LOST NOTE BOND APPLICATION *CHECKLIST*

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1 Artisan Bonding & Insurance Services LLC 155 Rochester Street, Costa Mesa, CA Toll Free: Fax: Phone: LOST NOTE BOND APPLICATION CA License #0E70906 WHY DO YOU NEED THIS BOND AND WHAT DOES IT DO? I. Under California Civil Code , a bond is required under the following circumstances: A. Whenever the obligation secured by a mortgage or Deed of Trust has been fully satisfied and the present beneficiary of record cannot be located after diligent search, or refuses to execute and deliver a proper discharge or request for reconveyance. B. Whenever a specified balance, including principal and interest, remains due and the mortgagor's or trustor's successor in interest cannot, after diligent search, locate the mortgagee or beneficiary of record. II. III. The bond you purchase is in favor and for the benefit of the following parties, known as the obligees under the bond: A. The trustee who executes the reconveyance. B. The mortgagee, beneficiary, or their successors. The bond and written declaration must be recorded in office of the County recorder where encumbered property is located. *CHECKLIST* Attached is an application and supporting information necessary for approval of your Lost Note Bond. Please furnish the following items: ALL information must be completed to process this application. 1. Completed and signed Application (enclosed). 2. Copy of Preliminary Title Report. 3. Copy of Recorded Trust Deed with any amendment(s). 4. Copy of Note and Settlement Statement. 5. Cashiers check or money order for the bond premium (2% of the bond amount). To Calculate Bond Amount: Bond amount is equal to twice the ORIGINAL Note Amount. 6. Completed and signed Declaration of Lost Trust Deed and/or Lost Beneficiary (enclosed) 7. Proof of payment (cancelled checks, etc.) 8. Lost Trust Deed or Note Questionnaire 9. Affidavit or Trustor Please note that we must receive the ORIGINAL application with wet signatures along with payment of premium in order to proceed. If you have any questions, please call us at Thank you. Page 1 of 6

2 CA License #0E70906 Bond for: Artisan Bonding & Insurance Services, LLC 155 Rochester Street, Costa Mesa, CA Toll Free: Fax: Phone: APPLICATON - LOST TRUST DEED OR LOST TRUST DEED NOTE BOND To be filed with (Obligee) Lost Trust Deed Lost Trust Deed Note BOND Both APPLICANT In lieu of Request for Reconveyance Amount $ Must be twice the amount of original note Name of Principal Soc. Sec. No. Address Phone Number Fax Number Estimated net worth Has applicant, or have any of its principals, ever failed in business, compromised with creditors, been the subject of bankruptcy or surety claims? Yes No (if yes, attach a full explanation) CONFIDENTIAL CREDIT INFORMATION For bonds required of INDIVIDUALS: Residence address: City, State, ZIP How long? Age Occupation Employer Annual salary $ Other Income $ Name and branch of bank: Bank balance $ Loan Amount $ Real estate owned $ Mortgage $ Securities owned $ Encumbrance $ Date of note: DESCRIPTION OF THE NOTE Date note paid: Principal Amount $ Maker (trustor) -- Name: Address: Payee (beneficiary) -- Name: Address: Trustee -- Name: Address: Release of Deed of Trust (Attach copy of preliminary title report) Recording data: Deed of Trust was filed as instrument number on and recorded in, Book, Page of Official Records of County, ESCROW INFORMATION MAILING INSTRUCTIONS (State) Escrow Company Address Mail bond to: Principal * Escrow Company Escrow Number * Principal must sign the bond before a Notary Public Page 2 of 6

