Notice and Acknowledgment With Respect to Owner's Title Insurance
RE: ____________________ (address or brief property description)
Pursuant to § 56-35-133, the undersigned purchaser or purchasers, hereby acknowledge(s) that they have received a notice that owner's title insurance may be available to them at their expense.
____________________ I(we) hereby desire to obtain owner's title insurance.
____________________ I(we) hereby decline to obtain owner's title insurance.
Tennessee law requires that you sign this acknowledgment. I (we) further acknowledge that the settlement agent in this transaction [or insert name of settlement agent here] shall have no responsibility to the undersigned for the status of the title to the real estate we are purchasing.
____________________
Signature of Purchaser or
Purchasers
Date: ____________________
T.C.A. § 56-35-133