* = Required

Customer Information
*First Name:
*Last Name:
*Email:
*Company:
*Address 1:
Address 2:
*City:
*State:
*Zip:
*Phone (ie. 111-111-1111x1111):
*Fax (ie. 111-111-1111x1111):
Escrow Information
Name of Escrow Officer:
*Date for Close of Escrow:	Select date << Friday, November 21, 2008  >>
Seller/Lender:
Seller/Lender Address:
Seller/Lender City:
Seller/Lender State:
Seller/Lender Zip:
Seller/Lender Phone (ie. 111-111-1111x1111):
Seller/Lender Fax (ie. 111-111-1111x1111):
Seller/Lender Email Address:
Buyer/Borrower:
Buyer/Borrower Address:
Buyer/Borrower City:
Buyer/Borrower State:
Buyer/Borrower Zip:
Buyer/Borrower Phone (ie. 111-111-1111x1111):
Buyer/Borrower Fax (ie. 111-111-1111x1111):
Buyer/Borrower Email Address:
Manner in which buyer is to hold title:
*Property address, brief legal description or parcel number:
Sale Price:
Initial Deposit:
Financing:
If new financing:	FHAVA Conv.Cal-Vet Seller carry backOther Clear
If other, please describe:
Unless otherwise noted, or unless it is not available, the title insurance policy to be issued will be a CLTA Homeowners in the amount of the purchase price. Any lender’s policy will be issued in accordance with the lender’s requirements.
Prorate the following to:	Close of Escrow Taxes, based on the latest tax bill Interest on any existing loan Rents, based on rental statement to be provided by the seller approved by the buyer Other Clear
If other, please describe:
Impound account with any existing loan is to be:	Reimbursed to seller Transferred to buyer without reimbursement to seller Clear
Unless otherwise noted, the transaction costs are to be paid in accordance with the custom of the county in which the property is based.
Real Estate brokers commission(s) in the amount of:
To be paid to:
Other terms and conditions of the escrow:

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