Re-Finance/Reverse Mortgage Form

We are delighted you have chosen Blue & Gray Title to close your Re-Finance or Reverse Mortgage transaction.  Your Blue & Gray Title team takes great pride in working hard to make sure that your closing is accurate, smooth, and efficient.

Please complete and send the form below.

Name:

E-mail address:

Daytime Phone#

Evening Phone#

Order Number:

FAX number:

The name of your Homeowner's
Insurance Agent:

Insurance agent's telephone #:

The amount of your first annual
insurance premium:

Did you ask your Insurance Agent to include a Mortgagee Clause?
Yes No

Buyers' Names as they should legally appear on the Closing Documents:

Buyer 1 Legal Name

Buyer 2 Legal Name

Comments or Questions? Feel free to enter them here: