REGZ-TIL Federal Truth-In-Lending Disclosure Statement

Federal Truth-In-Lending Disclosure Statement
Lender/Broker:

Loan Number:

Borrower(s):

Property Address:

Initial Disclosure estimated at time of application

ANNUAL
PERCENTAGE RATE
The cost of your credit as a
yearly rate.

%

TIL Date:

Final Disclosure based on contract terms

FINANCE
CHARGE

Amount Financed

Total of Payments

The dollar amount the credit will
cost you assuming the annual
percentage rate does not change.

The amount of credit provided to
you or on your behalf as of loan
closing.

The amount you will have paid after
you have made all payments as
scheduled assuming the annual
percentage rate does not change.

$

$

$

Your Payment Schedule Will Be:
Number of
Payments

Monthly Payments
Are Due Beginning

* Amount of Payments

Number of
Payments

* Amount of Payments

Monthly Payments
Are Due Beginning

* Includes mortgage insurance premiums, excludes taxes, hazard insurance and flood insurance.

Demand Feature: This loan transaction has a demand feature.
Required Deposit: The annual percentage rate does not take into account your required deposit.
Variable Rate Feature: Your loan contains a Variable Rate Feature. Disclosures about the Variable Rate Feature have been provided to you

separately.

Security Interest: You are giving security interest in:
the goods or property being purchased.

real property you already own.

Filing or Recording Fees: $
Late Charge: If a payment is more than

days late, you will be charged $

/

%

Prepayment: If you pay off your loan early, you
may
may

will not
will not

have to pay a penalty.
be entitled to a refund of part of the finance charge.

Insurance: Credit life insurance and credit disability insurance are not required to obtain credit, and will not be provided unless you sign
and agree to pay the additional cost.
Type

Premium

Signature

Credit Life

I want credit life insurance.

Signature:

Credit Disability

I want credit disability insurance.

Signature:

Credit Life and Disability

I want credit life and disability insurance.

Signature:

This loan transaction requires the following insurance:
Hazard Insurance

Flood Insurance

Credit Insurance

Credit Life Insurance

MMI

PMI

Borrower(s) may obtain hazard and flood insurance through any person of his/her choice, provided said carrier meets the requirements of the Lender. If
Borrower desires Property Insurance to be obtained through the Lender’s designated agency, the cost will be set forth in a separate insurance
statement furnished by the Lender.
If you purchase

insurance from creditor, you will pay $

for a one-year term.

Assumption: Someone buying your house:
may

may, subject to conditions,

may not assume the remainder of your loan on the original terms.

See your contract documents for additional information regarding nonpayment, default, right to accelerate the maturity of the obligation, prepayment
rebates and penalties, and the Lender’s policy regarding assumption of the obligation.

You are not required to complete this agreement merely because you have received these disclosures or signed a loan application.
All dates and numerical disclosures except late payment disclosures are estimates.

means an estimate.

“The undersigned hereby acknowledge receiving and reading a completed copy of this disclosure along with copies of the documents provided. The
delivery and signing of this disclosure does not constitute an obligation on the part of the lender to make, or the Borrower(s) to accept, the loan as
identified.”
Read, acknowledged and accepted this

Borrower
REGZ – TIL 11/09 ~ Encompass360TM

day of

. By:

Date

Co-borrower

Date