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Order Title
Fill in the form below as accurately as possible. To expedite the process, you can also send any files you may have (purchase contract, escrow receipts, prior policies, etc) to the following email address:
britan@mytitleagent.com
Transaction Details
Purchase with Financing
Cash
Refinancing
For Sale By Owner?
No
Yes
Short Sale?
No
Yes
Tell Us Who You Are
First Name
Last Name
Email Address
Phone Number
Property Information
Sales price:
Closing Date
Month
January
February
March
April
May
June
July
August
September
October
November
December
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
2019
2020
2021
2022
2023
2024
2025
2026
Address:
City:
zip:
HOA (if any):
The Seller
Is the seller an individual or company?
Individual
Company
First Name:
Last Name:
First Name:
Last Name:
Marital Status:
Married
Single
Seller's loan with (if applicable) (BOA, Chase, Wells Fargo, etc):
Email:
Phone:
The Seller's Agent
First Name:
Last Name:
Phone Number:
Email Address:
Company:
Compensation Amount:
MLS / Broker Additional Compensation:
The Buyer
Is the buyer an individual or company?
Individual
Company
First Name:
Last Name:
First Name:
Last Name:
Marital Status:
Married
Single
Buyer's loan with (if applicable) (BOA, Chase, Wells Fargo, etc):
Email:
Phone:
The Buyer's Agent
First Name:
Last Name:
Phone Number:
Email:
Company:
Compensation Amount:
MLS / Broker Additional Compensation:
Other details
Escrow amount:
Escrow held by:
Other specific details (POA, requires Survey, mail-away closing, etc):
Send Order
