---

Loan Officer:

Company:

---

Lender Contact:

Lender Fax:

Lender Phone:

Lender Email:

---

Who will investor be?:

---

Borrower 1:

Social Security:

Borrower 2:

Social Security:

Home Phone:

Work Phone:

Cell Phone:

---

Property Address:

City:

State:

Zip Code:

County:

Loan Amount:

Sale Price:

Earnest Money:

---

Seller 1:

Home Phone:

Work Phone:

Cell Phone:

Seller 2:

Home Phone:

Work Phone:

Cell Phone:

---

Selling Realtor:

Company:

Selling Realtor Phone:

Selling Realtor Fax:

Selling Realtor Cell:

---

Listings Realtor:

Company:

Listings Realtor Phone:

Listings Realtor Fax:

Listings Realtor Cell:

---

Commission Amount:

%

Commission Held By:

---

Title Company Order Payoffs?: .. Yes .... No

---

1st Mortgage With:

Account Number:

2nd Mortgage With:

Account Number:

---

Survey Required?: .. Yes .... No

Purchase Contract Attached?: .. Yes .... No

Borrowers Authorization Sent?: .. Yes .... No

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Estimated Closing Date:

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Notes or Comments:

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....