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Real Estate Intake Form
GENERAL INFORMATION
Property Address:
County:
PIN#:
Vol.:
Sale Price:
Client Name:
Client:
Seller
Buyer
Marital Status:
Single
Married
Divorced
Address:
SSN:
Phone (H):
Phone (W):
Phone (Cell/Pagerl):
Fax:
E-mail:
Contract Acceptance Date:
Costs Paid by Seller:
Purchase Price:
Costs Paid by Buyer:
Earnest Money:
Held By:
K Finance Contingency Date:
Days after contract signing (K finance contingency date):
Finance Commitment Date:
Days after signing (finance commitment date):
Inspection Contingency Date:
Days after signing (inspection contingency date):
Closing Date:
Time of Closing:
Location:
Phone:
Fax:
Final Closing Figure:
Name of Buyer/Seller:
Forenamed party was:
Buyer
Seller
Address:
Name of Buyer/Seller's Attorney:
Contact Person:
Address:
Phone:
Fax:
E-mail:
REALTORS
SELLER'S Agent
Name:
Company:
Address:
Phone:
Mobile/Pager:
Fax:
COMMISSION:
BUYER'S Agent
Name:
Company:
Address:
Phone:
Mobile/Pager:
Fax:
COMMISSION:
MORTGAGE BROKER/BANK
Name of Bank:
Loan Officer:
Phone Number:
Loan Amount:
Loan Type (Please Select):
FHA
VA
Conv
Processor:
Fax:
TITLE COMPANY
Name:
Commitment Number:
Phone:
Fax:
REFERENCE
Referred By: