Law Offices of Timothy A. Reilly, P.C.

Practice Areas

Northampton Office:
82 1/2 Maple Street
Florence, MA 01062
Tel: 413-584-9900
Fax: 413-586-9440
treilly@reillylaw.net

Springfield Office:
1350 Main Street, 4th Floor
Springfield, MA 01103
Tel: 413-739-1110
Fax: 413-586-9440
treilly@reillylaw.net

Submit Your Buyer/Borrower Information

BUYER INFORMATION

Personal Information (*required field)

Your New Lender:*

Your Name:*

Loan/Transaction Type:

Are you Purchasing a house?
Are you Refinancing your Existing mortgage?
Are you taking out an Equity mortgage?

Your Telephone:

Home:

Work:

Your Email Address:

Co-Borrower:

Co-Borrower Telephone:

Home:

Work:

Property Address:*

City*, State*, Zip:

Your Current Address:

City, State, Zip:

Purchase Information

Title Preference:

Joint Tenancy
Tenants in Common
Tenants by the Entirety
Individually (One Owner)

Your Insurance Agency:

Phone:

Refinance Information

Current First mortgage Lender:

Loan/Account Number:

Lender Telephone:

Current Equity / Second mortgage Lender:

Loan/Account Number:

Lender Telephone:

Notes or Special Instructions
to us: