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TITLE ORDER REQUEST FORM

PHONE: 859-402-1986 / EMAIL: [email protected]

File No.

Date: *

PROPERTY ADDRESS: *

Greetings:

Trifecta Title, LLC has been requested to provide title and closing services on the above-referenced property. So that we may properly assist all the parties to this transaction and provide a smooth closing, we would ask that you please complete the following questionnaire and provide us with any information that is relevant to this closing.

1. PAYOFFS. Listing Agent-please have the Seller(s) complete and sign the attached payoff authorization form. (Please note that even if the Seller(s) personally provide the payoff, we are required to obtain it from the Lender).

2. REAL ESTATE COMMISSION. Please provide the following:

a. Listing Agent Commission: *

b. Selling Agent Commission: *

c. Flat rate or if percentage/split is based on an amount other than sales price: *

d. Administrative Fee (if any):

e. Will Earnest Money Deposit be paid at closing or deducted from Selling Agent's Commission: *

3. HOA CONTACT AND DUES INFORMATION: *

4. HOME WARRANTY, INSPECTIONS OR OTHER FEES TO BE PAID FROM CLOSING: *

5. WHO IS TAKING TITLE TO THE PROPERTY? Be Specific: *

6. IF ANY OF THE PARTIES ARE INDIVIDUALS (NOT ENTITIES) IDENTIFY THE MARITAL STATUS OF EACH PARTY AND THE SPOUSE'S NAME:

a. Seller's Marital Status:

Single
Married
Divorced
Widowed
Separated
Domestic Partnership
Prefer not to say
No elements found. Consider changing the search query.
List is empty.

Name of Spouse:

Seller's Marital Status:

Single
Married
Divorced
Widowed
Separated
Domestic Partnership
Prefer not to say
No elements found. Consider changing the search query.
List is empty.

Name of Spouse:

b. Buyer's Marital Status:

Single
Married
Divorced
Widowed
Separated
Domestic Partnership
Prefer not to say
No elements found. Consider changing the search query.
List is empty.

Name of Spouse:

Buyer's Marital Status:

Single
Married
Divorced
Widowed
Separated
Domestic Partnership
Prefer not to say
No elements found. Consider changing the search query.
List is empty.

Name of Spouse:

c. Has the Seller's marital status has changed since they obtained title to the subject property?

Yes
No
N/A
No elements found. Consider changing the search query.
List is empty.

If yes, please explain:

d. Do any of the parties intend to execute documents via a Power of Attorney?

Yes
No
N/A
No elements found. Consider changing the search query.
List is empty.

If yes, please provide a copy of the POA as soon as possible.

7. MAIL AWAY: Do any of the parties need to have their documents mailed to them for execution in lieu of attending the closing in person? If so, to whom and which address will the documents be mailed: *

8. SALES PROCEEDS PAID BY: *

Check
Wire
No elements found. Consider changing the search query.
List is empty.

COMMISSIONS PAID BY: *

Check
Wire
No elements found. Consider changing the search query.
List is empty.

9. ADDITIONAL INFO: Any other information that you believe needs to be addressed prior to closing:

Thank you for assisting us by providing this information. It is our goal to provide you and your clients with a smooth closing process. I will be your primary point of contact for this closing and my contact information is provided below. The best way to reach me is via email, however, should you have an urgent matter that needs my immediate attention and I have not responded to your email, please feel free to give me a call. We look forward to working with you!

Annemarie Neisz, Closing Specialist

mailto:[email protected]

Direct Dial Number: 859-402-1986

Please upload the necessary documents below.

Copy of Purchase Contract: *

Copy of The Source Deed:

Signed DA (for Pay at Table)

Each office is independently owned and operated.