Fillable form and supporting documentation via fax to (949) (BLB Resources, Inc.)

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form and supporting documentation via fax to (949) (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
4D – Rev 8-11-20. All previous versions are obsolete. © BLB Resources, Inc. 2020 All rights reserved
Cancellation Request
4D: IA, NE, SD, WI
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) 379-2895 or email to 4Dclosings@blbreources.com.
Purchaser(s) and Seller do not intend to consummate the contract on the following property and hereby mutually agree to
release each other from any and all obligations, liabilities, and claims arising from the execution of the contract.
Purchaser(s) and 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 EMD disposition required in accordance with HUD guidelines as set forth in the
Forfeiture and Extension Policy and as directed in this document.
FHA Case Number: ______________________
Complete Property Address: _________________________________________________________________________
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 Other:
Death/Illness within immediate family
Unsatisfactory home inspection
Loss of employment
_________________________________________________ ___________________
Purchaser Signature (Required) Date
_________________________________________________ ___________________
Purchaser Signature (Required) Date
_________________________________________________ ___________________
Selling Agent Signature (Required) Date
Selling Broker/Closing Agent: if instructed to remit forfeited EMD funds HUD, please make certified funds (cashier’s
check or U.S. Postal Money orders only) payable to U.S. Department of Housing and Urban Development (HUD).
Mail certified funds to:
BLB Resources, Inc.
Attn: Accounting/Lockbox
16845 Von Karman Ave., Ste. 100
Irvine, CA 92606
*21*
Contract Cancellation
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Completed 9 February 2021

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