HomeMy WebLinkAbout927353
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Return To:
THE BANK OF STAR VALLEY
384 WASHINGTON STREET
AITON, WYOMING 83110
Attn.: Shipping DeptlDocument Control
Prepared By:
RECEIVED 3/512007 at 3:59 PM
RECEIVING # 927353
BOOK: 650 PAGE: 244
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
ISpace Above This Line For Recording Datal
MORTGAGE
DEFINITIONS
Words used in multiple sections of this document are defined below and other words are defined in
Sections 3, 11, 13, 18, 20 and 21. Certain rules regarding the usage of words used in this document
are also provided in Section 16,
\ 1
(A) "Security Instrument" means this document, which is dated February 26, 2007, together with
all Riders to this document.
(B) "Borrower" is Martha Zoe Hughes as sole owner. Borrower is the mortgagor under this
Security Instrument.
(C) "Lender" is THE BANK OF STAR VALLEY, Lender is a corporation organized and existing
under the laws of the State of WYOMING. Lender's address is 384 WASHINGTON STREET,
AFTON, WYOMING 83110. Lender is the mortgagee under this Security Instrument.
(D) "Note" means the promissory note signed by Borrower and dated February 26, 2007. The Note
states that Borrower owes Lender One Hundred Fifty Four Thousand Four Hundred And 00/100
Dollars ({J,S, $ 154,400.00) plus interest. Borrower has promised to pay this debt in regular Periodic
Payments! and to pay the debt in full not later than March I, 2037.
(E) "Property" means the property that is described below under the heading "Transfer of Rights in
the Property."
(F) "Loah" means the debt evidenced by the Note, plus interest, any prepayment charges and late
charges dµe under the Note, and all sums due under this Security Instrument, plus interest.
(G) "Riders" means all Riders to this Security Instrument that are executed by Borrower, The
following Riders are to be executed by Borrower [check box as applicable]:
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Return To:
THE BANK OF STAR V ALLEY
384 WASHINGTON STREET
AFTON, WYOMING 83110
Attn,: Shipping DeptlDocument Control
Prepared By:
[] Adjustable Rate Rider
[] Balloon Rider
[] V A Rider
[] Condominium Rider
[X] Planned Unit Development Rider
[] Biweekly Payment Rider
[] Second Home Rider
[] 1-4 Family Rider
[] Other(s) [specify]
(H) "Applicable Law" means all controlling applicable federal, state and local statutes, regulations,
ordinances and administrative rules and orders (that have the effect of law) as well as all applicable
final, non-appealable judicial opinions.
(I) "Community Association Dues, Fees, and Assessments" means all dues, fees, assessments and
other charges that are imposed on Borrower or the Property by a condominium association,
homeowners association or similar organization.
(J ) "Electronic Funds Transfer" means any transfer of funds, other than a transaction originated by
check, draft, or similar paper instrument, which is initiated through an electronic tenninal, telephonic
instrument, computer, or magnetic tape so as to order, instruct, or authorize a financial institution to
debit or credit an account. Such term includes, but is not limited to, point-of-sale transfers, automated
teller machine transactions, transfers initiated by telephone, wire transfers, and automated
clearinghouse transfers.
(K) "Escrow Items" means those items that are described in Section 3,
(L) "Miscellaneous Proceeds" means any compensation, settlement, award of damages, or proceeds
paid by any third party (other than insurance proceeds paid under the coverages described in Section
5) for: (i) damage to, or destruction of, the Property; (ii) condemnation or other taking of all or any
part of the Property; (iii) conveyance in lieu of condemnation; or (iv) misrepresentations of, or
omissions as to, the value and/or condition of the Property.
(M) "Mortgage Insurance" means insurance protecting Lender against the nonpayment of, or default
on, the Loan,
(N) "Periodic Payment" means the regularly scheduled amount due for (i) principal and interest
under the Note, plus (ii) any amounts under Section 3 of this Security Instrument.
(0) "RESPA" means the Real Estate Settlement Procedures Act (12 U,S,c. Section 2601 et seq, )
and its implementing regulation, Regulation X (24 C.F.R. Part 3500), as they might be amended from
time to time, or any additional or successor legislation or regulation that governs the same subject
matter. As used in this Security Instrument, "RESPA" refers to all requirements and restrictions that
are imposed in regard to a "federally related mortgage loan" even if the Loan does not qualify as a
"federally related mortgage loan" under RESPA,
(P) "Successor in Interest of Borrower" means any party that has taken title to the Property, whether
or not that party has assumed Borrower's obligations under the Note andlor this Security Instrument.
TRANSFER OF RIGHTS IN THE PROPERTY
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This Security Instrument secures to Lender: (i) the repayment of the Loan, and all renewals,
extensions and modifications of the Note; and (ii) the performance of Borrower's covenants and
agreements under this Security Instrument and the Note, For this purpose, Borrower does hereby
mortgage, grant and convey to Lender and Lender's successors and assigns, with power of sale, the
following described property located in the County [Type of Recording Jurisdiction] of Lincoln [Name of
Recording Jurisdiction]:
LOT SEVENTEEN (17) OF STAR VALLEY RANCH PLAT 10, RECORDED MARCH 16,
1976 AT DOCUMENT NUMBER 476273, MAP NUMBER 199, IN THE OFFICE OF THE
CLERK, LINCOLN COUNTY, WYOMING.
Parcel ID Number: 12-3518-31-2-05-022.00
which currently has the address of
256 Walnut Drive [Street]
Star Valley Ranch [City] , Wyoming 83127 [Zip Code] ("Property Address" ):
TOGETHER WITH all the improvements now or hereafter erected on the property, and all
easements, appurtenances, and fixtures now or hereafter a part of the property, All replacements and
additions shall also be covered by this Security Instrument. All of the foregoing is referred to in this
Security Instrument as the "Property."
BORROWER COVENANTS that Borrower is lawfully seised of the estate hereby conveyed
and has the right to mortgage, grant and convey the Property and that the Property is unencumbered,
except for encumbrances of record, Borrower warrants and will defend generally the title to the
Property against all claims and demands, subject to any encumbrances of record.
THIS SECURITY INSTRUMENT combines uniform covenants for national use and non-
uniform covenants with limited variations by jurisdiction to constitute a uniform security instrument
covering real property.
