Form for Buyer's Information - EquiTrust Title Company

BUYER'S INFORMATION SHEET

Name of Buyer(s)

First Name Last Name

Phone Country Code Area Code Phone First 3 Phone Last 4

Fax Area Code Phone First 3 Phone Last 4

Address of Buyer(s) AFTER CLOSING

Address1

Address 2

City

State

Zip

Marital Status(Please select appropriate box)

If an Entity

Partnership

TRANSACTION INFORMATION

MAIL AWAY CLOSING?

(please select appropriate box) *Require signed closing documents minimum of 5 business days prior to closing date.

Package Mailing Address

Phone Number(if different from above) Area Code Phone First 3 Phone Last 4

Email (if different from above)

BUYER AGENT INFORMATION

Agent Name

First Name Last Name

Company Name

Company Address

Address1

Address 2

City

State

Zip

Area Code Phone First 3 Phone Last 4

Email Address

Commission %

Processing Fee

Other

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Corporation

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Buyer's Information Form