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TANGIBLE NET BENEFIT WORKSHEET
A Net Tangible Benefit must be determined on all primary home loan refinances. If there is a State Specific Net
Tangible Benefit Form that form must be used. If there is not a State Specific form, this worksheet should be
used to provide the information supporting there is a Net Tangible Benefit to the Borrower(s). The original of
this form must be retained in the lender’s loan file.
If there is Not a State Specific Net Tangible Benefit form, this worksheet must be used in the determination of a
borrower’s tangible net benefit as the benefit relates directly to the new loan extended. Additional information may be
provided on supplemental sheets or on the reverse if the fields below are insufficient.
Part I. EXEMPTION TEST
1.  Yes  No The subject property will not be occupied by the borrower as his/her primary residence
2.  Yes  No Proceeds of the new loan will pay off an existing loan that was consummated more than:
 (GA & MA – 60); (SC – 42); (WV & VA – 24 months prior to the new loans application date**)
3.  Yes  No Proceeds of the new loan will be used primarily for business or investment purposes
4.  Yes  No The existing loan is a bridge loan (connected with the acquisition of a primary home, with a
maturity of less than one year)
5.  Yes  No The existing loan is a reverse mortgage transaction
If any item marked Yes – additional completion of this form is not required. If any item marked No – all information must
be provided*
The above is to be used as a general guide; the broker is responsible to follow their state’s regulations in regard to NTB**
Part II. TANGIBLE NET BENEFIT DETERMINATION
Was the previous loan provided by the lender or a related entity or affiliate of the lender? _____ YES
_____ NO
If Loan Amount of previous loan is unknown, you may substitute with the Loan Payoff as long as it is clearly identified
as such.
Loan Originator/Processor:
__________________________________________________________
Borrower Name(s):
__________________________________________________________
__________________________________________________________
Property Address:
__________________________________________________________
__________________________________________________________
Loan Number:
__________________________________________________________
LOAN INFORMATION
PREVIOUS LOAN
Loan Date
Loan Amount
Loan Terms (months)
$
Type of Loan
(Check One)
Loan Rate
Payment Amount
Prepayment Penalty Provision
Loan to Value (if applicable)
Debt to Income Level (if applicable)
Loan Purpose (if applicable)
Must be specific and relate to
distribution of loan proceeds
Revised: 7/1/2014
NEW LOAN
$
Fixed Rate
Fixed Rate
Adjustable Rate
Adjustable Rate
Balloon
Balloon
%
$
%
$
LOAN ORIGINATOR TO COMPLETE:
The borrower will receive the following described tangible net benefit through a refinancing of an existing
loan (please check every benefit that applies):
The borrower will receive cash-out from the new loan to pay necessary expenses. He/She will use the
proceeds of his/her new loan towards the following (please check all that apply):
Medical Expenses
Other: __________________________________
Education Expenses
Other: __________________________________
Debt Consolidation
Other: __________________________________
Home Improvement
Other: __________________________________
Obtaining a lower interest rate with the same or reduced term as the original loan.
Obtaining a lower monthly payment with the same or reduced term as the original loan.
Obtaining a shorter loan term with the same or reduced interest rate as the original loan.
Consolidating other high rate loans and debts into a single low rate loan.
The new total monthly payment will be lower than the total of all monthly obligations being financed,
taking into account points and fees.
Making the balloon payment on an existing mortgage loan.
Avoiding foreclosure under the terms of an existing mortgage loan.
Converting from an adjustable rate to a fixed interest rate.
Borrower regards this as a financial benefit.
Ability to remove mortgage insurance by lowering loan-to-value (LTV).
Other (please specify): ________________________________________________________________
IN MASSACHUSETTS, WHERE THE BROKER IS NOT PERMITTED TO MAKE THE DETERMINATION OF NET TANGIBLE BENEFIT, THE BROKER IS REQUIRED TO PROVIDE ALL THE SUPPORTING DATA/DOCUMENTATION NECESSARY TO COMPLETE THIS WORKSHEET, FOR THE UNDERWRITER TO USE TO DOCUMENT THE DETERMINATION OF THE NET TANGIBLE BENEFIT. IN ALL OTHER STATES, THE BROKER/LENDER IS TO CONFIRM THE NET TANGIBLE BENEFIT TO THE BORROWER. I have reviewed and determined a reasonable, tangible net benefit by the refinancing of this loan.
BROKER*:
_____________________________________________ Date: ________________________
LENDER:
_____________________________________________ Date: ________________________
BORROWER: _____________________________________________ Date: ________________________
Reviewed and Validated by:
UNDERWRITER: __________________________________________ Date: ________________________
*Except in Massachusetts or where prohibited by law **Originators are responsible to adhere to the property states regulatory requirements. This form is a guide and may not represent the most current legislation. Revised: 7/1/2014