Creditor Name:
Account #:
Creditor Name:
Account #:
Creditor Name:
Account #:
Creditor Name:
Account #:
Creditor Name:
Account #:
Proposed Settlement Date:
If the transaction is purchase money mortgage, please
complete the following:
Seller(s) Full Name(s):
Seller(s) Address:
Seller(s) Phone:
Seller(s) Attorney:
Seller(s) Attorney's Phone:
Seller(s) Attorney's Address:
Seller(s) Real Estate Agent:
Seller(s) Real Estate Agent's Phone:
Seller(s) Real Estate Agent's Address:
Do you need any of the following:
Flood Certification:
Life of
Loan Regular
Property Address:
County:
Township:
Residential Mortgage Credit Report:
Yes (Please provide 1003
application)
No
Apprasial:
Yes
No
Full Fannie Mae
Drive By
Property Address:
