BUYER Information Sheet

BUYER Information Form
Address of Purchased Property

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Will you be residing at the purchased property as your primary residence?
Closing date of this transaction

MonthDayYear
1. Full Name(s) to appear on Title

First NameLast Name
Date of Birth

MonthDayYear
Place of Employment
Occupation
2. Full Name(s) to appear on Title

First NameLast Name
Date of Birth

MonthDayYear
Place of Employment
Occupation
Marital Status
Number of years living together
Current Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Forwarding Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Telephone #’s
Cell

Area CodePhone Number
Home

Area CodePhone Number
Work

Area CodePhone Number
E-mail
Title Information
Are you a First Time Home Buyer
Mortgagee (Lender) Information

**Please ensure the mortgage lender is aware we are acting on your behalf and instructions are sent to our office at least 10 business days prior to closing**
Lender Name
Address
Tel. Number

Area CodePhone Number
Fax. Number

Area CodePhone Number
Mortgage Broker
Address
Tel. Number

Area CodePhone Number
Fax. Number

Area CodePhone Number
Will there be Bridge Financing?
Home Owners Insurance Information:

**Please ensure your agent faxes a binder letter to our office prior to closing**
Insurance Agent Name
Policy No
Company Name
Company Address
Tel. No

Area CodePhone Number
Fax. No

Area CodePhone Number
Realtor Information
Real Estate Agent
Company Name
Company Address
Tel. No

Area CodePhone Number
Fax. No

Area CodePhone Number
CLIENT CONSENT
Name/Names
hereby confirm that
a)         Green Germann Sakran has been asked to act for both or all parties involved in our purchase/sale/mortgage transaction;

b)         No information received, in connection with the matter, from one, can be treated as confidential so far as any of the others are concerned; and

c)         That, if a conflict develops, which cannot be resolved, Green Germann Sakran cannot continue to act for both or all parties and may have to withdraw completely.
Date
City
MonthDayYear
Client Name

First NameLast Name
Client Signature
Client Name

First NameLast Name
Client Signature
Enter the message as it's shown
Should be Empty:

CLIENT CONSENT