NOTICE OF RIGHT
TO CANCEL 1. Your Right to Cancel
You have agreed to
give us a [mortgage/lien/security interest] [on/in] your home as security
for your existing open-end credit account. You have a legal right
under federal law to cancel the [mortgage/lien/security interest],
without cost, within three business days after the latest of the following
events:
(1)
the
date of the [mortgage/lien/security interest] which is
; or
(2)
the
date you received your Truth-in-Lending disclosures; or
(3)
the date you received this notice of your right to cancel the [mortgage/lien/security
interest].
If you cancel the [mortgage/lien/security interest], your
cancellation will apply only to the [mortgage/lien/security interest].
It will not affect the amount you owe on your account. Within 20 calendar
days after we receive your notice of cancellation, we must take the
necessary steps to reflect that any [mortgage/lien/security interest]
[on/in] your home has been cancelled. We must also return to you any
money or property you have given to us or to anyone else in connection
with this increase.
You may keep any money or property we have given you until
we have done the things mentioned above, but you must then offer to
return the money or property. If it is impractical or unfair for you
to return the property, you must offer its reasonable value. You may
make the offer at your home or at the location of the property. Money
must be returned to the address shown below. If we do not take possession
of the money or property within 20 calendar days of your offer, you
may keep it without further obligation.
2. How to Cancel
If you decide to cancel the [mortgage/lien/security interest], you
may do so by notifying us, in writing, at
(creditor’s name and business address).
You may use any written statement that is signed
and dated by you and states your intention to cancel, or you may use
this notice by dating and signing below. Keep one copy of this notice
no matter how you notify us because it contains important information
about your rights.
If you cancel by mail or telegram, you must send the notice
no later than midnight of
(date)
(or midnight of the third business
day following the latest of the three events listed above). If you
send or deliver your written notice to cancel some other way, it must
be delivered to the above address no later than that time.
I WISH TO CANCEL.
Consumer’s Signature Date
