Loan Company InformationCompany Name*Borrower InformationBorrower First Name*Borrower Middle NameBorrower Last Name*Borrower SSNCo-Borrower InformationCo. Borrower First NameCo. Borrower Middle NameCo. Borrower Last NameCo. Borrower SSNTracking InformationWho will sign the documents ?*Who is your CLC Account Executive?*Michelle BaxterJohn A. EubankJanet LucasJohn D. EubankMailing InformationCurrent Address*City*State*Zip*Phone InformationWork#Home#Cell#*Email Property InformationAddress*City*Zip*State*County*SubdivisonProperty Type*ResidentialLand/ConstructionCommercialBuilding Type*Single Family DetachedTownhouseCondoAttached RowhouseSemi-Detached RowhouseMulti-UnitLot Size*Above Ground Living Area*Central Air* Central Air Basement* Basement Finished* Finished Number of Stories*Number of Bedroom*Full Bath*Half Bath*Property Description*Deal Synopsis*Renovation Description*Pricing InformationLoan Type*PurchaseReferencePurchase Price*Closing costs Requested*Renovations Requested*Total Loan Amount Requested*Est. Resale Value*Settlement InformationEst. Settlement Date* Settlement AgentATG Title (VA, MD, DC)Atlantic Title (VA, MD, DC)Brennan Title (VA, MD, DC)Jenny Colon, PC (Tidewater area)Seashore Title (Tidewater area)OtherSettlement Company Name*Address*Phone*Contact Person*CAPTCHA