info@esquiretitle.com| 614-855-9600

TO: ESQUIRE TITLE SERVICES, INC.
6648 Walnut Street, New Albany, OH 43054
Phone: 614.855.9600/ Fax: 614.855.6870

REFINANCE - PLEASE INCLUDE THE 1003 APPLICATION WITH YOUR REQUEST.

Also please include your general information release form for mortgage payoffs (including the Social Security Number for primary the borrower)

Date:

REQUESTED BY:

COMPANY :

ADDRESS :

Fax Number/Contact Numbers for you:

Email Address:

PROPERTY ADDRESS:

County:

BORROWER(S) NAME:

Home Phone # Work #s

Cell Phone # Married Single

Email Addresses:

LOAN AMOUNT:

ESTIMATED CLOSING DATE:

PAYOFF INFORMATION FOR EXISTING MORTGAGES:

1ST MORTGAGE:

Account #

Customer Service #

2nd MORTGAGE/EQUITY LINE OF CREDIT :

Account #

Customer Service #

Is there back title on the property? If the sellers/owners obtained owner’s title insurance less than 10 years ago we are able to give a discount of 30% on the new owner’s title insurance policy when a copy of Schedule A and Schedule B from the OWNERS TITLE INSURANCE POLICY is provided to us.