NOTICE
OF RIGHT OF RESCISSION
$__________________
Mortgage on Property Situated at:
________________________________________________________________
Notice
of Customer Required by Federal Law:
You
have entered into a transaction on ____________ (month & date), _____
(year) which may result in a lien, mortgage or other security interest on your
home. You have a legal right under
federal law to cancel this transaction, if you desire to do so, without any
penalty, or obligation, within three business days from the above date or any
later date on which all material disclosures required under the Truth in
Lending Act have been given to you.
If
you cancel the transaction, any lien, mortgage or other security interest on
your home arising from this transaction is automatically void. You are also entitled to receive a refund of
any down payment or other consideration if you cancel. If you decide to cancel this transaction,
you may do so by notifying:
____________________________________________________________________ (Name of Creditor)
at___________________________________________________________________ by mail or telegram sent no later than
midnight of __________ (month & day), _____ (year). You may also use any other form of written
notice identifying the transaction if it is delivered to the above address no
later than that time. This notice may
be used for that purpose by dating and signing below.
I
hereby cancel this transaction.
______________________________ ______________________________
(Customer's
Signature)
(Date)
Receipt
is herewith acknowledged of the foregoing:
NOTICE,
each of the undersigned customers having received two copies thereof, and one
copy of the Disclosure Statements concerning the above identified transaction
this ______ day of __________, _____ (year).
______________________________ ______________________________
(Signature) (Date)
(Issue
two copies to customer)