Mufg Union Bank, N.a. - Loan Estimate Certification

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MUFG UNION BANK, N.A.
LOAN ESTIMATE CERTIFICATION
NOTICE: This form to be used when the Broker’s application date is on or after October 3rd,
2015
The undersigned certifies that the following consumer(s):
• Have been provided with an initial Loan Estimate within 3 business
days of the application date (please check one box indicating which
method was used in delivering the Loan Estimate):
☐ In Person
☐ Electronically
☐ Fax
☐ Postal Mail
• Have confirmed receipt of the initial Loan Estimate; and,
• Have expressed verbally to you (Broker), their intention to proceed with
the loan covered by the issued Loan Estimate.
• The Intent to Proceed must be acknowledged on or after the date the
Loan Estimate is received.
• Borrower’s intent to proceed was expressed on: __________________
Borrower Name(s):
Property Address:
Mortgage Broker’s Company Name
Date
Print Name
Print Title
*
Signature
*
This is the printed name, title and signature of the person completing the
form on behalf of the Mortgage Company.
12-2015

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