Estimated Statement Request Form

Receive a complimentary estimate of closing costs from one of our escrow professionals by submitting the form below!

Contact Name:

Contact Email:

Contact Phone:

Agent Name:

Agent Email:

Agent Phone:

Prepare for:

Seller Buyer

Seller Name:

Buyer Name:

Purchase Price:

Loan Amt. for Buyer:

Property Address:

APN#:

COE Date:

Title Company of Choice:

**Please complete the remainder of this form only if a Seller estimate is being requested**

Payoffs

(Principal Balance 1):

(Principal Balance 2):

Listing Agent Commission:

Selling Agent Commission:

HOA Management:

Dues:

Monthly Quarterly

Zone Disclosure Company:

Termite Inspection Cost:

Work Cost:

Home Warranty Cost:

Is this Seller’s Primary Residence?

Yes No