MARYLAND APPLICATION DISCLOSUREresources.maibroker.com/MD.pdf · 1. SETTLEMENT SERVICES: Your...

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Maryland Disclosure Page 1 of 1 3 October2013 MARYLAND APPLICATION DISCLOSURE Borrower: Loan Number: Co-Borrower: Date Prepared: Subject Property: Company: Maryland law requires that we, the above-named mortgage lender or mortgage broker, make the following disclosure to you: 1. SETTLEMENT SERVICES: Your lender regularly imposes fees on borrowers for settlement or document review services performed by an attorney, title insurance company or other person designated by the lender. You have the right to employ an attorney or title insurance company of your choice to perform a title search, examination of title, or closing. To exercise this right, you must notify your lender, within seven (7) days after application for your loan, of the name and business address of your choice of attorney or title insurance company. Your lender may reject the attorney or title insurance company of your choice for good cause within seven (7) days after the lender's receipt of your election notice. Regardless of who performs these settlement or document review services, the attorney or title insurance company may perform services for the benefit of the lender and you may be required by the lender to pay all or a portion of the cost of such services at or prior to closing. A good faith estimate of the fee or fees to be charged has been provided to you in a separate document. 2. PROCESSING YOUR LOAN APPLICATION We will keep you generally informed of the progress of the processing of your loan application in the event that problems arise in the processing or underwriting of your loan which may delay closing. We cannot guarantee that your loan application will be accepted into a particular loan program MD COML §§ 12-119, 12-120; 12-1028 ACKNOWLEDGMENT Each of the undersigned acknowledges receipt of Maryland Application Disclosure. Borrower Borrowers Signature Date Co-Borrower Co-Borrowers Signature Date Co-Borrower Co-Borrowers Signature Date Mortgage Loan Originator Phone: Broker: Lender: Address: Address:

Transcript of MARYLAND APPLICATION DISCLOSUREresources.maibroker.com/MD.pdf · 1. SETTLEMENT SERVICES: Your...

Page 1: MARYLAND APPLICATION DISCLOSUREresources.maibroker.com/MD.pdf · 1. SETTLEMENT SERVICES: Your lender regularly imposes fees on borrowers for settlement or document review services

Maryland Disclosure Page 1 of 1 3 October2013

MARYLAND APPLICATION DISCLOSURE

Borrower: Loan Number:

Co-Borrower: Date Prepared:

Subject Property:

Company:

Maryland law requires that we, the above-named mortgage lender or mortgage broker, make the following disclosure to you:

1. SETTLEMENT SERVICES:

Your lender regularly imposes fees on borrowers for settlement or document review services

performed by an attorney, title insurance company or other person designated by the lender.

You have the right to employ an attorney or title insurance company of your choice to perform a

title search, examination of title, or closing. To exercise this right, you must notify your lender,

within seven (7) days after application for your loan, of the name and business address of your

choice of attorney or title insurance company. Your lender may reject the attorney or title

insurance company of your choice for good cause within seven (7) days after the lender's receipt

of your election notice.

Regardless of who performs these settlement or document review services, the attorney or title

insurance company may perform services for the benefit of the lender and you may be required

by the lender to pay all or a portion of the cost of such services at or prior to closing. A good

faith estimate of the fee or fees to be charged has been provided to you in a separate document.

2. PROCESSING YOUR LOAN APPLICATION

We will keep you generally informed of the progress of the processing of your loan application

in the event that problems arise in the processing or underwriting of your loan which may delay

closing.

We cannot guarantee that your loan application will be accepted into a particular loan program

MD COML §§ 12-119, 12-120; 12-1028

ACKNOWLEDGMENT

Each of the undersigned acknowledges receipt of Maryland Application Disclosure.

Borrower

Borrower’s Signature Date

Co-Borrower

Co-Borrower’s Signature Date

Co-Borrower

Co-Borrower’s Signature Date

Mortgage Loan Originator Phone:

Broker: Lender:

Address: Address:

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Maryland Disclosure Page 1 of 1 3 October2013

MARYLAND DISCLOSURE OF FEES TO BE PAID BY SELLER

Borrower: Loan Number:

Co-Borrower: Date Prepared:

Subject Property:

Company:

Pursuant to MD Regs. Code tit. 9, § 03.06.09(C)

As a condition of obtaining an extension of credit from the lender, the real estate seller, or someone

other than yourself, must pay the following fees:

Description of Fee Amount Paid BY

1. $

2. $

3. $

4. $

5. $

It is your responsibility to inform the real estate seller of these fees. The loan will not be made unless

the real estate seller, or someone other than yourself, pays these fees.