UNIFORM COVENANTS. Borrower and Lender covenant and agree as follows:
1. Payment of Principal, Interest, Escrow Items, Prepayment Charges, and Late
Charges. Borrower shall pay when due the principal of, and interest on, the debt evidenced by the
Note and any prepayment charges and late charges due under the Note. Borrower shall also pay funds
for Escrow Items pursuant to Section 3, Payments due under the Note and this Security Instrument
shall be made in U.S, currency, However, if any check or other instrument received by Lender as
payment under the Note or this Security Instrument is returned to Lender unpaid, Lender may require
that any or all subsequent payments due under the Note and this Security Instrument be made in one or
more of the following forms, as selected by Lender: (a) cash; (b) money order; (c) certified check,
bank check, treasurer's check or cashier's check, provided any such check is drawn upon an institution
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whose deposits are insured by a federal agency, instrumentality, or entity; or (d) Electronic Funds
Transfer,
Payments are deemed received by Lender when received at the location designated in the
Note or at such other location as may be designated by Lender in accordance with the notice
provisions in Section 15, Lender may return any payment or partial payment if the payment or partial
payments are insufficient to bring the Loan current. Lender may accept any payment or partial
payment insufficient to bring the Loan current, without waiver of any rights hereunder or prejudice to
its rights to refuse such payment or partial payments in the future, but Lender is not obligated to apply
such payments at the time such payments are accepted, If each Periodic Payment is applied as of its
scheduled due date, then Lender need not pay interest on unapplied funds, Lender may hold such
unapplied funds until Borrower makes payment to bring the Loan current. If Borrower does not do so
within a reasonable period of time, Lender shall either apply such funds or return them to Borrower. If
not applied earlier, such funds will be applied to the outstanding principal balance under the Note
immediately prior to foreclosure, No offset or claim which Borrower might have now or in the future
against Lender shall relieve Borrower from making payments due under the Note and this Security
Instrument or performing the covenants and agreements secured by this Security Instrument.
2. Application of Payments or Proceeds. Except as otherwise described in this Section 2,
all payments accepted and applied by Lender shall be applied in the following order of priority: (a)
interest due under the Note; (b) principal due under the Note; (c) amounts due under Section 3, Such
payments shall be applied to each Periodic Payment in the order in which it became due, Any
remaining amounts shall be applied first to late charges, second to any other amounts due under this
Security Instrument, and then to reduce the principal balance of the Note,
If Lender receives a payment from Borrower for a delinquent Periodic Payment which
includes a sufficient amount to pay any late charge due, the payment may be applied to the delinquent
payment and the late charge, Ifmore than one Periodic Payment is outstanding, Lender may apply any
payment received from Borrower to the repayment of the Periodic Payments if, and to the extent that,
each payment can be paid in full. To the extent that any excess exists after the payment is applied to
the full payment of one or more Periodic Payments, such excess may be applied to any late charges
due, Voluntary prepayments shall be applied first to any prepayment charges and then as described in
the Note.
Any application of payments, insurance proceeds, or Miscellaneous Proceeds to principal due
under the Note shall not extend or postpone the due date, or change the amount, of the Periodic
Payments.
3. Funds for Escrow Items. Borrower shall pay to Lender on the day Periodic Payments are
due under the Note, until the Note is paid in full, a sum (the "Funds" ) to provide for payment of
amounts due for: (a) taxes and assessments and other items which can attain priority over this Security
Instrument as a lien or encumbrance on the Property; (b) leasehold payments or ground rents on the
Property, if any; (c) premiums for any and all insurance required by Lender under Section 5; and (d)
Mortgage Insurance premiums, if any, or any sums payable by Borrower to Lender in lieu of the
payment of Mortgage Insurance premiums in accordance with the provisions of Section 10, These
items are called "Escrow Items," At origination or at any time during the term of the Loan, Lender
may require that Community Association Dues, Fees, and Assessments, if any, be escrowed by
Borrower, and such dues, fees and assessments shall be an Escrow Item, Borrower shall promptly
furnish to Lender all notices of amounts to be paid under this Section, Borrower shall pay Lender the
Funds for Escrow Items unless Lender waives Borrower's obligation to pay the Funds for any or all
Escrow Items. Lender may waive Borrower's obligation to pay to Lender Funds for any or all Escrow
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Items at any time, Any such waiver may only be in writing, In the event of such waiver, Borrower
shall pay directly, when and where payable, the amounts due for any Escrow Items for which payment
of Funds has been waived by Lender and, if Lender requires, shall furnish to Lender receipts
evidencing such payment within such time period as Lender may require. Borrower's obligation to
make such payments and to provide receipts shall for all purposes be deemed to be a covenant and
agreement contained in this Security Instrument, as the phrase" covenant and agreement" is used in
Section 9, If Borrower is obligated to pay Escrow Items directly, pursuant to a waiver, and Borrower
fails to pay the amount due for an Escrow Item, Lender may exercise its rights under Section 9 and pay
such amount and Borrower shall then be obligated under Section 9 to repay to Lender any such
amount. Lender may revoke the waiver as to any or all Escrow Items at any time by a notice given in
accordance with Section 15 and, upon such revocation, Borrower shall pay to Lender all Funds, and in
such amounts, that are then required under this Section 3.
Lender may, at any time, collect and hold Funds in an amount (a) sufficient to permit Lender
to apply the Funds at the time specified under RESP A, and (b) not to exceed the maximum amount a
lender can require under RESPA. Lender shall estimate the amount of Funds due on the basis of
current data and reasonable estimates of expenditures of future Escrow Items or otherwise in
accordance with Applicable Law,
The Funds shall be held in an institution whose deposits are insured by a federal agency,
instrumentality, or entity (including Lender, if Lender is an institution whose deposits are so insured)
or in any Federal Home Loan Bank, Lender shall apply the Funds to pay the Escrow Items no later
than the time specified under RESPA. Lender shall not charge Borrower for holding and applying the
Funds, annually analyzing the escrow account, or verifYing the Escrow Items, unless Lender pays
Borrower interest on the Funds and Applicable Law permits Lender to make such a charge. Unless an
agreement is made in writing or Applicable Law requires interest to be paid on the Funds, Lender shall
not be required to pay Borrower any interest or earnings on the Funds. Borrower and Lender can
agree in writing, however, that interest shall be paid on the Funds. Lender shall give to Borrower,
without charge, an annual accounting of the Funds as required by RESPA,
Ifthere is a surplus of Funds held in escrow, as defined under RESPA, Lender shall account
to Borrower for the excess funds in accordance with RESPA, If there is a shortage of Funds held in
escrow, as defined under RESPA, Lender shall notifY Borrower as required by RESPA, and Borrower
shall pay to Lender the amount necessary to make up the shortage in accordance with RESPA , but in
no more than 12 monthly payments, If there is a deficiency of Funds held in escrow, as defined under
RESPA, Lender shall notifY Borrower as required by RESPA, and Borrower shall pay to Lender the
amount necessary to make up the deficiency in accordance with RESP A, but in no more than 12
monthly payments,
Upon payment in full of all sums secured by this Security Instrument, Lender shall promptly
refund to Borrower any Funds held by Lender.
