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   Online Settlement Form
Email Settlement Form

Please complete the following form. When finished, click on the "Send" button. A link to the completed form will be sent to you and your client.

General Information
Your Email Address:
 Your Client's email address:
Date:
 		Closing Office:
Closing for:
 Buyer: Seller: 		Office Phone:
Settlement Date:
 Office Fax:
Property Address:
Listing Office:
 Listing Office Phone:
Listing Agent:
 Listing Office Fax:
  Listing Agent Cell/VM:
Selling Office:
 Selling Office Phone:
Selling Agent:
 Selling Office Fax:
  Selling Agent Cell/VM:

Seller Information
Sellers(s):
Address:
(if different from property address)

Contact #'s
Home #:
 		Work #:
Cell Phone:
 		Email:
Sellers Attorney:
 Phone #:
  Fax #:

Payoff Information
Company:
Loan #:
 		Phone #:
SSN:
Payoff Information: (2nd if applicable)
Company:
Loan #:
 		Phone #:
Homeowner's Association:
 		Phone #:
Termite Company:
 Phone #:
Home Warranty:
 Cost:
 Paid By:
Buyer Seller

Buyer Information
Buyer(s):
(the way that the names are to appear on title)
Current Address:
Contact#'s
Home #:
 		Work #:
Cell Phone:
 		Email:
Order Survey
 Yes No
Mortgage Company:
 Phone #:
Loan Officer:
 		Fax #:
  Email:
New Insurance Company:
 Phone#:
Earnest Money Deposit:
 Held by:
Commission Breakdown: % to Listing Office:
 		% to Selling Office:
 		Total % Commission:

   

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