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NOTICE OF RIGHT OF RESCISSION

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 Commonwealth and State law have been given to you. By cancelling this transaction, any caveat, lien, mortgage or other security interest on your home resulting from this transaction is automatically void. Any down payment 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]

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