Republic Settlement Services in Urbandale, Iowa Is Your One Stop For Abstract and Closing Settlement Services

Use this form for Closing Services.

ESCROW INSTRUCTION

REQUESTED BY
E-MAIL ADDRESS
CLOSING DATE
PROPERTY ADDRESS	(address, city, state, zip)
PURCHASE PRICE	$
EARNEST MONEY	$
	Purchase Refinance of Purchase Contract Refinance Title Guaranty Loans - Bond Loan FSBO - Our Office to Represent Manufactured Home

COMMISSION INFORMATION
TOTAL COMMISSION	% or FLAT FEE $
LISTING SIDE
SELLING SIDE
LISTING SIDE:
REFERRAL	YesNo
AGENT NAME
AGENT'S COMPANY
AGENT'S OFFICE PHONE
AGENT'S CELL PHONE
SELLING SIDE:
REFERRAL	YesNo
AGENT NAME
AGENT'S COMPANY
AGENT'S OFFICE PHONE
AGENT'S CELL PHONE

SELLERS INFO
SELLERS NAME(S)
FORWARDING ADDRESS	(address, city, state, zip)
CURRENT HOME PHONE
WORK/CELL PHONE
MARITAL STATUS
ATTEND CLOSING?	YesNo
ATTORNEY FOR DEED:
ATTORNEY NAME
WILL ATTORNEY PARTICIPATE IN GETTING DEED SIGNED?	YesNo
SELLERS MORTGAGE PAYOFF AT
PHONE
LOAN #
OTHER OUTSTANDING LOANS & #s

BUYERS INFO
FULL NAME(S) FOR DEED
CURRENT ADDRESS	(address, city, state, zip)
CURRENT HOME PHONE
WORK/CELL PHONE
DOES BUYER INTEND TO OCCUPY PROPERTY?	YesNo
MARITAL STATUS
ATTEND CLOSING?	YesNo
BUYER'S ATTORNEY NAME
BUYER'S LENDER
NEW LOAN AMOUNT	$
BUYER'S LOAN OFFICER
PHONE
IF REFINANCE: MORTGAGE PAYOFF AT
LOAN #
OTHER OUTSTANDING LOANS & #s

MISCELLANEOUS INFO
TERMITE INSPECTION PREFERENCE
HOME OWNER WARRANTY?	YesNo
WARRANTY PAID BY
COST OF WARRANTY	$
ABSTRACT PREFERENCE
ABSTRACT LOCATION
ADDITIONAL INSTRUCTIONS