Buyer - TerraTitle LLC

Buyer

Listing Realtor Information Form

Step 1 of 7

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Basic Information
01/22/2021
Address:
Our File Number

Listing Information
Listing Agent Company:
Realtor Name:
First Last
Phone:
Fax:
Cell Number:
Email:

Commission:
Listing:
Selling - Total Commission
Additional Commission/Administration Fee:

Seller Information
Seller:
First Last
SSN:
Marital Status:
Name of Spouse:
First Last
SSN:
Mailling Address:
Street Address Address Line 2 City State ZIP Code
Phone

Lender's Information
Payoff Lender:
Account Number:
Phone:
Payoff Lender:
Account Number:
Phone:

HOA/Condo Information
HOA/Condo Association:
Contact Name:
First Last
Phone
Earnest Money:
Type:
Seller Paid Closing Cost:
Property Tax Proration

Warranty & Repairs Information
Home Warranty:
$
Type:
Home Inspection:
$
Type:
Termite Inspection:
$
Type:
Termite Treatment:
$
Type:
Additonal Repairs:
$
Additional Information:

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