Seller Information Request

Thank you for allowing us to be your closing agent.

Our team prides itself on being consistent, patient and professional, giving each new closing the attention it deserves. We want you to feel comfortable and informed throughout the closing process. If you have any questions or concerns please feel free to contact us anytime. To continue processing your file, we will need you to fill out the following form entirely. Please remember that not completing this form may delay closing.

Email address*
Address of Sale Property*
Street Address Address Line 2 City State ZIP Code
Seller Name*
Seller's Social Security Number*
Seller Phone Number*
Martial Status*
- Single
- Married
Was the above your primary residence or investment property?*
- Primary residence
- Investment property
Are there any tenant(s) currently occupying the property?*
- Yes
- No
If this is your primary residence AND you're married, please list the name of your spouse
Co Seller Name
Co Seller Social Security Number
Co Seller Marital Status
- Single
- Married
Forwarding Address: (where you will live after sale)*
Street Address Address Line 2 City State ZIP Code
Do you have an existing mortgage?*
- Yes
- No
If so, what is your lenders name and phone number?
Mortgage Loan Number (for payoff purposes)*
2nd Mortgage / HELOC lenders name and phone number (if any)
2nd Mortgage / HELOC Loan Number (if any)
Does your home have a Homeowners or Condo Association?*
- Yes
- No
If so, Please provide Association contact information below:
As part of our duty to you as your closing agent, we contact and coordinate the sale with your Homeowners Association. Part of issuing free and clear title at closing requires that we order a statement, called an Estoppel, from the Homeowners association as to the status of your account with them. We will use this statement to ensure that all dues are paid up to date, that there are no code violations with the association, and what the dues are so that we may properly credit each party at closing. The homeowners associations typically charge a fee for these statements. Please check below that you acknowledge to reimburse any funds paid in advance in regards to the estoppel. **
- I acknowledge the above statement.
Is there a mobile or manufactured home on the property?*
Are all of the Sellers U.S. citizens?*
- Yes
- No
If not a U.S. citizen, are such Seller(s) U.S. residents that have been issued a Green Card?
- Yes
- No
Will you be present at closing or will this be a mail away?*
- Present at closing
- Mail Away
Will you be using a Power of Attorney for closing?*
- Present at closing
- Mail Away
Wire Fraud Alert: If you receive an email from J. Riley Williams, PLC or any other office or person requesting you wire or transfer funds to our office, you must confirm by telephone conversation with us before doing so. Failure to do so can result in lost funds. Criminals are targeting the real estate and legal counsel professions. WE DO NOT USE AN INTERMEDIARY BANK OR ANY BANK OTHER THAN AMERIS BANK. Please proceed with caution. **
- I acknowledge the above statement.
Any Other Information we will need? Any Questions?
- Send me a copy of my responses.

12058 San Jose Boulevard Suite 204

Phone: (904) 230-1063

9 A.M. to 5 P.M.

Seller Information Request

Seller Information Request

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