Form of Bank Disbursement Disclosure

[BANK LETTERHEAD]

[Date]

[Name & Address of Borrower/Owner]

Re:       Project description/address:                                                               (the “Project”)

Dear [Owner/Borrower Name]:

On _____________, 20___, your contractor _____________________________ made a payment request to the Bank of $_____________________ for work on the Project.

The following is the information the Bank is required to provide you under the Texas Property Code in connection with a payment request made by your contractor on the Project.

Since ________________________ (the date the last statement was provided to you), the Bank has disbursed the following funds in connection with the Project:

 

Date

Payee (To Whom Funds Paid)

Amount

 

 

 

 

 

 

 

 

 

 

Attached is a copy of the Payment Disclosure letter prepared by your contractor which the Bank is also required by the Texas Property Code to provide to you.  However, please be advised that the Bank is not responsible for the accuracy or completeness of the information contained in the attached Payment Disclosure.

Very truly yours,

[TYPED NAME OF BANK]

By:                                                                              

Printed Name:                                                            

Title: