ABOUT YOUR LOAN Is this loan for a Purchase Refinance What is the Jurisdiction? Washington, DC Maryland Virginia Florida Pennsylvania Anticipated Settlement Date January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 , 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 Purchase Price $ Loan Amount $ PROPERTY INFORMATION Address City, State, Zip Code , County Subdivision Lot/Block/Square PURCHASER/BORROWER INFORMATION Purchaser 1 Name Work Phone Home Phone E-mail Attending Closing? Yes     No Purchaser 2 Name Work Phone Home Phone E-mail Attending Closing? Yes     No General FAX Current Address City, State, Zip Code , First-Time Homebuyer Yes     No Married? Yes     No SELLER INFORMATION     (Purchases Only) Seller 1 Name Work Phone Home Phone E-mail Attending Closing? Yes     No Seller 2 Name Work Phone Home Phone E-mail Attending Closing? Yes     No General FAX Current Address City, State, Zip Code , Married? Yes     No LOAN AND TRUST INFORMATION New Loan Information Lender Loan Officer Phone Number Sales Price $ Loan Amount $ Loan Type Existing Trust Information (First Lender) Lender Account Number Phone Number Existing Trust Information (Second Lender) Lender Account Number Phone Number REALTOR INFORMATION     (Purchases Only) Selling Agent Name Office Phone Number Alternate Phone FAX Listing Agent Name Office Phone Number Alternate Phone FAX SPECIAL INSTRUCTIONS (if necessary) FINAL CONTACT INFORMATION Order Placed By Phone Number E-mail address