3 FINANCIAL STATEMENT As of Financial statements, when required, need not be on this form. The space below is for the convenience of those who do not have signed copies of current financial statements read available on other forms. Cash on Hand ASSETS Cash in Bank (Name and address of bank) Accounts Receivable Merchandise at cost (Not on consignment) Other (Describe) TOTAL CURRENT ASSETS Land and Buildings (Depreciated Value) Machinery, Fixtures, and Equipment (Depreciated Value) Due from Others - Not Current (Describe) Other Assets (Describe) TOTAL CURRENT ASSETS Dollars Cents LIABILITIES Dollars Cents Accounts Payable Notes Payable - Unsecured: Banks Partners or officers Other AGREEMENT OF INDEMNITY Notes Payable - Secured: Owing to Taxes Payable or Accrued Accrued Payroll and other expense Other Current Liabilities (Describe) TOTAL CURRENT Liens or Chattel Mortgages on Equipment Mortgages on Real Estate Other Liabilities (Describe) Net Worth TOTAL LIABILITIES Capital $ { Surplus $ } TOTAL LIABILITIES AND NET WORTH The undersigned and each of them hereby certify that the statements contained herein or attached hereto are true, and are made to induce SAFECO Insurance Company of America, General Insurance Company of America, First National Insurance Company of America, or American States Insurance Company (herein called SURETY) to execute or continue the suretyship described herein and authorize SURETY to confirm bank balances and all other items which appear in said statement. In consideration of the execution by SURETY of the suretyship herein applied for, I agree: 1. To pay to SURETY upon demand: (a) All loss and expense, including attorney's fees, for which SURETY shall become liable by reason of such suretyship, whether or not SURETY shall have paid such loss and expense at the time of demand. (b) The term premium for such suretyship. (c) All attorney's fees and costs incurred by SURETY in enforcing this agreement. (d) An amount sufficient to discharge any claim against SURETY by reason of such suretyship. This sum may be used by SURETY to pay such claim or be held by SURETY as collateral security against loss SURETY shall have the exclusive right to determine whether any claim or suit shall, on the basis of liability, expediency or otherwise, be paid, compromised, defended or appealed. An itemized statement of loss and expense incurred by SURETY, sworn to by an officer of SURETY, shall be prima facie evidence of the fact and extent of my obligation to SURETY. SURETY may procure its release from said suretyship under any law for release of sureties without liability to me for any damages I sustain therefrom. Signed and dated this day of, 20 SIGNATURE INSTRUCTIONS SIGNATURE OF APPLICANT(S) FOR BOND: If sole proprietorship, applicant and spouse should sign; if partnership, all partners and spouses must sign; if corporation, president or vice-president must sign under legal corporate name, with signature attested by corporate secretary under corporate seal. In consideration of the execution by SURETY of the bond herein applied for, the undersigned, jointly and severally, join in the foregoing indemnity agreement. SIGNATURE OF INDEMNITORS SIGNATURE / PRINT INDEMNITORS NAME SIGNATURE / PRINT INDEMNITORS NAME SIGNATURE / PRINT SPOUSES NAME SIGNATURE / PRINT SPOUSES NAME Page 3 of 6

