PURCHASER:
SELLER:
_____________________________ Date:________
_____________________________ Date:________
(sign name)
(sign name)
__________________________________
__________________________________
(print name)
(print name)
Telephone: _______________________
Telephone: _______________________
Fax: _______________________
Fax: _______________________
email: _______________________
email: _______________________
Address: _______________________
Address: _______________________
_______________________
_______________________
_____________________________ Date:________
_____________________________ Date:________
(sign name)
(sign name)
__________________________________
__________________________________
(print name)
(print name)
Telephone: _______________________
Telephone: _______________________
Fax: _______________________
Fax: _______________________
email: _______________________
email: _______________________
Address: _______________________
Address: _______________________
_______________________
_______________________
Existing Lien Payoff / Assumption Information:
1. Lender: _________________________________
Loan #: ___________________________________
telephone #:
________________________________
1. Lender: _________________________________
Loan #: ___________________________________
telephone #:
________________________________
3