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<br />I <br /> <br />¡' <br /> <br />EXHIBIT D <br /> <br />Reauest For Disbursement <br /> <br />Eligible Acquisition Costs <br /> <br />Attn: Manager <br />Division of Community Development <br />Department of Development <br />112 Hamilton Avenue, 4th Floor <br />Cleveland, OH 44114 <br /> <br />Subject: <br /> <br />Homebuyer Program <br /> <br />Section 3 of the HOME Loan Agreement, dated , 199 (the "HOME <br />-- - <br />Loan Agreement"), among the Cuyahoga Housing Consortium, the owner (the "Eligible <br />Borrower") and the City of Lakewood, Ohio, provides for the disbursement of Consortium <br />HOME Loan, as defined therein, on behalf of the Eligible Borrower for certain Eligible <br />Acquisition Costs of the Project (as defined in the HOME Loan Agreement) upon request of the <br />Eligible Borrower in the form provided herein. <br /> <br />Request is hereby being made for disbursement of the agreed-upon Eligible <br />Acquisition Costs certified herewith, namely, $ , from the Consortiuffi <br />HOME Loan in accordance with the provisions of Section 3.B. of the HOME Loan Agreement. <br /> <br />The Eligible Borrower hereby further certifies that to the best of its knowledge, <br />the above information is correct and the disbursement is in accordance with the provisions of <br />the HOME Loan Agreement. <br /> <br />Eligible Borrower <br /> <br />By: <br /> <br />Name Typed or Printed <br /> <br />Date <br /> <br />D-l <br />