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Recordation Tax Table
LENDER INFORMATION:
Lender:
Loan Amount:
Type: Refinance Purchase HELOC
Principal Residence? Yes No
Expected Settlement Date:
PURCHASER(S):
Name:
Name:
Property Address:
County:
Daytime Phone Numbers
SELLER(S):
Name:
Name:
Daytime Phone Numbers
PAYOFF INFORMATION:
Lender #1
Name:
Phone Number:
Lender #2
Name:
Phone Number:
Lender #3
Name:
Phone Number:
Loan Officer:
Processor:
Rate Lock Expiration Date:
SS#
SS#
Home Phone #
SS#
SS#
Account #
Account #
Account #