Statement of Information

Basic Details

Residence Details

Confidential Information Statement to be used in connection with order no.

Completion of this form will expedite your order and will help protect you

THE STREET ADDRESS of the property in the transaction is :

Address

City

Improvements Single ResidenceMultiple ResidenceCommercial Occupied by OwnerLesseeTenants Any portion of new loan funds to be used for construction YesNo

Your details

Name (First Middle Last)

Birth Place

Birth Date

I have lived in California since

Social Security Number

Drivers License Number

Wife's maiden name

We were married on

Married at

Spouse Details

Name (First Middle Last)

Birth Place

Birth Date

I have lived in California since

Social Security Number

Drivers License Number

Wife's maiden name

We were married on

Married at

Residence(s) for last 10 years

Number

Street

City

From/To

Number

Street

City

From/To

Number

Street

City

From/To

888-587-9757

info@superiorloanservicing.com

Statement of Information

Confidential Information Statement to be used in connection with order no.

Your details

Spouse Details

Residence(s) for last 10 years

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Superior Loan Servicing

888-587-9757

818-876-0337

Mon-Fri, 7AM - 5:30PM PST

lss@slsbox.com

Canoga Park, CA

Las Vegas, NV

888-587-9757

lss@slsbox.com

Canoga Park, CA

Las Vegas, NV