Date ___________________

1.

I (we) have been informed by The AgentOwned Realty Co. ("AgentOwned") that I (we) have a right to select legal counsel to represent me (us) in all matters of this transaction relation to the closing of the loan. (a) I select____________________________ Attorney's Name ________________________________ Borrower's Signature   ________________________________ Borrower's Signature (b) Having been informed of this right, and having no preference, I asked for assistance from AgentOwned and was referred to a list of acceptable attorneys. From that list, I select_______________________________ Attorney's Name ________________________________ Borrower's Signature   ________________________________ Borrower's Signature

2.

I (we) have been informed by AgentOwned that I (we) have a right to select an insurance agent to furnish required Homeowners insurance in connection with this mortgage transaction. (a) I select__________________________________ Insurance Agent or Insurance Company _____________________________ Borrower's Signature   _____________________________ Borrower's Signature (b) Having been informed of this right, and having no preference, I asked for assistance from AgentOwned and was referred to a list of qualified agents. From that list, I select__________________________________ Insurance Agent or Insurance Company ________________________________ Borrower's Signature   ________________________________ Borrower's Signature