CD-Closing Info Request Borrower Name:* GHMC Loan #:* Requester’s Email Address:* Request Type:* Purchase Refinance Does anyone else have rescission rights?(i.e. spouses or additional title holders) Yes No Please download and complete this form. Once completed, you will need to upload the form to “LAM Conditions” in OpenClose. For Sale By Owner:* Yes No Borrower's Email Address:* Additional Email Addresses for All Other Borrowers: separate by commaNotes to LAM/Closer:Anticipated Closing Date:* MM slash DD slash YYYY Dry State Closings: Signing Date: MM slash DD slash YYYY Funding Date: MM slash DD slash YYYY Broker/Correspondent Contact to receive a copy of Initial CD when CD is issued to Customer:Name:* Email:* Additional Broker/Corre Contact(s) for initial copyAdd rows as neededNameEmail HiddenName: HiddenEmail: Do you want an interest credit? If Yes, must close and disburse by the 5th of the month. Yes No Do you want to review the CD before it is issued? Yes No Is POA being used at closing? If Yes, please provide a copy to the LAM. Yes No Title Company / Settlement Agent InfoClosing Agent Name:* Address:* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone Number:*Company License ID #:* Contact Name:* Contact Email:* Contact Person’s License ID #:* Email to send package to: Listing Agent Info:Company Name: Address: Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone Number:License ID #: Listing Agent Name: Listing Agent Email:* Listing Realtor License ID #: if no Realtor, please indicate N/ABuyer Agent Info:Company Name: Address: Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone Number:License ID #: Buyer Agent Name: Buyer Agent Email:* Buyer Realtor License ID #: if no Realtor, please indicate N/ACorrespondents Only:Warehouse Line used: Invoices must be uploaded to LAM for all fees: 3rd Party Fees Pay To Check if Applicable Appraisal: Appraisal FeeAppraisal Pay To* Appraisal Check if Applicable POC by Borr POC by Broker -Reimburse Final Inspection: Final Inspection FeeFinal Inspection Pay To* Final Inspection Check if Applicable POC by Borr POC by Broker -Reimburse Credit Report: Credit Report FeeCredit Report Pay To* Credit Report Check if Applicable POC by Borr POC by Broker -Reimburse Termite: Termite FeeTermite Pay To* Termite Check if Applicable POC by Borr POC by Broker -Reimburse 3rd Party Processing Fee: 3rd Party Processing Fee3rd Party Processing Fee Pay To* 3rd Party Processing Fee Check if Applicable POC by Borr POC by Broker -Reimburse Other: Other Description Other FeeOther Pay To Other Check if Applicable POC by Borr POC by Broker -Reimburse Other 2: Other 2 Description Other 2 FeeOther 2 Pay to Other 2 Check if Applicable POC by Borr POC by Broker -Reimburse Other 3: Other 3 Description Other 3 FeeOther 3 Pay to Other 3 Check if Applicable POC by Borr POC by Broker -Reimburse In order to be able to process your CD, please confirm the following requirements have been met:* Loan is locked and locked LE has been disclosed Title Commitment has been uploaded Prelim CD from Settlement Agent has been uploaded