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selling agent form

Agent Name
Agent Phone Fax
E-mail Address

Buyer(s) Name
Property Address
Estimated Closing Date (mm/dd/yyyy) Time

Buyer(s) Email if none then fax #
Commission % Listing Agent % Selling Agent %

Borrower's Lender
Contact Person Telephone #
Homeowner's Insurance Co.
Agent Telephone #
Marital status of Buyer SingleMarriedDivorcedWidow/er
Is this a Primary Residence? If not please provide mailing address after closing
Address

City / State / Zip	/ /

Will all parties be attending closing Yes No
DOES THE BUYER WANT A SURVEY? Yes No
We recommend a survey on all purchase closings.
Inspections to be shown on Settlement Statement:
To Fee
To Fee
To Fee
Homebuyer's Warranty Fee
Termite Inspection Fee

Please note: If past or present termite infestation exists, please advise our office or the lender as soon as possible so that we may ascertain whether the lender will require a structural report.
PLEASE REMIND your client we will need a driver's license or other government-issued photo ID when documents are signed.

phone: 910.256.8252
fax: 910.256.9788

1904 eastwood rd. ste. 214
wilmington, nc 28403