BROKER CERTIFICATION OF COMPLIANCE
WITH MORTGAGE DISCLOSURE IMPROVEMENT ACT AND
REAL ESTATE SETTLEMENT PROCEDURES ACT
Loan Number:
Broker:
Borrower(s):
Property Address:
If an appraisal is ordered prior to a consumer's receipt of the initial TIL and GFE provided by Broker, the Broker certifies and
warrants that the consumer's credit card was not used and is not being used to order the appraisal nor have funds been collected
from the consumer to pay for the appraisal.
________________________________________________
Broker Representative Date
Broker Certification Compliance with MDIA and RESPA 0110 Page 1 of 1 ML4D