*Borrower's Name:

Co-Borrower's Name:

Who is your Estate Planner (Wills/Estates/Probate Avoidance)?

Name

Phone

Email

Comments on this professional

*Do you have a will or trust? Choose One Yes No

If not, may we recommend an estate planner? Choose One Yes No

Who is your Financial Planner?

Name

Phone

Email

Comments on this professional

*Are you working with a Financial Professional for retirement planning? Choose One Yes No

If not, may we recommend one? Choose One Yes No

Who is your CPA / Tax Professional

Name

Phone

Email

Comments on this professional

*Do you work with a professional in the preparation of your taxes? Choose One Yes No

If not, may we recommend one? Choose One Yes No

Who is your Real Estate Professional

Name

Phone

Email

Comments on this professional

*Are you working with a real estate professional? Choose One Yes No

If not, may we recommend one? Choose One Yes No

I (We) hereby authorize the above referenced professionals to release any and all information requested by OrangeCountyLender.com as needed to assist in the process of my loan application. I further understand that I am under no obligation to work with any referred professionals.

*Borrower Signature: Date: