Seller Information Form Seller Information Form Address of Property being Sold:(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Is the seller a Business, Trust, or Estate?(Required) Yes No Seller Number OneName- Seller One(Required) First Last Marital Status(Required)Are you a U.S. Citizen?(Required) Yes No Social Security Number - Seller One(Required)Phone- Seller One(Required)Email- Seller One(Required) Do you have a Seller Number Two?(Required)YesNoSeller Number TwoName- Seller Two(Required) First Last Marital Status(Required)Are you a U.S. Citizen?(Required) Yes No Social Security Number- Seller Two(Required)Phone- Seller Two(Required)Email- Seller Two(Required) An EntityEntity Name(Required)Entity Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Authorized Signor(Required)Title(Required)Phone Number(Required)Email(Required) Tax ID(Required)Will the signatory be attending the closing?(Required) Yes No Additional InformationMailing/Forwarding Address after closing:(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Are you attending closing?(Required) Yes No *IF NO, ADDITIONAL FEES WILL APPLY**If No, will this be a(Required) Mail Away Power of Attorney During your ownership is/was there a(Required) Divorce (in process) Separation Foreclosure Bankruptcy None PLEASE PROVIDE FINAL DECREE OF DIVORCE IF IT PERTAINS TO THIS PROPERTY(Required) Drop files here or Select files Max. file size: 256 MB. Are you selling the property as your primary residence?(Required) Yes No Are you considered a Georgia Resident?(Required) Yes No Have you filed Georgia taxes within the last two years?(Required) Yes No *We may need more documentation than the below, but please provide the following: We will also need a Certificate of Existence for your entity which we will be happy to obtain on your behalf for a fee of $20.00. For Corporations: Resolution, Corporate By-Laws For LLCs: Operating Agreement with all amendments, Resolution For Partnerships: Partnership Agreement For Trusts: Trust Agreement and all Amendments, Certificate of Trust For Estates: Probate Documents (Death Certificate, Letters of Testamentary, WillDo you have a mortgage, lien, or equity line of credit?(Required) Yes No Mortgage, Lien or Equity Line of CreditLender Name(Required)Loan Number(Required)Phone Number(Required)Forbearance / Modification?(Required) I/We have entered into any forbearance or loan modification agreement with the lender(s) above relative to delayed or postponed payments or other restructuring of the debt secured by the mortgage(s). I/We have not entered into any forbearance or loan modification agreement with the lender(s) above relative to delayed or postponed payments or other restructuring of the debt secured by the mortgage(s). Additional Mortgage (if applicable) Yes No Mortgage, Lien or Equity Line of CreditLender Name(Required)Loan Number(Required)Phone Number(Required)Forbearance / Modification?(Required) I/We have entered into any forbearance or loan modification agreement with the lender(s) above relative to delayed or postponed payments or other restructuring of the debt secured by the mortgage(s). I/We have not entered into any forbearance or loan modification agreement with the lender(s) above relative to delayed or postponed payments or other restructuring of the debt secured by the mortgage(s). Homeowners AssociationIs the property a part of a Homeowners/Condominium Association?(Required) Yes No Name of Association(Required)Contact Person & Title(Required)Association Management Company(Required)Phone Number(Required)Email Address(Required) Website Property Tax AppealsHave the property taxes on the property been appealed in the past five years?(Required) Yes No If yes, what was the date of the last appeal?(Required) MM slash DD slash YYYY Mobile or Manufactured HomeIs there a mobile or manufactured home on the property?(Required) Yes No Septic SystemIs there a Septic System on the property?(Required) Yes No Water Provider*If the water provider charges a fee for obtaining the water bill, a request processing/handling fee may be chargedWater Type Public Well Vacant land / No water Provider(Required)Phone(Required)Upload water bill (if available) Drop files here or Select files Max. file size: 256 MB. Short SaleIs this a short sale?(Required) Yes No Home WarrantyDoes the sales contract indicate that you are paying for a home warranty?(Required) Yes No Termite LetterDoes the sales contract indicate that you are providing/paying for a termite letter?(Required) Yes No Final InformationWould you prefer a check or wire transfer for your proceeds?(Required) Check Wire *If you select a wire transfer for your proceeds you will receive an email and text message from CertifiD to provide your wire instructionsSignature(Required)Date MM slash DD slash YYYY DO YOU HAVE ANY ADDITIONAL INFORMATION/NOTES YOU WANT TO PROVIDE TO US?