Buyer Intake Form

BUYER INTAKE
Name of Your Agent and Real Estate Company*
If not represented, insert "Buyer"
Address of property being purchased*
Street Number and Street Name
Buyer-1 : Full Legal Name (if Company include where incorporated) *
Buyer-1 : Status*

MarriedSingleSeparatedDivorcedCompanyOther
If more than one Buyer, how will the property be owned?*

Tenancy by Entirety with right of survivorshipJoint Tenants with right of survivorshipTenants in CommonQuit Claim, non-warrantyN/A
Buyer-2 : Full Legal Name (if Company include where incorporated) *
Type "n/a" if not applicable
Buyer-2 : Status*

MarriedSingleSeparatedDivorcedCorporationN/A
Buyer-1 Email*
example@example.com
Buyer-1 Phone Number*
Please enter a valid phone number.
Buyer-1 CURRENT Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Will the purchase be by Loan?*

YesNo (cash only)
Lender Name *
Type "n/a" if not applicable
Loan Officer Name *
Type "n/a" if not applicable
Loan Officer Email*
Type "n/a" if not applicable
Loan Officer Phone*
Type "n/a" if not applicable
Buyers are recommended to obtain a survey prior to closing and provide to title insurer before it issues a title policy. This will help to ensure there are no exceptions referencing issues that could have been found and/or resolved if a survey was performed.
Do you want us to order a survey of the property?*

Yes (bill me at closing)No (I will order my own and provide copy)No. I understand the risks and benefits and accept same
List invoices to be paid at closing (Inspection, etc)*
Type "n/a" if not applicable
Homeowners Insurance Company*
Type "n/a" if not applicable
Agent Name*
Type "n/a" if not applicable
Agent Email*
Type "n/a" if not applicable
Other instructions*
Type "n/a" if not applicable
You agree to retrieve, review, and understand all homeowners and associations and/or and related ownership documents, restrictions, easements, affects and requirements thereof that concern or relate to the property prior to closing*

Yes
Should be Empty:

BUYER INTAKE