Settlement Order Form
Settlement type:
Sale
Refinance
Requested Settlement Date:
(mm/dd/yyy)
Property Information
Address:
County:
City:
State:
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip:
Borrower Information
Borrower Name:
*
Co-Borrower Name:
Mailing Address:
City:
State:
Zip:
Borrower Social Security Number:
-
-
Borrower Home Phone Number:
*
Borrower Work Phone Number:
Loan Information
Loan Amount:
$
Type of Loan:
Conventional
FHA
VA
Service Type:
Regular
Rush
Mortgage Type:
1st
2nd
3rd
Seller Home Phone Number:
Seller Work Phone Number:
Lender Phone Number:
Lender Address:
(for insured closing protection letter)
Lender City:
Lender State:
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Broker Name:
Broker Number:
Processor Name:
Existing First Lender
Account Number:
Phone Number:
Existing Second Lender:
Account Number:
Phone Number:
Office for case referral:
Silver Spring
Largo
Who would you like to refer this case to:
(if known)
Ralph A. Bernardo
Jim Gittens
Kito Bradford
Andrea Bernardo
Other:
Unknown