Appendix A to Part 1041 - Model Forms
12:9.0.1.1.3.4.1.6.27 : Appendix A
Appendix A to Part 1041 - Model Forms A-1 and A-2 Model Forms
[Reserved] A-3 Model Form for First Payment Withdrawal Notice Under
§ 1041.9(b)(2)
![](https://ecfr.io/graphics/er17no17.012.gif)
A-4 Model Form for
Unusual Withdrawal Notice Under § 1041.9(b)(3)
![](https://ecfr.io/graphics/er17no17.013.gif)
A-5 Model Form for
Consumer Rights Notice Under § 1041.9(c)
![](https://ecfr.io/graphics/er17no17.014.gif)
A-6 Model Clause
for First Payment Withdrawal Electronic Short Notice Under §
1041.9(b)(4)
![](https://ecfr.io/graphics/er17no17.015.gif)
A-7 Model Clause
for Unusual Withdrawal Electronic Short Notice Under §
1041.9(c)(4)( ii)(B)
![](https://ecfr.io/graphics/er17no17.016.gif)
A-8 Model Clause
for Consumer Rights Electronic Short Notice Under § 1041.9(c)(4)
![](https://ecfr.io/graphics/er17no17.017.gif)
[82 FR
54871, Nov. 17, 2017, as amended at 84 FR 27929, June 17, 2019; 85
FR 44445, July 22, 2020]