(a) When a provider provides a disclosure (either directly to the recipient or to a broker) under sections 600.6 through 600.16 of this Part, and the amount financed is greater than the recipient funds, the provider shall also provide a disclosure entitled “Itemization of Amount Financed.” The disclosure shall be substantially similar in form to the example disclosure provided in subdivision (b) of this section, including at a minimum:

1. (1) the recipient funds described as “Amount Given Directly to You.”;
2. (2) the amount credited to the recipient’s account with the financer, described as “Amount Paid on your Account with Us,” followed by the account number, if applicable. Where the amount to be credited to the recipient’s account may vary based upon changes to the outstanding balance due on a recipient’s account, a disclosure shall be considered accurate if it is accurate the time disclosure is provided;
3. (3) any amounts paid to other persons by the financer on the recipient’s behalf, each listed on a separate line. The disclosure shall identify those persons. The following payees maybe described using generic or other general terms and need not be further identified: a recipient’s supplier or retailer; public officials or government agencies; credit reporting agencies; appraisers; and insurance companies. Where an amount disclosed pursuant to this section may change based upon changes to the outstanding balance due under the recipient’s other obligations, a provider’s disclosure of a payoff amount shall be considered accurate if it is accurate at the time the disclosure is provided;
4. (4) the sum of the amounts described in paragraphs (1), (2), and (3) of this subdivision, described as “Amount Provided to You or on Your Behalf,” followed by a reference to how the amount was calculated (e.g. “Sum of Items 1-7.”);
5. (5) the prepaid finance charge, described as “Prepaid Finance Charge” or “prepaid Finance Charges,” as applicable, followed by a description of the purpose of the charge or charges (e.g. “Brokerage Fee”); and
6. (6) the amount financed, described as “Amount Financed,” followed by a reference to how the amount was calculated (e.g. “Item 5 minus Item 4.”)

(b) Examples:

1. (1) for transactions where no part of the amount financed is credited to the recipient’s account with the financer:

   ITEMIZATION OF AMOUNT FINANCED
   1. Amount Given Directly to You	$8,900
   2. Property Valuation Fee paid to [____]	$100
   3. Property Insurance	$1,000
   4. Amount Provided to You or on Your Behalf (1+2+3)	$10,000
   5. Prepaid Finance Charges: Brokerage Fee	$1,000
   6. Amount Financed (4 minus 5)	$9,000

2. (2) where part of the amount financed is credited to the recipient’s account with the financers:

   ITEMIZATION OF AMOUNT FINANCED
   1. Amount Given Directly to You	$8,900
   2. Property Valuation Fee paid to [____]	$100
   3. Property Insurance	$1,000
   4. Amount Paid on your Account with Us (#XXXXX)	$2,000
   5. Amount Provided to You or on Your Behalf (1+2+3+4)	$12,000
   6. Prepaid Finance Charges: Brokerage Fee	$1,000
   7. Amount Financed (5 minus 6)	$11,000

(c) The disclosure required by subdivision (a) of this section:

1. (1) shall appear as a separate document from the disclosures required by sections 600.6 through 600.16 of this Part;
2. (2) shall appear immediately following the disclosures required by sections 600.6 through 600.16 of this Part;
3. (3) need not be signed by the recipient; and
4. (4) may include an explanation of any assumptions the provider used to make the disclosure required by subdivision (a) of this section.