Goggans, Stutzman, Hudson, Wilson, and Mize, LLP.

Seller Information Form

Step 1 of 3

33%

Address of Property being Sold:(Required)

Street Address Address Line 2 City State ZIP Code

The Seller is:(Required)

An Individual(s)

An Entity (Corporation, LLC, Trust)

An Estate (Please note all proceeds will be made payable to the Estate)

An Estate

Name of Estate(Required)

EIN(Required)

Seller Number One

Name- Seller One(Required)

First Last

Social Security Number- Seller One(Required)

Email- Seller One(Required)

Phone- Seller One(Required)

Do you have a Seller Number Two?(Required)

Seller Number Two

Name- Seller Two(Required)

First Last

Social Security Number- Seller Two(Required)

Email- Seller Two(Required)

Phone- Seller Two(Required)

An Entity (Corporation, LLC, Trust)

Name of Entity(Required)

EIN / Tax ID Number(Required)

Name of Representative Attending Closing(Required)

We must receive the signer’s proof of authority to sign on behalf of the entity prior to the closing. Please send the entity’s Operating Agreement, By-Laws or Resolution for review as soon as possible.

First Last Title

Representative Email(Required)

Representative Phone(Required)

Additional Information

Forwarding Address

If unavailable currently, please provide before closing.

Street Address Address Line 2 City State ZIP Code

Is the Seller a Georgia Resident?(Required)

Yes

Was the property your primary residence for two of the last five years?(Required)

Yes

Is the Seller a U.S. Citizen or possess Permanent Resident status?(Required)

Yes

(If not, you may be subject to US withholding tax).

Water Service

Provider Name(Required)

Account Number

Provider Phone Number

Please Attach a Copy of your Most Recent Water Bill if Available

Max. file size: 50 MB.

Loan Payoffs

We will order loan payoffs as part of the closing process. Please complete the attached Payoff Authorization form for each mortgage.

There is a

Please select all that apply.

First Mortgage Lender

Second Mortgage Lender

Home Equity Lender

There are no Loans

First Mortgage Lender

Mortgage Lender Name- First Mortgage(Required)

Loan Number- First Mortgage(Required)

Lender Phone- First Mortgage

Second Mortgage Lender

Mortgage Lender Name- Second Mortgage(Required)

Loan Number- Second Mortgage(Required)

Lender Phone- Second Mortgage

Home Equity Lender

Please provide info even if the line was never used or has a zero balance as the line must be closed as part of closing. Equity lines may be frozen when we request the payoff statement. Please let us know if you have made a recent drawor are planning to make one before closing.

Mortgage Lender Name- Home Equity Loan(Required)

Loan Number- Home Equity Loan(Required)

Lender Phone- Home Equity Loan

Homeowners Association

Management Company Name(Required)

Representative's Name

First Last

HOA Phone Number

HOA Email Address

Final Information

Do you need your proceeds wired?(Required)

Please note we will collect a wire fee of $35 on the settlement statement for wires. If Yes, please plan to bring a voided check to closing or fax a copy to 404-207-1624 prior to closing.

Yes

Will all Sellers be attending closing?(Required)

Yes

When all sellers are unable to attend closing, we offer two options to accommodate the situation. Please select one.

1. POWER OF ATTORNEY: We will send you the POA form to execute with a notary and witness. There is a $140 charge to prepare and record.
2. MAIL AWAY CLOSING: There is a $225 charge for us to deliver the seller documents to you for you to execute them in front of an attorney and witness and return them to us prior to the closing.

Power of Attorney (Preferred)

Mail Away

Name of POA(Required)

If not known, please type "not known."

First Last

POA Phone (Optional)

Loan Payoff Authorization(Required)

I/we hereby authorize the representatives of GSH Attorneys to complete and submit any forms on my behalf necessary to obtain any loan or lien payoffs.

Step 1 of 3

33%

Address of Property being Sold:(Required)

Street Address Address Line 2 City State ZIP Code

The Seller is:(Required)

An Individual(s)

An Entity (Corporation, LLC, Trust)

An Estate (Please note all proceeds will be made payable to the Estate)

An Estate

Name of Estate(Required)

EIN(Required)

Seller Number One

Name- Seller One(Required)

First Last

Social Security Number- Seller One(Required)

Email- Seller One(Required)

Phone- Seller One(Required)

Do you have a Seller Number Two?(Required)

Seller Number Two

Name- Seller Two(Required)

First Last

Social Security Number- Seller Two(Required)

Email- Seller Two(Required)

Phone- Seller Two(Required)

An Entity (Corporation, LLC, Trust)

Name of Entity(Required)

EIN / Tax ID Number(Required)

Name of Representative Attending Closing(Required)

First Last Title

Representative Email(Required)

Representative Phone(Required)

Additional Information

Forwarding Address

If unavailable currently, please provide before closing.

Street Address Address Line 2 City State ZIP Code

Is the Seller a Georgia Resident?(Required)

Yes

Was the property your primary residence for two of the last five years?(Required)

Yes

Is the Seller a U.S. Citizen or possess Permanent Resident status?(Required)

Yes

(If not, you may be subject to US withholding tax).

Water Service

Provider Name(Required)

Account Number

Provider Phone Number

Please Attach a Copy of your Most Recent Water Bill if Available

Max. file size: 50 MB.

Loan Payoffs

We will order loan payoffs as part of the closing process. Please complete the attached Payoff Authorization form for each mortgage.

There is a

Please select all that apply.

First Mortgage Lender

Second Mortgage Lender

Home Equity Lender

There are no Loans

First Mortgage Lender

Mortgage Lender Name- First Mortgage(Required)

Loan Number- First Mortgage(Required)

Lender Phone- First Mortgage

Second Mortgage Lender

Mortgage Lender Name- Second Mortgage(Required)

Loan Number- Second Mortgage(Required)

Lender Phone- Second Mortgage

Home Equity Lender

Mortgage Lender Name- Home Equity Loan(Required)

Loan Number- Home Equity Loan(Required)

Lender Phone- Home Equity Loan

Homeowners Association

Management Company Name(Required)

Representative's Name

First Last

HOA Phone Number

HOA Email Address

Final Information

Do you need your proceeds wired?(Required)

Please note we will collect a wire fee of $35 on the settlement statement for wires. If Yes, please plan to bring a voided check to closing or fax a copy to 404-207-1624 prior to closing.

Yes

Will all Sellers be attending closing?(Required)

Yes

When all sellers are unable to attend closing, we offer two options to accommodate the situation. Please select one.

Power of Attorney (Preferred)

Mail Away

Name of POA(Required)

If not known, please type "not known."

First Last

POA Phone (Optional)

Loan Payoff Authorization(Required)

I/we hereby authorize the representatives of GSH Attorneys to complete and submit any forms on my behalf necessary to obtain any loan or lien payoffs.