4. Charges; Liens. Borrower shall pay all taxes, assessments, charges, fines, and
impositions attributable to the Property which can attain priority over this Security Instrument,
leasehold payments or ground rents on the Property, if any, and Community Association Dues, Fees,
and Assessments, if any, To the extent that these items are Escrow Items, Borrower shall pay them in
the manner provided in Section 3,
Borrower shall promptly discharge any lien which has priority over this Security Instrument
unless Borrower: (a) agrees in writing to the payment of the obligation secured by the lien in a manner
acceptable to Lender, but only so long as Borrower is performing such agreement; (b) contests the lien
in good faith by, or defends against enforcement of the lien in, legal proceedings which in Lender's
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opinion operate to prevent the enforcement of the lien while those proceedings are pending, but only
until such proceedings are concluded; or (c) secures from the holder of the lien an agreement
satisfactory to Lender subordinating the lien to this Security Instrument. If Lender determines that any
part of the Property is subject to a lien which can attain priority over this Security Instrument, Lender
may give Borrower a notice identifYing the lien, Within 10 days of the date on which that notice is
given, Borrower shall satisfY the lien or take one or more of the actions set forth above in this Section
4.
Lender may require Borrower to pay a one-time charge for a real estate tax verification and/or
reporting service used by Lender in connection with this Loan.
5. Property Insurance. Borrower shall keep the improvements now existing or hereafter
erected on the Property insured against loss by fire, hazards included within the term "extended
coverage," and any other hazards including, but not limited to, earthquakes and floods, for which
Lender requires insurance. This insurance shall be maintained in the amounts (including deductible
levels) and for the periods that Lender requires, W hat Lender requires pursuant to the preceding
sentences can change during the term of the Loan, The insurance carrier providing the insurance shall
be chosen by Borrower subject to Lender's right to disapprove Borrower's choice, which right shall
not be exercised unreasonably. Lender may require Borrower to pay, in connection with this Loan,
either: (a) a one-time charge for flood zone determination, certification and tracking services; or (b) a
one-time charge for flood zone determination and certification services and subsequent charges each
time remappings or similar changes occur which reasonably might affect such determination or
certification. Borrower shall also be responsible for the payment of any fees imposed by the Federal
Emergency Management Agency in connection with the review of any flood zone determination
resulting from an objection by Borrower,
If Borrower fails to maintain any of the coverages described above, Lender may obtain
insurance coverage, at Lender's option and Borrower's expense. Lender is under no obligation to
purchase any particular type or amount of coverage. Therefore, such coverage shall cover Lender, but
might or might not protect Borrower, Borrower's equity in the Property, or the contents of the
Property, against any risk, hazard or liability and might provide greater or lesser coverage than was
previously in effect. Borrower acknowledges that the cost of the insurance coverage so obtained
might significantly exceed the cost of insurance that Borrower could have obtained, Any amounts
disbursed by Lender under this Section 5 shall become additional debt of Borrower secured by this
Security Instrument. These amounts shall bear interest at the Note rate from the date of disbursement
and shall be payable, with such interest, upon notice from Lender to Borrower requesting payment.
All insurance policies required by Lender and renewals of such policies shall be subject to
Lender's right to disapprove such policies, shall include a standard mortgage clause, and shall name
Lender as mortgagee and/or as an additional loss payee. Lender shall have the right to hold the
policies and renewal certificates. If Lender requires, Borrower shall promptly give to Lender all
receipts of paid premiums and renewal notices, If Borrower obtains any form of insurance coverage,
not otherwise required by Lender, for damage to, or destruction of, the Property, such policy shall
include a standard mortgage clause and shall name Lender as mortgagee andlor as an additional loss
payee.
In the event of loss, Borrower shall give prompt notice to the insurance carrier and Lender,
Lender may make proof of loss if not made promptly by Borrower. Unless Lender and Borrower
otherwise agree in writing, any insurance proceeds, whether or not the underlying insurance was
required by Lender, shall be applied to restoration or repair of the Property, if the restoration or repair
is economically feasible and Lender's security is not lessened. During such repair and restoration
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period, Lender shall have the right to hold such insurance proceeds until Lender has had an
opportunity to inspect such Property to ensure the work has been completed to Lender's satisfaction,
provided that such inspection shall be undertaken promptly. Lender may disburse proceeds for the
repairs and restoration in a single payment or in a series of progress payments as the work is
completed, Unless an agreement is made in writing or Applicable Law requires interest to be paid on
such insurance proceeds, Lender shall not be required to pay Borrower any interest or earnings on
such proceeds. Fees for public adjusters, or other third parties, retained by Borrower shall not be paid
out of the insurance proceeds and shall be the sole obligation of Borrower, If the restoration or repair
is not economically feasible or Lender's security would be lessened, the insurance proceeds shall be
applied to the sums secured by this Security Instrument, whether or not then due, with the excess, if
any, paid to Borrower, Such insurance proceeds shall be applied in the order provided for in Section
2.
If Borrower abandons the Property, Lender may file, negotiate and settle any available
insurance claim and related matters, If Borrower does not respond within 30 days to a notice from
Lender that the insurance carrier has offered to settle a claim, then Lender may negotiate and settle the
claim, The 30-day period will begin when the notice is given. In either event, or if Lender acquires
the Property under Section 22 or otherwise, Borrower hereby assigns to Lender (a) Borrower's rights
to any insurance proceeds in an amount not to exceed the amounts unpaid under the Note or this
Security Instrument, and (b) any other of Borrower's rights (other than the right to any refund of
unearned premiums paid by Borrower) under all insurance policies covering the Property, insofar as
such rights are applicable to the coverage of the Property. Lender may use the insurance proceeds
either to repair or restore the Property or to pay amounts unpaid under the Note or this Security
Instrument, whether or not then due,
6. Occupancy. Borrower shall occupy, establish, and use the Property as Borrower's
principal residence within 60 days after the execution of this Security Instrument and shall continue to
occupy the Property as Borrower's principal residence for at least one year after the date of occupancy,
unless Lender otherwise agrees in writing, which consent shall not be unreasonably withheld, or unless
extenuating circumstances exist which are beyond Borrower's control.
