Form of Realtor Information - EquiTrust Title Company

REALTOR INFORMATION SHEET

Transaction Property Address

Is this a Short Sale?

To ensure a timely closing, we need to request certain reports and examinations immediately. According to your real estate contract, you are responsible for certain expenses such as title search and abstract, lien and open permit reports, and miscell

Agent Name First Name Last Name

Company Name

Address1

Address 2

City

State

Zip

Phone Number Country Code Area Code Phone First 3 Phone Last 4

Commision %

Processing Fee

Other

ASSOCIATION INFORMATION

1 st Association Name

Contact Name

Phone Number Country Code Area Code Phone First 3 Phone Last 4

Other Information

2nd Association Name

Contact Name

Phone Number Country Code Area Code Phone First 3 Phone Last 4

Other Information

TRANSACTION INFORMATION

MAIL AWAY CLOSING? * (Please Check 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)

MORTGAGE(S) TO BE PAID OFF AT CLOSING

The Seller(s) will need to sign an Authorization To Release Information must be presented to obtain a payoff.

1 st Mortgage Bank Name

Loan Number

Phone Number Country Code Area Code Phone First 3 Phone Last 4

2 nd Mortgage Bank Name

Loan Number

Phone Number Country Code Area Code Phone First 3 Phone Last 4

Select States

Please provide a copy of the OWNER'S TITLE INSURANCE POLICY AND SURVEY.

Provide Seller's prior owner title policy

Drag files here or choose files

Upload File

Provide seller's survey

Drag files here or choose files

By completing and submitting this form, you agree to the terms set forth above.

Submit

Realtor Information Form