Buyer Questionnaire 

* Required Field

Buyer 1 Name:  
Social Security Number:  
Marital Status:  
Phone #:   
Home:  
Work:  
Cell:  
Fax:  
* Email:  

Buyer 2 Name:  
Social Security Number:  
Marital Status:  
Phone #:  
Home:  
Work:
Cell:  
Fax:  
Email Adress:  

Relationship of Buyers to each other:
Husband & Wife Single Not Related Married to Other Other:

Realtor Information
Realtor's Name:  
Phone:  

Homeowner's Insurance Info
(Not applicable if purchasing a condominium or for a cash transaction):
Agent:  
Phone:  
Annual Premium:  
Renewal Date:  
(The amount of insurance must be at least the mortgage amount or provide guaranteed replacement)

Address of the property you are buying:

Address:  
City:  
State:  
ZIP:  

If this property is a condominium
(Only applicable if purchasing a condominium):
Association Name:
Phone:  
Management Company:  
Phone:  

Will any Buyer be using a power of attorney?
Yes     No

Will this property serve as your primary residence?
Yes     No

Will this property serve as primary residence for Buyer #2?
Yes     No

Required at closing:

• All Buyers must attend the closing even if not listed as a co-borrower.
• Picture identification will be required from all parties at closing.
• Any funds due must be in the form of a Cashier's or Certified check made payable to Accurate Title.

Authorize
Do Not Authorize