You are not required to complete
this agreement merely because you have received these disclosures
or have signed a loan application.
 If you obtain
this loan, the lender will have a mortgage on your home.
 YOU COULD LOSE YOUR HOME, AND ANY MONEY YOU HAVE PUT INTO
IT, IF YOU DO NOT MEET YOUR OBLIGATIONS UNDER THE LOAN.
 
You are borrowing $      (optional credit insurance is □  is not □  included in this amount).
 
The annual percentage rate on your loan will be     %.
 
Your regular [frequency]   payment will be $      .
 
[At the end of your loan, you will still owe us $[balloon
amount] .]
 
[Your interest rate may increase. Increases in the interest
rate could increase your payment. The highest amount your payment
could increase is to $      .]