FORM T-19 LOAN POLICY ENDORSEMENT

SURVEY CHECKLIST

(Revised JANUARY, 2014)

GF NO.

Effective February 1, 2010, do not physically delete any text from the face of the Form T-19 Endorsement itself. When coverage deletion from the Endorsement is necessary, place the following deletion statement in Schedule “B” of the Loan Policy as a separately-numbered item: “The following subparagraph(s) of the attached Form T-19 Restrictions, Encroachments, Minerals Endorsement are deleted: .”

NOTE: In this Checklist, the terms “improvement” or “improvements” refer to any improvement affixed to either the insured land or adjoining land and INCLUDE landscaping, lawn, shrubbery, or trees.

CHECK ANY APPLICABLE ITEM BELOW, and note date and source of any required underwriter waiver [NWR = No Waiver Required].

(Note Any Underwriter

Waiver)

BUILDING SETBACK VIOLATIONS (plat or restrictions).

NWR Newer structure (less than four years old) encroaches over a setback line by 10% or less of the setback distance: YOU MAY ISSUE THE LOAN POLICY ENDORSEMENT WITHOUT EXCEPTING TO THIS ENCROACHMENT IN SCHEDULE “B”. (No related deletion is required in the T-19 Endorsement).

Date: Newer structure (less than four years old) encroaches over a setback line

By: by more than 10% of the setback distance: UNLESS UNDERWRITER WAIVER IS OBTAINED, YOU MUST EXCEPT TO THE ENCROACHMENT IN SCHEDULE “B” OF THE LOAN POLICY. (No related deletion is required in the T-19 Endorsement).

NWR Older structure (more than four years old) encroaches over a setback line by up to 100% of the setback distance, without overlapping any boundary line: YOU MAY ISSUE THE LOAN POLICY WITHOUT EXCEPTING TO THIS ENCROACHMENT IN SCHEDULE “B”. (No related deletion is required in the T-19 Endorsement).

NWR Structure encroaching into the setback width is not permanent (e.g., outbuilding erected on wood or dirt floor), OR encroaching feature is not structural (e.g., in-ground pool, uncovered patio, walkway, driveway, fence, or retaining wall): YOU MAY ISSUE THE LOAN POLICY WITHOUT EXCEPTING TO THIS ENCROACHMENT IN SCHEDULE “B”. (No related deletion is required in the T-19 Endorsement).

EASEMENT ENCROACHMENTS.

NWR An improvement encroaches over 50% or less of the width of an easement created by plat or restrictions: YOU MAY ISSUE THE LOAN POLICY WITHOUT EXCEPTING TO THIS ENCROACHMENT IN SCHEDULE “B”. (No related deletion is required in the T-19 Endorsement).

NWR An improvement encroaching into the easement is not permanent (e.g., outbuilding erected on wood or dirt floor): YOU MAY ISSUE THE LOAN POLICY WITHOUT EXCEPTING TO THIS ENCROACHMENT IN SCHEDULE “B”. (No related deletion is required in the T-19 Endorsement).

Date: An improvement encroaches over more than 50% of the width of an

By: easement created by plat or restrictions: UNLESS UNDERWRITER WAIVER IS OBTAINED, YOU MUST EXCEPT TO THE ENCROACHMENT IN SCHEDULE “B” OF THE LOAN POLICY, AND SUB-PARAGRAPH NO. 4(c) MUST BE DELETED FROM THE T-19 ENDORSEMENT.

Date: Swimming-pool basin encroaches any distance into the area of an ease-

By: ment: UNLESS UNDERWRITER WAIVER IS OBTAINED, YOU MUST EXCEPT TO THE ENCROACHMENT IN SCHEDULE “B” OF THE LOAN POLICY, AND SUB-PARAGRAPH NO. 4(c) MUST BE DELETED IN THE T-19 ENDORSEMENT.

Date: Improvement encroaches any distance into the area of a pipeline ease-

By: ment or more than 10% of the width of another separately-recorded easement specifically granted to a named user: UNLESS UNDERWRITER WAIVER IS OBTAINED, YOU MUST EXCEPT TO THE ENCROACHMENT IN SCHEDULE “B” OF THE LOAN POLICY, AND SUB-PARAGRAPH NO. 4(c) MUST BE DELETED IN THE T-19 ENDORSEMENT.

PROTRUSIONS/ENCROACHMENTS OVER BOUNDARY LINES.

NWR Seller’s/borrower’s fence protrudes onto neighboring public or private land OR is inset any distance from a boundary shared with a public road/street/alley: YOU MAY ISSUE THE LOAN POLICY WITHOUT EXCEPTING TO THIS PROTRUSION OR INSET IN SCHEDULE “B”. (No related deletion is required in the T-19 Endorsement).

Date: Adjoining owner’s fence encroaches into and encloses a strip exceeding

By: three feet (3’) in width out of the land being insured: UNLESS UNDERWRITER WAIVER IS OBTAINED, YOU MUST EXCEPT TO RIGHTS AND CLAIMS OF THE ADJOINING OWNER IN SCHEDULE “B” OF THE LOAN POLICY. (No related deletion is required in the T-19 Endorsement.)

NWR _____ Structure either protruding onto or encroaching from adjoining private or public land is not permanent, e.g. outbuilding constructed with dirt/ wooden floor. YOU MAY ISSUE THE LOAN POLICY WITHOUT EXCEPTING TO THIS ENCROACHMENT IN SCHEDULE “B”. (No related deletion is required in the T-19 Endorsement.)

Date: Improvement protrudes from land being insured onto adjoining property:

By: UNLESS UNDERWRITER WAIVER IS OBTAINED, YOU MUST EXCEPT TO THE PROTRUSION IN SCHEDULE “B” OF THE LOAN POLICY, AND SUB-PARAGRAPH NO. 4(b) MUST BE DELETED IN THE T-19 ENDORSEMENT.

NWR Improvement from adjoining property encroaches a distance of less than two feet (2’) onto the land being insured: YOU MAY ISSUE THE LOAN POLICY WITHOUT EXCEPTING TO THIS ENCROACHMENT IN SCHEDULE “B”. (No related deletion is required in the T-19 Endorsement.)

Date: Improvement from adjoining property encroaches a distance of more

By: than two feet (2’) onto the land being insured: UNLESS UNDERWRITER WAIVER IS OBTAINED, YOU MUST EXCEPT TO THE ENCROACHMENT IN SCHEDULE “B” OF THE LOAN POLICY, AND SUB-PARAGRAPH NO. 4(b) MUST BE DELETED FROM THE T-19 ENDORSEMENT.

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