LOAN OFFICER / LENDER Company (required) Contact (required) Email (required) Phone (required) Fax Direct Address City State, ZIP REFINANCE PROPERTY INFORMATION Address (required) City (required) State, ZIP County Parcel Number Legal Description OWNER 1 Name Home Phone Cell Phone Email Address (if different than above) City, State, ZIP (if different than above) OWNER 2 Name Home Phone Cell Phone Email Address (if different than above) City, State, ZIP (if different than above) LOAN INFORMATION Transaction Type ---ConventionalFHAVA Anticipated Closing Date Lender's Policy Amount New Loan Number Loan Officer Loan Officer Phone Loan Officer Email SURVEY Survey required? YesNo Surveyor Name CURRENT MORTGAGE INFORMATION Mortgage Company #1 Company 1 Account Number Phone Fax Mortgage Company #2 Company 2 Account Number Phone Fax ADDITIONAL COMMENTS CONTACT INFO Email team@expresstc.com johnson city 2909 E. Oakland Ave Suite 103C, Johnson City, TN 37601 phone +1 423-434-9200 Business Hours Monday – Friday :: 8am – 5pm Fax +1 866-777-6521