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| Corporate Office |
Eastern Regional Office |
9680 Haven Ave. Suite 300
Rancho Cucamonga, CA 91730
Tel : 909-348-1600 / Fax : 909-266-8605
E-mail : [email protected]
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2700 N Berkeley Lake Rd. Building A, Suite 300
Duluth, GA 30096
Tel : 678-879-5000 / Fax : 678-935-1350
E-mail : [email protected]
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| Date |
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Acct. Exec |
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| Company name |
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Broker ID |
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| Loan Officer |
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Contact |
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| Phone |
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Fax |
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| Email |
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| Borrower Information |
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Spouse Information |
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| Borrower Name |
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| SSN |
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| Address |
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| City |
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| State |
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| Residency Status |
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| Employment Status |
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| Spouse Name |
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| SSN |
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| Address |
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| City |
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| Residency Status |
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| Employment Status |
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| Property Address |
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| City |
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Zip |
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| Occupancy Type |
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Property Type |
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| Seller's Full Name |
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| Loan Program |
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| Register Number |
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(If pre-Locked) |
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| Loan Purpose |
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Documentation Type |
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| Appraisal Value |
$0.00 |
LTV/CLTV |
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| Sales Price |
$0.00
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Credit Score |
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| Loan Amount |
$0.00
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Term/Due |
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| Cash-Out Amount |
$0.00
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Interest Rate |
0.00%
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| Impound ? |
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Start Rate(JO100) |
0.00%
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| Pre-Pay Penalty |
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Margin(JO100) |
0.00%
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| Interest Only |
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Projected Close Date |
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| 2nd Loan with ? |
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I/We hereby assign and transfer all rights, title and interest in the above referenced loan package to Majestic Home Loan
I/We hereby certify that all disclosures required by law were given to the borrower(s) within three (3) business days of the completion of the original application. I/We hereby indemnify Majestic Home Loan, their successors and/or assigns from any and all claims and/or losses that may arise from the issuance of such required disclosures.
I/We hereby certify that all copies in the above referenced loan package submitted to Majestic Home Loan are true and exact copies of the original documents that I/we witnessed, and from which we took copies.
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| Print Name : |
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Date : |
2/11/2013 |
| Signature : |
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Date : |
2/11/2013 |
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