Contract Release And Earnest Money Refund Request Form
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1Contract Release and Earnest Money Refund Request
Notice is hereby given by Purchaser(s), _______________________________________
(print names clearly)
that closing will not occur on a certain real estate sales contract between Purchaser(s), and Cityside Management as
M&MIII contractors for the U.S. Department of Housing and Urban Development (HUD) as Seller. The contract
form is HUD Sales Contract 9548, more particularly described as:
FHA Case #:_____________________________________
Property Address: ________________________________
Check Applicable: _______Owner Occupant _______ Investor
Financing Check Applicable:
_____FHA203B/203B Repair _____FHA 203K ______Conventional/Cash
Contract Signed Date: _____________________________
Selling Broker Name: ___________________________________
NAID:___________________
Selling Broker Phone: ________________________ Selling Broker Email: ___________________
Purchaser(s) and Seller do not intend to consummate the Contract described about, and hereby agree mutually to
release each other from any and all obligations, liabilities and claims arising from execution of the Contract.
Purchaser(s) and Selling Broker hereby release and all rights, title and interests in and to the subject property, and
agree to accept and follow the earnest money disposition required in accordance with HUD guidelines, set forth in
the Forfeiture of Earnest Money Addendum, and as described in this document.
______________________________
_____________________________
Purchaser Signature
Date
Purchaser Signature
Date
______________________________
Selling Broker Signature
Date
Purchaser(s) hereby request return of the earnest money deposit in the amount of $____________. Purchaser must
provide a letter of explanation and appropriate documentation to support the cancellation reason, examples are
inspection findings, loan denial etc. For Michigan, fax cancellation request to 586-685-2228. For all other States fax
cancellation request to 603-420-1122.
Cityside to Complete:
As the Closing Agent responsible for holding the earnest money deposit for this property, you should immediately
complete the following:
______Return 100% of the Earnest Money deposit to the Purchaser(s)
______Return 50% of the Earnest Money deposit to the Purchaser (s)
______Remit 100% of the Earnest Money deposit payable to HUD mailed to Cityside Management
______Remit 50% of the Earnest Money deposit payable to HUD mailed to Cityside Management
________________________________
___________________
Cityside HUD Representative Signature
Date
_______________________________
___________________
Print Name
Title
For Michigan, fax cancellation request to 586-685-2228, or e-mail to:
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