Borrower(s)*

Property Address* City* Zip Code*

Access Instructions Contact* Phone* Email*

Lockbox (Y) (N) Code

BORROWER CERTIFICATION:

Borrower hereby requests the itemized funds from Lender to pay for the work performed as a part of the construction project at the above referenced Property. Borrower hereby certifies that all work has been performed in a good and workmanlike manner, free of any liens or encumbrances and is in accordance with the previously approved Escrow Agreement executed as of even date with the loan.

Borrower

Date : By :

Draw amount is subject to Wildcat Lending inspection and may be less than amount requested. The inspector will contact you within 24-48 hours after the draw request has been submitted.