7. Preservation, Maintenance and Protection of the Property; Inspections. Borrower
shall not destroy, damage or impair the Property, allow the Property to deteriorate or commit waste on
the Property. Whether or not Borrower is residing in the Property, Borrower shall maintain the
Property in order to prevent the Property from deteriorating or decreasing in value due to its condition,
Unless it is determined pursuant to Section 5 that repair or restoration is not economically feasible,
Borrower shall promptly repair the Property if damaged to avoid further deterioration or damage. If
insurance or condemnation proceeds are paid in connection with damage to, or the taking of, the
Property, Borrower shall be responsible for repairing or restoring the Property only if Lender has
released proceeds for such purposes, Lender may disburse proceeds for the repairs and restoration in a
single payment or in a series of progress payments as the work is completed, If the insurance or
condemnation proceeds are not sufficient to repair or restore the Property, Borrower is not relieved of
Borrower's obligation for the completion of such repair or restoration.
Lender or its agent may make reasonable entries upon and inspections of the Property, I f it
has reasonable cause, Lender may inspect the interior of the improvements on the Property, Lender
shall give Borrower notice at the time of or prior to such an interior inspection specifYing such
reasonable cause,
8. Borrower's Loan Application. Borrower shall be in default if, during the Loan
application process, Borrower or any persons or entities acting at the direction of Borrower or with
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Borrower's knowledge or consent gave materially false, misleading, or inaccurate information or
statements to Lender (or failed to provide Lender with material information) in connection with the
Loan, Material representations include, but are not limited to, representations concerning Borrower's
occupancy of the Property as Borrower's principal residence.
9. Protection of Lender's· Interest in the Property and Rights Under this Security
Instrument. If (a) Borrower fails to perform the covenants and agreements contained in this Security
Instrument, (b) there is a legal proceeding that might significantly affect Lender's interest in the
Property andlor rights under this Security Instrument (such as a proceeding in bankruptcy, probate, for
condemnation or forfeiture, for enforcement of a lien which may attain priority over this Security
Instrument or to enforce laws or regulations), or (c) Borrower has abandoned the Property, then
Lender may do and pay for whatever is reasonable or appropriate to protect Lender's interest in the
Property and rights under this Security Instrument, including protecting and/or assessing the value of
the Property, and securing and/or repairing the Property, Lender's actions can include, but are not
limited to: (a) paying any sums secured by a lien which has priority over this Security Instrument; (b)
appearing in court; and (c) paying reasonable attorneys' fees to protect its interest in the Property
andlor rights under this Security Instrument, including its secured position in a bankruptcy proceeding,
Securing the Property includes, but is not limited to, entering the Property to make repairs, change
locks, replace or board up doors and windows, drain water from pipes, eliminate building or other
code violations or dangerous conditions, and have utilities turned on or off, Although Lender may
take action under this Section 9, Lender does not have to do so and is not under any duty or obligation
to do so. It is agreed that Lender incurs no liability for not taking any or all actions authorized under
this Section 9.
Any amounts disbursed by Lender under this Section 9 shall become additional debt of
Borrower secured by this Security Instrument. These amounts shall bear interest at the Note rate from
the date of disbursement and shall be payable, with such interest, upon notice from Lender to
Borrower requesting payment.
If this Security Instrument is on a leasehold, Borrower shall comply with all the provisions of
the lease, If Borrower acquires fee title to the Property, the leasehold and the fee title shall not merge
unless Lender agrees to the merger in writing.
10. Mortgage Insurance. If Lender required Mortgage Insurance as a condition of making
the Loan, Borrower shall pay the premiums required to maintain the Mortgage Insurance in effect. If,
for any reason, the Mortgage Insurance coverage required by Lender ceases to be available from the
mortgage insurer that previously provided such insurance and Borrower was required to make
separately designated payments toward the premiums for Mortgage Insurance, Borrower shall pay the
premiums required to obtain coverage substantially equivalent to the Mortgage Insurance previously in
effect, at a cost substantially equivalent to the cost to Borrower of the Mortgage Insurance previously
in effect, from an alternate mortgage insurer selected by Lender, If substantially equivalent Mortgage
Insurance coverage is not available, Borrower shall continue to pay to Lender the amount of the
separately designated payments that were due when the insurance coverage ceased to be in effect.
Lender will accept, use and retain these payments as a non-refundable loss reserve in lieu of Mortgage
Insurance, Such loss reserve shall be non-refundable, notwithstanding the fact that the Loan is
ultimately paid in full, and Lender shall not be required to pay Borrower any interest or earnings on
such loss reserve, Lender can no longer require loss reserve payments if Mortgage Insurance coverage
(in the amount and for the period that Lender requires) provided by an insurer selected by Lender
again becomes available, is obtained, and Lender requires separately designated payments toward the
premiums for Mortgage Insurance, If Lender required Mortgage Insurance as a condition of making
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the Loan and Borrower was required to make separately designated payments toward the premiums for
Mortgage Insurance, Borrower shall pay the premiums required to maintain Mortgage Insurance in
effect, or to provide a non-refundable loss reserve, until Lender's requirement for Mortgage Insurance
ends in accordance with any written agreement between Borrower and Lender providing for such
termination or until termination is required by Applicable Law, Nothing in this Section 10 affects
Borrower's obligation to pay interest at the rate provided in the Note.
Mortgage Insurance reimburses Lender (or any entity that purchases the Note) for certain
losses it may incur if Borrower does not repay the Loan as agreed. Borrower is not a party to the
Mortgage Insurance,
Mortgage insurers evaluate their total risk on all such insurance in force from time to time,
and may enter into agreements with other parties that share or modifY their risk, or reduce losses.
These agreements are on terms and conditions that are satisfactory to the mortgage insurer and the
other party (or parties) to these agreements. These agreements may require the mortgage insurer to
make payments using any source of funds that the mortgage insurer may have available (which may
include funds obtained from Mortgage Insurance premiums).
