Contract Release & Earnest Money Disposition
Request Form
Please email this completed form along with the supporting documentation listed below to:
Cancellation Code _________________ ATL Contract Release Form 11.13.19
Reason for Cancellation
Supporting Documentation (MUST be submitted with this form)
Lender funding cause of cancellation
Formal denial letter from lender (email from lender not acceptable and will be rejected)
All other reasons for cancellation
(Unsatisfactory home inspection, termite
inspection, LBP inspection. Death of
immediate family member, etc.)
Letter requesting cancellation signed by buyer(s) and broker stating reason(s) for cancellation. All parties
MUST sign the letter. Letter MUST include property address. One letter or separate letters are
acceptable. MUST include supporting documentation: copy of home inspection; termite report; lead
based paint report; estimate for repairs; documentation of death, etc or other applicable documentation.
Purchaser type: Owner Occupant Investor Non-profit or Government Agency
Note: Guidelines for refund of earnest money and non-refundable extension fees are outlined in the Forfeiture and Extension Policy Addendum
Notice is hereby given by the Purchaser(s), ________________________________________________________________________
that closing will not occur on a certain real estate sales contract between the Purchaser(s) and Sage Acquisitions, Asset Manager for
the Department of Housing and Urban Development as the Seller. The Contract form is the HUD-9548, more particularly described
FHA Case Number: ____________________________ Property Address: _______________________________________________
The Purchaser(s) and the Seller do not intend to consummate the Contract described above, and hereby agree mutually to release
each other from any and all obligations, liabilities and claims arising from the execution of the Contract.
The Purchaser(s) and the Selling Broker hereby release any and all of their rights, title and interests in and to the subject property, and
agree to accept and follow the guidelines set forth in the Forfeiture and Extension Policy Addendum, and as directed in this
The Purchaser(s) hereby request the return of the earnest money deposit in the amount of $__________ and has provided sufficient
supporting documentation with this request as to the reason.
Purchaser signature: _____________________________________Purchaser signature: ____________________________________
Selling Agent: __________________________________________ Date: _________________________________________________
Selling Agent Email: ____________________________________
To Be Completed by Sage Acquisitions
Asset Manager for the Department of Housing and Urban Development
As the Closing Agent responsible for holding the earnest money deposit for this transaction, the following instructions must be
100% of the earnest money deposit is to be returned to the purchaser(s)
50% of the earnest money deposit to the purchaser(s) and remit 50% to the U.S. Department of Housing and Urban
Development (HUD) c/o Sage Acquisitions (all checks payable to HUD must be sent to Sage’s office identified below)
100% of the earnest money deposit is forfeited.
Please remit forfeited earnest money within 3 business days to: Sage Acquisitions made payable to the Housing and Urban
Development (HUD) Mail check directly to: 3575 Piedmont Road NE, STE L-120, Atlanta, GA 30305
____________________________________________ ____________________________ __________________
Sage Acquisitions Representative Title Date Processed
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