|
To:
From:
Property:
Date:
This is to give you notice that [referring party] has a business
relationship with [settlement services providers(s)]. [Describe the
nature of the relationship between the referring party and the
providers(s), including percentage of ownership interest, if
applicable.] Because of this relationship, this referral may provide
[referring party] a financial or other benefit.
[A.] Set forth below is the estimated charge or range of charges for
the settlement services listed. You are NOT required to use the listed
provider(s) as a condition for [settlement of your loan on] [or]
[purchase, sale, or refinance of] the subject property. THERE ARE
FREQUENTLY OTHER SETTLEMENT SERVICE PROVIDERS AVAILABLE WITH SIMILAR
SERVICES. YOU ARE FREE TO SHOP AROUND TO DETERMINE THAT YOU ARE
RECEIVING THE BEST SERVICES AND THE BEST RATE FOR THESE SERVICES.
[provider and settlement service] [charge or range of charges]
____________________________________________________
____________________________________________________
[B.] Set forth below is the estimated charge or range of charges for
the settlement services of an attorney, credit reporting agency, or
real estate appraiser that we, as your lender, will require you to
use, as a condition of your loan on this property, to represent our
interests in the transaction.
[provider and settlement service][charge or range of charges]
_____________________________________________________
_____________________________________________________
ACKNOWLEDGMENT
I/we have read this disclosure form, and understand that [referring
party] is referring me/us to purchase the above-described settlement
service(s) and may receive a financial or other benefit as the result
of this referral.
.......[signature]
[INSTRUCTIONS TO PREPARER:] [Use paragraph A for referrals other than
those by a lender to an attorney, a credit reporting agency, or a real
estate appraiser that a lender is requiring a borrower to use to
represent the lender's interests in the transaction. Use paragraph B
for those referrals to an attorney, credit reporting agency, or real
estate appraiser that a lender is requiring a borrower to use to
represent the lender's interests in the transaction. When applicable,
use both paragraphs. Specific timing rules for delivery of the
affiliated business disclosure statement are set forth in 24 CFR
3500.15(b)(1) of Regulation X.] These INSTRUCTIONS TO PREPARERS should
not appear on the statement.
|
Software
