Offer Request
Agent Email Address
Agent Name and Phone #
Date Offer Request Needed
*
-
Month
-
Day
Year
Date
Do you already have Buyer Agency?
*
Yes
No
If you do not have Buyer Agency, how long is the term? Or is it property specific?
Buyer #1 Full Legal Name
*
Buyer #1 Email Address
*
Buyer 1 Full Legal Name
*
First Name
Last Name
Buyer 1 Email
*
example@example.com
Buyer 1 Phone Number
-
Area Code
Phone Number
Buyer 2 Full Legal Name
First Name
Last Name
Buyer #2 Full Legal Name
Buyer #2 Email
example@example.com
Buyer 2 Phone Number
-
Area Code
Phone Number
Property Address or MLS #
*
Property Address or MLS #
*
The property will or will not include a manufactured home....
*
Will include
Will not include
The Property will or will not include an off-site and/or separate septic lot, boat slip, garage, parking space, or storage unit.
*
Will include
Will not include
Purchase Price
*
Due Diligence Amount
*
Due Diligence Date
*
Or days after ratified contract
Are you doing EM or AEM
*
EM
AEM
Neither
EM or AEM Amount
EM Delivered by:
Effective Date
Within 5 days of Effective Date
Date of AEM (if applicable)
-
Month
-
Day
Year
Date
How will funds be delivered?
*
Cash
Personal Check
Official Bank Check
Wire Transfer
Electric Transfer
Settlement Date
*
Or days after ratified contract
Escrow Agent
*
Personal Property to convey (blank = none)
*
Do you have a Prequal Letter or Proof of Funds? If yes, please email to KellyC@homecontractsconcierge.com
Yes
No
Loan Type
*
Cash
Conventional
V/A
FHA
USDA
Other
Down Payment or Principle Amount of Loan
Additional Loan Information
Does the buyer(s) have to sell a property to buy?
*
Yes
No
If yes, what is the property address?
Is the property currently under contract?
Yes
No
If no,
is listed with and actively marketed by a licensed real estate broker.
will be listed with and actively marketed by a licensed real estate broker.
Buyer is attempting to sell/lease the Buyer's Property without the assistance of a licensed real estate broker.
Is there a fuel tank located on the property?
*
Yes
No
If yes, is it currently in use?
Yes
No
If yes, is it owned or leased?
Owned
Leased
If leased, what is the name of the company it is leased from?
Is it above ground or below ground?
Above ground
Below ground
Type of fuel?
Oil
Propane
Gasoline and/or diesel
Other
Is this property leased?
*
Yes
No
How will name(s) appear on the Deed?
*
Closing Costs (blank = none)
Home Warranty?
*
Yes
No
If yes, who pays and in what amount?
Do you put your buyer's email on the contract?
Yes
No
Is this a referral?
*
Yes
No
Any other addenda to be included? (Appraisal Addendum, Additional Provisions, etc.)
Any additional Information
When offer has been signed, would you like us to send it to the Listing Agent or do you want to send it yourself?
*
Please send on my behalf
I will send
Undecided
Submit
Should be Empty: