Disclosure

RESPA Business Arrangement Disclosure Statement Form

AFFILIATED BUSINESS ARRANGEMENT DISCLOSURE STATEMENT

From: Campbell & Brannon, LLC

This is to give you notice that Campbell & Brannon, LLC has a business relationship with QuickInsured.com, LLC (“QuickInsured.com”).  Both Campbell & Brannon, LLC and QuickInsured are affiliates of Acrisure, LLC.  Because of this relationship, the referral of a customer (including you) by Campbell & Brannon, LLC may provide Campbell & Brannon, LLC its affiliates, and/or employees with a financial or other benefit.

Set forth below is the estimated charge or range of charges by QuickInsured.com for the settlement services listed. You are NOT required to use this listed provider as a condition to obtain the services of Campbell & Brannon, LLC

THERE ARE FREQUENTLY OTHER SETTLEMENT SERVICE PROVIDERS AVAILABLE WITH SIMILAR SERVICES. YOU ARE FREE TO SHOP AROUND TO DETERMINE THAT YOU ARE RECEIVING THE BEST SERVICES AND THE BEST RATE FOR THESE SERVICES.

 

Provider Settlement Service Estimated Range of Charges
QuickInsured.com Homeowner’s Insurance $300-$10,000 plus per year; charges may vary based on coverage requested and other factors including multi-unit properties.

 

ACKNOWLEDGEMENT

I / we have read this disclosure form and understand that the referring party may refer me/us to purchase the above-described settlement service(s) and that any such referrals may provide the referring company, its affiliates, and/or their employees with a financial or other benefit.

 

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