Refinance Questionnaire

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About You


Borrower 1 *

Borrower 2

Email *

Daytime Phone

Evening Phone

Marital Status *
SingleMarried

Primary Residence? *
YesNo

Borrower 1 SSN *

Borrower 2 SSN

Borrower 2 Relationship

About Your Homeowner's Insurance


Insurance Company

Agent's Phone

Expiration Date

Annual Premium

If you do not have the insurance information available at this time, please provide it as soon as possible. (This applies to condominiums as well.)

Owners Currently listed on deed

Current Mortgage Information


Lending Institution (1st Mortgage)

Equity Line/ Second Mortgage


Lending Institution (2nd Mortgage)

Will the 2nd mortgage be?
SubordinatedPaid off

Refinancing a Condominium?


Condo Assoc. Contact

Condo Contact Phone

Association Fee

Is water/sewer included in fee?
YesNo

Notes

Would you like to attach any documents?
(i.e. tax bill, insurance binder)

By submitting this form, I authorize Summit Title Services Corp to receive any payoff information with regard to my/our loan.

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