Borrower Requested
Compensation Change Certification
The undersigned,
(
borrower 1 name),
(
borrower 2 name),
(
borrower 3 name),
(
borrower 4 name),
hereby certify the request that compensation to be paid on the residential mortgage loan for
which I have applied, be changed from Lender Paid Compensation to Borrower Paid
Compensation.
S
igning this form is an acknowledgement that by changing from Lender Paid Compensation to
Borrower Paid Compensation, requiring payment of the disclosed compensation amount in cash
at closing or to finance the compensation amount into the Loan Amount (this option is allowed for
refinance transactions only). Signing this form further acknowledges that this may cause the
estimated charges associated with the loan to increase. *
Borrower 1 Signature
Date
Borrower 2 Signature
Date
Borrower 3 Signature
Date
Borrower 4 Signature
Date
*
Please note: such estimated charges will be provided to you on a revised disclosure which you
will have the opportunity to review prior to consummating the loan transaction.
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