Home
About
Documents
Information Authorization Disclosure
REQUEST FOR TITLE SERVICES
Title Order Form
Seller Info Sheet
Buyer Info Sheet
Dual Agent & Seller and Buyer Information Form
Listing Agent Questionnaire
Contact
✕
Dual Agent & Seller and Buyer Information Form
Home
Dual Agent & Seller and Buyer Information Form
Dual Agent & Seller and Buyer Information Form
File Number
AGENT INFORMATION
Dual Agent Name
Dual Agent Phone Number
Dual Agent Firm
Dual Agent Email Address
SUBJECT PROPERTY ADDRESS
Street Address
City
Street Address Line 2
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
PROPERTY INFORMATION
Is property subject to HOA dues?
Yes
No
Is there a manufactured home included with the property?
Yes
No
SELLER INFORMATION
Seller Name(s)
Seller Email Address
Marital Status/Entity Type
Single
Married
Divorced
Widowed
Company
Estate
Trust
Seller Phone Number
Company/Estate Representative Name
Will seller be attending closing?
No
Yes
Seller SSN
Will seller be using a POA at closing?
No
Yes
Seller Spouse SSN
SELLER PAYOFF INFORMATION
1st Mortgage Payoff Lender Name
2st Mortgage Payoff Lender Name
1st Mortgage Payoff Loan Number
2nd Mortgage Payoff Loan Number
BUYER INFORMATION
Buyer Name(s)
Company/Estate Representative Name
Buyer SSN
Buyer Email Address
Buyer Spouse SSN
Buyer Phone Number
Marital Status/Entity Type
Single
Married
Divorced
Widowed
Company
Estate
Trust
Will buyer be attending closing?
No
Yes
Will buyer be using a POA at closing?
No
Yes
HUD-1 INFORMATION
Final Contract Sales Price
Seller Paid Closing Costs
Earnest Money Deposit Amount
Dual Agent Commission Amount
Earnest Money Deposit Held by
Dual Agent
Builder
FWLT
Dual Agent Admin Fee
INVOICES TO BE PAID AT CLOSING
Invoice Type
No Invoices to be Collected on HUD-1
Termite Inspection/Treatment
Home Warranty
Repairs
Other
Invoice Amount
Paid By
Buyer
Seller
Dual Agent
Other
Invoice Paid To
Invoice Type
No Invoices to be Collected on HUD-1
Termite Inspection/Treatment
Home Warranty
Repairs
Other
Invoice Amount
Paid By
Buyer
Seller
Dual Agent
Other
Invoice Paid To
Invoice Type
No Invoices to be Collected on HUD-1
Termite Inspection/Treatment
Home Warranty
Repairs
Other
Invoice Amount
Paid By
Buyer
Seller
Dual Agent
Other
Invoice Paid To
DOCUMENTS NEEDED FOR CLOSING
Upload Documents
Drop files here or
Select files
Max. file size: 2 MB.
Additional Notes
Δ
