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Real Estate Transactions
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Borrower Information
Personal Information
Your New Lender:
*
Your Name:
*
Loan/Transaction Type:
Are you Purchasing a house?
Are you Refinancing your Existing Mortgage?
Are you taking out an Equity Mortgage?
Your Telephone:
Home:
Work:
Your Email Address:
Co-Borrower:
Co-Borrower Telephone:
Home:
Work:
Property Address:
*
City
*
, State
*
, Zip:
MA
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NB
NC
ND
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Your Current Address:
City, State, Zip:
MA
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NB
NC
ND
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Purchase Information
Title Preference:
Joint Tenancy
Tenants in Common
Tenants by the Entirety
Individually (One Owner)
Joint Tenancy
Tenants in Common
Tenants by the Entirety
Individually (One Owner)
Tenancy Help
Your Attorney (If any or, If not our office):
Your Attorney Address:
City, State, Zip:
MA
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NB
NC
ND
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Phone:
Your Insurance Agency:
Phone:
Refinance Information
Current First Mortgage Lender:
Loan/Account Number:
Lender Telephone:
Current Equity / Second Mortgage Lender:
Loan/Account Number:
Lender Telephone:
Notes or Special Instructions to us:
44 Park Street | Andover, Massachusetts 01810 | Tel: 978-475-1518 | Fax: 978-470-3448 |
mlombard@mlombard.com
Copyright 2007, Law Office of Michael E. Lombard. All Rights Reserved.
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