Buyer Questionnaire

Buyer 1 Information

Buyer 1 Name *

Social Security # *

Marital Status *

Email *

Cell Phone *

Home Phone

Work Phone

Fax

How do you wish to take title to the property? *

Is there a 2nd Buyer?

Yes

No

Buyer 2 Name *

Buyer 2 Email

Buyer 2 Marital Status

Buyer 2 Social Security #

Buyer 2 Cell Phone

Buyer 2 Home Phone

Buyer 2 Work Phone

Buyer 2 Fax

Trust Information

Name of Trust

Trustees

Trust Tax ID or Social Security #

Date of Trust

Grantor of Trust

Entity Information

Name of Corporation or LLC

Authorized Signer and Title

Tax ID#

Shareholders, Members or Partners (Must List ALL)

Acknowledgement

I understand that you require a resolution or corporate vote to confirm authorization to sell property, confirm who is signing and in what capacity on behalf of the corporation, company or partnership.

Relationship & Ownership
(Please fill out this field if there is more than one borrower...)

Relationship of Buyers to Each Other

How would you like your name to appear on the Deed?

Insurance Information

Agency

Contact Person

Contact Phone #

Policy # (if available)

General Information

Will this be the primary residence for Buyer #1? *

Current Address Buyer #1

Will this be the primary residence for Buyer #2?

Current Address Buyer #2

Will any of the Buyers be using a power of attorney? *

Please note, there is a $200 closing accommodation fee for parties who are not attending closing.

Condominium, Homeowners Association, Mobile Home or Co-op
(If Applicable)

Association Name

Association Phone

Management Company

Management Phone

Contact Email

Amount of Dues

Realtor Information

Do you have a Realtor?

Yes

No

Realtor Name

Realtor Phone

Acknowledgements

Funds *

I understand that any funds due must be wired or be in the form of a Cashier’s or Certified check made payable to Accurate Title. I understand that prior to utilizing any wiring instructions we must have verbal confirmation with Accurate Title.

ID *

I understand that current government issued photo identification will be required from all parties at closing.

Signature

Clear

By signing above, I hereby authorize Accurate Title to release completed copies of the Settlement Statement to realtors or attorneys representing parties to this transaction.

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