Free Notice of Right of Rescission Form 

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        $__________________Mortgage on Property Situated at:





        Notice of Customer Required by Federal Law:


               You have entered into a transaction on__________,

        19__ which may result in a lien, mortgage or other security

        interest on your home.  You have a legal right under federal law

        to cancel this transaction, if you desire to do so, without any

        penalty, or obligation, within three business days from the

        above date or any later date on which all material disclosures

        required under the Truth in Lending Act have been given to you.

        If you so cancel the transaction, any lien, mortgage or other

        security interest on your home arising from this transaction is

        automatically void.  You are also entitled to receive a refund

        of any down payment or other consideration if you cancel.  If

        you decide to cancel this transaction, you may do so by




                               (Name of Creditor)




        by mail or telegram sent not later than midnight of

        __________, 19__.   You may also use any other form of written

        notice identifying the transaction if it is delivered to the

        above address not later than that time.  This notice may be used

        for that purpose by dating and signing below.


               I hereby cancel this transaction.




        __________________________   __________________________

        Date)                                                    (Customer's Signature)



               Receipt is herewith acknowledged of the foregoing NOTICE,

        each of the undersigned CUSTOMERS having received two copies

        thereof, and one copy of the Disclosure Statements concerning the

        above identified transaction this ______day of_________,19__.


        ______________________________  __________________________


        Issue two copies to customer.