(Required) Yes No ADDITIONAL INFORMATION/NOTES(Required) Address of Property being Sold:(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Is the seller a Business, Trust, or Estate?(Required) Yes No Seller Number OneName- Seller One(Required) First Last Marital Status(Required)Are you a U.S. Citizen?(Required) Yes No Social Security Number - Seller One(Required)Phone- Seller One(Required)Email- Seller One(Required) Do you have a Seller Number Two?(Required)YesNoSeller Number TwoName- Seller Two(Required) First Last Marital Status(Required)Are you a U.S. Citizen?(Required) Yes No Social Security Number- Seller Two(Required)Phone- Seller Two(Required)Email- Seller Two(Required) An EntityEntity Name(Required)Entity Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Authorized Signor(Required)Title(Required)Phone Number(Required)Email(Required) Tax ID(Required)Will the signatory be attending the closing?(Required) Yes No Additional InformationMailing/Forwarding Address after closing:(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Are you attending closing?(Required) Yes No *IF NO, ADDITIONAL FEES WILL APPLY**If No, will this be a(Required) Mail Away Power of Attorney During your ownership is/was there a(Required) Divorce (in process) Separation Foreclosure Bankruptcy None PLEASE PROVIDE FINAL DECREE OF DIVORCE IF IT PERTAINS TO THIS PROPERTY(Required) Drop files here or Select files Max. file size: 256 MB. Are you selling the property as your primary residence?(Required) Yes No Are you considered a Georgia Resident?(Required) Yes No Have you filed Georgia taxes within the last two years?(Required) Yes No *We may need more documentation than the below, but please provide the following: We will also need a Certificate of Existence for your entity which we will be happy to obtain on your behalf for a fee of $20.00. For Corporations: Resolution, Corporate By-Laws For LLCs: Operating Agreement with all amendments, Resolution For Partnerships: Partnership Agreement For Trusts: Trust Agreement and all Amendments, Certificate of Trust For Estates: Probate Documents (Death Certificate, Letters of Testamentary, WillDo you have a mortgage, lien, or equity line of credit?(Required) Yes No Mortgage, Lien or Equity Line of CreditLender Name(Required)Loan Number(Required)Phone Number(Required)Forbearance / Modification?(Required) I/We have entered into any forbearance or loan modification agreement with the lender(s) above relative to delayed or postponed payments or other restructuring of the debt secured by the mortgage(s). I/We have not entered into any forbearance or loan modification agreement with the lender(s) above relative to delayed or postponed payments or other restructuring of the debt secured by the mortgage(s). Additional Mortgage (if applicable) Yes No Mortgage, Lien or Equity Line of CreditLender Name(Required)Loan Number(Required)Phone Number(Required)Forbearance / Modification?(Required) I/We have entered into any forbearance or loan modification agreement with the lender(s) above relative to delayed or postponed payments or other restructuring of the debt secured by the mortgage(s). I/We have not entered into any forbearance or loan modification agreement with the lender(s) above relative to delayed or postponed payments or other restructuring of the debt secured by the mortgage(s). Homeowners AssociationIs the property a part of a Homeowners/Condominium Association?(Required) Yes No Name of Association(Required)Contact Person & Title(Required)Association Management Company(Required)Phone Number(Required)Email Address(Required) Website Property Tax AppealsHave the property taxes on the property been appealed in the past five years?(Required) Yes No If yes, what was the date of the last appeal?(Required) MM slash DD slash YYYY Mobile or Manufactured HomeIs there a mobile or manufactured home on the property?(Required) Yes No Septic SystemIs there a Septic System on the property?(Required) Yes No Water Provider*If the water provider charges a fee for obtaining the water bill, a request processing/handling fee may be chargedWater Type Public Well Vacant land / No water Provider(Required)Phone(Required)Upload water bill (if available) Drop files here or Select files Max. file size: 256 MB. Short SaleIs this a short sale?(Required) Yes No Home WarrantyDoes the sales contract indicate that you are paying for a home warranty?(Required) Yes No Termite LetterDoes the sales contract indicate that you are providing/paying for a termite letter?(Required) Yes No Final InformationWould you prefer a check or wire transfer for your proceeds?(Required) Check Wire *If you select a wire transfer for your proceeds you will receive an email and text message from CertifiD to provide your wire instructionsSignature(Required)Date MM slash DD slash YYYY DO YOU HAVE ANY ADDITIONAL INFORMATION/NOTES YOU WANT TO PROVIDE TO US?(Required) Yes No ADDITIONAL INFORMATION/NOTES(Required)
