Form H-19(A) - Fixed Rate Mortgage Model Form

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H-19(A) Fixed Rate Mortgage Model Form
(Name of Creditor)
(Loan Originator Unique Identifier)
LOAN SUMMARY
Loan Amount:
$_____
(length of term)
Loan Term:
Loan Type and
Fixed Rate Mortgage
Features:
 [Includes [interest-only payments][step-payments]]
Total Settlement
$_____
Charges:
 [$_____ of these charges are already included in your loan amount above.]
[This total does not include a down payment. See your Good Faith Estimate or HUD-1 for
details.]
[Prepayment Penalty:
Up to $_____ if you pay off your loan, refinance, or sell this property within (period).]
ANNUAL PERCENTAGE RATE (APR)
Overall cost of this loan,
___%
including interest and
APR
settlement charges:
How does this loan compare? For the week of (date), the average APR on similar [but ]conforming loans offered
to applicants with excellent credit was ___%. Today, an APR of ___% or above is considered high cost and is
usually available to applicants with poor credit history.
How much could I save by lowering my APR? For this loan, a __% reduction in the APR could save you an
average of $_____ each month.
INTEREST RATE AND PAYMENT SUMMARY
Rate & Monthly Payment
Interest Rate
____%
Principal + Interest Payment
$_____
Est. Taxes + Insurance (Escrow)
$_____
 [Includes [Private] Mortgage Insurance]
Total Est. Monthly Payment
$____
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