Buyer Name *

First Name

Last Name

Property Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Anticipated Closing Date *

MM

DD

YYYY

Time

Hour

Minute

Second

AM PM

Buyer's Agent Name

First Name

Last Name

Seller's Agent

First Name

Last Name

Seller Name(s)

First Name

Last Name

First Name

Last Name

Seller Phone *

(###)

###

####

Is there a mobile home on the property? *

Yes

No

Will seller attend closing? *

(Sellers are encouraged to attend closing if possible -- Additional fee of $150.00 will be charged if seller will not attend due to the additional time involved.)

Yes

No

Is seller a legal resident of the state in which the property is located? *

(I.E. Is your primary residence located in the state where the property is located?)

Yes

No

For SC Property: Since the last property tax bill, has seller changed the property tax classification on this property from owner-occupied to non-owner occupied, or vice versa?

Yes

No

Are all people who originally purchased / acquired the property when seller acquired it still alive?

Alive

Deceased

For NC property: Spouses of owners must be alive and able to sign closing doccuments -- We are not married or our spouse(s) are alive and will sign.

Yes

No

Is seller a US citizen or legal resident? *

Yes

No

Is the property subject to Homeowner's Association (HOA) dues? *

Yes

No

If yes, HOA contact info: Name

First Name

Last Name

HOA contact info: Phone

(###)

###

####

First mortgage lender name

First Name

Last Name

First mortgage lender phone

(###)

###

####

Second mortgage lender name

First Name

Last Name

Second mortgage lender phone

(###)

###

####

Date

MM

DD

YYYY