Please Complete the Following and Return Via Fax Or Email

SELLER INFORMATION

The following information is necessary for us to schedule your closing and to ensure that all information from your title is accurate and all payoff information is received in a timely fashion.

Please complete the following and return via fax or email:

Fax: 603-434-7226 Email:

Address of Property to be Sold: ______

______

Mailing Address After Closing: ______

______

Is the property comprised of multiple lots? ¨ YES ¨ NO

Are you selling your primary residence? ¨ YES ¨ NO

Is this property in foreclosure? ¨ YES ¨ NO

Have you filed bankruptcy in the past 10 years? ¨ YES ¨ NO

SELLER INFORMATION / MARITAL STATUS
If spouse not on title, list name / SSN or EIN
Name:
Mailing Address:
Phone:
Email:
Are you a U.S. Citizen: ¨ YES ¨ NO
Name:
Mailing Address:
Phone:
Email:
Are you a U.S. Citizen: ¨ YES ¨ NO

If you are selling a condominium, please provide the name and contact information of your association representative or property management company so that we may request a Certificate of Condominium fees due:

Name: ______

Phone: ______

MORTGAGES/HOME EQUITY LINES/LIENS AGAINST PROPERTY:

Please complete the following for any and all mortgages (private or with lender) so that we may obtain payoff information:

BANK NAME
BANK TELEPHONE NUMBER
ACCOUNT NUMBER
BANK NAME
BANK TELEPHONE NUMBER
ACCOUNT NUMBER
BANK NAME
BANK TELEPHONE NUMBER
ACCOUNT NUMBER

I (we), hereby authorize Hudkins Law PLLC to obtain and receive payoff information on my (our) behalf for the above referenced loan(s).

______

BORROWER SIGNATURE CO-BORROWER SIGNATURE

______I/We would like Hudkins Law PLLC to prepare our deed for a fee of $150.00. I/We

understand that if this option is not selected, I/We are responsible for delivering the deed at closing and will have a copy of the deed faxed or mailed to Hudkins Law PLLC for approval at least five days prior to the scheduled closing date.

______I/We would like Hudkins Law PLLC to prepare Power of Attorney Form(s) for an additional

fee of $150.00. (If selecting this option, please fill in the information below)

I, ______, would like to grant power of attorney to ______to execute all closing documents (except the deed) pertaining to the sale of the above referenced property. I understand that I will be required to sign the Power of Attorney form in the presence of a notary and return the form to Hudkins Law PLLC prior to closing.

*Please note that Hudkins Law PLLC does not perform title examinations for the benefit of a Seller unless we are specifically engaged and retained to do so. A title examination is customarily performed by either a buyer’s closing/settlement attorney or a lender’s closing/settlement attorney.