As a result of these agreements, Lender, any purchaser of the Note, another insurer, any
reinsurer, any other entity, or any affiliate of any of the foregoing, may receive (directly or indirectly)
amounts that derive from (or might be characterized as) a portion of Borrower's payments for
Mortgage Insurance, in exchange for sharing or modifYing the mortgage insurer's risk, or reducing
losses. If such agreement provides that an affiliate of Lender takes a share of the insurer's risk in
exchange for a share of the premiums paid to the insurer, the arrangement is often termed "captive
reinsurance," Further:
(a) Any such agreements will not affect the amounts that Borrower has agreed to pay
for Mortgage Insurance, or any other terms of the Loan. Such agreements will not increase the
amount Borrower will owe for Mortgage Insurance, and they will not entitle Borrower to any
refund.
(b) Any such agreements will not affect the rights Borrower has - if any - with respect to
the Mortgage Insurance under the Homeowners Protection Act of 1998 or any other law. These
rights may include the right to receive certain disclosures, to request and obtain cancellation of
the Mortgage Insurance, to have the Mortgage Insurance terminated automatically, andlor to
receive a refund of any Mortgage Insurance premiums that were unearned at the time of such
cancellation or termination.
11. Assignment of Miscellaneous Proceeds; Forfeiture. All Miscellaneous Proceeds are
hereby assigned to and shall be paid to Lender,
If the Property is damaged, such Miscellaneous Proceeds shall be applied to restoration or
repair of the Property, if the restoration or repair is economically feasible and Lender's security is not
lessened, During such repair and restoration period, Lender shall have the right to hold such
Miscellaneous Proceeds until Lender has had an opportunity to inspect such Property to ensure the
work has been completed to Lender's satisfaction, provided that such inspection shall be undertaken
promptly. Lender may pay for the repairs and restoration in a single disbursement or in a series of
progress payments as the work is completed. Unless an agreement is made in writing or Applicable
Law requires interest to be paid on such Miscellaneous Proceeds, Lender shall not be required to pay
Borrower any interest or earnings on such Miscellaneous Proceeds, If the restoration or repair is not
economically feasible or Lender's security would be lessened, the Miscellaneous Proceeds shall be
applied to the sums secured by this Security Instrument, whether or not then due, with the excess, if
WYOMING-Single Family- Fannie Mae/Freddie Mac UNIFORM INSTRUMENT
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any, paid to Borrower. Such Miscellaneous Proceeds shall be applied in the order provided for in
Section 2,
In the event of a total taking, destruction, or loss in value of the Property, the Miscellaneous
Proceeds shall be applied to the sums secured by this Security Instrument, whether or not then due,
with the excess, if any, paid to Borrower.
In the event of a partial taking, destruction, or loss in value of the Property in which the fair
market value of the Property immediately before the partial taking, destruction, or loss in value is
equal to or greater than the amount of the sums secured by this Security Instrument immediately
before the partial taking, destruction, or loss in value, unless Borrower and Lender otherwise agree in
writing, the sums secured by this Security Instrument shall be reduced by the amount of the
Miscellaneous Proceeds multiplied by the following fraction: (a) the total amount of the sums secured
immediately before the partial taking, destruction, or loss in value divided by (b) the fair market value
of the Property immediately before the partial taking, destruction, or loss in value. Any balance shall
be paid to Borrower,
In the event of a partial taking, destruction, or loss in value of the Property in which the fair
market value of the Property immediately before the partial taking, destruction, or loss in value is less
than the amount of the sums secured immediately before the partial taking, destruction, or loss in
value, unless Borrower and Lender otherwise agree in writing, the Miscellaneous Proceeds shall be
applied to the sums secured by this Security Instrument whether or not the sums are then due.
If the Property is abandoned by Borrower, or if, after notice by Lender to Borrower that the
Opposing Party (as defined in the next sentence) offers to make an award to settle a claim for
damages, Borrower fails to respond to Lender within 30 days after the date the notice is given, Lender
is authorized to collect and apply the Miscellaneous Proceeds either to restoration or repair of the
Property or to the sums secured by this Security Instrument, whether or not then due, "Opposing
Party" means the third party that owes Borrower Miscellaneous Proceeds or the party against whom
Borrower has a right of action in regard to Miscellaneous Proceeds,
Borrower shall be in default if any action or proceeding, whether civil or criminal, is begun
that, in Lender's judgment, could result in forfeiture of the Property or other material impairment of
Lender's interest in the Property or rights under this Security Instrument. Borrower can cure such a
default and, if acceleration has occurred, reinstate as provided in Section 19, by causing the action or
proceeding to be dismissed with a ruling that, in Lender's judgment, precludes forfeiture of the
Property or other material impairment of Lender's interest in the Property or rights under this Security
Instrument. The proceeds of any award or claim for damages that are attributable to the impairment of
Lender's interest in the Property are hereby assigned and shall be paid to Lender,
All Miscellaneous Proceeds that are not applied to restoration or repair of the Property shall
be applied in the order provided for in Section 2,
12. Borrower Not Released; Forbearance By Lender Not a Waiver. Extension of the
time for payment or modification of amortization of the sums secured by this Security Instrument
granted by Lender to Borrower or any Successor in Interest of Borrower shall not operate to release
the liability of Borrower or any Successors in Interest of Borrower. Lender shall not be required to
commence proceedings against any Successor in Interest of Borrower or to refuse to extend time for
payment or otherwise modifY amortization of the sums secured by this Security Instrument by reason
of any demand made by the original Borrower or any Successors in Interest of Borrower. Any
forbearance by Lender in exercising any right or remedy including, without limitation, Lender's
acceptance of payments from third persons, entities or Successors in Interest of Borrower or in
WYOMING-Single Family- Fannie Mae/Freddie Mac UNIFORM INSTRUMENT
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amounts less than the amount then due, shall not be a waiver of or preclude the exercise of any right or
remedy.
13. Joint and Several Liability; Co-signers; Successor s and Assigns Bound. Borrower
covenants and agrees that Borrower's obligations and liability shall be joint and several. However,
any Borrower who co-signs this Security Instrument but does not execute the Note (a "co-signer"): (a)
is co-signing this Security Instrument only to mortgage, grant and convey the co-signer's interest in
the Property under the terms of this Security Instrument; (b) is not personally obligated to pay the
sums secured by this Security Instrument; and (c) agrees that Lender and any other Borrower can agree
to extend, modify, forbear or make any accommodations with regard to the terms of this Security
Instrument or the Note without the co-signer's consent.
