Person Ordering Title Phone Date Email Seller's Agent CompanyPhone Address Fax Agent(s) Cell Fax Email Buyer's Agent Company Phone Address Fax Agent(s) Cell Fax Email Sales Price Earnest Money Seller's Assist Commission Amount Broker Service Fee/Additional Commission to Buyer Settlement Location AllentownBethlehemStroudsburgPoconoMediaWest ChesterKennett SquareOther Settlement Date -- mm-dd-yyyy Settlement Time Property Information Property Address City State AKALARAKALARAZCACOCTDCDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPARISCSDTNTXUTVAVTWAWIWVWY Zip County Township/Borough Tax Parcel ID # Is there a Homeowner's Association ? YesNo If Yes Association NameContact Name Phone # Type of Property (Please check all that apply) Residential Single Family Existing Commercial Multifamily New Construction Land Other Please Describe Seller Information Seller Name # 1 MaleFemale Marital Status SingleMarriedSeparatedDivorcedWindow/er Mailing Address Phone CellFax Email Seller Name # 2 MaleFemale Marital Status SingleMarriedSeparatedDivorcedWindow/er Mailing Address Phone CellFax Email Seller Name # 3 MaleFemale Marital Status SingleMarriedSeparatedDivorcedWindow/er Mailing Address Phone CellFax Email Buyer Information Buyer Name # 1 MaleFemale Marital Status SingleMarriedSeparated Mailing Address Phone CellFax Email Buyer Name # 2 MaleFemale Marital Status SingleMarriedSeparated Mailing Address Phone CellFax Email Buyer Name # 3 MaleFemale Marital Status SingleMarriedSeparated Mailing Address Phone CellFax Email Lender ( First Mortgage) Contact Name Address Phone Email Fax Loan Amount Attorney BuyerSeller Attorney Name Address Phone: Fax Email Attorney BuyerSeller Attorney Name Address Phone: Fax Email NOTES: Please enter any additional info here: