Seller Information Form

Seller Information:

Team*

First Name*

Last Name*

Phone*

Email*

Address of property to be sold*

Marital Status*
MarriedSingleDivorcedWidow(er)

Will this closing being performed as a mailout*
YesNo

If yes, please provide email address/ mailing address to send closing docs:

Loan Payoff Information: (if applicable)

Loan Company Name*

Loan Number*

Phone*

Last 6 digits of SSN*

Are there any payoffs that you are aware of that are needed on the property?*
YesNo

If so, please explain*

Survey Information

Is there an existing survey of the property*
YesNo

If yes, have any structural changes been made to the exterior of the property since the
survey was done?
YesNo

If yes, please explain the changes*

*Please provide a copy of the survey to us as soon as possible.

If you are the real-estate agent for this transaction, please complete the following question.

Commission:

Split

Transaction fee (if applicable)

I authorize Service Title Company to obtain payoff information from my lender.

Signature*

Date*