TPO LE Disclosure Request

Please note: PRMG requires an Underwriting Fee which will be added to the disclosures

TPO LE Disclosure Request

Please note: PRMG requires an Underwriting Fee which will be added to the disclosures

TPO Company Name
Name
Email
Phone
FT360 Loan#
1003 Date* (mm/dd/yyyy)
Compensation Type
VA Loan Entitlement (If not VA Loan, choose "Not a VA Loan")
Subject Property Address

Origination / Fees Borrower CANNOT Shop:

( please enter all correct fee amounts )

Fee Name
Fee $
Fee Name
Fee $
Fee Name
Fee $
Fee Name
Fee $
Fee Name
Fee $
Fee Name
Fee $

Fees Borrower CAN Shop:


Fee $
Fee Name
Did Shop?
Fee $
Fee Name
Did Shop?
Fee $
Fee Name
Did Shop?
Fee $
Fee Name
Did Shop?
Fee $
Fee Name
Did Shop?
Fee $
Fee Name
Did Shop?
Fee $
Fee Name
Did Shop?

Government Fees

( please enter all correct fee amounts )

Fee Name
Fee $
Fee Name
Fee $

Optional Fees

( please enter all correct fee amounts )

Fee Name
Fee $
Fee Name
Fee $
Fee Name
Fee $
Fee $
Fee Name

Settlement Service Providers List (SSPL)

Provider Type
Phone
Provider
Address
City
St
Zip
Provider Type
Phone
Provider
Address
City
St
Zip
Provider Type
Phone
Provider
Address
City
St
Zip

Tax Transcript

4506-T Type


Additional Comments

By pressing "SEND" and submitting this information, I certify the *1003 Date is the date the applicant submitted the following information:

• Name
• Income
• Social Security Number to obtain a credit report
• Property Address
• Estimate of Property Value
• Loan Amount Sought