Claremont Escrow

405 W. Foothill Blvd. #101

Claremont, CA 91711

Phone: (909) 399-1171

Refinance Take Sheet

Broker/Lender Name

Lender Address

Loan Officer Name

Processor

Telephone

Fax Number

Property Address

Property City

Property State

Property ZIP

Borrower 1 Full Name

Borrower 2 Full Name

Social # (Borrower 1)

Social # (Borrower 2)

Home Phone

Work Phone

Mailing Address

Loan Amount

$

Loan Type

Conventional

FHA

VA

Second Loan Amount

$

Second Loan Type

Conventional

FHA

VA

Escrow Instructions Sent to the:

Borrower

Broker

First Loan Details

Existing First Loan:

To Be Paid Off

To Remain

To Subordinate

First Lender Payoff

First Loan #

First Lender Phone

First Loan Balance

$

Second Loan Details

Existing Second Loan:

To Be Paid Off

To Remain

To Subordinate

Second Lender Payoff

Second Loan #

Second Lender Phone

Second Loan Balance

$

Title Information

Title Company

Title Co. City

Title Officer

Rep

Order # (if already opened)

Insurance

Insurance Company

Premium Amount

$

Expires (MM/DD/YYYY)

Insurance Phone

Insurance Agent

Borrower Authorization

PLEASE PROVIDE BORROWERS SIGNED AUTHORIZATION & IF ANY CREDIT CARDS ARE TO BE PAID OFF THROUGH THIS REFINANCE PLEASE PROVIDE PAYMENT COUPONS.

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