Seller/ Agent Form Seller/ Agent Form 620 GREEN VALLEY ROAD, SUITE 200 GREENSBORO, NORTH CAROLINA 27408 WWW.CHANDLERANDSCHIFFMAN.COM MICHAEL R. CHANDLER, ESQ. ADELIA T. SCHIFFMAN, ESQ. CAMERON E. JOHANNESEN, ESQ. CHRISTIAN M. HAIRSTON, ESQ. TELEPHONE: (336) 274-4455 FACSIMILE: (336) 274-7030 Buyer Names: * Seller Names: * Property Address: * Closing Date: SELLER/AGENT SHEET SELLER NAME: SSN: Will Call Yes No SELLER NAME: SSN: Will Call Yes No MARITAL STATUS OF SELLER: UNMARRIED MARRIED SEPARATED WIDOWED Spouse's Name: SELLER’S FORWARDING ADDRESS: SELLER EMAIL ADDRESS: SELLER PHONE NUMBER: Is seller attending closing? Yes No If Seller is not attending closing when is deed needed by? Do we prepare Deed? Yes No If we are not preparing, who is? ***NOTE: If Seller isn’t attending closing OR is signing early, a POA is REQUIRED!*** ***Our fee for preparing this document is $100.00*** Name of POA: COMMISSION SPLIT: Selling Realtor Listing Realtor Flat Fee Amount Earnest Money: None OtherOther Held By: Listing Agent Selling Agent Attorney WHO MANAGES HOMEOWNER’S ASSOCIATION? Phone Number: Email ***DUE TO LENDER DISCLOSURE REQUIREMENTS AND OUR OFFICE’S CLOSING TIMELINE, ALL HOA INFOMRTAION WILL BE ORDERED AS A “RUSH”. SELLER IS RESPONSIBLE FOR ALL FEES CHARGED BY HOA COMPANY, INCLUDING RUSH FEES*** MORTGAGE AND/OR EQUITY LINE OF CREDIT: PAYOFF INFORMATION – LIEN ONE Company Phone Number Account Number PAYOFF INFORMATION – LIEN TWO Company Phone Account Number PAYOFF INFORMATION – LIEN THREE Company Phone Account Number Proceeds: Pick Up Overnight: $50 Wire: $100 Address: (PLEASE FILL OUT SELLER WIRE DIRECTIVE) If you are human, leave this field blank. Submit Δ Contact Us Name Email Address Message 5 + 9 = Submit Request
