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REAL ESTATE ONLINE ORDER FORM

* denotes required field

Date: *

Lsting Agent/Office: *

E-Mail Address:

Phone/Fax: *

Total Commision: % *

Selling Agent: % *

Transaction Fee for Selling Agent: $

Listing Agent: % *

Transaction Fee for Listing Agent: $

Sale Price of Property: $ *

Amount of Loan: $

Buyers Deposit of $:

Held By:

Property Address: *

Legal Description:

RE Parcel #:

County

Anticipated Closing Date: *

NEW MORTGAGE INFO:

Lender:

Contact:

Phone #:

Fax #:

E-Mail Address:

Will any of the parties require pre-signing?

Buyer Seller

Is/Are the seller(s) a foreign person?

Yes No

Is the property a mobile home?

Yes No

Will any of the parties require a mail away signing?

Buyer Seller

If yes, address to mail package:

Does the borrower have a current survey?

Yes No

If not, has a survery been ordered?

Yes No

Surveyor:

Notes:

BUYER INFO:

Name Buyer #1 *

Contact Numbers:

home:

work:

cell:

Marital Status:

Buyer's Address after Closing:

Name Buyer #2

Contact Numbers:

home:

work:

cell:

Marital Status:

Buyer's Address after Closing:

SELLER INFO:

Name Seller #1: *

Contact Numbers: home:

work:

cell:

Marital Status:

E-Mail Address:

Forwarding Address:

Name Seller #2:

Contact Numbers: home:

work:

cell:

Marital Status:

E-Mail Address:

Forwarding Address:

LOAN #1:

LENDER:

ACCOUNT #:

LOAN #2:

LENDER:

ACCOUNT #:

Contract Upload

**Reissue credit will be given provided a previous owner's policy was issued insuring the seller or the mortgagor in the current transaction. For purchases, the policy must have an effective date of less than three years prior to the closing of the new transaction. The existing Owner's Policy may have been written by any Title Insurer.

action title services of st. johns county, inc.

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phone: 904.797.4777
3670 US 1 South, Suite 110 | St. Augustine, FL 32086

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