I think you can google this work sheet; the work sheet will list the line and forms you need to pull the numbers from.
You can find it online including instructions for completion
Your loan officer should be filling that out, and you should just need to sign. The funny thing about that disclosure, is you can pretty much answer it whatever way yu want and you still get the loan. It is really meant to encourage you to think about the loan, and to make sure it makes sense for you to do a refinance.
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