CFL Broker Borrower Disclosure Form



CALIFORNIA BORROWER/BROKER STATEMENTBorrower(s): Property Address: Lender: Lender CFL License Number: Lender Address: Pursuant to the California Finance Lenders Law, California Financial Code 22337, this lender is required to obtain a signed statement from you, the borrower, as to whether any person has performed any act as a Broker in connection with the funding of this mortgage loan. No company has performed any act as a Broker in connection with the making of this mortgage loan. The following company has acted as a Broker in connection with the making of this mortgage loan.Broker: Broker CFL or DRE License Number: Broker Address: Compensation to Broker in connection with the making of this mortgage loan.Loan Origination Fee: By signing below, I/we acknowledge that I/we have read and received a copy of this statement.Borrower: _____________________________________Date: ______________Borrower: _____________________________________Date: ______________ ................
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