AFFIDAVIT AND WAIVER OF RIGHT OF RESCISSION



                We, __________________, ___________________, and 
        ______________________________ as Tenants in _____________ (the 
        "Customer"), being first duly sworn, hereby depose and say that:

                We have entered into a $_______________ loan transaction 
        with _______________ Bank and Trust Company, ______________, 
        ____________________ (the "Creditor") on ______________, 20__ 
        which may result in a lien, mortgage, or other security interest 
        on our home.

                We hereby waive our right to rescind the transaction for 
        the following reasons:



                The extension of credit is vitally necessary to meet a 
        bonafide personal financial emergency, whereby a delay of three 
        (3) business days in performance of Creditor's obligation under 
        this transaction will jeopardize our financial welfare and 
        endanger us and our family.

                Therefore, We hereby waive our right of rescission and do 
        so under the pains and penalties of perjury this _______day of 
        ___________, 20__.



                                        _____________________________



                                        _____________________________



                                        _____________________________


        Signatures witnessed by:



        ____________________________



                                                     Form 134