CHICAGO TITLE INSURANCE COMPANY NORTH SOUTH CENTRAL HUDSON 3200 Main Street NW #330 14985 Glazier Avenue, #240 7701 France Avenue South, #120 1200 Hosford Street, #201 Coon Rapids, MN 55448 Apple Valley, MN 55124 Edina, MN 55435 Hudson, WI 54016 Ph (763)427-6831 Fax (763)427-5451 Ph (952)953-6000 Fax (952)953-9743 Ph (952)826-3000 Fax (952)826-3050 Ph (715)386-7772 Fax (715)386-7664 [email protected] [email protected] [email protected] [email protected]

CLOSING INFORMATION WORKSHEET

Sales Price: $______Earnest Money: $______Sale Date: ______Closing Date: ______Time Preference: ______Location Preference: ______PROPERTY INFORMATION: Property Address: ______County: ______Legal Description:______Abstract ____ Torrens ____ Certificate # ______Abstract/Prior Policy Location:______TOWNHOUSE/CONDOMINIUM: Townhouse______Condo______Name of Association: ______Address:______Contact Person: ______Phone Number:______Email: ______Blanket Insurance Company:______Insurance Agent:______Phone Number: ______Insurance Included in Dues? ______SELLERS INFORMATION: Sellers Names: ______Social Security #:______Social Security #:______Address:______Home Phone:______Work Phone: ______Email:______Marital Status:______Will all sellers attend closing**?______Yes ______No Will Power of Attorney be Used**? ______Yes ______No Title Held in: ______Sellers ______Corporation ______Trust ______Estate ______Other EXISTING MORTGAGES/PAYOFF INFORMATION: Lender Name Loan # Phone # 1.______2.______3.______BUYERS INFORMATION: Buyers Names:______Social Security #:______Social Security #:______Address:______Home Phone:______Work Phone: ______Email:______Marital Status:______Will Power of Attorney be Used**?______Yes ______No **IF ANY PARTIES INTEND TO PRE-SIGN DOCUMENTS OR USE A POWER OF ATTORNEY, PLEASE CONTACT CHICAGO TITLE AS SOON AS POSSIBLE. THERE ARE SPECIFIC REQUIREMENTS REGARDING THE FORM AND NOTARIZATION OF THESE DOCUMENTS. NEW FINANCING INFORMATION: New Lender: ______Address: ______Loan Officer: ______Loan Processor: ______Phone Number: ______Email:______Loan Type: ______Loan Amount: $ ______LISTING ASSOCIATE(S): SELLING ASSOCIATE(S): Name:______Name:______Company:______Company:______Office:______Office:______Phone:______Phone:______Email:______Email:______Admin Fee: ______Commission Split ______% Admin Fee: ______Commission Split ______% Commission Rate: ______% Based on $______Seller Paid Closing Costs______Earnest Money Deposited With: Listing Broker______Seller ______Other______SELLER TITLE COMPANY: BUYER TITLE COMPANY: Company Name: ______Company Name: ______Address: ______Address: ______Closer: ______Closer: ______Phone: ______Fax:______Phone: ______Fax:______Email: ______Email: ______

ADDITIONAL INFORMATION: TITLE ISSUES (circle any that apply): Divorce Bankruptcy Tax Liens Judgments Death Delinquent Utility Bills Recent Work Done Name Change HOME WARRANTY TO BE PAID BY (circle one): Seller Buyer Listing Agent Selling Agent SHORT SALE FORECLOSURE – REDEMPTION PERIOD OTHER ______ATTACHMENTS: Purchase Agreement Prior Owners Policy Divorce Decree Authorization Form Other ______CHICAGO TITLE INSURANCE COMPANY NORTH SOUTH CENTRAL HUDSON 3200 Main Street NW #330 14985 Glazier Avenue, #240 7701 France Avenue South, #120 1200 Hosford Street, #201 Coon Rapids, MN 55448 Apple Valley, MN 55124 Edina, MN 55435 Hudson, WI 54016 Ph (763)427-6831 Fax (763)427-5451 Ph (952)953-6000 Fax (952)953-9743 Ph (952)826-3000 Fax (952)826-3050 Ph (715)386-7772 Fax (715)386-7664 [email protected] [email protected] [email protected] [email protected]

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