New Customer Registration Form

SELLER INFORMATION SHEET

Email: brionna@blakelawga.com or call 770.925.5049 with questions
IT IS IMPORTANT THAT ALL APPLICABLE INFORMATION BE FILLED IN COMPLETELY TO ENSURE A SMOOTH CLOSING.

PLEASE FEEL FREE TO CONTACT THIS OFFICE SHOULD YOU HAVE ANY QUESTIONS REGARDING THE ABOVE INFORMATION.
Full Name*

First NameMiddle NameLast NameSuffix
Seller #1 Social Security No:
If only providing the last 4 #'s for payoff purposes, the full will be required at closing.
Full Name*

First NameMiddle NameLast NameSuffix
Seller #2 Social Security No:
If only providing the last 4 #'s for payoff purposes, the full will be required at closing.
Full Name*

First NameMiddle NameLast NameSuffix
Seller #3 Social Security No:
If only providing the last 4 #'s for payoff purposes, the full will be required at closing.
Property Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Forwarding Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
E-mail
example@example.com
Phone Number*
E-mail
example@example.com
Phone Number*
E-mail
example@example.com
Is this property owned in name(s) other than that of the seller(s)

YesNo
If not, how is this property currently vested?

TrustCorporationLLCEstateOther
If you answered other above, please specify:
Name of Trust/Corporation/LLC/Estate/Other
Who are the Authorized Signor(s) and what is/are their title(s)?
Is this member attending closing?

YesNo
Please forward (as applicable) to brionna@blakelawga.com:

● LLC Corp Docs: Operating Agreement / Articles of Organization / Secretary of State Filing / Corporate
Resolution / Signing Authority
● Last Will and Testament (if existing) / Letters Testamentary / Letters of Administration / Death Certificate

● Full copy of the Trust (a Trust Affidavit is not sufficient)

● Proof of Marriage Certificate / Name Change Order / Divorce Decree
PLEASE ADVISE OF ANY SPECIAL CONDITIONS THAT WILL NEED TO BE ADDRESSED PRIOR TO CLOSING. FAILURE TO DISCLOSE CAN RESULT IN DELAYS IN CLOSING!
Is the property currently involved in:

BankruptcyForeclosureShortsaleForbearance
If yes, please provide details:
Has the seller(s) recently filed for or finalized a divorce:

YesNo
Are any individuals on title deceased?

YesNo
Has there been a change of name for any individual on title since the purchase of the property or in recent months:

YesNo
Did the Seller(s) purchase using, or have you at any time refinanced or modified your mortgages using any type of down payment assistance (For example: Georgia Dream, CHENOA, Invest Atlanta, Homestretch:

YesNo
If yes, please provide details:
Are there any outstanding loans/mortgages against the Property?

YesNo
Please include information on ALL loans that may still be open. This will include lines of credit that were paid off or have a zero balance.
Lender Name
Loan Account #
Email Address
Lender Phone #
Type of Loan:

1st Mortgage2nd Mortgage3rd MortgageHELOCUCCOther
Lender Name
Loan Account #
Email Address
Lender Phone #
Type of Loan:

1st Mortgage2nd Mortgage3rd MortgageHELOCUCCOther
Blake Law Group, LLC recommends strongly that all parties should plan to attend closing in person but we understand that some situations make it difficult to attend and we want to work with you to accommodate these situations to the best of our ability
Will one or more seller(s) be unable to attend closing?

No, I/We will come into the office to signYes, I/We would like to assign a power of attorney to sign on my behalf (Additional charges apply)Yes, I would like a mailaway closing (Additional charges apply)Yes, I would like to schedule an appointment for signing
Is there a Condo or Homeowners Association present for this property?

YesNo
If Yes, please complete the below:
Name of Association
Contact Email Address
Management Company
Contact Phone #
Website (if applicable)
Please forward a copy of your most recent HOA statement to: brionna@blakelawga.com
Is there an additional Master Condo or Homeowners Association present for this property

YesNo
If yes, please complete the below:
Name of Association
Contact Email Address
Management Company
Contact Phone #
Website (if applicable)
What is the property type:

Single Family ResidenceTownhomeCondoMobile HomeSubdivision LotVacant LandMultifamily ResidentialCommercial Property
How is the property occupied:

Seller OccupiedTenant OccupiedUnoccupied/Other
If the property is tenant occupied, please send a copy of the current lease to:

brionna@blakelawga.com
Has/have the Seller(s) filed for state taxes in the past 2 years with the State of Georgia?

YesNo
Is/are the Seller(s) resident(s) of the State of Georgia?

YesNo
Is/are the Seller(s) citizen(s) of the United States of America?

YesNo
If not, is/are the Seller(s) Permanent Resident Aliens?

YesNo
Please forward a copy of your government issued photo ID as well as your Resident Alien Greencard to:

brionna@blakelawga.com
Should be Empty:

SELLER INFORMATION SHEET