4 Order No. Escrow No. Loan No. WHEN RECORDED MAIL TO: SPACE ABOVE THIS LINE FOR RECORDER'S USE DECLARATION of LOST DEED of TRUST and or LOST BENEFICIARY DECLARATION RECORDED PURSUANT TO CALIFORNIA CIVIL CODE SECTION THE DEED OF TRUST INVOLVED IS AS FOLLOWS: $ TRUSTOR: BENEFICIARY: RECORDED ON: INSTRUMENT NO. COUNTY: I/WE THE UNDERSIGNED RESIDE AT: THE OBLIGATION SECURED BY SAID DEED OF TRUST HAS BEEN FULLY SATISFIED AND THE PRESENT BENEFICIARY OF RECORD CANNOT BE LOCATED AFTER A DILIGENT SEARCH OR REFUSES OR IS UNABLE TO PROVIDE AND DELIVER THE CANCELLED PROMISSORY NOTE AND REQUEST FOR RECONVEYANCE AS REQUIRED BY CIVIL CODE SECTION I/WE DECLARE THAT WE HAVE MAILED BY CERTIFIED MAIL RETURN RECEIPT REQUESTED, TO THE LAST KNOWN ADDRESS OF THE PERSON TO WHOM PAYMENTS UNDER SAID DEED OF TRUST WERE MADE AND TO THE LAST BENEFICIARY SHOWN ON THE INSTRUMENTS CREATING, ASSIGNING OR CONVEYING SUCH INTEREST, A NOTICE OF RECORDING A BOND AND DECLARATION UNDER CIVIL CODE SECTION SAID NOTICE CONTAINED THE NAME AND ADDRESS OF THE TRUSTEE OF RECORD UNDER SAID DEED OF TRUST AND THE ADDRESS OF SAID TRUSTEE WHERE THE BENEFICIARY MAY RECORD A WRITTEN OBJECTION TO THE RELEASE OR RECONVEYANCE OF SAID DEED OF TRUST. THE NOTICE ALSO CONTAINED A STATEMENT OF THEIR RIGHT TO NOTIFY THE TRUSTEE IN WRITING OR BY RECORDING AN OBJECTION TO THE RECONVEYANCE OF SAID DEED OF TRUST. I/WE MAILED TO SAID BENEFICIARY BY CERTIFIED MAIL RETURN REQUESTED ON DATE TO THE FOLLOWING PARTIES AND ADDRESS SHOWN BELOW: NAME: NAME: ADDRESS: ADDRESS: I/WE HEREIN DECLARE UNDER PENALTY OF PERJURY THAT THE INFORMATION ABOVE TO BE TRUE AND CORRECT TO THE BEST OF OUR KNOWLEDGE, AND FURTHER DECLARE WE MADE THE DILIGENT SEARCH EFFORTS TO CONTACT THE PARTIES AS SPECIFIED BY SAID SECTION OF THE CIVIL CODE. DATE: BY: BY: BY: Page 4 of 6

5 LOST TRUST DEED OR NOTE QUESTIONNAIRE 1. IS THIS A SALE? ( ) YES ( ) NO 2. IS THIS A RE-FINANCE? ( ) YES ( ) NO IF THIS IS A SALE, DOES THE APPLICANT OWN ANY OTHER REAL ESTATE OR IS HE/SHE BUYING ANOTHER PROPERTY, PLEASE GIVE NEW ADDRESS AND EXPLANATION. IF RE-FINANCING, WHAT IS THE AMOUNT OF THE LOAN? $ NAME OF LENDER: TO WHOM WERE THE PAYMENTS MADE? IF OTHER THAN THE ORIGINAL BENEFICIARY, PLEASE EXPLAIN: PLEASE EXPLAIN THE CIRCUMSTANCES INVOLVING THE LOST TRUST DEED AND/OR NOTE: IF PROOF OF PAYMENT HAS BEEN LOST, PLEASE EXPLAIN THE CIRCUMSTANCES: DESCRIPTION OF NOTE: DATE OF NOTE: PRINCIPAL AMOUNT: MAKER / TRUSTOR BENEFICIARY / PAYEE: Page 5 of 6

6 AFFIDAVIT OF TRUSTOR I, being duly sworn, do hereby declare as follows: executed that certain trust deed and note dated in favor of in the amount of $ said note called for monthly payments of $ per month commencing in. Said trust deed was recorded on as instrument number in Book, Page of Official Records and affects the following described real property: Said note and trust deed was paid off on or about The original note and trust deed have been lost and no reconveyance has been issued for said trust deed. The whereabouts of the original beneficiaries are unknown to the affiant and attempts to reach them have failed. I am presently the sole owner of the real property described above. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: Signature: State of California County of ) ) ss. ) Subscribed and sworn before me, the undersigned, a Notary Public in and for said County and State, on personally appeared, who proved to me on the basis of satisfactory evidence or known to me to be the person whose name is subscribed to the within instrument and acknowledged that he/she executed the same. Notary Public in and for said County and State Page 6 of 6

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