Request for Title - Sale
Listing Agent Information--
*
Agent Name:
Company Name:
Company Address:
City:
State:
Zip:
Phone:
Fax:
Cell Phone:
Email:
Commission:
%
Admin Fee:
$
Selling Agent Information--
Agent Name:
Company Name:
Company Address:
City:
State:
Zip:
Phone:
Fax:
Cell Phone:
Email:
Commission:
%
Admin Fee:
$
Property Information--
Sales Price:
$
Earnest Money: $
Address:
Unit No.:
City:
State:
Zip:
Legal Description:
Home Owners Assn.:
(enter name of HOA in place of None)
HOA Phone:
Seller Information--
Seller1 Name:
SSN:
Seller2 Name:
SSN:
Seller Address:
City:
State:
Zip:
Phone:
Payoff Lender1:
Loan Number:
Payoff Lender1 Phone:
Payoff Lender2:
Loan Number:
Payoff Lender2 Phone:
Buyer Information--
Buyer1 Name:
SSN:
Buyer2 Name:
SSN:
Buyer Address:
City:
State:
Zip:
Phone:
Cash Deal?
Yes
No
New Lender:
Loan Officer:
Phone:
Fax:
Loan Amount:
$
Loan Type:
(i.e. VA, Conv, etc.)
Contract Information--
Commitment Due Date:
Closing Date:
Contract will be:
Delivered
Faxed
Misc Information--
Mail commitment to:
Buyer
Seller
Is this a "Mail Out"?
Yes
No - If Yes, To:
Buyer
Seller
Is a POA involved?
Yes
No - If Yes, For:
Buyer
Seller
Home Warranty?
Yes
No
Home Warranty Company:
Cost: $
Special Instructions: