2021 Tennessee Code
Part 1 - Operation of Title Insurance Businesses
§ 56-35-133. Notification to Buyers of the Availability of Title Insurance

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:
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:
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Structure 2021 Tennessee Code