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Loan Number: Date:
Borrower Name(s):
You have applied for a mortgage loan through
To ensure you have sufficient information to determine the appropriate loan for you, we are providing you with the
following loan options.
These loan options provide you with the detail you need to carefully review the loan options presented to you below,
and to ensure you have the detailed rate and loan cost information needed to assist you in choosing the correct loan
for your particular financial situation.
Your mortgage broker has obtained loan options from various creditors for each type of transaction in which you
expressed an interest. Your mortgage broker has good faith that you will likely qualify for the following loans:
Type of Transaction: (check One) Fixed Rate Adjustable Rate
Loan Options
Total Origination
points or fees and
discount points
Option 1 – Loan with the lowest interest rate
Option 2 – Loan with the lowest interest rate without negative amortization, a
prepayment penalty, interest-only payment, a balloon payment in the first 7
years of the life of the loan, a demand feature, shared equity, or shared
Option 3 – Loan with the lowest total dollar amount for origination points or
fees and discount points.
You are applying for a loan with the following terms:
This is not a lock-in agreement or a loan commitment. The interest rate and fees described throughout this disclosure
are available on the date the document was prepared, and they may be subject to change if you have not locked in
your interest rate. You may be required to lock the rate to obtain the rate and origination cost disclosed above.
Additionally, even if your loan is locked, the interest rate and fees may be subject to change as the loan is
Borrower Name Signature Date
Borrower Name Signature Date
Type of Transaction – The loan originator is required to disclose loan Options for each “type of transaction” (Fixed or Adjustable Rate) for
which the borrower has expressed interest.
Interest Rate – The interest rate presented to the borrower.
Total origination points or fees and discount points – This section must be expressed in a dollar amount and may be a negative number,
if applicable.
<Broker Company Name>
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