Buyer / Borrower Information Form (Simple Note) Buyer/Borrower Information FormΔSubject Property InformationNote: This is the address of the property being purchased.Address InformationStreet AddressAppt #CityStateZip CodeThis Property will be a Primary Home Second Home Investment PropertyMailing AddressIs this a cash transaction? Yes NoWould you like a boundary survey completed before closing? Yes No**Note: If HOA approval is required, the buyer(s) name(s) on the HOA approval letter MUST match the contract, lender, and title documents. A copy of the approval letter must be faxed or emailed before closing for approval. Buyers Agent InformationDo you have a Real Estate Agent representing you on this transaction? Yes NoFirst NameLast NamePhone NumberEmail AddressBuyer #1 InformationBuyer(s) name(s) as they appear on the contract, title policy, and Deed. If the name(s) do not match the contract an Addendum of the contract is required. First NameLast NamePhone NumberEmail AddressBuyer #1 is Single MarriedBuyer #1 is a Man WomanSpouse Full NameWill you be present in our office for closing? Yes NoAre you a U.S. Citizen or a permanent Green Card Holder with a valid U.S. Social Security Number? Yes NoOur Office Address: OakTree Plaza Building4700 W Prospect Rd #115,Fort Lauderdale, FL 33309 Someone from our team at 954-335-9305 will call you to obtain a valid photo id.Is there an additional buyer on this transaction? Yes NoBuyer #2 InformationBuyer(s) name(s) as they appear on the contract, title policy, and Deed. If the name(s) do not match the contract an Addendum of the contract is required. First NameLast NamePhone NumberEmail AddressMailing AddressBuyer #2 is Single MarriedBuyer #2 is a Man WomanSpouse Full NameWill you be present in our office for closing? Yes NoAre you a U.S. Citizen or a permanent Green Card Holder with a valid U.S. Social Security Number? Yes NoOur Office Address: OakTree Plaza Building4700 W Prospect Rd #115,Fort Lauderdale, FL 33309 Someone from our team at 954-335-9305 will call you to obtain a valid photo idLender InformationLender NameProcessor's NameProcessor's EmailLoan Officer's NameLoan Officer's PhoneLoan Officer's EmailLoan AmountPreapproval Letter Received Yes NoIf you have receved a Pre-Approval Letter please attach itUpload Pre-approval Letter Attorney InformationDo you have an attorney representing you or assisting you on this transaction? Yes NoIs the attorney a Probate Attorney? Yes NoDo you have or will you be using a Power of Attorney to sign closing documents Yes NoUpload Power of AttorneyUpload Power of Attorney **If there is a power of attorney in this transaction please provide Independence Title, Inc with a copy to be approved by our underwriting attorney and to the lender (if applicable). The original needs to be provided to our office for recording. First NameLast NamePhone NumberEmailPlease provide any information or notes you would like to add*If there are any additional buyers on this transaction, please put their personal information in the notes above. I acknowledge that I will inform Independence Title Inc if the transaction financing changes from a cash to loan within ten business days of closing and will provide contact information for the lender. I acknowledge that I will inform Independence Title Inc that this transaction is an international or domestic mail away at least ten business days prior to closing. I acknowledge that all funds must be in the form of a wire transfer and must be credited to our trust account the day before or day of closing.SUBMIT
