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- AFFIDAVIT AND WAIVER OF RIGHT OF RESCISSION
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-
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- We, __________________, ___________________, and
- ______________________________ as Tenants in _____________ (the
- "Customer"), being first duly sworn, hereby depose and say that:
-
- We have entered into a $_______________ loan transaction
- with _______________ Bank and Trust Company, ______________,
- ____________________ (the "Creditor") on ______________, 19__
- which may result in a lien, mortgage, or other security interest
- on our home.
-
- We hereby waive our right to rescind the transaction for
- the following reasons:
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-
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- The extension of credit is vitally necessary to meet a
- bonafide personal financial emergency, whereby a delay of three
- (3) business days in performance of Creditor's obligation under
- this transaction will jeopardize our financial welfare and
- endanger us and our family.
-
- Therefore, We hereby waive our right of rescission and do
- so under the pains and penalties of perjury this _______day of
- ___________, 19__.
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-
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- _____________________________
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-
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- _____________________________
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-
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- _____________________________
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- Signatures witnessed by:
-
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- ____________________________
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- Form 134