Realtor Purchase Order Form

WANT EASIER FORMS? SELECT THE LINK TO THE LEFT "REQUEST USERNAME/PASSWORD" TO REGISTER FOR PAPERLESS CLOSER AND GET ACCESS TO DIFFERENT FORMS, AND ALSO BE ABLE TO TRACK PROGRESS ON YOUR ORDER FROM START THROUGH CLOSING.

OR YOU CAN COMPLETE AND SUBMIT THE FORM BELOW TO PLACE YOUR ORDER.

Person Placing Order

Full Name *

Company *

Listing Or Sellling Agent *

Please confirm if you are the listing agent or selling agent. If you are both listing and selling agent, please select both by holding down the control key and clicking each one.

Phone *

Email *

Fax

Purchase Price * $

Anticipated Closing Date

Month

Day

Year

Type of Loan

Preliminary HUD

Short Sale

Short Sale?

Short Sale Contact Person

Short Sale Lender Name

Name of Short Sale Lender

Short Sale Lender Email

Short Sale Lender's Phone

Name of Short Sale Lender

Special Instructions

Additional Realtor

Additional Agent *

Additional agent

Broker Company *

Additional Agent

Phone

Additional Agent

Fax

Additional Agent

Commission 2 * %

Enter percent of commission, for additional agent, if not known enter unknown

Property Information

Address *

City *

State *

Zip *

County *

Acreage

Lot Number

Tax Parcel ID

Second Tax Parcel ID

Type of Property

Legal Description

Buyer Information

Buyer will receive title as

Trust or Company Name, if applicable

Insert Legal name of Trust or Corporation or LLC here.

Name of trustees or names of officers and title, if applicable

Enter names of Trustees. If Corporation or LLC enter the names and title of the persons signing.

Buyer 1 Full Name *

If individual buyer enter name here. If Corp, or LLC or Trust enter name of first person signing.

Marital Status *

Marital Status of Buyer 1

Spouse's Name *

If not applicable, enter N/A

Address *

Buyer

City *

State *

Zip Code *

Phone *

Buyer

Fax

Buyer

Co-Buyer Information

Co-Buyer Full Name

If there is no Co-Buyer, enter N/A. If additional person signing for Corp, or LLC or Trust enter here.

Marital Status Buyer 2

Spouse's Name

Name of buyer 2 spouse. Enter N/A if not applicable.

Address

Co-Buyer

City

Co-Buyer

State

Zip Code

Co-Buyer

Phone

Co-Buyer

Fax

Co-Buyer

Additional Buyers

Buyers Lender

Lender

Loan Officer

Phone

fax

Seller Information

Title Held As

Trust or Company Name, if applicable

Enter Legal name of Trust, Corporation or LLC here.

Name of trustees or names of officers and title, if applicable

Enter names of Trustees here. If Corporation or LLC enter names and title of persons signing.

Seller Full Name *

If individual enter seller name. If title held in Trust, Corporation, or LLC enter first person signing.

Marital Status *

Seller marital status

Spouse *

Enter spouses name. If not applicable enter N/A. If Trust, Corporation or LLC enter N/A

Address *

Seller

City *

State *

Zip *

Phone

Seller

Fax

Seller

Co-Seller Information

Co Seller Full Name

If individual enter name, if no Co-seller, enter N/A. If title held in Corp, LLC or Trust enter 2nd person signing

Marital Status

Co-Seller marital status

Spouse Seller 2

Enter Seller 2 spouses name. If not applicable enter N/A. If a Trust, Corporation or LLC enter N/A

Address

Co-Seller: Street, City, State, Zip

City

Co-Seller

State

Zip Code

Co-Seller

Phone

Co-Seller

Fax

Co-Seller

Additional Sellers

Additional sellers and their information

Seller Payoff Information

Seller's Payoff Lender 1

Enter name of Seller's first morgage Payoff Lender here.

Loan Number

Lender 1

Loan Balance

Lender 1

Address

Lender 1: Street, City, State, Zip

Phone

Lender 1

Fax

Lender 1

Seller's Payoff Lender 2

Enter name of seller's 2nd Payoff Lender here. If there is not a second payoff, enter N/A

Loan Number

Lender 2

Loan Balance

Lender 2

Address

Lender 2: Street, City, State, Zip

Phone

Lender 2

Fax

Lender 2

Homeowners Association Contact

Association Contact Person's Name and Title

Enter association contact persons name and title here.

Monthly Dues Amount $

Phone

Current Month Paid

Yes

Notes

CAPTCHA

This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.