Home Abstract Corp. 8225 Third Avenue, Brooklyn NY 11209 Tel. 718.680.HOME Fax. 718.680.4668

Cooperative Refinance Application

Applicant Information:
**Email Address: (Required)
Company Name:
Contact Name:
Address:
City: State: Zipcode:
Phone Number: Fax:
Relation to Transaction: (attorney, mortgage broker, etc.)

Property Information:
Property Address: Unit#:
Block (if known): Lot (if known):
County:

Owners Information:
Owners Name:
2nd Owners Name:
Owners Address:

Owners Attorney:
Attorney Name:
Address:
City: State: Zipcode:
Phone Number: Fax:
Email: (optional)

Lenders Information:
Lenders Name:
Loan Amount: Is this loan to be Consolidated? yes no

Lenders Attorney:
Attorney Name:
Address:
City: State: Zipcode:
Phone Number: Fax:
Email: (optional)

Cooperative Information:
Name of Coop:
Managing Agent : Phone Number:

Co-op Attorney:
Attorney Name:
Address:
City: State: Zipcode:
Phone Number: Fax:
Email: (optional)

(Any information you can provide regarding a prior transaction would be greatly appreciated, such as a copy of the title report or Fee Policy or copy of survey.) Remarks:

Disclaimer: Home Abstract represents that the information contained in its website is reliable, however, it does not guarantee the accuracy of any of the information or forms presented herein.