Subject to the provisions of Section 18, any Successor in Interest of Borrower who assumes
Borrower's obligations under this Security Instrument in writing, and is approved by Lender, shall
obtain all of Borrower's rights and benefits under this Security Instrument. Borrower shall not be
released from Borrower's obligations and liability under this Security Instrument unless Lender agrees
to such release in writing. The covenants and agreements of this Security Instrument shall bind
(except as provided in Section 20) and benefit the successors and assigns of Lender.
14. Loan Charges. Lender may charge Bon-ower fees for services performed in connection
with Borrower's default, for the purpose of protecting Lender's interest in the Property and rights
under this Security Instrument, including, but not limited to, attorneys' fees, property inspection and
valuation fees, In regard to any other fees, the absence of express authority in this Security Instrument
to charge a specific fee to Borrower shall not be construed as a prohibition on the charging of such fee.
Lender may not charge fees that are expressly prohibited by this Security Instrumènt or by Applicable
Law,
If the Loan is subject to a law which sets maximum loan charges, and that law is finally
interpreted so that the interest or other loan charges collected or to be collected in connection with the
Loan exceed the permitted limits, then: (a) any such loan charge shall be reduced by the amount
necessary to reduce the charge to the permitted limit; and (b) any sums already collected from
Borrower which exceeded pennitted limits will be refunded to Borrower. Lender may choose to make
this refund by reducing the principal owed under the Note or by making a direct payment to Borrower.
If a refund reduces principal, the reduction will be treated as a partial prepayment without any
prepayment charge (whether or not a prepayment charge is provided for under the Note), Borrower's
acceptance of any such refund made by direct payment to Borrower will constitute a waiver of any
right of action Borrower might have arising out of such overcharge,
15. Notices. All notices given by Borrower or Lender in connection with this Security
Instrument must be in writing. Any notice to Borrower in connection with this Security Instrument
shall be deemed to have been given to Borrower when mailed by first class mail or when actually
delivered to Borrower's notice address if sent by other means. Notice to anyone Borrower shall
constitute notice to all Borrowers unless Applicable Law expressly requires otherwise. The notice
address shall be the Property Address unless Borrower has designated a substitute notice address by
notice to Lender. Borrower shall promptly notify Lender of Borrower's change of address, If Lender
specifies a procedure for reporting Borrower's change of address, then Borrower shall only report a
change of address through that specified procedure. There may be only one designated notice address
under this Security Instrument at anyone time. Any notice to Lender shall be given by delivering it or
by mailing it by first class mail to Lender's address stated herein unless Lender has designated another
address by notice to Borrower. Any notice in connection with this Security Instrument shall not be
deemed to have been given to Lender until actually received by Lender, If any notice required by this
WYOMING-Single Family- Fannie Mae/Freddie Mac UNIFORM INSTRUMENT
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Security Instrument is also required under Applicable Law, the Applicable Law requirement will
satisfy the corresponding requirement under this Security Instrument.
16. Governing Law; Severability; Rules of Construction. This Security Instrument shall
be governed by federal law and the law of the jurisdiction in which the Property is located. All rights
and obligations contained in this Security Instrument are subject to any requirements and limitations of
Applicable Law. Applicable Law might explicitly or implicitly allow the parties to agree by contract
or it might be silent, but such silence shall not be construed as a prohibition against agreement by
contract. In the event that any provision or clause of this Security Instrument or the Note conflicts
with Applicable Law, such conflict shall not affect other provisions of this Security Instrument or the
Note which can be given effect without the conflicting provision.
As used in this Security Instrument: (a) words of the masculine gender shall mean and
include corresponding neuter words or words of the feminine gender; (b) words in the singular shall
mean and include the plural and vice versa; and (c) the word "may" gives sole discretion without any
obligation to take any action,
17. Borrower's Copy. Borrower shall be given one copy of the Note and of this Security
Instrument.
18. Transfer of the Property or a Beneficial Interest in Borrower. As used in this
Section 18, "Interest in the Property" means any legal or beneficial interest in the Property, including,
but not limited to, those beneficial interests transferred in a bond for deed, contract for deed,
installment sales contract or escrow agreement, the intent of which is the transfer of title by Borrower
at a future date to a purchaser.
If all or any part of the Property or any Interest in the Property is sold or transferred (or if
Borrower is not a natural person and a beneficial interest in Borrower is sold or transferred) without
Lender's prior written consent, Lender may require immediate payment in full of all sums secured by
this Security Instrument. However, this option shall not be exercised by Lender if such exercise is
prohibited by Applicable Law.
If Lender exercises this option, Lender shall give Borrower notice of acceleration. The notice
shall provide a period of not less than 30 days from the date the notice is given in accordance with
Section 15 within which Borrower must pay all sums secured by this Security Instrument. If Borrower
fails to pay these sums prior to the expiration of this period, Lender may invoke any remedies
permitted by this Security Instrument without further notice or demand on Borrower,
19. Borrower's Right to Reinstate After Acceleration. If Borrower meets certain
conditions, Borrower shall have the right to have enforcement of this Security Instrument discontinued
at any time prior to the earliest of: (a) five days before sale of the Property pursuant to any power of
sale contained in this Security Instrument; (b) such other period as Applicable Law might specify for
the termination of Borrower's right to reinstate; or (c) entry of a judgment enforcing this Security
Instrument. T hose conditions are that Borrower: (a) pays Lender all sums which then would be due
under this Security Instrument and the Note as if no acceleration had occurred; (b) cures any default of
any other covenants or agreements; (c) pays all expenses incurred in enforcing this Security
Instrument, including, but not limited to, reasonable attorneys' fees, property inspection and valuation
fees, and other fees incurred for the purpose of protecting Lender's interest in the Property and rights
under this Security Instrument; and (d) takes such action as Lender may reasonably require to assure
that Lender's interest in the Property and rights under this Security Instrument, and Borrower's
obligation to pay the sums secured by this Security Instrument, shall continue unchanged. Lender
may require that Borrower pay such reinstatement sums and expenses in one or more of the following
forms, as selected by Lender: (a) cash; (b) money order; (c) certified check, bank check, treasurer's
WYOMING-Single Family- Fannie Mae/Freddie Mac UNIFORM INSTRUMENT
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check or cashier's check, provided any such check is drawn upon an institution whose deposits are
insured by a federal agency, instrumentality or entity; or (d) Electronic Funds Transfer, Upon
reinstatement by Borrower, this Security Instrument and obligations secured hereby shall remain fully
effective as if no acceleration had occurred, However, this right to reinstate shall not apply in the case
of acceleration under Section 18,
20. Sale of Note; Change of Loan Servicer; Notice of Grievance. The Note or a partial
interest in the Note (together with this Security Instrument) can be sold one or more times without
prior notice to Borrower. A sale might result in a change in the entity (known as the "Loan Servicer" )
that collects Periodic Payments due under the Note and this Security Instrument and performs other
mortgage loan servicing obligations under the Note, this Security Instrument, and Applicable Law.
