Cd checklist form borrowers information

CD Checklist form
BORROWERS Information
Name (as appears on Driver’s License):
Date of birth:	SSN:	Phone:
Name:
Date of birth:	SSN:	Phone:
Current address:
City:	State:	Zip:
Real Estate broker/agent
Real Estate Broker Name:		License#:
Address:
City:	State:	Zip:
Email:		Phone:
Buyers RE Agent:
Address
City:	State:	Zip:
Email:	Phone:	License#:
Settlement agent COMPANY
Loyalty Abstract, Inc
Address: 1021 Mill Creek Dr, Suite 1
City: Feasterville	State: PA	ZIP Code: 19053
Email: [e-mail] Phone: [phone] Fax: [phone]
PA License #449286 NJ License #1062819
Settlement Agent Names
Name: Rachel Basin Phone: [phone]
Email: [e-mail]	PA License #: 449255	NJ License #: 1062751
Name: Julia Shteyn Phone: [phone]
Email: [e-mail]	PA License#: 449256	NJ License#: 1062810
LENDER INformation
Name:
Address:		NMLS ID#
Phone:	E-mail:	Fax:
City:	State:	ZIP Code:
Contact:	Email:	License ID#:
FEES
Name:	Payable to:	Amount:
Lender Policy Premium	First American Title Insurance
Owner Policy Premium	First American Title Insurance
Name:	Payable to:	Amount:
Endorsements	First American Title Insurance
Notary Fee	Loyalty Abstract
Tax Cert	Loyalty Abstract
Wire Fee	Loyalty Abstract
Recording Fee	Recorder of Deeds
Transfer Taxes	Recorder of Deeds
Pest Inspection
Home Warranty
Home Inspection
Hazard Insurance Premium
RE Tax/Sewer/Water Prorations
HOA/Condo Tax Prorations
Buyer/Seller Credits
Real Estate Commission
Real Estate Agent -Other fees
Deposit(s)
Payoff(s)
CLOSING DATE: Sale price: Loan Amount: Appraised Value: Loan Type: Loan Term: Interest Rate: P&I Escrows: Y or N
Sellers Information
Name (as appears on Driver’s License):
Date of birth:	Date of birth:	Date of birth:
Name:
Date of birth:	Date of birth:	Date of birth:
Current address:	Current address:	Current address:
City:	City:	City:
Real Estate broker/agent
Real Estate Broker Name:		License#:
Address:
City:
Email:		Phone:
Buyers RE Agent:
Address
City:	State:	Zip:
Email:	Phone:	License#:
Conveyancer Contact:
Email:	Phone:	Fax: