Borrower’s Certification of Notary Duties

 

  I signed. Furthermore, I hereby attest that the following was fulfilled:

  • The notary has provided me with copies of the entire loan package.
  • Specifically, the notary has provided me with a copy of the Truth in Lending Disclosure as well as three copies of the Notice of Right to Cancel/Rescission Notice.
  • The transaction date on all copies of the Notice of Right to Cancel/Rescission Notice is complete with today’s date of ___________ and the final day to cancel is complete with the date of _____________.
  • The notary did not express personal opinions about my loan nor did he or she attempt to sway or discourage me from this loan in any way.

I chose not to sign. Furthermore, I hereby attest that the following was fulfilled:

  • The notary did not express personal opinions about my loan nor did he or she attempt to sway or discourage me from this loan in any way.
  • The notary did not use the rescission period as a tool to convince me to sign. If I have signed this loan with the intent to use this period to make a final decision, I did so under my own volition and without council from the notary.
_______________________ ________________ _______________________ ________________
Borrower’s Signature Date Borrower’s Signature Date
State of ______________________________________
County of ______________________________________
Subscribed and sworn to (or affirmed) before me on
this __________ day of ___________________________, 20__________,
by ______________________________________________ personally known to me or proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me.
      (Seal) Signature _______________________________
Notary Public

To protect yourself, please keep the original copy for your records.
DO NOT RETURN THIS FORM WITH THE LOAN DOCUMENTS.