There also might be one or more changes ofthe Loan Servicer unrelated to a sale of the Note. If there
is a change of the Loan Servicer, Borrower will be given written notice of the change which will state
the name and address of the new Loan Servicer, the address to which payments should be made and
any other information RESPA requires in connection with a notice of transfer of servicing. If the Note
is sold and thereafter the Loan is serviced by a Loan Servicer other than the purchaser of the Note, the
mortgage loan servicing obligations to Borrower will remain with the Loan Servicer or be transferred
to a successor Loan Servicer and are not assumed by the Note purchaser unless otherwise provided by
the Note purchaser.
Neither Borrower nor Lender may commence, join, or be joined to any judicial action (as
either an individual litigant or the member of a class) that arises from the other party's actions pursuant
to this Security Instrument or that alleges that the other party has breached any provision of, or any
duty owed by reason of, this Security Instrument, until such Borrower or Lender has notified the other
party (with such notice given in compliance with the requirements of Section 15) of such alleged
breach and afforded the other party hereto a reasonable period after the giving of such notice to take
corrective action. If Applicable Law provides a time period which must elapse before certain action
can be taken, that time period will be deemed to be reasonable for purposes of this paragraph. The
notice of acceleration and opportunity to cure given to Borrower pursuant to Section 22 and the notice
of acceleration given to Borrower pursuant to Section 18 shall be deemed to satisfY the notice and
opportunity to take corrective action provisions of this Section 20,
21. Hazardous Substances. As used in this Section 21: (a) "Hazardous Substances" are
those substances defined as toxic or hazardous substances, pollutants, or wastes by Environmental
Law and the following substances: gasoline, kerosene, other flammable or toxic petroleum products,
toxic pesticides and herbicides, volatile solvents, materials containing asbestos or formaldehyde, and
radioactive materials; (b) "Environmental Law" means federal laws and laws of the jurisdiction where
the Property is located that relate to health, safety or environmental protection; (c) "Environmental
Cleanup" includes any response action, remedial action, or removal action, as defined in
Environmental Law; and (d) an "Environmental Condition" means a condition that can cause,
contribute to, or otherwise trigger an Environmental Cleanup.
Borrower shall not cause or permit the presence, use, disposal, storage, or release of any
Hazardous Substances, or threaten to release any Hazardous Substances, on or in the Property.
Borrower shall not do, nor allow anyone else to do, anything affecting the Property (a) that is in
violation of any Environmental Law, (b) which creates an Environmental Condition, or (c) which, due
to the presence, use, or release of a Hazardous Substance, creates a condition that adversely affects the
value of the Property. The preceding two sentences shall not apply to the presence, use, or storage on
the Property of small quantities of Hazardous Substances that are generally recognized to be
WYOMING-Single Family- Fannie Mae/Freddie Mac UNIFORM INSTRUMENT
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appropriate to normal residential uses and to maintenance of the Property (including, but not limited
to, hazardous substances in consumer products).
Borrower shall promptly give Lender written notice of (a) any investigation, claim, demand,
lawsuit or other action by any governmental or regulatory agency or private party involving the
Property and any Hazardous Substance or Environmental Law of which Borrower has actual
knowledge, (b) any Environmental Condition, including but not limited to, any spilling, leaking,
discharge, release or threat of release of any Hazardous Substance, and (c) any condition caused by the
presence, use or release of a Hazardous Substance which adversely affects the value of the Property.
If Borrower learns, or is notified by any governmental or regulatory authority, or any private party,
that any removal or other remediation of any Hazardous Substance affecting the Property is necessary,
Borrower shall promptly take all necessary remedial actions in accordance with Environmental Law,
Nothing herein shall create any obligation on Lender for an Environmental Cleanup.
NON-UNIFORM COVENANTS. Borrower and Lender further covenant and agree as
follows:
22. Acceleration; Remedies. Lender shall give notice to Borrower prior to acceleration
following Borrower's breach of any covenant or agreement in this Security Instrument (but not
prior to acceleration under Section 18 unless Applicable Law provides otherwise). The notice
shall specify: (a) the default; (b) the action required to cure the default; (c) a date, not less than
30 days from the date the notice is given to Borrower, by which the default must be cured; and
(d) that failure to cure the default on or before the date specified in the notice may result in
acceleration of the sums secured by this Security Instrument and sale of the Property. The
notice shall further inform Borrower of the right to reinstate after acceleration and the right to
bring a court action to assert the non-existence of a default or any other defense of Borrower to
acceleration and sale. If the default is not cured on or before the date specified in the notice,
Lender at its option may require immediate payment in full of all sums secured by this Security
Instrument without further demand and may invoke the power of sale and any other remedies
permitted by Applicable Law. Lender shall be entitled to collect all expenses incurred in
pursuing the remedies provided in this Section 22, including, but not limited to, reasonable
attorneys' fees and costs of title evidence.
If Lender invokes the power of sale, Lender shall give notice of intent to foreclose to
Borrower and to the per son in possession of the Property, if different, in accordance with
Applicable Law. Lender shall give notice of the sale to Borrower in the manner provided in
Section 15. Lender shall publish the notice of sale, and the Property shall be sold in the manner
prescribed by Applicable Law. Lender or its designee may purchase the Property at any sale.
The proceeds of the sale shall be applied in the following order: (a) to all expenses of the sale,
including, but not limited to, reasonable attorneys' fees; (b) to all sums secured by this Security
Instrument; and (c) any excess to the person or persons legally entitled to it.