ACKNOWLEDGMENT

I/We have read the above document and acknowledge receiving a copy by signing below.

Borrower Borrower’s Signature Date

Borrower

Borrower’s Signature Date

Borrower

Borrower’s Signature Date

Borrower

Borrower’s Signature Date

Seller/Real Estate Agent: Phone:

Seller/Real Estate Agent: Phone:

Mortgage Loan Originator Phone:

Broker: Lender:

Address: Address:

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MARYLAND FINANCING AGREEMENT

Borrower: Loan Number:

Co-Borrower:

Date Prepared:

Subject Property:

Company:

The following terms will apply to the loan you have applied for, if your application is approved:

Loan term: Principal Loan Amount:

Interest Rate: Type of Mortgage:

This rate is subject to change

This rate is a variable rate

This rate is subject to final determination at a future date based on:

Points (if applicable) to lender:

Points are to be paid by the borrower

Points are to be paid by the seller

Points are to be paid by both the borrower and the seller

The terms of this financing agreement remain in effect from to .

No decision has been made concerning the approval or disapproval of your loan application, and this

financing agreement is not a commitment to make a loan to you. Approval of your loan application

will be contingent upon the satisfaction of all our underwriting requirements.

The terms of your loan are subject to change between the date of this financing agreement and the

issuance of a commitment letter by the lender.

ACKNOWLEDGMENT

I/We acknowledge receipt of this financing agreement within ten (10) business days after completion

of the loan application. I/We understand the provisions of this financing agreement.

Borrower

Borrower’s Signature Date

Co-Borrower

Co-Borrower’s Signature Date

Co-Borrower

Co-Borrower’s Signature Date

Mortgage Loan Originator Phone:

Broker: Lender:

Address: Address:

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Maryland Disclosure Page 1 of 1 3 October2013

MARYLAND LENDER ATTORNEY’S FEE DISCLOSURE

Borrower: Loan Number:

Co-Borrower: Date Prepared:

Subject Property:

Lender/Company:

Md. Com. Law § 12-120(b)

Under Maryland law, the lender may require you to pay for services rendered by the lender's attorney in

connection with your mortgage loan only if:

The attorney's fee is limited to legal services attributable to processing and closing the loan and

not to unrelated services performed by the attorney for the lender;

The amount of the attorney's fee is reasonable based on the legal services performed; and

The attorney's fee is separately itemized on the loan settlement sheet and identified as a fee to the

lender's attorney.

Additionally, if the attorney's fee is greater than $100, it must be supported by a statement provided to

you at or prior to settlement that describes the services performed, sets forth the time spent by the

attorney and the hourly rate or other basis for determining the fee, states that the legal services are

performed on behalf of the lender and not on behalf of the borrower, and states that you are paying for

the services.

ACKNOWLEDGMENT

By signing below, I/we acknowledge that I/we have read and received a copy of this document.

Borrower Borrower’s Signature Date

Borrower

Borrower’s Signature Date

Borrower

Borrower’s Signature Date

Borrower

Borrower’s Signature Date

Mortgage Loan Originator Phone:

Broker: Lender:

Address: Address:

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Maryland Disclosure Page 1 of 2 3October2013

MARYLAND MORTGAGE BROKER AGREEMENT AND DISCLOSURE

Borrower:

Loan Number:

Co-Borrower:

Date Prepared:

Property Address:

Mortgage Broker:

NMLS #:

Broker Address:

Maryland law requires this agreement to be executed prior to the time we collect a fee for acting as a

mortgage loan broker or perform any mortgage brokerage services on your behalf. We are not a

mortgage lender and we do not provide credit.

MD COML § 12-805

WE WILL PROVIDE THE FOLLOWING SERVICES IN CONNECTION WITH YOUR LOAN

Assist you in completing the loan application for the type of loan you are seeking.

Inform you of the various types of loan programs available and the terms of such loans.

Analyze your income and debt and pre-qualify you to determine the maximum mortgage

loan you could afford.

Assist the lender in originating and underwriting the loan by obtaining and verifying

information needed by the lender to evaluate your loan application, including credit reports,

appraisal reports, employment verifications, and deposit verifications.

Coordinate with you and the lender in fulfilling conditions to your loan approval and in

preparing for loan closing, if your loan application is approved.

Other (describe):

FOR OUR SERVICES

We will receive a loan application fee of $ .

We will receive $ or % of the loan directly from

the loan closing (if any) or following the rescission period (for loans which qualify for

rescission under the Federal Truth-in-Lending Act).

We will receive from the lender compensation in the amount of $

or % of the loan at loan closing (if any) or following the rescission

period (for loans which qualify for rescission under the Federal Truth-in-Lending Act), based

on our arrangement with the lender.

In no event shall the cost of these services exceed $ . Such amounts shall

include all compensation paid to us whether directly or indirectly.

Please Initial: Borrower Borrower Borrower

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Maryland Disclosure Page 2 of 2 3October2013

Loan Number:

REFUNDABILITY

The application fee deposit made by you was used to pay third party fees incurred on your behalf for a

property appraisal or credit report. Any third party fees collected in excess of the actual costs will be

refunded to you.

If for any reason the mortgage loan application you submit does not result in a loan closing, you will

not be required to pay us for our services other than an application fee. If your loan is subject to the

right of rescission under the Federal Truth-in-Lending Act and you exercise that right, within 20

calendar days the lender must return any money you have given to anyone in connection with the

transaction. If any money has been paid from loan proceeds and you later rescind, you understand the

money will be refunded to the lender.

If you agree to the terms and conditions stated above, this agreement will be in effect from the date of

this agreement until

Broker / Mortgage Loan Originator Signature Date

NMLS # / Maryland License #

ACKNOWLEDGMENT

By signing below, borrower(s) agree(s) to the terms and conditions of this agreement and

acknowledges receipt of this Mortgage Broker Agreement.

Borrower Borrower’s Signature

Date

Co-Borrower Co-Borrower’s Signature

Date

Co-Borrower Co-Borrower’s Signature Date

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NTBW Page 1 of 2 Rev. 23April2013

MARYLAND NET TANGIBLE BENEFIT WORKSHEET

Borrower:

Loan Number:

Co-Borrower:

Date Prepared:

Subject Property:

S T A T E O F M A R Y L A N D

COMMISSIONER OF FINANCIAL REGULATION

500 North Calvert Street, Suite 402

Baltimore, Maryland 21202

This Net Tangible Benefit Worksheet has been prescribed by the Commissioner of Financial Regulation

in conformity with COMAR 09.03.06.20 and COMAR 09.03.09.04 (Duty of Care). Persons complying

with these regulations shall use a form substantially similar to this form.

All information must be typed or printed.

This form shall be maintained in the broker/lender licensee’s loan files pursuant to COMAR 09.03.06.04 “Records”.

Mortgage Originator Name:

Employer:

MD License #:

Business Address

City:

State: Zip code:

Direct Tel #:

Toll Free #:

Fax Number:

Email:

Lender Name:

MD License #:

Business Address

City:

State: Zip code:

Direct Tel #

Toll Free #:

Fax Number:

Email:

Broker Name:

MD License #:

Business Address

City: State: Zip code:

Direct Tel # Toll Free #:

Fax Number: Email:

I/We, the undersigned borrower(s), plan to enter into a transaction which refinances one or more existing loans

with a new mortgage loan secured by my/our home located at:

Address: City:

State:

Zip code:

Please Initial: Borrower Borrower

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NTBW Page 2 of 2 Rev. 23April2013

I/we acknowledge that:

I/We understand the costs associated with the new loan;

The new loan may have different terms (including duration of term and rate of interest) than

my/our existing loan(s); and,

The new loan will provide a reasonable, tangible net benefit to me/us after taking into account

the terms of both the new and existing loan(s), the cost of the new loan, and my/our particular

circumstances.

By refinancing my/our existing loan(s), the following benefits apply to me/us (each borrower should

initial any benefit that applies):

Obtaining a lower interest rate.

Obtaining a lower monthly payment, including principal, interest, taxes, and insurance.

Obtaining a shorter amortization schedule.

Changing from an adjustable rate to a fixed rate.

Eliminating a negative amortization feature.

Eliminating a balloon payment feature.

Receiving cash-out from the new loan in an amount greater than all closing costs incurred in

connection with the loan.

Avoiding foreclosure.

Eliminating private mortgage insurance.

Consolidating other existing loans into a new mortgage loan.

Other (please specify):

I/We have considered the terms of both the existing and new loan, the cost of the new loan, and my/our personal

circumstances.

I/We believe the overall benefits of the new loan make the new loan beneficial to me/us for the reason or reasons

identified above.

