Refinance Order Form NEW loan / refi / equity / new construction Thank you for your order! Please complete the information boxes below for your title and / or escrow order. Once submitted, your order will be processed and our order desk will reply to you with your order number. Open Up Contact Information:Person completing this form*Email address that we should reply to* Contact Phone Number*Proposed Closing Date* Date Format: MM slash DD slash YYYY Attach 1003.Yes, I will email the 1003 - please email to: OrderCenter@pnwtkitsap.com, or fax it to 360.692.5569 If a copy of the 1003 is sent to PNWT – please only complete any additional information not included in the 1003 below.Property InformationTax Account NumberProperty Address (Street or P.O. Box, City, State, Zip)Borrower InformationBorrower & Co-borrower NameIs the Borrower's address the same as the property address?YesNo (if no please provide address below)Borrower's Address (Street or P.O. Box, City, State, Zip)Borrower's Phone NumberLoan Policy InformationLoan TypeRefinanceNew Construction LoanEquity / GEMLoan Amount $Loan NumberLender's Policy:Extended Coverage Loan Policy (Customary)Standard Coverage Loan PolicyGEM/HELOC/SMART/LITE/EQUIITY PolicyLender / Mortgage Broker InformationCompany NameAddress (Street or P.O. Box, City, State, Zip)PhoneFaxLoan Officer NameEmail Email Copy Fax Hard Copy Processor NameEmail Email Copy Fax Hard Copy Lender Proposed InsuredEscrow Information Escrow will be closed by PNWT, please assign this transaction to the following branch: Silverdale BranchPort Orchard BranchBainbridge Island Branch Escrow will be closed with an outside escrow company: Company Name:AttnEscrow No.Address (Street or P.O. Box, City, State, Zip)PhoneFaxEmail Email Copy Fax Hard Copy Special Instructions / Comments This iframe contains the logic required to handle Ajax powered Gravity Forms.