Title Consultants, Inc. - Closing Statement Order Form

Closing Statement and Deed & Transfer order form

Date:
Date of Closing:
Ordered By:
Seller Names:
Buyer Names:
Property Address:
Is Title Consultants doing the Closing Statement? Yes No (if yes please complete page the rest of this page)
Is Title Consultants ordering the Deed & Transfer? Yes No (if yes go to page two)
Special Instructions:
Closing Statement Information
Closing Date and Time:
Closing Location:
Sales Price:
Earnest Money Recieved:
Commission Split:
Is it rental property? Yes No
Tax Proration before the Lottery Credit? Yes No
Seller's Current Mortgage information for payoff:
Lender:	Account Number:
Lender:	Account Number:
Lender:	Account Number:
Deed & Transfer Information
Seller Names:
Seller Security Number:
Seller Security Number:
Seller New Address:
Was this homestead property for the seller? Yes No
Buyer Names:
Buyer Social Security Number:
Buyer Social Security Number:
Will tax bill be mailed to property address? Yes No
If no, where should the tax bill be sent?
Lot Size:
Acres:
Has this been the principal residence for the seller during two of the last five years? Yes No
Will seller have gain in amount of $250,000.00 or $500,00.00 on this transaction? Yes No
Is the buyer going to live in this property? Yes No
If no, please provide home address:
Are Seller & Buyer Related? Yes No
How is buyer taking title? Survivorship Marital Property Single Person Joint Tenants Tenants in Common Individual
What kind of property is this? Land Land and buildings Other
If Other, explain:
Whas is buyer's intended use? Single Family/Condo Time Share Multi Family Commercial-Business Agricultural Miscellaneous
If Multi Family, number of units:
If Commercial-Business Use:
If Miscellaneous Use: