Borrowers Information Form "*" indicates required fields Property 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 How Many Borrowers Will There Be?* One Two Borrower One Name* First Last Borrower One Marital Status*MarriedSingleWidowedDivorcedBorrower Two Name* First Last Borrower One Marital Status*MarriedSingleWidowedDivorcedPhone*Email* Is this property currently your primary residence?* Yes No What is your current 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 Will you be present for closing?* Yes No Do you have an Owner's Title Insurance Policy?* Yes No Upload Copy of Owner's Title Insurance PolicyUpload now or email separately.Accepted file types: jpg, png, gif, pdf, Max. file size: 512 MB.Do you have a current survey?* Yes No Upload Copy of SurveyUpload now or email separately.Accepted file types: jpg, png, gif, pdf, Max. file size: 512 MB.Existing MortgagesIf there is an existing mortgage(s), please indicate the name, phone number, and loan number for all mortgage holders.Mortgage Information*Mortgage Company NamePhone NumberLoan Number Add Remove
