Refinance Order

Borrower 1
Name : SS# :
Home Phone Number: Work Number:
Non Borrowing Spouse Name : Cell Phone Number :
Marital Status: Email :
Perfered Method of Contact :

Co-Borrower
Name : SS# :
Phone Number: Work Number:
Cell Phone Number : Email :
Marital Status:

Property Information
Property Address :
City : Zip Code :
County :

Lender(s) Information
New Lender : Loan Amount :
2nd Mortgage New Lender : 2nd Loan Amount :
Contact Name : Contact Number :
Email :

Loan Type
Refinance Loan
Purchase (Please Complete the Purchase Transaction Order)
Land Contract
2nd mortgage - Search only, no payoffs
(If purchase or land contract, please fax a copy of the contract to (614) 880-1076 and complete seller info below)

Property Owner Information, if Land Contract
Name : Home Phone Number :
Cell Phone Number : Email :
Perfered Method of Contact :

Do we need to order a mortgage location survey? Yes No
Do we need to order payoffs? Yes No

Payoff Information - We must have account numbers and borrower authorization for most payoff requests. Please fax customer authorization to 614-880-1076
1st Mortgage : Phone : Account # :
2nd Mortgage : Phone : Account # :
Other Liens : Phone : Account # :

Order Information
Ordered By : Company :
Office Number : Cell Number : Fax Number :
Email :

Additional Contact
Contact :
Specific Information :
PLEASE FAX THE FOLLOWING WITH ORDER WHEN APPLICABLE TO 614-880-1076
- Reissue rate - please profivde copy of Owner's Policy; 10 years or younger
- Borrowers Authorization (for payoffs to be ordered)
- Copies of paid receipts for buyer insurance, inspections or other items
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