Refinance Information Sheet | McDuffy Law Firm

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New Client Refinance Form

Please complete this questionnaire as completely and accurately as you can.

All information that you provide will be held in strict confidence.

Legal First Name

Legal Middle Name

Legal Last Name

Street Address

County

Mailing Address if Different Than Above

Home Phone

Cell Phone

Work Phone

Email

By providing my email address I authorize that the McDuffy Law Firm, PLLC may send me emails concerning my case.

Last 4 of Social Security Number

Marital Status *

Married

Unmarried

Divorced

Separated

Widowed

Spouse Full Legal Name

Last 4 of Social Security Number (Spouse)

Home Phone (Spouse)

Cell Phone (Spouse)

Work Phone (Spouse)

Email (Spouse)

Is the property being refinanced your primary residence? *

Yes

No

Does the property have a mortgage or deed of trust? *

Yes (if yes complete loan information below).

No

Mortgage/bank contact information

Loan Number(s)

Do you authorize our office to obtain loan information from your lender including but not limited to a payoff statement?

Yes

No

Is the property governed by a Home Owners Association? *

Yes

No

Home Owners Association company name

Home Owners Association phone number

Home Owners Association email address

Home Owners Association fees

Do you authorize our office to obtain HOA information from a third party company if applicable? Additional fees may be associated with this

Yes

No

Will the seller be attending closing? *

Yes

No

If no, where will your documents be sent? (mail away fee and Notary fee will be collected at closing.

PLEASE ACKNOWLEDGE THE FOLLOWING IMPORTANT STATEMENTS & SIGN BELOW:

I have completed this form as fully and accurately as possible and have not knowingly provided any false statements.

Signature

Signature

Date * required

The undersigned has engaged CERTIFID, INC. to provide payoff quote services in connection with the above-referenced property and any loan(s) secured by it (the "Loan") and hereby authorizes and approves the release of any and all information and the performance of any and all actions requested by CERTIFID, INC. relating to the Loan, including by not limited to providing any outstanding balance, payoff statement, and/or satisfaction/release status.

I/We accept, acknowledge, and authorize the collection of any fees and/or charges necessary to generate, deliver, and expedite the payoff request.

Signature

Signature

Date * required

Thank you for submitting the Refinance Information Sheet.

We will reach out to you soon once we have reviewed your information.

Contact Us Today To Schedule Your Appointment

Mills River Office

317 Banner Farm Rd. Suite A

Mills River, NC 28759

Brevard Office

23 S. Broad St. Suite 207

Brevard, NC 28712

Email

office@mcduffylaw.com

Phone

828.674.4802

Hours
Monday - Friday
9am - 5pm

Thanks for submitting!

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