMED AND ARE NOT SOLELY FOR THE PURPOSE OF REFERRING THIS BORROWER TO PARK HOLLOW MORTGAGE. I UNDERSTAND THAT COMPENSATION IS FOR BONA FIDE SERVICES ACTUALLY PERFORMED AND IS NOT BASED ON LOAN AMOUNT, INTEREST RATE, OR LOAN OUTCOME.

Helped the borrower understand and resolve credit report issues

Provided credit / qualification assistance

Collected financial documents (tax returns, pay stubs, bank statements, etc.)

Explained the financing process and available loan products, including how costs and payments differ

Analyzed the borrower's income, assets and debts and prequalified the borrower

Took the borrower's loan application (Uniform Residential Loan Application)*

SERVICES PERFORMED

List the applicable date below. Leave blank if not applicable. A minimum of 5 of the 7 services below must be completed to qualify under our agreement.

PLEASE CONFIRM THE BONA FIDE ORIGINATION SERVICES YOUR TEAM HAS PERFORMED FOR THIS BORROWER. COMPENSATION IS BASED ON THE COMPLETION OF ACTUAL SERVICES - NOT THE REFERRAL OF BUSINESS. 

origination services certification

Originating Bank & Loan Originator

borrower information

Maintained regular contact with the borrower, agents and Park Hollow Mortgage through closing

The borrower has provided written authorization to share their information with Park Hollow Mortgage and to order third-party verifications. The signed authorization is on file with the bank.