Loan Appraisal Order Form - Excel by rbr20408


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                                                                                                 BROKER DOC ORDER FORM

         Important: Please complete all applicable sections on this form. Any omitted items may result in a delay in processing your request.
                                Please note that Texas loans require additional time to process loan documents.

                                                            GENERAL INFORMATION

                                        Borrower(s)                                                                    Loan Number

              Loan Program (ex: 5/1 ARM, 30-yr fixed)                                         Loan Amount                                   Rate

                                                                 Loan Pricing:                                    OR
  Property State              1st Payment Date                                             YSP / Rebate                              Discount

            Purchase                    Refinance                                Impounds (check one):           Yes            No        Partial

                                          TITLE AND CLOSING AGENT INFORMATION
                     TITLE COMPANY                                                    ESCROW / CLOSING AGENT



   Phone #:

   Fax #:

   Order #:

              Mail Away Signing                  Email Address for Docs:

Signing Date:                                        Time:                    Additional Info:

                            BROKER FEES                                                          BROKER INFORMATION
        ** Indicate fees paid by: S = Seller, L = Lender,
    B = Broker (if paying for specific fees versus flat credit amt),
            or leave blank if charged to BORROWER.
1 ORIGINATION CHARGES                                  **        Amount                                 Broker (Company) Name:
   Icon Lender Commitment Fee           (required)
   Mortgage Broker Fee                           %

   Origination Fee                               %                                                           Address (line 1)

   Processing Fee
   Administration Fee
   Application Fee                                                                                           Address (line 2)
   Portion of YSP retained (from "X" below)                  $            -
                                    TOTAL for Box 1:         $            -
2 YSP, DISCOUNT FEE, OR BROKER CREDITS                           Amount                                      Contact Name
Total YSP (must equal X + Y below)                           $            -
   (X) Retained by broker
   (Y) Credit to borrower                                                                                    Email Address
Lender Discount Fee
Broker Credits to Borrower
                                    TOTAL for Box 2:         $            -                                  Phone Number
3 REQUIRED SERVICES                                    **        Amount
   Appraisal Fee
   Credit Report Fee                                                                                          Fax Number
   Flood Cert Fee (lender)                                   $        15.00
   Tax Service Fee (lender)                                  $        78.00
   Texas Attorney Fee (lender - $275)                                                                       Alternate Number

                                    TOTAL for Box 3:         $        93.00

The fees at closing will be compared to the most recent GFE approved and/or re-issued by the lender. The broker will be held responsible for
                           any amount that exceeds the tolerance allowed by RESPA. New fees cannot be introduced.

                        Signature                                                   Print Name                                           Date


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