94001-ORCF-RI Healthcare Facility Note - Rider (various states - LA)

OMB Approval No. 2502-0605

(exp. 11/30/2022)

Rider 1

(Louisiana)

HUD Project Number:

Project Name:

The title of the Note is modified as follows: MORTGAGE NOTE (LOUISIANA)

The following section is inserted below Mortgagor’s signature and made a part thereof:

“Ne Variertur” in conformity with an act of mortgage passed before me, Notary. ________________, La., _________, 20__. ____________________________________ Notary Public Print Name:__________________________ Bar or Notary No._____________________ My commission expires:________________

[Insert name of Mortgagor) By: [Insert name of President, Manager or General Partner or other capacity] By: _____________________ (Signature of President, Manager or General Partner or other capacity)

This is to certify that this is the note described in and secured by mortgage of even date and in the same principal amount as herein stated and secured by real estate situated in ______ Parish, State of Louisiana.

Dated ________, 20__.

Previous versions obsolete Page 1 of 1 Form HUD-94001-R1-ORCF (06/2019)

Healthcare Facility Note - Rider