Realtor Closing Information

* denotes required fields
Closing Information

Closing Officer: *
Transaction Type: *	Cash Contract for Deed Lender Financing 1031 Exchange Other
Date Needed:	(mm/dd/yyyy)
Estimated Closing Date:	(mm/dd/yyyy)
Title Services (click all that apply):	Attorney Title Opinion Deed Preparation Contract for Deed Owners Title Insurance Escrow Agreement

Ordered By

Agent Type: *	Listing Agent Selling Agent
Agent Name: *
Contact Name: *
Company Name:
Company Address:
City / State / Zip Code:
Phone: *
Fax:
E-mail: *

Loan Information

Loan Officer:
Lender's Loan Number:
Sales Price:
Loan Office Contact Number:
Abstract Location:	Lender Realtor Other If other, specify:
1031 Exchange Involved:	Yes No
Owner's Policy:	Yes No
Property Address: *
City / State / Zip Code: *
Legal Description:
Is there a Well (if Minnesota property)?:	Yes No
Parcel Split (if Minnesota property)?:	Yes No

Seller/Buyer Information

Seller Name: *
Seller Social Security Number: *	(nnn-nn-nnnn)
Marital Status: *	Married Divorced Widowed Estate
Will Seller Attend Closing?: *	Yes No
Buyer Name: *
Buyer Present Address:
City / State / Zip Code:
Buyer Social Security Number:	(nnn-nn-nnnn)
Will Buyer Attend Closing?: *	Yes No
Power of Attorney Used by Any Party?: *	Yes No
If Yes, Please Indicate Whom:	Please note, all Power of Attorneys must be approved by Northern Title prior to closing.
Are Any of the Current Owners Deceased?: *	Yes No
If Yes, Please Enter Name(s):
Are Any of the Parties Currently Divorcing?: *	Yes No
If Yes, Please Enter Name(s):
Deed Preparation Required?: *	No Yes Individual Tenants in Common Joint Tenancy

Seller's Mortgage Information

Seller Has Existing Mortgage(s): *	Yes No
Please List Existing Mortgage(s):
Mortgage Company #1:
Loan Number:
Mortgage Company #2:
Loan Number:
Mortgage Company #3:
Loan Number:

Other Information

Listing Realtor: *
Selling Realtor: *
Commission Amount/Percent: *
Commission Based On:
Commission Split:
Earnest Money Retained By: *
Closing Location: *	Northern Title Lender's Office Branch: Other Please Specify:
Additional Comments/Instructions:

Verification

Verification Code: *	Please enter the letters and numbers you see on the image into the text box below.