Submit Your Seller Information

In order for us to serve you better, please provide your contact information, etc. on the form below and submit to us.

Personal Information

Full Name *

Address Line 1 *

Address Line 2

City *

State *

Zip *

Phone *

Email *

Marital Status

Spouse's Name

Enter Spouse's name if not Co-Seller. Enter N/A if not applicable

Seller Holds Title As

Trust or Company Name, if applicable

Name of trustees or names of Officers & Title, if applicable

Co-Seller Information

Full Name

If individual Co-Seller enter name. If Trust, Corporation or LLC enter name of 2nd person who would be signing.

Address Co-Seller

Address Co-Seller Line 2

City Co-Seller

State Co-Seller *

Zip Code Co-Seller

Phone

Marital Status

Spouse's Name

Spouse's name if not seller 1. Enter N/A if not applicable.

Additional Sellers

Additional sellers and their information.

Lender Payoff Information

First Mortgage Lender

Loan Number (First Lender)

First Lender Phone

Second Mortgage Lender

Loan Number (Second Lender)

Second Lender Phone

Property Being Sold

Property Address (Line 1) *

Property Address (Line 2)

City *

State *

Zip *

County *

Acreage

Lot Number

Tax Parcel ID #

Tax Parcel ID #–2

Type of Property

Legal Description

Real Estate Agent or Broker (If Applicable)

Real Estate Broker

Real Estate Agent

Agent Phone

Agent Email

Agent Fax

Attorney (If Any)

Full Name

Phone

Fax

Notes or Special Instructions

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