Buyer/Seller Information Request

Property Information

Address *

City *

State

Zip

Select a Closer *

Transaction Type

Buyer/Seller's Information

Name (1) *

Marital Status

Social Security Number/Tax ID

Phone Number

Email Address

Forwarding Address

Name (2)

Marital Status

Social Security Number/Tax ID

Phone Number

Email Address

Forwarding Address

Mortgage Information

Including loans, mortgages, home equity loans lines of credit (including accounts with zero balance or loans relating to this property). Skip if buying a property.

Name

Address

Loan Number

Phone Number

Name

Address

Loan Number

Phone Number

Do you plan on making this month's mortgage payment?

If yes, when?

Townhouse or Condominium Information

Please fill in if you belong to a homeowners association. This is only required from the sellers of a property.

Association Name

Management Company

Contact Person

Phone Number

Email Address

Address

Do you plan on making this month's association dues?

Additional Questions

Please answer to the best of your knowledge (while you have had an interest in the property or signed the purchase agreement). Items may affect title.

Have you filed bankruptcy or is there a bankruptcy in process now?

If yes, year discharged

Has there been or will there be any changes in your marital status before closing (ie., marriage, separation, divorce)?

Are there any current or pending Judgements, Federal, State or County tax liens filed against you?

Does the property have any deferred taxes (Green Acres, conservation programs) or any levied or pending assessments?

Are you aware of any recent work or improvements done to the property within the last 12 months?

Have you received medical assistance from the State of MN or any County medical assistance agency, that could result in a Medical Assistance Lien to be filed on your property?

Will there be any renters or tenants in the property as of the day of closing?

Are there any unrecording contracts, leases or other agreements related to the property?

Are you aware of any wells, including sealed/capped well on the property?
NOTE: A capped well is not a sealed well. If the well is capped, please contact your real estate agent to make sure property disclosure of the well has been provided to the purchaser(s).

If you purchased the property prior to 1990, has there been any changes in the status or number of wells since you purchased?

Are there any encroachments or boundary line questions?

Any shared driveways, lack of access or party walls?

Will you be purchasing this property or hold title to this property as a corporation, Partnership, Limited Liability Company, Estate, Conservatorship, Guardianship, or a Trustees of the Trust?

Do you have a disability or need special accommodations?

If you answered yes to any of the questions above, please explain

Are you a United States Citizen of legal age?

Are you currently or will you be occupying this property?

Attach copy of your driver's license