Refinance Information Request Form | Stegall & Clifford

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Refinance – Information Request Form

Closing Date:

MM slash DD slash YYYY

Property Address:

Owner(s) name(s): Please list full name and marital status of all property owners. **If married provide spouse’s name as a separate owner** Use additional sheets if necessary. Reference who is married to whom.

Full Legal/Corporate Name (as shown on government-issued ID):

Sex:

M

F

Married:

Yes

No

Full Social Security Number/Full Tax ID Number***

Spouse's Name (as shown on government-issued ID):

Full Social Security Number/Full Tax ID Number***

Full Legal/Corporate Name (as shown on government-issued ID):

Sex:

M

F

Married:

Yes

No

Full Social Security Number/Full Tax ID Number***

Spouse's Name (as shown on government-issued ID):

Full Social Security Number/Full Tax ID Number***

Full Legal/Corporate Name (as shown on government-issued ID):

Sex:

M

F

Married:

Yes

No

Full Social Security Number/Full Tax ID Number***

Spouse's Name (as shown on government-issued ID):

Full Social Security Number/Full Tax ID Number***

**Spouses are required to sell real estate in NC. ***Required for 1099 filing with IRS.
Best contact information for owners:

Phone

Email

Is the property being sold your current primary residence?

Yes

No

Post-Closing Mailing Address:

(for return of documents, refunds, etc.)

How would you like to receive closing proceeds?

Pick–Up (no charge)

UPS ($50 fee-see below)

Wire ($60 fee-see below)

***In order to send a wire, we must have an ORIGINAL voided check, or wire instructions from an attorney’s trust account. If you do not have a physical check to provide, please ask for a Wire Authorization Form, though it will need to be notarized. We are unable to send a UPS to a PO Box.

Current Liens & Mortgages (Payoff Information)

Name of Mortgage or Equity Lender

Full Loan

Current Balance Estimate ($)

Contact Phone #

Mortgage or Equity Lender

Full Loan

Current Balance Estimate ($)

Contact Phone #

Mortgage or Equity Lender

Full Loan

Current Balance Estimate ($)

Contact Phone #

Mortgage or Equity Lender

Full Loan

Current Balance Estimate ($)

Contact Phone #

-Typically, written payoffs will be provided by your lender. We will use the information provided above order any necessary documentation if they are unable to provide a payoff to us.
-Provide information for all Mortgage/Equity Lines even if they have a $0.00 balance.
-Stegall & Clifford will order your payoff statement. We will charge $50 per loan to overnight the funds to your mortgagor.

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Greensboro Office:
445 Dolley Madison Road, Suite 102
Greensboro, NC 27410

Winston-Salem Office:
202 Fair Oaks Lane
Winston-Salem, NC 27127

Contact Us:

Phone: 336-281-3110

Fax: 336-285-7276

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