
*Your Mortgage Broker or Lender:
*Your Name:
Your Soc. Sec. Number:	- -
This is:
*Subject Property Address:
*City:
*State:
*Zip:
Your Current Address: (State "Same"if same as Subject Property)
City:
State:
Zip:
*1st Telephone #:	( ) - Type:
2nd Telephone #:	( ) - Type:
Your Email Address:

Co-Borrower Name: (if any)
Co-Borrower Soc. Sec. Number:	- -
1st Telephone #:	( ) - Type:
2nd Telephone #:	( ) - Type:

Note: Please provide information about your current mortgage(s) below. This information will be used to obtain accurate balance and payoff information for the accounts entered.

Current First Mortgage Lender: (if any)
Loan/Account Number:
Telephone #:	( ) -

Current Equity or Second Mortgage Lender: (if any)
Loan/Account Number:
Telephone #:	( ) -

Other Current Mortgage: (if any)
Loan/Account Number:
Telephone #:	( ) -

Home Owners Insurance Agent:
Insurance Agent Telephone #:	( ) -

Special Instructions, Comments, or Questions:



*Items denoted with an Asterisk are required.

New law requires carbon monoxide detectors in Bay State homes

Under new legislation signed into law last week by Gov. Mitt Romney, Massachusetts has become the ninth state in the U.S. to require carbon monoxide detectors for residential dwellings. The measure, which was supported by the Massachusetts Association of REALTORS®, will take effect
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As an attorney I appreciate being able to call an expert in the area of real estate law when I have a question or need a legal opinion in this area. David is one of the finest real estate attorneys in the state and has helped my clients and friends in the past. He provides expertise in both residential and commercial closings.

--- Mary C. Casey, Esq.
The Harbor Law Group

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