By signing below, I/we certify that I/we have read and I/we understand this Net Tangible Benefits Worksheet.

Borrower Name

Borrower Signature Date:

Co-Borrower Name

Co-Borrower Signature Date:

Borrower Name

Borrower Signature Date:

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Maryland Disclosure Page 1 of 1 3 October2013

MARYLAND NON-ESCROW ACCOUNT DISCLOSURE

Borrower: Loan Number:

Co-Borrower: Date Prepared:

Subject Property:

Lender/Company:

Waiving Escrow Account

YOU ARE RESPONSIBLE FOR PROPERTY TAX AND HOMEOWNER’S

INSURANCE PAYMENTS IN ADDITION TO YOUR REGULARLY SCHEDULED

PERIODICMORTGAGE LOAN PAYMENT:

The terms of your mortgage loan do not provide for the establishment of an escrow account from which

your property taxes and homeowner’s insurance will be paid. This means that your regularly scheduled

periodic mortgage loan payment does not cover these sums and you are responsible for paying property

taxes and homeowner’s insurance premiums when the bills arrive. You will need to consider your ability

to pay these taxes and insurance amounts in addition to paying your regularly scheduled periodic

mortgage loan payment.

ACKNOWLEDGMENT

I/we have read the above document and acknowledge receiving a copy by signing below.

Borrower Borrower’s Signature Date

Borrower

Borrower’s Signature Date

Borrower

Borrower’s Signature Date

Borrower

Borrower’s Signature Date

Mortgage Loan Originator Phone:

Broker: Lender:

Address: Address:

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Maryland Disclosure Page 1 of 3 3 October2013

MARYLAND RIGHT TO RECEIVE HOUSING COUNSELING

Borrower:

Loan Number:

Co-Borrower:

Date Prepared:

Subject Property:

Company:

Maryland Department

of Housing and

Community Development

IMPORTANT NOTICE REGARDING HOUSING COUNSELING

You are receiving this notice because you have applied for a Maryland residential mortgage

loan secured by a first lien. In applying for and entering into a mortgage loan you will be required

to sign complex legal documents. You should be certain that you understand the terms of the loan

being offered to you in these documents before you commit in writing. If you do not pay the loan

according to its terms, you could lose your home.

BE ADVISED: The State of Maryland recommends that all residential

mortgage loan applicants receive home-buyer education or housing counseling

from a nonprofit or government agency before signing any documents that

commit them to a loan.

Home-buyer education or housing counseling may be provided face-to-face or over the

telephone. Set forth below is a list prepared by the Maryland Department of Housing and Community

Development of nonprofit and government agencies that provide home-buyer education or housing

counseling.

See attached

List of Nonprofit and Government Agencies

Offering Home-Buyer Education or Housing Advice

Please Initial: Borrower Co-Borrower

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Maryland Disclosure Page 2 of 3 3 October2013

Agency Name Phone/ Website Address Languages

Anne Arundel County Community Action Agency, Inc.

410-626-1900 www.aaceoc.com

251 West St, P.O. Box 1951 Annapolis, MD 21404

English Spanish

Arundel Community Development Service Inc

410-222-7600 www.acdsinc.org

2666 Riva Road, Suite 210 Annapolis, MD 21401

English Spanish

Affordable Housing Centers Of America, Baltimore, MD

410-433-9790 www.ahcoa.org

5640 Midwood Ave, First Floor Baltimore, MD 21212

English Spanish

Belair - Edison Neighborhoods, Inc. 410-485-8422 belair-edison.org

3412 Belair Road Baltimore, MD 21213 English

Bon Secours 410-383-4710 26 N. Fulton Ave Baltimore, MD 21223

English

CCCS of Maryland And Delaware - Catonsville Office

800-640-2227 www.cccs-inc.org

757 Frederick Rd. Baltimore, MD 21228

English

CCCS Of Maryland And Delaware 866-731-8486 www.cccs-inc.org

757 Frederick Rd. Baltimore, MD 21228

English

CCCS Of Maryland And Delaware – Brooklyn Park Office

800-640-2227 111.cccs-inc.org

5410 Ritchie Hwy. Baltimore, MD 21225

English

CCCS Of Maryland And Delaware - Essex Office

800-640-2227 www.cccs-inc.org

408 Eastern Blvd. Baltimore, MD 21221

English

CCCS Of Maryland And Delaware - Parkville Office

800-640-2227 www.cccs-inc.org

7905B Harford Rd. Baltimore, MD 21234

English

Druid Heights Community Development Corp.

410-523-1350 www.druidheights.com

2140 McCulloh Street Baltimore, MD 21217-3529

English

Eastside Community Development Corp. 410-284-9861 www.eastsidecdc.org

7835 Eastern Ave, Ste. 302 Baltimore, MD 21224

English

Garwyn Oaks Northwest Housing Resource Center, Inc

410-947-0084 www.go-northwesthrc.org

2300 Garrison Blvd, Ste 140 Baltimore, MD 21216

English

Greater Baltimore Urban League 410-523-8150-247 www.bul.org

512 Orchard St Baltimore, MD 21201-1947

English

Harbel Housing Partnership 410-444-9152 www.harbel.org

5807 Harford Rd. Baltimore, MD 21214

English

NACA (Neighborhood Assistance Corp Of America) Baltimore, MD

410-783-0465 www.naca.com

1 East Mount Royal Ave Baltimore, MD 21202

English

Neighborhood Housing Services Of Baltimore,

410-327-1200 www.nhsbaltimore.org

819 Park Ave Baltimore, MD 21201

English

Oliver Economic Development Corp 443-388-9809 1400 E Federal St Baltimore, MD 21213

English

Southeast Community Development Corp 410-342-3234 www.southeastcdc.org

3700 Eastern Ave Baltimore, MD 21224

English Spanish

St. Ambrose Housing Aid Center, Inc. 410-366-8550 www.stambros.org

321 East 25th Street Baltimore, MD 21218-5303

English French

The Development Corp Of Northwest Baltimore

410-578-7190 3521 West Belvedere Ave Baltimore, MD 21215-5802

English

CCCS Of Maryland And Delaware – Bel Air Office

800-640-2227 www.cccs-inc.org

1202 Agora Dr. Bel Air, MD 21014

English

Harford County Housing Agency 410-638-3045 www.harfordcountymd.gov

15 South Main Street, Ste 106 Bel Air, MD 21014

English Spanish

United Communities Against Poverty 301-322-5700 www.ucappgc.org

1400 Doewood Lane, Capitol Heights, MD 20731-0356

English

Cumberland Neighborhood Housing Services, Inc

301-722-6958 www.cumberlandnhs.org

400 N Mechanic St Cumberland, MD 21502

English

Mission Of Peace 810-232-0104 www.missionofpeace.com

6045 Fenton Ave Dearborn Heights, MD 48127

English

CCCS Of Maryland And Delaware – Easton Office

800-640-2227 www.cccs-inc.org

219 Marlboro Rd. Easton, MD 21601

English

Please Initial:

Borrower Co-Borrower

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Maryland Disclosure Page 3 of 3 3 October2013

Cecil County Housing Agency 410-996-8216 200 Chesapeake Blvd. Ste 1800 Elkton, MD 21921

English

Frederick Community Action Agency 301-600-1506 www.cityoffrederick.com/depar tments/CAA/Agency.htm

100 S Market St Frederick, MD 21701-5527

English Spanish

Money Management International - Frederick

800-747-4222 www.moneymanagement.org

1003 West 7th St., Ste. 404 Fredrick, MD 21701

English Spanish

Maryland Rural Development Corp 410-479-3566 www.mrdc.net

101 Cedar Lane, PO Box 739 Greensboro, MD 21639-0739

English Spanish

Hagerstown Neighborhood Development Partnership, Inc.

301-797-0900 www.hagerstownhomestore.org

21 East Franklin Street Hagerstown, MD 21740

English

Washington County Community Action Council

301-797-4161 www.wccac.org

101 Summit Ave. Hagerstown, MD 21740

English

Southern Maryland Tri-County Community Action

301-274-4474 www.smtccac.org

8383 Old Leonardtown Road Hughesville, MD 20637

English Spanish

Homefree - U S A 301-891-8400 www.homefreeusa.org

3401 A East-West Highway Hyattsville, MD 20782

English Spanish

Housing Initiatives Partnership, Incorporated

301-699-3835 www.hiphomes.org

6525 Belcrest Road, Suite 555 Hyattsville, MD 20782

English

The Greater Washington Urban League 301-985-3519 www.gwul.org

5012 Rhode Island Ave Hyattsville, MD 20781

English

Home Partnership, Incorporated 410-679-3200 www.homepartnershipinc.org

Rumsey Towers Building, Suite 301 626 Towne Center Dr. Joppatowne, MD 21085

English

Clearpoint Financial Solutions, Inc. 877-877-1995 www.clearpointcreditcounselin gsolutions.org

9344 Lanham Severn Road #205 Lanham, MD 20706

English

Prince Georges County Homeownership Center

301-883-5570 9400 Peppercorn Place, Suite 120 Largo, MD 20774

English Spanish

Garrett County Community Action Committee, Inc.

