4/13/2020
RECOMMENDED FORM
New Hampshire Housing Employment and Income Borrower(s) Affidavit
I/We, the undersigned, as part of my/our uniform loan application (Loan Application) for financing (the
Mortgage Loan), through a lender of the undersigned’s choosing for the purchase of a single family
residence, being duly sworn do hereby represent and warrant as follows:
I/We executed a Loan Application as part of my/our application for a Mortgage Loan.
(Check and complete Section (a) or (b), whichever applies.)
(a) ____ I/We have reviewed the aforementioned Loan Application and declare there has been no change
in the statements therein and said statements remain true and accurate as of the date hereof.
(b) ____ I/We have reviewed the aforementioned Loan Application and declare that the following changes
have occurred from the statements therein:
_________________________________________________________________________________________
Given that, the undersigned, being duly sworn, do hereby further represents and warrants as follows:
• There has been no change in employment or income as of the date of the Mortgage Loan Closing;
• I/We have no knowledge that my/our employment will be discontinued or that I/we will be furloughed;
• I/We have no knowledge that my monthly income disclosed on my most recently signed Loan
Application will be reduced;
• My/Our financial obligations disclosed on my/our most recently signed Loan Application have not
changed including opening new credit accounts or increasing credit balances;
• I/We am/are not in a forbearance plan or have requested mortgage relief;
• I/We do not anticipate requiring a forbearance plan or mortgage relief within the next 6 months; and
• I/We anticipate having the ability to pay my mortgage payment in full within the next 6 months.
I/We acknowledge and understand that this Affidavit will be relied upon for the purpose of determining the
Applicant’s eligibility for a Mortgage Loan.
I/WE DECLARE UNDER PENALTIES OF PERJURY THAT ALL STATEMENTS IN THIS AFFIDAVIT
ARE TRUE AND ACCURATE.
Executed on: (Date)
Signature Signature
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