Fillable Cancellation Request Please fill out form completely, including (BLB Resources, Inc.)

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Cancellation Request Please fill out form completely, including (BLB Resources, Inc.)

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This section for BLB Resources, Inc. use only
BLB Resources Processed by: ________________________ Date:______________
Approved Insufficient documentation to process
EMD Disposition:
Refund – return 100% of the EMD to purchaser(s)
Forfeit – remit 100% of EMD to HUD c/o BLB Resources
50/50 Split – return 50% of EMD to purchaser(s), remit 50% to HUD c/o BLB Resources
HI – Rev. 3-20-14 All previous versions are obsolete. © BLB Resources, Inc. 2013-2014 All rights reserved
Hawaii
Cancellation Request
Please fill out form completely, including a detailed explanation of the reason for the cancellation.
Supporting documentation must be attached and all purchasers must sign. Failure to provide
appropriate documentation and/or signatures may result in cancellation of the sale and forfeiture of the
Earnest Money Deposit (EMD). Please refer to the Selling Broker Handbook and the Forfeiture and
Extension Policy for disposition of the EMD. Please submit the completed form and supporting
documentation via fax to (949) 379-2896 or email to
5SClosings@blbresources.com.
FHA Case Number: __________________________
Property Address (include city, state & county)
____________________________________________________________________________________
Purchaser(s):
____________________________________________________________________________________
Purchaser type: Owner Occupant Investor
Contract status: Accepted, Not Ratified Accepted, Ratified
Selling Agent: ______________________________________ Agent Phone: ____________________
Reason for cancellation (please attach supporting documentation):
Lender Denial/Insufficient Funds
Death/Illness within immediate family
Unsatisfactory home inspection
Loss of employment
Other:
_________________________________________________ ___________________
Purchaser Signature (Required) Date
_________________________________________________ ___________________
Purchaser Signature (Required) Date
_________________________________________________ ___________________
Selling Agent Signature (Required) Date
*21*
Contract Cancellation
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Cancellation Request Please fill out form completely, including (BLB Resources, Inc.)

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Completed 9 February 2021

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