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

Address of the property you are selling:

Address:  
City:  
State:  
ZIP:  

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

Realtor Information
Realtor's Name:  
Phone:  

Please list all current Mortgages pertinent to this property including loans with a zero dollar balance:
1). Bank/Mortgage Co.:  
Telephone no.:  
Acct.#:  
Is this an FHA Mortgage? Yes  No
Is there a Pre-Payment Penalty?Yes  No

2). Bank/Mortgage Co.:  
Telephone no.:  
Acct.#:  
Is this an FHA Mortgage?  Yes  No
Is there a Pre-Payment Penalty?Yes  No

3). Bank/Mortgage Co.:  
Telephone no.:  
Acct.#:  
Is this an FHA Mortgage?  Yes  No
Is there a Pre-Payment Penalty?Yes  No

4). Bank/Mortgage Co.:  
Telephone no.:  
Acct.#:  
Is this an FHA Mortgage?  Yes No
Is there a Pre-Payment Penalty?Yes  No

** It is your responsibility to cancel any automatic withdrawals if applicable**

Should Accurate Title prepare the deed on the Seller's behalf?  Yes  No
If no, please provide name and phone number of the preparer:  

Will any of the Sellers be using a power of attorney? Yes  No
Is this property your primary residence? Yes  No
Is this property the primary residence for Seller #2?   Yes  No

This section is applicable to condominium sellers only:
Association Name:  
Management Company:  
Phone:  

Tax Information:
Please provide a paid receipt for all tax bills pertaining to this property
Does this property have:   Multiple Lots?   Yes  No
Multiple Tax Bills?   Yes  No

If Seller is a Corporation, LLC, Partnership, etc.,
NAME & TITLE of individual signing at closing:  

By clicking the check box below, you authorize ACCURATE TITLE to receive any and all information with regard to my/our loans.

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