Original
loan information: 
What is the
original term of your current loan:
Years 
How long have
you had this loan:
Years
Months 
What is the
current balance of this loan:
$

What is the
interest rate of this loan:
% 
New
loan information: 
What is the new
loan amount:
$

What is the new
term of the loan:
Years 
What is the new
interest rate of the loan:
% 
What is the
estimated closing cost:
% 
How
long do you plan to stay after you refinance:
Years 
