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<br />6.11 <br />Page 19 <br /> <br />E1. Name of New First Mortgage: E3. My new loan will have a term of years <br /> at % interest and is (check one) <br /> o Flxed or (] Adjusted <br />E2. How much am I borrowing in my new loan? E4. My new monthly payment will be <br /> $ each month. <br /> E5. Total savings on Housing Cost Is <br /> $ per month1 <br />F1. Note to Borrower: Indicate If cash there Is cash out. OVes or CJNo <br />If cash out is requested. cover letter much address proposed use of funds. <br /> <br />We the undersigned, declare the Infonnatlon shown is true and correct under penalty of pe~ury. dated <br /> <br />this <br /> <br />day of <br /> <br />.2004. <br /> <br />To be Completed by CIty <br /> <br />Loan to Value Before Refinance % <br /> <br />loan to Value After Refinance % <br /> <br />1 A3 + 86 - E4 = ES <br /> <br />Page 2 of4 <br />