Colorado Mortgage Loan Originator Compensation Disclosure Form
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1Colorado Mortgage Loan Originator Compensation Disclosure Form
Pursuant to § 12-61-914(2)(c) and 4, Colorado Revised Statutes
Mortgage Loan Originator:
__________________________________________________________________________
Borrower:
_________________________________ Co-Borrower: __________________________________
Property Address:
________________________________________________________________________________
Loan Number:
_________________________________
Date:
_________________________________
This disclosure provides information about the total compensation and commission that is paid, including
compensation paid by the funding lender, as the result of the closing of your mortgage loan. This disclosure is
based on information currently available.
The compensation is also included in the cost of your proposed loan. The cost of the proposed loan is
described on the Good Faith Estimate of Settlement Costs and the Truth in Lending disclosures that will be
disclosed after application and before closing. You should review these documents and discuss them with me
and/or another mortgage loan originator of your choice to help you understand and compare the cost of your loan
with loans offered by others. To learn more about mortgage transactions and financing, please visit the Division
of Real Estate’s website at
1. I, the mortgage loan originator, am: (check if applicable)
_____
An employee of a company that may make you a mortgage loan or may arrange to make you a mortgage
loan. Company: ________________________________________________________.
_____
An individual who may be paid as an independent contractor for my services in originating a mortgage
loan.
_____
Other (describe) _________________________________________________________.
.
2. (Check if applicable):
_____
The total compensation paid may be calculated in part based upon the interest rate and fees charged on your
loan. This means, in some cases, that if your loan’s interest rate and fees increase, the compensation will
increase as a result.
_____
I am paid by a salary or other method that is not affected directly by your loan’s interest rate and fees.
3. (Check if applicable):
_____
The total front end compensation is $____,________. The total back end compensation is $____,_______.
The total compensation for this transaction is $_____,_________.
_____
At this time, the compensation cannot be determined. As a result, my good faith estimate of the total front
end compensation is $____,________ to $____,________. My good faith estimate of the total back end
compensation is $_____,___________ to $_____,_________.
My good faith estimate of the total
compensation for this transaction is $____,________ to $____,________.
_____
I may receive other forms of compensation related to this transaction. Other compensation may include:
_____________________________________________________________________________________.
4. You may decide to pay upfront closing costs in cash at closing, or from the proceeds of your loan. If you pay these
costs at closing, this may generally result in a lower interest rate. In some circumstances, you may also decide to
pay the closing costs by agreeing to a slightly higher interest rate and having the closing costs paid by the mortgage
lender. Also, in some circumstances, a property seller or third party may agree to pay your upfront closing costs.
I/we acknowledge receipt of this disclosure:
__________________________________ ___________
_________________________________ __________
Primary Borrower
Date
Co-Borrower
Date
________________________________ ______________________________
___________________________
___________
Mortgage Loan Originator Printed Name Mortgage Loan Originator Signature
License Number
Date
Clear Form
Colorado Mortgage Loan Originator Compensation Disclosure Form
Revised 08/05/2009
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