888-877-8403 www.garrettcac.org

104 E. Center Street Oakland, MD 21550-1328

English Spanish

CCCS Of Maryland And Delaware 800-640-2227 www.cccs-inc.org

10220 S. Dolefield Rd. Owings Mills, MD 21117

English

Housing Options & Planning Enterprise, Inc.

301-567-3330 www.hopefinancial.org

6188 Oxon Hill Road, Suite 700 Oxon Hill, MD 20745

English Spanish

Centro De Apoyo Familiar (Caf) 301-328-3292 www.mycaf.org

6801 Kenilworth Ave, Ste 201 Riverdale, MD 20737

English Spanish

Seed - Sowing Empowerment And Economic Development

301-458-9808 www.seedinc.org

6201 Riverdale Road, Ste 200 Riverdale, MD 2073

English

Money Management International Rockville

800-747-4222 www.moneymanagement.org

15847 Crabbs Branch Way Rockville, MD 20855-2635

English Spanish

CCCS Of Maryland And Delaware 800-640-2227 www.cccs-inc.org

242 Tilghman Rd. Salisbury, MD 21804

English

Salisbury Neighborhood Housing Service, Inc

410-543-4626 www.salisburynhs.org

400 Snow Hill Road Salisbury, MD 21804

English

Shore Up!, Inc 410-749-1142 www.shoreup.org

520 Snow Hill Rd Salisbury, MD 21804-6031

English

Telamon Corp 410-546-4604 917 Mt. Hermon Road, Ste 2 Salisbury, MD 21804

English Spanish

National Foundation For Credit Counseling, Inc.

800-388-2227 www.nfcc.org

801 Roeder Road, Suite 900 Silver Spring, MD 20910-3372

English Spanish

Omega Gold Development Group 301-847-0255 www.omegagolddevelopmentgr oup.com

3000 Victory Lane Suitland, MD 20752

English

Unity Economic Development Corp 301-505-0331 3231 Brinkley Road Temple Hills, MD 20748

English

Please Initial:

Borrower Co-Borrower List of Department of Housing and Urban Development Approved Organizations for Maryland Updated 9/30/2010. Notice updated 11/5/2010.

Source: http://www.hud.gov/offices/hsg/sfh/hcc/hcs.cfm?webListAction=search&searchstate=MD

Page 13: MARYLAND APPLICATION DISCLOSUREresources.maibroker.com/MD.pdf · 1. SETTLEMENT SERVICES: Your lender regularly imposes fees on borrowers for settlement or document review services

MARYLAND RIGHT TO SELECT CLOSING AGENT

Borrower:

Loan Number:

Co-Borrower:

Date:

Property Address:

Lender:

Lender address:

Selection of Settlement Agent

In connection with your loan application, as a refinancing homeowner or a purchaser of a property in

the state of Maryland, you have the right to select the closing agent.

In the state of Maryland, closings are conducted by independent closing agents and/or attorneys.

Please check appropriate box

I(We) acknowledge that I(we) have received the list of approved closing attorneys.

I(we) have been given the opportunity to select an attorney to represent me(us) to close

my(our) loan and have no preference. I(we) defer selection to my(our) Loan Originator.

Closing Agent:

Address:

Phone/Fax:

- OR -

I(We) acknowledge that I(we) have received the list of approved closing attorneys.

I(We) have selected the following attorney:

Closing Agent:

Address:

Phone/Fax:

Note: You have the right within seven (7) days after the date of your loan application to notify Lender of the name and

business address of your choice of closing agent or title insurance company to perform the title search, examination

of title, or closing for your loan. If your selection is not rejected by Lender for good cause within seven (7) days

after receipt of such notice by Lender, your notice will establish the closing agent or title insurance company to be

used for the title search, examination of title, or closing. If you desire to change the above selection, notice of

change must be given in writing to the Lender.

Settlement date is anticipated to be:

Acknowledgment

I/We acknowledge receipt of a copy of these notices.

Signature of Borrower Date

Signature of Co-Borrower Date

Mortgage Loan Originator Date