REQUEST FOR WAIVER OF

ERRORS AND OMISSIONS POLICY

I,  . . . . . ., residing at  . . . . . ., City of  . . . . . ., County of  . . . . . ., State of Washington, declare the following:

(1) An errors and omissions policy is not reasonably available to a substantial number of licensed escrow officers; and

(2) Purchasing an errors and omissions policy is cost-prohibitive at this time; and

(3) I have not engaged in any conduct that resulted in the termination of my escrow certificate; and

(4) I have not paid, directly or through an errors and omissions policy, claims in excess of ten thousand dollars, exclusive of costs and attorneys' fees, during the calendar year preceding submission of this affidavit; and

(5) I have not paid, directly or through an errors and omissions policy, claims, exclusive of costs and attorneys' fees, totaling in excess of twenty thousand dollars in the three calendar years immediately preceding submission of this affidavit; and

(6) I have not been convicted of a crime involving honesty or moral turpitude during the calendar year preceding submission of this application.

THEREFORE, in consideration of the above, I,  . . . . . ., respectfully request that the director of financial institutions grant this request for a waiver of the requirement that I purchase and maintain an errors and omissions policy covering my activities as an escrow agent licensed by the state of Washington for the period from  . . . . . ., (year) . . . ., to  . . . . . ., (year) . . . .

Submitted this day of  . . . . day of  . . . . . ., (year) . . . .

 

(signature)

State of Washington,

ss.

I certify that I know or have satisfactory evidence that  . . . . . . . . ., signed this instrument and acknowledged it to be  . . . . . . . . . free and voluntary act for the uses and purposes mentioned in the instrument.

 

Dated . . . .

 

Signature of

 

Notary Public . . . .

(Seal or stamp)

Title . . . .

 

My appointment expires . . . .