Authorization to Release Payoff Information

Seller Information Sheet

All information is sent secured and encrypted
We appreciate your cooperation and look forward to working with you. If you have any questions or concerns, please email us at info@closing.legal or call us at 678-999-4252.
Seller #1*

First NameLast Name
Email*
example@example.com
Phone Number*

Area CodePhone Number
Social Security Number/Tax ID Number:
all information is sent encrypted
*If the Seller does not have a Social Security Number or Tax Identification Number that was assigned by the U.S. Internal Revenue Service, please inform our office immediately.
Seller #2

First NameLast Name
Email
example@example.com
Social Security Number/Tax ID Number:
Phone Number

Area CodePhone Number
Property Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Is the Seller a Georgia Resident?*
Is the Seller a United States Citizen?*
Please note for non-Georgia residents regarding 3% withholding requirements:

https://dor.georgia.gov/documents/information-georgias-withholding-requirements-sales-or-transfers-real-property

Please note for Foreign Person - FIRPTA Withholdings https://www.irs.gov/individuals/international-taxpayers/firpta-withholding
Is the Seller a Resident Alien?
If Multiple Sellers, are the Sellers married?
Seller Forwarding Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Complete the following section only if the seller is NOT an individual
Is the Seller (or the Title to the Property in the Name of) a Trust? (if yes, please provide below information along with a full copy of the Trust Agreement)

YesNo
Name of Trust:
Tax ID No:
Name of Trustee(s):
Is Seller a Corporation/LLC/Partnership or other entity? (if yes, please provide a copy of the Corporate Documents, to include Operating Agreement/Signing Authority)

YesNo
Name of Entity:
Name of Authorized Signor(s) and Title:
example: Member, President
Tax ID No.:
Property Information:
Is there a Mandatory Homeowners or Condominium Association?
Association Name:
Association Contact Person:
Name
Association Email
example@example.com
Is there a mobile home being sold with this property?
Please list all Tax Parcel ID for this property:
Is there a current Tax Appeal pending on this property?
If Yes, please list the tax years under Appeal:
Are there any other liens on the property?
If Yes, please list:
Mortgage Payoffs:

Privacy laws require signed authorizations in order for written payoffs to be provided to our Firm. Please complete, sign and email to us the attached Authorization to Release Payoff Information forms along with this information sheet.

*Please let us know if there are more than two mortgages to be paid off at closing.
Additional Information:
Will all sellers attend the closing?
Is a Power of Attorney needed? (Additional fees apply)
*Please note that all POA’s must be reviewed and approved by our firm in advance of closing. Original POA’s must be brought to closing.
Are the Sellers using proceeds from this closing for another immediate closing?
Is the property involved in probate?
Is there an active bankruptcy? Or are you under a bankruptcy payment plan?
Is there a pending or finalized divorce?
If yes - please foward final divorce decree and complete settlement agreement
Seller:

Absent an engagement letter signed by Kham Law, LLC our firm does not represent the Seller. A Seller may choose to obtained independent representation and advice from his or her own lawyer and advisors on any potential legal, tax, credit or other consequences of their purchases.

Identification: All Sellers must bring a valid, government-issued photo ID to closing.

If you have any questions regarding this form, please feel free to contact our office.

If there is no loan or mortgage, please skip to the acknowledgement and submit button at the end of this page.
Authorization to Release Payoff Information
Lender Name:
Loan Account:
Lender Phone Number

Area CodePhone Number
Is this loan a:
Borrower Name

First NameLast Name
Second Borrower Name

First NameLast Name
First Borrower Last 4 Digits of Social Security Number
Second Borrower Last 4 Digits of Social Security Number
Property Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Settlement Agent: Kham Law, LLC

The undersigned hereby authorizes the above named Lender to release Kham Law, LLC and any of its employees acting on its behalf any and all payoff information associated with the loan account referenced above. Please furnish any and all pertinent payoff information to Kham Law, LLC as they may require.

If this account allows for advances of a credit line, the undersigned requests and authorizes the Lender to block this account against all future draws. If the Lender makes additional advances, they will not be secured by the above referenced Property. Upon issuance if a payoff statement and receipt of payment based upon that statement, Lender will be obligated to release the Security Instrument securing the line of credit.

A photocopy of the Authorization bearing the signature of the undersigned may be deemed equivalent to the original
Borrower: (All Borrowers on the above referenced loan must sign)
Signature

Clear
Date

MonthDayYear
Date
Signature

Clear
Date

MonthDayYear
Date
By checking this circle, I hereby give Kham Law, LLC , and its employees/agents, authorization to release my Closing Disclosure, transaction terms and/or Settlement Statement to my real estate agent(s), lender(s), Utility Company(ies) and/or my Homeowner’s/Condominium Association and its Management Company (as well as ordering any HOA/Condo letter updates if necessary), authorization to obtain information on my accounts, such as payoff requested, payments made and similar inquiries.*

Yes
Should be Empty:

Seller Information Sheet

Authorization to Release Payoff Information