Customer Amount Security

___________________________________________________________
NOTICE TO CUSTOMER REQUIRED BY FEDERAL LAW
Today, _____________, you have entered into a transaction
which may result in a lien, mortgage or other security
interest on your home. Federal Law provides you with the
right to cancel this transaction, if you so desire, without
any penalty or obligation at any time within three business
days from the above date or the date on which all material
disclosures required under the Truth in Lending Act have
been given to you. By cancelling this transaction, any
lien, mortgage or other security interest on your home
resulting from this transaction is automatically void. Any
downpayment or other consideration you may have tendered on
entering this transaction must be refunded to you in the
event you cancel. If you desire to cancel this transaction,
you may do so by notifying the following party:

_____________________________________
_____________(address)_______________
by mail or telegram sent by midnight_______________________, or
by any other form of written notice delivered to the above
address no later than midnight______________________________.
Please acknowledge your receipt of this notice by signing the
form indicated below.
ACKNOWLEDGMENT OF RECEIPT OF NOTICE
Each of the undersigned hereby acknowledges the receipt of two
completed copies of the Notice of Right of Rescission.

______________________________ Date______________________
______________________________ Date______________________
(Customer’s Signature)