Information on your CURRENT
mortgage 
What was the month
in which this mortgage originated? 

What was the year in which this mortgage originated? 

What was the original amount of this mortgage? 

What is the term of this mortgage? 
year 
What is the interest rate? 

Information on your NEW
mortgage 
What is the mortgage amount? (The value at right is the
calculated amount you currently owe) 

What is the term of this mortgage? 
year 
What is the interest rate? 

What are your estimated closing costs, including any points paid
upfront? 
