Buyer's Information Form

Please Pick Below the Answer Which Best Describes Buyer(s):

One buyer taking title alone (includes married persons taking title in name alone)

Buyer:

Name:

Email:

Phone:

Address of Property You Are Buying:

Address Line 1:

Address Line 2:

City:

State:

Florida

Zip Code:

Current Mailing Address:

Address Line 1:

Address Line 2:

City:

State:

Florida

Zip Code:

Post Closing Mailing Address:

Address Line 1:

Address Line 2:

City:

State:

Florida

Zip Code:

The Property will be:

Primary Residence ("Homestead")

Property Other:

Marital Status:

Unmarried

Spouse:

Name:

Phone:

Email:

Which Spouse Should Be Our Primary Point of Contact?

Spouse 1

Spouse 1:

Name:

Phone:

Email:

Spouse 2:

Name:

Phone:

Email:

Address of Property You Are Buying:

Address Line 1:

Address Line 2:

City:

State:

Florida

Zip Code:

Current Mailing Address:

Address Line 1:

Address Line 2:

City:

State:

Florida

Zip Code:

Post Closing Mailing Address (If different from current mailing address and different from property address):

Address Line 1:

Address Line 2:

City:

State:

Florida

Zip Code:

The Property will be:

Primary Residence ("Homestead")

Property Other:

Address of Property You Are Buying:

Address Line 1:

Address Line 2:

City:

State:

Florida

Zip Code:

Buyer 1:

Name:

Marital Status:

Unmarried

Email:

Phone:

Current Mailing Address:

Address Line 1:

Address Line 2:

City:

State:

Florida

Zip Code:

Post Closing Mailing Address (If different from current mailing address and different from property address):

Address Line 1:

Address Line 2:

City:

State:

Florida

Zip Code:

Buyer 2:

Name:

Marital Status:

Unmarried

Email:

Phone:

Current Mailing Address:

Address Line 1:

Address Line 2:

City:

State:

Florida

Zip Code:

Post Closing Mailing Address (If different from current mailing address and different from property address):

Address Line 2:

City:

State:

Florida

Zip Code:

The Property will be:

Primary Residence ("Homestead")

Address of Property You Are Buying:

Address Line 1:

Address Line 2:

City:

State:

Florida

Zip Code:

How Many Buyers?

Three

Buyer 1:

Name:

Marital Status:

Unmarried

Email:

Phone:

Current Mailing Address:

Address Line 1:

Address Line 2:

City:

State:

Florida

Zip Code:

Post Closing Mailing Address (If different from current mailing address and different from property address):

Address Line 1:

Address Line 2:

City:

State:

Florida

Zip Code:

Buyer 2:

Name:

Marital Status:

Unmarried

Email:

Phone:

Current Mailing Address:

Address Line 1:

Address Line 2:

City:

State:

Florida

Zip Code:

Post Closing Mailing Address (If different from current mailing address and different from property address):

Address Line 1:

Address Line 2:

City:

State:

Florida

Zip Code:

Buyer 3:

Name:

Marital Status:

Unmarried

Email:

Phone:

Current Mailing Address:

Address Line 1:

Address Line 2:

City:

State:

Florida

Zip Code:

Post Closing Mailing Address (If different from current mailing address and different from property address):

Address Line 1:

Address Line 2:

City:

State:

Florida

Zip Code:

Buyer 4:

Name:

Marital Status:

Unmarried

Email:

Phone:

Current Mailing Address:

Address Line 1:

Address Line 2:

City:

State:

Florida

Zip Code:

Post Closing Mailing Address (If different from current mailing address and different from property address):

Address Line 1:

Address Line 2:

City:

State:

Florida

Zip Code:

Will the Property the Primary Residence ("Homestead") of any of the Buyers?

Yes

Name of the Business Entity:

Type of Entity?

Limited Liability Company (LLC)

State (Country) of Incorporation / Organization / Origin?

Name and Title of Officer / Manager Responsible for this Transaction

Email Address of Officer / Manager Responsible for this Transaction

Telephone Number of Officer / Manager Responsible for this Transaction

Address of Property You Are Buyer:

Address Line 1:

Address Line 2:

City:

State:

Florida

Zip Code:

Company Address for Correspondence Relating to this Transaction:

Address Line 1:

Address Line 2:

City:

State:

Florida

Zip Code:

Name of Contact Person:

Email Address of Contact Person:

Telephone Number of Contact Person:

Address of Property You Are Buyer:

Address Line 1:

Address Line 2:

City:

State:

Florida

Zip Code:

Post Closing Forwarding Address (if known):

Address Line 1:

Address Line 2:

City:

State:

Florida

Zip Code:

Name of Contact Person:

Email Address of Contact Person:

Telephone Number of Contact Person:

Address of Property You Are Buyer:

Address Line 1:

Address Line 2:

City:

State:

Florida

Zip Code:

Post Closing Forwarding Address (if known):

Address Line 1:

Address Line 2:

City:

State:

Florida

Zip Code:

Please briefly explain your circumstances / needs:

Miscellaneous:

Do you intend to close i.e. execute your closing documents in person at our offices in Melbourne, Florida, or will you be closing from a remote location i.e. "mail away closing"?

Closing (signing) in person at Echelon Title Services, LLC offices at 5815 S. Highway 1 Suite 1 Rockledge, FL 32955

If you are obtaining mortgage financing to purchase the property, please check the box below:

Please provide your lender's contact information below:

Is There Anything You Think We Should Know?

Please Enter the Email Address of the Person Completing this Form to Receive a Confirmatory Email:

Is There Anything You Think We Should Know?

Closing (signing) in person at Echelon Title Services, LLC offices at 5815 S. Highway 1 Suite 1 Rockledge, FL 32955

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