Seller(s) Intake Form Seller(s) Intake Form Location Location---ClermontDavenportFishhawkKissimmeeLakelandWinter Haven Sellers #1 Name: Marital Status:- Select Marital Status -Single MaleSingle FemaleMarried MaleMarried FemaleDivorced MaleDivorced FemaleWidowed MaleWidowed Female Social Security Number: (For your security, please contact the branch directly to provide your Social Security Number.) Property Address: Future Mailing Address: Phone: Please leave this field empty.Email: Seller #2 Name: Marital Status:- Select Marital Status -Single MaleSingle FemaleMarried MaleMarried FemaleDivorced MaleDivorced FemaleWidowed MaleWidowed Female Social Security Number: (For your security, please contact the branch directly to provide your Social Security Number.) Property Address: Future Mailing Address: Phone: Please leave this field empty.Email: Seller’s Realtor Company: Agent: Phone: Please leave this field empty.Email: Current Mortgage Lender 1st Mortgage Company: Full Loan Number (including any leading zeros): Phone: 2nd Mortgage Company: Full Loan Number (including any leading zeros): Phone: Is the subject property your homestead?:- Select -YesNo HOA Name: Contact Phone Number: Are HOA Dues Monthly / Quarterly / Annually?: Amount of Dues?: Is there more than one HOA? (ie: Master Association):- Select -YesNo 2nd Association Information: Name: Contact Phone Number: Are HOA Dues Monthly / Quarterly / Annually?: Amount of Dues?: Will all Sellers be present at Title Company for closing?:- Select -YesNo OR will this be a Mobile closing (additional fees may apply):- Select -YesNo Do you have a copy of your Owner’s Title Insurance Policy?:- Select -YesNo If yes, please provide same to title office: Do you have a prior Survey?:- Select -YesNo If yes, have you made any changes? Fences, buildings, pool, driveway? Please provide a copy of survey to title. (Max 12MB, File Types: .gif, .png, .jpg, .pdf, .xls, .doc, .docx) To prove you are human: What is 2 + 2? Our Services Realtors Consumers Lenders Get In Touch Call Us Email Us Order Title