Refinance / Second Mortgage

    Type of Transaction

    TRID Compliant Loan

    *Select Yes or No:

    Property Information

    *Property Address

    *City

    *State

    *Zip

    *County

    Legal Description

    Property Type

    Buyer/Borrower(s):

    *Complete Name(s)

    Marital Status: marriedsingle

    Current Address (City, State & Zip)

    Phone No - Please use this format: (###) ###-####

    Cell Phone No - Please use this format: (###) ###-####

    Email

    Loan Amount

    Please use this format: $1,234.10

    Lender Information

    *Company Name

    NMLS #

    State License ID

    State

    Complete Address (City, State & Zip)

    Loan No.

    Loan Officer

    Name

    NMLS #

    State License ID

    State

    Phone No - Please use this format: (###) ###-####

    Cell Phone No - Please use this format: (###) ###-####

    Email

    Loan Processor

    Name

    Phone No - Please use this format: (###) ###-####

    Cell Phone No - Please use this format: (###) ###-####

    Email

    Closing Protection Letter (CPL)

    CPL Required? yesno

    Complete Address for CPL (City, State & Zip)

    Closing

    Is Thomson-Affinity Title Closing? yesno

    Closing Office/Closer

    Liberty:

    Overland Park:

    Closing Date

    Ordered By

    Your Name

    Company

    Address (City, State & Zip)

    Phone No - Please use this format: (###) ###-####

    Cell Phone No - Please use this format: (###) ###-####

    *Email

    Additional Copies To (Realtors, Attorneys, Surveyors, Additional parties, etc.):

    Contact Name

    Company Name

    Phone No

    Email

    Special Instructions