Delaney's Law Firm - Real Estate Sale Intake Form

intake

Mortgage Intake Form- Enter the information into the form. After you have completed the form but before clicking submit, you may want to print the form out for your records.

Mortgagor Information: Enter information for up to two people. Title must be in the same names as shown in the mortgage application.

Mortgagor 1:

Title in the name of (Last/First/Middle name, no initials):

Date of birth:

Phone Number:

Mortgagor 2:

Title in the name of (Last/First/Middle name, no initials):

Date of birth:

Phone Number:

Spousal Status:
Single Married

Hold Title As:
Joint Tenants Tenants in Comon (2 people)
Registered Owner (1 person)

Address for service (if different than property address):

New Mortgage Information

Mortgagee:

Address:

Branch/Contact Person:

Contact person phone number:

Insurance

We recommend that you obtain fire insurance on the property effective the date of closing and have the insurance agent show loss payable to the mortgagee. Please have the insurance agent fax an insurance binder to our office prior to closing.

Name of Insurance Broker:

Phone Number:

Most lenders require an insurance binder naming them in the policy in order to complete your re-finance. Would you like Delaney's Law Firm to forward your information to RIO Insurance for a no-obligation quote? They will keep the information confidential and it will not be re-transmitted without your approval. If you click "yes" someone will contact you by email to get the process started!

I would like someone from RIO Insurance to contact me: Yes No

Existing Mortgage

Mortgagee:

Branch/Contact Person:

Mortgage Reference No (VERY IMPORTANT):

Property Information:

Total amount of last tax bill: $
Amount of taxes paid to date: $

Is the property a condominium? Yes No
Name of Property Manager:

My e-mail address: * (required)
I would like my final Documentation by e-mail: Yes No