Title and Closing Order Form

Title and Closing Order Form

Please complete the entire form below to apply.

Contact Information
Your Name:
 Phone:
 Fax:
 E-Mail:
Street Address:
 City:
 State:
 Zip:
Seller Information
Seller Name:
 Marital Status:
 Social Security Number:
  
Street Address:
 City:
 State:
 Zip:
Name:
 Marital Status:
 Social Security Number:
  
Street Address:
 City:
 State:
 Zip:
Mail away to seller(s)?
Yes  No 		Is this a foreign seller:
Yes  No 		Phone:
 Fax:
Buyer Information
Name:
 Marital Status:
 Social Security Number:
  
Street Address:
 City:
 State:
 Zip:
Name:
 Marital Status:
 Social Security Number:
  
Street Address:
 City:
 State:
 Zip:
Mail away to buyer(s)?
Yes  No 		Is this a foreign buyer:
Yes  No 		Phone:
 Fax:
Property Information
Property Address:
Legal Description:
Closing Date:
 Contract Effective Date:
 Purchase Price:
 Property Is:
Residential Commercial
Current Mortgage Lender:
 Loan Number:
New Mortgage Lender:
 Loan Amount:
Mortgage Contact Name:
 Phone:
 Fax:
Homeowners' Insurance Agent:
 Phone:
 Fax:
Flood Insurance Agent:
 Phone:
 Fax:
Survey Ordered From:
 By:
 Amount:
Well/Septic Inspection Ordered From:
 By:
 Amount:
Termite Inspection Ordered From:
 By:
 Amount:
Home Inspection Ordered From:
 By:
 Amount:
Home Protection Plan charged to:
 Amount:
 Payable To:
Is there a mandatory Homeowners/Condominium Association and if so please provide contact information.
Name:
 Phone:
 Fax:
Street Address:
 City:
 State:
 Zip:
Amount:
 Paid Through:
 Payable:
Monthly Quarterly Yearly Other
Deposit Received:
 Date:
 Held By:
Realtor Information
Commission:
 Split:
  
Listing Associate:
 Listing Office:
  
Office Phone:
 Cell:
 Fax:
Selling Associate:
 Selling Office:
  
Office Phone:
 Cell:
 Fax:
Additional Comments:

Please enter the validation words below.

Copyright ©2009 Blucher Law Group, LLC. All Rights Reserved. | Site by Creative Aesthetics - Sarasota Web Design