Closing Questionnaire

Closing Questionnaire

Thank you for choosing Brown County Title Company!
Property Address*

Street Address

Street Address Line 2

CityState

Zip Code
Closing Date

MonthDayYear
Date
Hour MinutesAM/PM Option
Buyer(s) Attend Closing?

YesNo
Seller(s) Attend Closing?

YesNo
Am I Preparing the Deed?

YesNo
Earnest Money
Amount
Who is Holding the Earnest Money?

Listing AgentSelling AgentSettlement Agent/Title CompanyOther
Commission % based on Amount
Commission Split

Listing AgentSelling Agent
Buyer Information:

If Applicable
Name

First NameLast Name
Current Address

Street Address

CityState

Zip Code
Marital Status:

MarriedSingleOther
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
How do they want to take title?
Will this be their primary residence (homestead)?

YesNo
Seller Information:

If Applicable
Name

First NameLast Name
Current Address

Street Address

CityState

Zip Code
Marital Status:

MarriedSingleOther
If Married, Spouse's Name:

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
SSN/TIN
Primary Seller's SSN/TIN
SSN/TIN
Seller's Spouse SSN (if applicable)
Forwarding Address

Street Address

CityState

Zip Code
Seller's Loan Information for Payoff

If Applicable
Lender Name
Loan Number
Borrower's Authorization

Please attach signed borrower's authorization
Cancelof
Any additional information we may need for closing?
File Upload

Cancelof
Your Email Address
For confirmation that we received your submission
Should be Empty:

Closing Questionnaire

Buyer Information:

Seller Information:

Seller's Loan Information for Payoff