Quote Request Form - Simultaneous Closing

Property Seller Information   

Your Name :      

Address :          

City :                                 State/Prov :                   

Country :                                   Zip/Post. code  :        

Phone no:                                    Email :                       

Property Information   

Prop. Type:        Single Family Residence Duplex / Fourplex Condo / Townhome Commercial Land only Land with improvements (utilities) Other (Please explain in comments)

Address :          

City :                                     State/Prov :              

Country :                                  Zip/Post. code  :        

Appraised Val :                       Appraisal date   :        

Appraised Val. based on:      Please select Full Appraisal Market Analysis B.P.O. (Broker Price Opinion) Real Estate Assessment Comparables Other (Please explain in comments)

Owner Occupied: Yes No    Title Policy : Yes No   

Current liens on the property :

1st Mortgage:                              2nd Mortgage :   

 Other liens   :    

If seller has owned property for less than 24 months :

Purchase  date:                               Purchase price: 

$ Improvmnts :                   

Comments  :                             Reasons for selling :

 Payor Information  

Payor name :                 Address : 

Credit Score :     Please select 700 or more 651-699 600-650 551-559 550 or less Unknown     Actual       Estimate

Proposed Terms        ( If unsure, leave blank)

Sales Price:                               Down Payment :   

                  Proposed 1st Mortgage                                                        Proposed  2nd Mortgage

Mortgage Amt:                         Mortgage Amt :   

Interest Rate:                             Interest Rate    :   

Mnthly Pymt:                            Mnthly Pymt :      

Amtzn. Period:                          Amtzn. Period:      

Balloon Pymt:                            Balloon Pymt:       

Balloon Date:                             Balloon Date:       

Documents Available 

Could you provide copies of the following documents upon request ?

   Title Insurance : No Yes     Current Hazard Insurance :   No Yes         Current pictures/appraisal : No Yes

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