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Borrower:___________________________________________________________ Property Address:____________________________________________________ City:________________________________, Arizona - Zip Code:____________ Borrower Home Phone:________________, Work Phone:__________________
Legal Description:___________________________________________________ Assessors Parcel No.:________________________________________________ Refinance-Estimated Value:____________ Loan Amount:__________________ Sale-Sale Price:______________________ Loan Amount:__________________ New Construction Price:_______________ Loan Amount:__________________ Realtor Name:_______________________ Phone No.:____________________ Builder Name:_______________________ Phone No.:____________________ Additional Information/Special Instructions: ____________________________ __________________________________________________________________ Bill:____________________ C.O.D._______ From:______________________
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