PurchaseRefinance
Anticipated Settlement Date
Property Information:
Property Address
City
State	MD VA DC FL
Zip
County
Purchaser/Borrower Information:
Purchaser 1
Purchaser 2
Office Phone
Home Phone
Email
Present Address
City, State, Zip	MD VA DC
1st Time Homebuyer in Maryland	YesNo
Seller Information (Purchase Transactions Only):
Seller 1
Seller 2
Work Phone
Home Phone
Email
Present Address
City, State, Zip	MD VA DC
Loan Information:
New Loan
Lender
Loan Officer
Phone Number
Loan Amount
Existing Loan Information
Lender (1st)
Account Number
Phone Number
Lender (2nd)
Realtor Information (Purchase Transaction Only):
Selling AgentListing Agent
Name
Office
Phone Number
Alt. Phone
Email
Special Instructions