23. Release. Upon payment of all sums secured by this Security Instrument, Lender shall
release this Security Instrument. Borrower shall pay any recordation costs, Lender may charge
Borrower a fee for releasing this Security Instrument, but only if the fee is paid to a third party for
services rendered and the charging of the fee is permitted under Applicable Law,
24. Waivers. Borrower releases and waives all rights under and by virtue of the homestead
exemption laws of Wyoming,
WVOMING-Single Family- Fannie Mae/Freddie Mac UNIFORM INSTRUMENT
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BY SIGNING BELOW, Borrower accepts and agrees to the terms and covenants contained in
this Security Instrument and in any Rider executed by Borrower and recorded with it.
Witnesses:
~
Martha Zoe Hughes
(Seal)
-Borrower
(Seal)
-Borrower
(Seal)
-Borrower
I
WYOMING-Single FamrlY- Fannie Mae/Freddie Mac UNIFORM INSTRUMENT
Page 15 of 16
Form 3051 1/01
0927353
000259
STATE OF WYOMING,
County ss:
The foregoing instrument was acknowledged before me this. é;) ð(P . 0"-=1- by
Martha Zoe Hughes,
My Commission Expires: d·Ø-}· Dc¡
CHERYL A. JONES - NOTARY PUBLIC
COU'lly of. Slate 01
LIncoln ~mlng
My Commission expires Feb. 4, 2000
WYOMING-Single Family- Fannie MaelFreddie Mac UNIFORM INSTRUMENT
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PLANNED UNIT DEVELOPMENT RIDER
THIS PLANNED UNIT DEVELOPMENT RIDER is made this 26th day of February, 2007,
and is incorporated into and shall be deemed to amend and supplement the Mortgage, Deed of Trust,
or Security Deed (the "Security Instrument") of the same date, given by the undersigned (the
"Borrower") to secure Borrower's Note to THE BANK OF STAR VALLEY (the "Lender") of the
same date and covering the Property described in the Security Instrument and located at:
256 Walnut Drive, Star Valley Ranch, WYOMING 83127
[Property Address]
The Property includes, but is not limited to, a parcel of land improved with a dwelling,
together with other such parcels and certain common areas and facilities, as described in the
Covenants, Conditions and Restrictions of the (the "Declaration"), The Property is a part of a
planned unit development known as
STAR VALLEY RANCH
[Name of Planned Unit Development]
(the "PUD"). The Property also includes Borrower's interest in the homeowners association or
equivalent entity owning or managing the common areas and facilities of the PUD (the "Owners
Association") and the uses, benefits and proceeds of Borrower's interest.
PUD COVENANTS. In addition to the covenants and agreements made in the Security
Instrument, Borrower and Lender further covenant and agree as follows:
A. PUD Obligations. Borrower shall perform all of Borrower's obligations under the PUD's
Constituent Documents. The "Constituent Documents" are the (i) Declaration; (ii) articles of
incorporation, trust instrument or any equivalent document which creates the Owners Association; and
(iii) any by-laws or other rules or regulations of the Owners Association, Borrower shall promptly
pay, when due, all dues and assessments imposed pursuant to the Constituent Documents.
B. Property Insurance. So long as the Owners Association maintains, with a generally
accepted insurance carrier, a "master" or "blanket" policy insuring the Property which is satisfactory to
Lender and which provides insurance coverage in the amounts (including deductible levels), for the
periods, and against loss by fire, hazards included within the term "extended coverage," and any other
hazards, including, but not limited to, earthquakes and floods, for which Lender requires insurance,
MUL TlSTA TE PUD RIDER - Single Family - Fannie Mae/Freddie Mac UNIFORM INSTRUMENT F~rm 3150 1
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then: (i) Lender waives the provision in Section 3 for the Periodic Payment to Lender of the yearly
premium instaIlments for property insurance on the Property; and (ii) Borrower's obligation under
Section 5 to maintain property insurance coverage on the Property is deemed satisfied to the extent that
the required coverage is provided by the Owners Association policy,
What Lender requires as a condition of this waiver can change during the term of the loan.
Borrower shall give Lender prompt notice of any lapse in required property insurance
coverage provided by the master or blanket policy.
In the event of a distribution of property insurance proceeds in lieu of restoration or repair
following a loss to the Property, or to common areas and facilities of the PUD, any proceeds payable to
Borrower are hereby assigned and shall be paid to Lender. Lender shall apply the proceeds to the
sums secured by the Security Instrument, whether or not then due, with the excess, if any, paid to
Borrower,
C. Public Liability Insurance. Borrower shaIl take such actions as may be reasonable to
insure that the Owners Association maintains a public liability insurance policy acceptable in form,
amount, and extent of coverage to Lender,
D. Condemnation. The proceeds of any award or claim for damages, direct or
consequential, payable to Borrower in connection with any condemnation or other taking of all or any
part of the Property or the common areas and facilities of the PUD, or for any conveyance in lieu of
condemnation, are hereby assigned and shaIl be paid to Lender. Such proceeds shall be applied by
Lender to the sums secured by the Security Instrument as provided in Section I 1.
E. Lender's Prior Consent. Borrower shaIl not, except after notice to Lender and with
Lender's prior written consent, either partition or subdivide the Property or consent to: (i) the
abandonment or termination of the PUD, except for abandonment or termination required by law in the
case of substantial destruction by fire or other casualty or in the case of a taking by condemnation or
eminent domain; (ii) any amendment to any provision of the "Constituent Documents" if the provision
is for the express benefit of Lender; (iii) termination of professional management and assumption of
self-management of the Owners Association; or (iv) any action which would have the effect of
rendering the public liability insurance coverage maintained by the Owners Association unacceptable
to Lender.
F. Remedies. If Borrower does not pay PUD dues and assessments when due, then Lender
may pay them. Any amounts disbursed by Lender under this paragraph F shall become additional debt
of Borrower secured by the Security Instrument. Unless Borrower and Lender agree to other terms of
payment, these amounts shall bear interest from the date of disbursement at the Note rate and shaIl be
payable, with interest, upon notice from Lender to Borrower requesting payment.
MUL TlSTATE PUD RIDER - Single Family - Fannie Mae/Freddie Mac UNIFORM INSTRUMENT
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BY SIGNING BELOW, Borrower accepts and agrees to the terms and covenants contained in this
PUD Rider,
Martha Zoe Hughe
(Seal)
-Borrower
~
(Seal)
-Borrower
(Seal)
-Borrower
MUL TISTA TE PUD RIDER - Single Family - Fannie Mae/Freddie Mac UNIFORM INSTRUMENT
7R (0411 ) 0 I Page 3 of 3
Form 3150 1/01