Wyoming Administrative Code
Agency 021 - Audit, Dept. of
Sub-Agency 0006 - Residential Mortgage Practices
Chapter 2 - MORTGAGE LENDER/BROKER LICENSING; SURETY BOND; PREPAYMENT PENALTY DISCLOSURE FORM
Section 2-6 - Prepayment Penalty Disclosure Form

If a prepayment penalty may be a condition of a residential mortgage loan offered to a borrower, a disclosure notice in substantially the following form must be provided to the borrower pursuant to W.S. 40-23-113(a)(ii) and W.S. W.S. 40-23-115:

__________________________________________________________

IMPORTANT PREPAYMENT PENALTY DISCLOSURE

The loan that you are applying for contains a PREPAYMENT PENALTY provision. If you pay off or refinance this loan before

(date) , you will be assessed a PREPAYMENT

PENALTY calculated according the following formula:

(complete explanation of the prepayment penalty calculation)

Do not sign this document unless you fully understand and accept the prepayment penalty provision of this loan.

Applicant ______________________ Date ______________

Applicant ______________________ Date ______________