Borrower 2 Name:  
Social Security Number:  
Marital Status:  
Phone #:  
Home:  
Work:
Cell:  
Fax:  
Email Address:  

Address of the property you are refinancing:

Address:  
City:  
State:  
ZIP:  

Relationship of Borrowers to each other:
Husband & Wife Single Not Related Married to Other Other:

Please list all current Mortgages pertinent to this property including loans with a zero dollar balance:
1). Bank/Mortgage Co.:  
Telephone no.:  
Acct.#:  
Is this an FHA Mortgage? Yes  No
Is there a Pre-Payment Penalty?Yes  No

2). Bank/Mortgage Co.:  
Telephone no.:  
Acct.#:  
Is this an FHA Mortgage?  Yes  No
Is there a Pre-Payment Penalty?Yes  No

3). Bank/Mortgage Co.:  
Telephone no.:  
Acct.#:  
Is this an FHA Mortgage?  Yes  No
Is there a Pre-Payment Penalty?Yes  No

** It is your responsibility to cancel any automatic withdrawals if applicable**

Will any of the borrowers be using a power of attorney?
Yes  No
Is this property your primary residence?
Yes  No
Is this property the primary residence for Borrower #2?  
Yes  No

Homeowner's Insurance Info
(Not applicable if refinancing a condominium or for a cash transaction):
Agent:  
Phone:  
Annual Premium:  
Renewal Date:  
(The amount of insurance must be at least the mortgage amount or provide guaranteed replacement)

This section is applicable to condominium borrowers only:
Association Name:  
Management Company:  
Phone:  

Tax Information:
Please provide a paid receipt for all tax bills pertaining to this property
Does this property have:   Multiple Lots?   Yes  No
Multiple Tax Bills?   Yes  No

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