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Laurie R. Stegall
Brian Clifford
Robert W. Brown III
Kermit Robinson
Nick Canovai
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Seller Information Request Form
(Including Agent Authorization page)
"
*
" indicates required fields
Closing Date:
MM slash DD slash YYYY
Property Address:
*
Seller(s) name(s). Please list full name and marital status of all property owners. If married, provide spouse's name as a separate seller**. Please clearly reference who is married to whom.
Full Legal/Corporate Name (as shown on government-issued ID):
Upload Copy of Government ID
Max. file size: 50 MB.
Sex:
M
F
Married:
Yes
No
Full Social Security Number/Full Tax ID Number***
Is there more than one seller in this transaction?
Yes
No
Spouse's Name (as shown on government-issued ID):
Full Social Security Number/Full Tax ID Number***
Full Legal/Corporate Name (as shown on government-issued ID):
Upload Copy of ID
Max. file size: 50 MB.
Sex:
M
F
Married:
Yes
No
Full Social Security Number/Full Tax ID Number***
Spouse's Name (as shown on government-issued ID):
Full Social Security Number/Full Tax ID Number***
Full Legal/Corporate Name (as shown on government-issued ID):
Government issued identification
Max. file size: 50 MB.
Sex:
M
F
Married:
Yes
No
Full Social Security Number/Full Tax ID Number***
Spouse's Name (as shown on government-issued ID):
Full Social Security Number/Full Tax ID Number***
Full Legal/Corporate Name (as shown on government-issued ID):
Government issued identification
Max. file size: 50 MB.
Sex:
M
F
Married:
Yes
No
Full Social Security Number/Full Tax ID Number***
Spouse's Name (as shown on government-issued ID):
Full Social Security Number/Full Tax ID Number***
**Spouses are required to sell real estate in NC. ***Required for 1099 filing with IRS.
Best contact information for sellers:
Phone
*
Email
*
Is the property being sold your current primary residence?
Yes
No
Post-Closing Mailing Address:
*
(for return of documents, refunds, etc.)
Would you like our firm to provide the seller's closing package (Deed, etc.)?
*
Yes
No
Unknown
Our fee for preparation of these documents is $200 for standard sales. $300 for estates and/or Trusts.
Are you attending closing?
*
Yes
No
Unknown
If NO, how will you be signing your documents?
*
Send by email to:
Making an appointment to sign early in our office
Other:
Email
Please specify:
How would you like to receive closing proceeds?
*
Pick–Up (no charge)
UPS ($50 fee-see below)
Wire ($50 fee-see below)
***In order to send a wire, we must have an ORIGINAL voided check, or wire instructions from an attorney’s trust account. If you do not have a physical check to provide, please ask for a Wire Authorization Form, though it will need to be notarized. We are unable to send a UPS to a PO Box.
Current Liens & Mortgages (Payoff Information)
Name of Mortgage or Equity Lender
Full Loan
Balance ($)
Contact Phone
Are there any additional mortgages or equity lines associated with this property?
Yes
No
Mortgage or Equity Lender
Full Loan
Balance ($)
Contact Phone
-Unfortunately, most lenders do not accept digitally signed Payoff Authorization Forms. We will need a wet-signed payoff authorization form for each loan/lien associated with the property. For a payoff authorization form, please reach out to our firm or request it from your agent (if applicable); it was included with the original Seller Information Request Forms.
-Provide information for all Mortgage/Equity Lines even if they have a $0.00 balance.
-Stegall & Clifford will order your payoff statement. We will charge $50 per loan to overnight the funds to your mortgagor.
Homeowners Association (Property Dues) Information:
Is there an HOA?
*
Yes
No
Name of association and/or management company
HOA Contact Name
HOA Email Address
HOA Phone Number
Authorization of Release of Information To Be Signed by Seller(s)
(Please Disregard if There is No Agent)
I/We
and
authorize Stegall & Clifford, PPLC to release and obtain necessary documentation and information throughout the closing process on the above-referenced property to my real estate agent
Agent Name:
of
Date Signed
MM slash DD slash YYYY
Signature 1
Signature 2
Printed Name 1
Printed Name 2
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