Xyz Mortgage Services Fee Agreement Form printable pdf download

XYZ MORTGAGE SERVICES, INC.

000 MAIN STREET

ANYWHERE, SOUTH CAROLINA 29000

TELEPHONE: 803-000-0000

Notice to Prospective Borrower(s): Read this contract carefully so that you can make an informed

choice. You are entitled to a copy of this contract. Signing this contract does not obligate you to

obtain a mortgage loan through this mortgage broker, nor does it constitute mortgage loan approval.

This agreement is valid for ninety (90) days from this date.

Proposed Loan Amount $_________

or 2

Mortgage _________

Interest Rate _________

Who do I Represent?

__________________________________, as your mortgage broker and/or originator, (we

are/I am) acting as your agent in providing mortgage brokerage services. As your agent

we/I owe you a duty of the utmost care, honesty and loyalty, including full disclosure of all

material facts.

(Broker/originator initial the following statement that is applicable.)

____We are/I am, also, the agent for

____________________________________________

(Name of Additional Person with an agency relationship)

____We/I do not have an agency relationship with any other person.

We will provide the following services at the estimated cost shown for each. These services will be

paid for by the person indicated, either you (the borrower), the lender or both. (See attached Good

Faith Estimate (GFE) for services provided, estimated cost and the person responsible for payment)

Lender Payments to Broker (Yield Spread Premium) Disclosure

For purposes of this disclosure, a yield spread premium (YSP) is the amount paid to the broker by the

lender based on the difference between the interest rate at which the broker originates the loan and

the par, or market rate offered by a lender. If you would rather pay a lower interest rate, you may

pay higher up front fees; if you pay less up front, you may pay a higher interest rate. Before you sign

this contract, I can display alternatives for you. The amounts disclosed here apply only if you qualify

for this loan.

Dollar amount of Yield Spread Premium $____________

Dollar amount of mortgage $_______________________

Percent of Yield Spread Premium in relation to loan amount ________% (Item 1/Item 2)

The following is an itemization of points, fees and commissions related to my mortgage

_______________________________________

$___________

_______________________________________

$___________

_______________________________________

$___________

_______________________________________

$___________

_______________________________________

$___________

Mortgage Broker Fee Agreement

Rev. 06/12

Page 1 of 3

Xyz Mortgage Services Fee Agreement Form

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