Net Tangible Benefit Worksheet Template
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2S T A T E O F M A R Y L A N D
COMMISSIONER OF FINANCIAL REGULATION
500 North Calvert Street, Suite 402
Baltimore, Maryland 21202
Net Tangible Benefit Worksheet
This Net Tangible Benefit Worksheet has been prescribed by the Commissioner of Financial Regulation in
conformity with COMAR 09.03.06.20 and COMAR 09.03.09.04 (Duty of Care). Persons complying with these
regulations shall use a form substantially similar to this form.
All information must be typed or printed.
This form shall be maintained in the broker/lender
licensee’s loan files pursuant to
COMAR 09.03.06.04 “Records”.
Name of Borrower(s):
_______________________________________________
_______________________________________________
Mortgage
Originator
Name:
Employer:
MD License #:
Business
Address:
City:
State:
Zip code:
Direct Tel #:
Toll Free #:
Fax:
Email:
Lender Name:
MD License #:
Business
Address:
City:
State:
Zip code:
Direct Tel #:
Toll Free #:
Fax:
Email:
Broker Name:
MD License #:
Business
Address:
City:
State:
Zip code:
Direct Tel #:
Toll Free #:
Fax:
Email:
I/We, the undersigned borrower(s), plan to enter into a transaction which refinances one or more existing
mortgage loans with a new mortgage loan secured by my/our home located at:
Address:
City:
State:
Zip code:
NTBW
Page 1
Rev. 11/12/08
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