Selling Agent Information Sheet

Date:*

Property Address:*

Selling Agent

First Name*: Last Name:*

Agency*:

Email*:

Commission:* % or $ Agent Bonus: $ Flat/Admin. Fee:* $

Purchaser (1)

First Name*: Last Name:*

Soc. Security # or Tax ID:

Current Mailing Address:

City/State/ZIP:

Phone:

Email:

Purchaser (2)

First Name: Last Name:

Soc. Security # or Tax ID:

Current Mailing Address:

City/State/ZIP:

Phone:

Email:

Marital Status: ---MarriedSingleDivorcedWidowedDomestic Partnership

Title to be held as: ---Sole OwnerTenants in CommonTenants by the EntiretyJoint Tenants

See Vesting Information on our website.

Mortgage Information:

1st Mortgage Broker or Lender Name: Phone # Email:

Loan Officer Name: Phone # Email:

2nd Mortgage Broker or Lender Name: Phone # Email:

Loan Officer Name: Phone # Email:

Is Buyer a First Time Home Buyer? YesNo.

Owner OccupiedInvestment Property

Is the Purchaser applying for DC Tax Abatement? YesNo.