PRE-APPLICATION DISCLOSURE AND FEE AGREEMENT FOR
USE BY NEW YORK LICENSED MORTGAGE BANKERS AND EXEMPT
ORGANIZATIONS ACTING AS MORTGAGE BROKERS
Company Name: ____________________________________________________________________________
Company Address: __________________________________________________________________________
In the following disclosure I = applicant, you = lender acting as mortgage broker
You have advised me that you are authorized and prepared to assist me in securing financing. I
understand that your services may include, but are not limited to the following:
• Counseling on available mortgage products;
• Counseling on general mortgage qualification procedures and requirements;
• Counseling on my financial capabilities;
• Assistance in obtaining information required to complete the mortgage application.
• Assistance in processing the loan application, and in meeting conditions of the loan commitment, such as:
I hereby agree to engage you for the purpose of advising me about financing and to provide
the services described above. This agreement will continue until the earlier of the
declination of my loan request(s), the closing of my loan or my termination of your services.
I acknowledge that prior to paying any fees or completing any application(s), I was advised of the following:
• Your services are advisory and administrative in nature;
• You are not authorized to make mortgage loans or commitments;
• You cannot guarantee acceptance into any particular loan program or specific loan terms or conditions;
• You may be eligible to receive a lender-paid bonus (cash or non-cash) if my loan is placed with a
particular lender, and you will notify me if this occurs.
I understand that, as compensation for your services, you will be paid as checked below:
The lender will pay you a fee of ________% of the loan amount or $ __________. The compensation you
will receive from the lender for your services is included in the rate, points, fees, and terms of the loan as
quoted by the lender in its commitment. The maximum points paid, including premium pricing payable by the
lender to you, shall not exceed _________________________ ( ________ ) points.
The fee the lender will pay you is not known at this time but will be disclosed to me at the time of lock-in or
when the rate is set. The maximum points paid, including premium pricing payable by the lender to you,
shall not exceed ____________________________ ( ______ ) points.
I will pay you, from the loan proceeds, a fee of ____________ % of the loan amount or $ _____________. I
authorize the lender’s attorney to collect this fee from me at closing.
I will pay you, directly, upon my signed acceptance of a commitment or at closing , a fee of ________ %
of the loan amount or $ ______________ .
MORTGAGE BROKER FEE ACKNOWLEDGMENT:
I acknowledge that this mortgage broker fee will be paid to you. I further acknowledge that there
is no other mortgage broker fee agreement between us.
I understand that I am required to pay the following fees at application:
• Application Fee
• Property Appraisal Fee *
• Credit Report Fee *
• The property appraisal fee and the credit report fee are estimates of the actual cost of the services. Should
the actual costs exceed the estimate, I understand that I will be billed and will pay the shortfall at or prior to