1. A title insurer or title agent who issues a policy of mortgagee’s title insurance upon a loan which is made simultaneously with the purchase of all or part of the real property which secures the loan, where no owner’s title insurance has been ordered shall, before the disbursement of loan proceeds or the issuance of the mortgagee’s title policy, inform the owner in writing that the title policy is to be issued, that the policy does not protect the owner, and that the owner may obtain title insurance for protection. If the owner elects not to purchase title insurance, the title insurer or title agent shall obtain from the owner a statement in writing that the notice has been received and that the owner waives the right to purchase title insurance. The statement, together with the waiver, if any, shall be retained by the title insurer or title agent for not less than 5 years after its receipt.
2. The form of the written notice and waiver shall be substantially as follows: