Settlement Charge Quote Request

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(Non Title Company)

Settlement Charge Quote Request (To Settlement Service Provider from Loan Originator)

Date: _________________________ To: _________________________________________Attn: ___________________________________ Sent by: ___________________________________ (“Loan Originator”) Tel no. __________________ Sent by: Fax to: ________________________________________ Email to: ______________________ Borrower: ___________________________________________________________________________ Property: ____________________________________________________________________________ Sales Price: $______________ Settlement Date (e): _____________ Other info:___________________________________________________________________________ RESPA and other regulations require us to provide accurate estimates of Borrower’s closing costs for a covered loan transaction by providing a Good Faith Estimate (GFE) of settlement cots. Please provide the amount for the following requested charge that is required in the GFE: [__] Survey

Cost $_________________

[__] Pest Inspection

Cost $_________________

[__] Other:_______

Cost $_________________

Return ASAP to ______________________________%_____________________________________ By: [__] fax to: ____________________ [__] email to: ____________________________________

YOUR FEE QUOTE MUST NOT VARY BY MORE THAN 10% FROM YOUR ACTUAL CHARGE IMPOSED UPON BORROWER AT CLOSING.

X________________________________________ Signature of Authorized Agent for Service Provider Printed Name: _____________________________

Settlement Charge Quote Request (To Settlement Agent from Loan Originator)

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Last revised: Mar 27, 2012