Refinance Application Please fill out the form below as accurately as possible and submit to the closing office of your choice. You will receive a confirmation email after submitting for your records. Thank you. Â Date Needed: MM slash DD slash YYYY Estimated Closing Date: MM slash DD slash YYYY Property InformationProperty Address: Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Legal DescriptionCounty:PID#:Property Type:Existing BuildingVacant LandNew ConstructionCommercialOtherCurrent Owners/Borrowers InformationIs Borrower an Individual or Company? Individual(s) Company Company Name:Authorized Signor: First Last Title:Name: First Last Marital Status:SingleMarriedSeparatedDivorceWidowedSpouse or Co-owner/Borrower: Prefix First Last Suffix Is borrower's address same as property address?YesNoBorrower Address: Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home Phone:Work Phone:Mobile Phone:Email What is the best way to contact the borrower? Home Phone Other Phone Email Existing Financial InformationCurrent Mortgage CompanyLoan NumberSecond Mortgage CompanyLoan NumberNew Financing Information:Lender/Broker Name: Address: Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Loan Officer First Last Processor: First Last Phone:Fax:Lender Email: Loan Type:FHAFHA-ARMVAVA-ARMConventionalConventional-ARMSecond MortgageOtherMortgage Amount:This field is hidden when viewing the formMortgage Amount:Name of Proposed Insured:Loan NumberLender OptionsIs a Closing Protection Letter (CPL) RequiredYesNoIs the address for the CPL same as Lender/Broker above? Yes No CPL Address: Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Is a chain of title required? Yes No How many months for chain of title? 6 months 12 months 24 months Closing/Disbursement by Home Security Abstract Title:YesNoPlat Drawing/Site Inspection:YesNoPlease note that survey coverage (including an ALTA 9 Endorsement) will not be provided if a plat drawing is not requested.Special Assessment Search:YesNoPlease note that coverage for levied or pending assessments will not be provided if an Assessment Search is not requested.Priority Pictures:YesNoApplicant Information:Contact Name (Ordered By):* First Last Contact Email:* Additional Comments/Info:Please enter any additional information that would help in processing this file. (i.e. recent divorce, bankruptcy, power of attorney for borrower, etc.)Send this application to:* Elk River Office Milaca Office Princeton Office