Buyer Information Request Form

Buyer Information Request Form
(Including Agent Authorization page)

Buyer(s) name(s): Please list full name and martial status of all new owners. If married, provide spouse’s name as a separate buyer*. Use additional sheets if necessary. Please clearly reference who is married to whom.
Male/Female (optional)
Married: (If Yes, add spouses name as a buyer)
Male/Female (optional)
Married: (If Yes, add spouses name as a buyer)
Male/Female (optional)
Married: (If Yes, add spouses name as a buyer)
Male/Female (optional)
Married: (If Yes, add spouses name as a buyer)

Spouses may be required to purchase real estate in the state of North Carolina. Please check with our office before assuming a spouse does not need to attend closing.
 
Best contact information for buyers:

Lender Information (If paying cash, enter N/A):
Homeowner’s Insurance Information:
If the buyer/spouse is not attending the closing then a Power of Attorney (POA) is required (lender approval is necessary if there is a loan).
Will the buyer need a POA?
If YES, then please call our office to discuss.
Are you getting a survey of the property?
If Yes, Should we order a survey for you?
If you are getting your own survey, please forward a copy of the survey, report and invoice to our office.
File Upload
Maximum upload size: 209.72MB
If you are getting your own survey, please forward a copy of the survey, report and invoice to our office.
File Upload
Maximum upload size: 209.72MB
  

Authorization of Release of Information
To Be Signed by Buyer(s) (Please Disregard if There is No Agent)

Authorization of Release of Information
To Be Signed by Buyer(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
I/We understand that Stegall & Clifford, PPLC is not permitted to release this information without my/our express written authorization. 
  

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