ESCROW OFFICER (REQUIRED): Copy and paste the email of ESCROW OFFICER you want to send this form in the field below. Amber Wagner- Amber@only-escrow.com Marlen Videz- Marlen@only-escrow.com Jorge Lopez- Jorge@only-escrow.com Berenice Acevedo- Berenice@only-escrow.com Sylvie Torrence- Admin@only-escrow.com ESCROW OFFICER: (Copy and paste here the email of Escrow Officer from above) YOUR NAME (REQUIRED): FIRST NAME LAST NAME PHONE NUMBER (REQUIRED): EMAIL (REQUIRED): SUBJECT PROPERTY ADDRESS (REQUIRED): STREET ADDRESS CITY STATE/PROVINCE POSTAL / ZIP CODE COUNTRY TITLE COMPANY TITLE REP KEY DOCUMENTATION UPLOAD FEATURE LENDER LENDER/MORTGATE COMPANY ADDRESS CITY, STATE AND ZIP PHONE FAX EMAIL NEW LOAN AMOUNT $ TYPE OF LOAN FIRSTSECOND BORROWER BORROWER PROPERTY ADDRESS MAILING ADDRESS (IF DIFFERENT) WORK HOME CELL FAX EMAIL OWNER #1 SOCIAL SECURITY OWNER #2 SOCIAL SECURITY TITLE COMPANY TITLE COMPANY TITLE OFFICER PHONE FAX EMAIL TITLE REP TO CREDIT EXISTING FIRST MORTGAGE FIRST MORTAGE LOAN NUMBER LOAN AMOUNT APPROXIMATE BALANCE ADDRESS PHONE EXISTING SECOND MORTGAGE SECOND MORTAGE LOAN NUMBER LOAN AMOUNT APPROXIMATE BALANCE ADDRESS PHONE COMMENTS BY PROVIDING THE ABOVE AFOREMENTIONED INFORMATION, YOU HAVE SUPPLIED US WITH ENOUGH INFORMATION TO OPEN ESCROW. PLEASE FEEL FREE TO CONTACT US IF YOU HAVE ANY QUESTIONS. A MEMBER OF OUR TEAM WILL CONTACT YOU TO OBTAIN ANY ADDITIONAL INFORMATION THAT MAY BE REQUIRED TO PROCESS THIS ESCROW.