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Buyer's Agent Form

Dear Valued Agent,

Our title company is handling an upcoming settlement for you.  We would greatly appreciate your taking a few moments to complete this form to make sure we have accurate closing information for our file.  If you have any questions about this form, or believe you have received this form in error, please contact my title processor, Kim Minter, at 410-719-0200 and let her know.

Thank you for your help and, as always, we greatly value your business.

Jeffrey P. Shiller, Esq.

* Required fields
Name *
E-mail Address *
Name of Buyer's Broker *
Agent's Phone Number *
Agent's Fax Number
Buyer's Agent Commission (% or $) *
Buyer's Deposit Amount *
Deposit Held By *
Is There A Buyer's Agent Admin Fee? * Yes
No
If Admin Fee, How Much?
Is There Any Seller Contribution to Buyer's Costs? * Yes
No
If There Is Seller Contribtion, How Much?
Buyer #1 Name *
Buyer #1 Phone Number
Buyer #2 Name
Buyer #2 Phone Number
Name of Buyer's Lender (if cash deal, write "cash") *
Name of Buyer's Loan Officer
Lender's Phone Number
How Will Title Be Held? *
Are ALL Buyer's 1st Time Homebuyers? * Yes
No
What Is Purpose of the Property? *
Which Does The Property Have? *
Will There Be a Well Inspection? Yes
No
Cost of Well Inspection (if unknown write "unknown")
Will There Be a Septic Inspection? Yes
No
Cost of Septic Inspect (if unknown write "unknown")
Will There Be a Termite Inspection? Yes
No
Name of Termite Company
Cost of Termite Inspection
Is Buyer Paying For a Home Warranty? Yes
No
If Yes, Name of H/Warranty Co.
Cost of H/Warranty
Is There Any Seller Financing? Yes
No
Are ALL Buyers Attending Closing? Yes
No
What Is Closing Date?
Specific Comments/Questions

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Please Do Not Forget To Fax Any Invoices or Bills To Be Placed On The HUD-1 To:

443-957-4517

Or Email Them To:

jeff@viprealestatelaw.com

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 Jeffrey P. Shiller, P.A. One Sanford Avenue Baltimore, Maryland 21228
Office 443.463.5909 | Fax 866.859.6019 | jeff@viprealestatelaw.com