Buyer Questionnaire Form

Print and Fax

Buyer Questionnaire Form

Please provide us with the following information as soon as possible to help aide in the efficiency of your closing transaction. Please print the questionnaire, complete the printed form and fax it at your earliest convenience, you may fax it to us at (941) 495-5479. In the event that you will be out of town during the processing of your closing, please provide us with any telephone numbers or an address where we may reach you.

I/WE WISH TO TAKE TITLE TO THE PROPERTY AS FOLLOWS: (Please be certain to include any middle initials, Jr., Sr., and please CHOOSE ONLY 1 OF THE FOLLOWING 5 CHOICES ... #1, #2, #3, #4, or #5.)

(1)___________________________________________

a ___ single person OR (check one)

a ___ married person

(2)

____________________________________

and

_________________________________

husband and wife, as tenants by the entireties (Property will go to survivor listed on title in the event of death of any party in title.)

(3)_____________________________

, as Trustee(s) of

_____________________________

_______________________________________________with the following powers: ___ yes ___ no ( check one)

WITH FULL POWER AND AUTHORITY TO PROTECT, CONSERVE AND TO SELL, OR TO LEASE, OR TO ENCUMBER, OR OTHERWISE TO MANAGE AND DISPOSE OF THE REAL PROPERTY DESCRIBED HEREIN

(4) ________________________________	a ___ single person OR (check one) a ___ married person
AND
__________________________________	a ___ single person OR (check one) a ___ married person
AND
__________________________________	a ___ single person OR (check one) a ___ married person

___ (Select One) AS JOINT TENANTS WITH FULL RIGHTS OF SURVIVORSHIP (Property will go to survivor (s) listed on title in the event of death of any party in title.)

___ AS TENANTS IN COMMON (In the event of death of a party in title, the interest of the deceased party would go directly to their heir (s).)

(5)

________________________________,

a _______________ corporation

a _______________ limited liability company

(choose one and state organized)

************************************

THE ADDRESS TO BE PLACED ON THE DEED FOR FUTURE MAILINGS OF ANY COUNTY/TITLE POLICY CORRESPONDENCE:

Address____________________________________

City ____________________________________

State ______

Zip Code ______

(SELECT ONE)

___ I/We will be in Naples, Florida for the closing.

___ I/We will not be in Naples, Florida for the closing. Please courier express my/our documents to the following street address:

Address____________________________________

City ____________________________________

State ______

Zip Code ______

***********************************

Financing

We are obtaining financing through the following bank/mortgage co.:

____________________________________Phone____________________

Loan Officer/Processor is: ____________________________________

************************************

Daytime Phone

Please provide your day-time phone number (s) :

Home____________________

Fax ____________________

Other____________________

Email Address ____________________________________

************************************

Comments:

***********************************

Please be aware that the funds necessary for closing must be in the form of a cashier’s check or you may wire transfer as per Florida State Law.

Please be aware that you must have proof of identification (picture and signature identification) for your closing. Preferably a valid Driver’s License. If you do not have a Driver’s License, a State ID can be obtained from any Driver’s License Bureau. Credit Cards, Club Membership Cards ARE NOT acceptable for notarization of your documents.

Should you have any questions regarding the questionnaire, or regarding the processing of your file, please feel free to contact me directly at (941) 436-3866 or 1-800-804-3866.

I DO HEREBY CERTIFY THAT THE ABOVE IS TRUE AND ACCURATE FOR CLOSING.
Signature __________________________________________________ Date: _______________