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Seller’s Required Information

Seller’s Required Information

To expedite the handling of your escrow, please complete the following information:

Escrow Number
List all Seller’s names:
Name
Gender
- Male
- Female
Marital Status
- Single
- Married
Spouse's Name and Date Married
Home Phone
Work Phone
Fax
Cell Phone
Email
Name
Gender
- Male
- Female
Marital Status
- Single
- Married
Spouse's Name and Date Married
Home Phone
Work Phone
Cell Phone
Fax
Email
If any documents are faxed or e-mailed to you, what size paper do you prefer?
- Letter
- Legal
- Both
I: EXISTING LENDER(S) TO BE PAID OFF OR ASSUMED AT CLOSE OF ESCROW:
IF NONE – PLEASE SELECT “NONE”
Existing Lender(s) to be Paid Off or Assumed at Close of Escrow?
- Yes
- None
Name
Loan #
Address
Street Address City State ZIP Code
Phone
Approx. Unpaid Balance
Loan - Home Equity, Line of Credit (Lender will freeze/suspend pursuant to A.R.S. 33-420.01)
IF NONE – PLEASE SELECT “NONE”
Is there a loan - Home Equity Line of Credit?
- Yes
- None
Name
Loan #
Address
Street Address City State ZIP Code
Phone
Approx. Unpaid Balance
II: HOMEOWNERS' ASSOCIATION(S):
IF NONE – PLEASE SELECT “NONE”
Homeowners Association?
- Yes
- None
Name of HOA Association/Management Co.
Address
Phone
Date of Last Payment
Date Format: MM slash DD slash YYYY
Second HOA Association/Management Co.
Address
Phone
Date of Last Payment
Date Format: MM slash DD slash YYYY
III: WHERE SHOULD WE SEND YOUR MAIL AFTER CLOSE OF ESCROW?
Address
Street Address City State ZIP Code
Phone
IV: PENDING BANKRUPTCY
Are Any of the Sellers In a Pending Bankruptcy
- Yes
- No
Date Filed?
Date Format: MM slash DD slash YYYY
In What State?
V. MOBILE OR MANUFACTURED HOME ON PROPERTY
Is There a Mobile or Manufactured Home on Property?
- Yes
- No
1) Has an Affidavit of Affixture been recorded?
- Yes
- No
2) Is there a loan against the home?
- Yes
- No
Lender Name
Loan No.
Address
Phone
VI. ASSESSMENTS OR RENTS ON PROPERTY
Are There Assessments (Including but not Limited to Irrigation or Improvement Districts) Or Rent on Property?
- Yes
- No
Name
Address
Acct. No.
Phone
2) Are Assessments paid current?
- Yes
- No
VII. SEPTIC OR ALTERNATE SYSTEM
Is the Property Connected to a Septic or Alternate System?
- Yes
- No
VIII. PRIVATE OR SHARED WELL
Is the Property Serviced by a Private or Shared Well?
- Yes
- No
1) Is the Well Located on Property?
- Yes
- No
2) What is the Well Registration No.? 55-
IX. ESCROW/TITLE DISCOUNTS AVAILABLE
Please indicate if any of the following apply as you may qualify to receive discounted escrow and/or title fees. NOTE: Minimum rate may apply.
- Senior Citizen (age 60 or over)
- Active Military
- Active Licensed Realtor®
- Employed by a Title Company
- Public Servant (i.e. currently employed as a teacher, a policeman, a firefighter, or emergency medical personnel such as an EMT)
Type of Public Servant
X. SOLAR / ENERGY EFFICIENT COMPONENTS
Does the Property Include Solar/Energy Efficient Components?
- Yes
- No
If yes: Please indicate if any of the following apply. The Sale price includes solar energy devices, energy efficient building components, renewable energy equipment or combined heat and power systems that impacted the Sale Price by 5 percent or more?
Briefly describe the solar / energy efficient components
Authorization
By submitting this form, I/we hereby authorize the release of information to Yavapai Title Agency, Inc. for payoff purposes.
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Yavapai Title Agency remains the only locally owned and operated title company in the county. We are committed to maintaining our complete title operations here in Yavapai County. We recognize performing this vital function locally not only assures in-depth knowledge and expertise, but keeps our community strong as our employees and their families are committed to our community.

Prescott Main Headquarters

123 N. Montezuma
Prescott AZ 86301

Phone: (928) 445-2528
Fax: (866) 594-1890

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