Williams County Abstract Company
WCAC REAL ESTATE CLOSING REQUEST FORM (Rev. February 2019)
DATE OF REQUEST: ____________________ DESIRED CLOSING DATE: _______________________
COPY OF PURCHASE AGREEMENT: YES NO
ABSTRACT OF RECORD TITLE: YES NO
OTHER PAPERS:
1. REALTOR INFORMATION:
Listing Agent: __________________________________ Cell Phone Number: __________________
Email Address: __________________________________ Commission: ____________
Closing fee paid by: Buyer / Seller / Split Selling Agent: _____________________________
2. BUYER/BORROWER INFORMATION:
Complete Names as to taking title:
Buyer 1: _____________________________________ SS# or TIN#: ________________________
Buyer 2: _____________________________________ SS# or TIN#: ________________________
How will Buyer take title? Joint Tenancy / Tenants in Common / Other _________________________
Email address: _______________________________________________________________________
Buyer's current mailing address: ________________________________________________________
Phone Number: Home ________________ Work _________________ Cell ___________________
Financing (lender, phone #, contact): _____________________________________________________
Loan Amount: ___________________________ Sales Price: _______________________________
3. SELLER INFORMATION:
Name (all names on title, spouse or otherwise):
Seller 1: ______________________________ SS# or TIN#:______________________________
Seller 2: ______________________________ SS# or TIN#:______________________________
Marital Status: Married ___ Single ____ Other __________________
Email addresses: _____________________________________________________________________
Property Address: ____________________________________________________________________
Forwarding Address: __________________________________________________________________
Phone Number: Home ________________ Work _________________ Cell ___________________
Will Sellers be present at closing: YES NO Is there a MOBILE HOME on the property? YES NO
Outstanding Mortgage with ______________________________ Phone Number: ________________
Loan Number: ________________________________________
4. SECURE THE FOLLOWING (Please circle choice):
Abstract of Title: YES NO Location of Abstract: __________________________
Obtain Deed: YES NO
Minerals reserved (per PA): YES NO
Obtain Title Opinion: YES NO
Obtain Lenders Title Insurance: YES NO Loan Amount: $___________
Plat Sketch (for LP): YES NO
Obtain Owners Title Insurance: YES NO Sale Price: $___________
This form shows REQUIRED information and must be COMPLETELY filled out.
If this transaction falls through for any reason, Williams County Abstract Company and any third-party work that has been completed are to be paid for any fees or costs incurred in preparation for this transaction, including a cancellation fee.
WCAC is to be notified immediately of any cancellation or failure.
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