Refinance Forms Twitter 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) Goins Law 2212 Eastchester DriveHigh Point, NC 27265(336) 307-9211 Call Us