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REAL ESTATE INTAKE FORM
PROPERTY ADDRESS:
COUNTY PIN# - - - - Vol.
Sale Price $ (SFD / Multi-Unit /Condo/Twnhse/Commercial/ Other)
Client: Seller/Buyer: Marital Status:
Address: SSN: ___-__-____
Phones: (H) +1 ( ) and (Pg/Cell) +1 ( )
(W) +1 ( ) and (Fax) +1 ( )
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)
Finance Commitment Date: ( Days after contract signing)
Inspection Contingency Date: ( Days after contract signing)
Closing Date: Time:
Location:
Phone #: +1 ( ) Fax#: +1 ( ) Final Closing Figure $
Buyer/Seller:
Address:
Buyer/Seller Attorney: Contact Person:
Address:
Phone#:
Fax #:
E-Mail:
Realtors:
SELLER’S Agent: BUYER’S Agent:
Name: Name:
Company: Company:
Address: Address:
Phone #’s: + 1 ( ) Phone #’s: + 1 ( )
Fax #’s: +1 ( ) Fax #’s: +1 ( )
Pager #’s: + 1 ( ) Pager #’s: + 1 ( )
Cell/Other:+1 ( ) Cell/Other:+1 ( )
COMMISSION: ____________________________ COMMISSION: ____________________________
Mortgage Broker/Bank:
Name: Loan Amt: $ (FHA/VA/Conv)
Loan Officer: Processor:
Phone #: + 1 ( ) Fax #: +1 ( )
Title Company:
Name: Commitment #:
Phone #:+ 1 ( ) Fax #: + 1 ( )
REFERRED BY:
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