Refinance Forms Phone Your Name: * Social Security: * Seller's Marital Status: * Single Married Divorced Widow(er) Free Trader If married, name of spouse: Contact Number: * Email Address: * Lender Name, Loan Officer, and Phone Number: * Homeowner's Insurance Info (insurer, agent, and phone number): * Will this be the principal residence? Yes No If not, provide that address: PLEASE COMPLETE OR WRITE N/A FOR NO MORTGAGE OR EQUITY LINE LENDER NAME 1. 2. 3 LOAN NUMBER . . . PHONE NUMBER . . . EQUITY LINE . YES NO . YES NO . YES NO REFI PROCEEDS AFTER CLOSING: Pick-Up Mailed Wired (for a $30 fee) DISCOUNTED PREMIUM SERVICES At Goins Law, it is our pleasure to offer discounted estate documents to the people using our office for real estate services. FOR ONLY A COST OF $300 (normally, we charge $650), at the time of your closing, we can provide you with: a simple will, a healthcare power of attorney, advance directives for end-of-life care, and a general power of attorney. Would you like this service? Yes No Goins Law2212 Eastchester DriveHigh Point, NC 27265(336) 307-9211Call Us