g CLIENT INFORMATION
Property Address:
Sellers Names as listed on Warranty Deed:
Current Address of Sellers:
Phone, Owner: Home: Work: Cell: FAX:
Phone, Co-Owner: Home: Work: Cell: FAX:
E-Mail, Owner: Home: Work:
E-Mail, Co-Owner: Home: Work:
Social Security #: Owner: Co-Owner:
Owner Occupation: Employer:
Co-Owner Occupation: Employer:
Children’s Names and Ages:
g OWNERSHIP
Type of Ownership: [ ] Fee-Simple [ ] Condominium
Do you have a copy of Warranty Deed from when property was purchased? [ ] YES [ ] NO
*Copy provided to Agent? [ ] YES [ ] NO
How long have you owned this property? Years Months
Do you have Owners’ Title Insurance? [ ] YES [ ] NO
*Copy provided to Agent? [ ] YES [ ] NO
Has any portion of property been conveyed to another party? (i.e.: quit claim deed) [ ] YES [ ] NO
If YES, explain:
Has there been a name change for a property owner? [ ] YES [ ] NO
If YES, explain:
Was a new Warranty Deed issued in new name? [ ] YES [ ] NO
*Copy provided to Agent? [ ] YES [ ] NO
Has a property owner died? [ ] YES [ ] NO
If YES, name: Date of death:
Did deceased own property as a joint tenant with right of survivorship? [ ] YES [ ] NO
Do you have a certified copy of the death certificate? [ ] YES [ ] NO
*Copy provided to Agent? [ ] YES [ ] NO
Is there a pending or prior divorce involving current owners? [ ] YES [ ] NO
If YES, explain:
Are property owners citizens of the United States? [ ] YES [ ] NO
If NO, explain:
Are property owners Georgia residents? [ ] YES [ ] NO
If NO, explain:
Is property your primary residence? [ ] YES [ ] NO
If NO, explain:
REQUIRED SELLER INFORMATION Page 2 of 3
g PROPERTY BOUNDARIES
Do you have a survey of property? [ ] YES [ ] NO
*Copy provided to Agent? [ ] YES [ ] NO
Are there any rights-of-way, easements or encroachments not shown on survey? [ ] YES [ ] NO
If YES, explain:
Is your property located in a FEMA designated flood zone? [ ] YES [ ] NO
Are you required to pay flood insurance? [ ] YES [ ] NO
Have there been any additions / alterations to property since date of purchase? [ ] YES [ ] NO
If YES, explain:
Has the road been widened or has utility construction occurred since you purchased property? [ ] YES [ ] NO
If YES, explain:
Has an adjacent neighbor added to their property (i.e. a fence) since your date of purchase? [ ] YES [ ] NO
If YES, explain:
Has an adjacent property owner ever questioned property lines? [ ] YES [ ] NO
If YES, explain:
Do you have a plat of subdivision? [ ] YES [ ] NO
*Copy provided to Agent? [ ] YES [ ] NO
g MORTGAGES
Do you have a mortgage? [ ] YES [ ] NO If YES, provide the following:
Name of Lender:
Address:
Telephone#: Contact:
Loan #: Outstanding Balance: $ Type: [ ] Conv. [ ] FHA [ ] VA
Is your payment current? [ ] YES [ ] NO If NO, explain:
Do you have a second mortgage? [ ] YES [ ] NO If YES, provide the following:
Name of Lender:
Address:
Telephone#: Contact:
Loan #: Outstanding Balance: $
Is your payment current? [ ] YES [ ] NO If NO, explain:
Do you have additional mortgages? [ ] YES [ ] NO If YES, give information:
g TITLE ISSUES
Have any of the owners declared bankruptcy since property purchase? [ ] YES [ ] NO
If YES, explain: Discharge date:
Are any of the property owners currently in bankruptcy? [ ] YES [ ] NO
If YES, explain:
Name of bankruptcy attorney: Telephone#:
Do owners owe any unpaid taxes to Internal Revenue or State of Georgia? [ ] YES [ ] NO
If YES, explain:
Are their current liens or judgments against the property, other than mortgages? [ ] YES [ ] NO
If YES, explain:
REQUIRED SELLER INFORMATION Page 3 of 3
g PROPERTY TAXES
County: (Year- ) (Amount-$ )
City: (Year- ) (Amount-$ ) Date Payable:
Includes: (i.e. garbage pick-up, etc.):
*Copy of tax bills provided to Agent? [ ] YES [ ] NO
Are your property taxes current? [ ] YES [ ] NO If NO, explain:
Held in escrow by your mortgage company? [ ] YES [ ] NO If NO, where?
Under appeal? [ ] YES [ ] NO If YES, explain:
g TERMITE BOND
Name of Company:
Telephone #: Contact:
Type of Bond: [ ] Treatment only [ ] Treatment and repair [ ] Other:
Annual costs: $ Due:
Renewal Date: Transfer fee: $
*Copy of bond provided to Agent? [ ] YES [ ] NO
g HOMEOWNER’S ASSOCIATION
Membership: [ ] Mandatory [ ] Voluntary Transferable? [ ] YES [ ] NO Initiation Fee: $ Annual Dues: $ Due Date: Are dues current? [ ] YES [ ] NO
What are included in dues?
Name of President: Telephone #
Name of Treasurer: Telephone#
Are there neighborhood covenants? [ ] YES [ ] NO
*Copy provided to Agent? [ ] YES [ ] NO
Special assessments: $ Due: For:
Is there a management company? [ ] YES [ ] NO If YES, provide the following:
Name: Telephone #
Address: Contact:
g NEIGHBORHOOD RECREATIONAL ASSOCIATION
Check all included: [ ] Swim [ ] Tennis [ ] Lake [ ] Club House [ ] Play Ground [ ] Park [ ] Golf
[ ] Other includes:
Initiation fee: $ Paid: To Whom?
Membership: Dues $ Paid: To Whom?
Transferable? Sellable?
Outstanding assessments: $ Due: For:
Is there a management company? [ ] YES [ ] NO If YES, provide the following:
Name: Telephone #
Address: Contact: