Fillable Proceeds/funds Disbursement Form - First American Title printable pdf download

Proceeds/funds Disbursement Form - First American Title

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First American Title

Phone 877-295-4328

______________________

To: First American Title

File No.:

Re: __________________________________________,

___________________________________ ("Property")

Proceeds/Funds Disbursement Instructions

Proceeds: The undersigned directs that the proceeds/funds due will be disbursed in the following manner:

[ ] Mailed to the address below

[ ] Sent via overnight delivery

[ ] Sent via wire transfer **

[ ] Other:________________________________________

** If checked, attach wiring instructions of receiving bank or fill in below.

With cyber fraud on the

increase, we suggest you mail, use an overnight service or hand-deliver any items

containing banking or other private information and not send via email.)

Bank Name:

____________________________________________________

Address:

___________________________________________________

Name on the Acct: ___________________________________________________

Account No.:

__________________________________________________

Routing No.:

___________________________________________________

_____ ____________________ __________________________

Phone No.:

Checking

Savings

Type of Account:

Any further instructions: ________________________________________________________________

Please Note:

Modified or amended disbursement instructions must be signed by the parties at a First

American office. Proof of identity will be required.

Funds disbursed to other than record owner must be in writing with authorized approval by First American

Title Company and possibly buyer/borrower’s lender on a TILA-RESPA Integrated Disclosure (TRID) regulated

loan.

Receiving Banks may impose a charge for the receipt of any wire transfers.

Escrow Holder is not responsible for delays in wiring caused by time restrictions of the Federal Reserve

Board or late confirmation of recording.

When funds are sent to a bank outside the United States, Escrow Holder shall not be responsible or liable

for any loss or expense incurred as a result of currency exchange rates, delays in availability of funds, or delays

due to the U.S. bank or foreign bank requiring additional information. Escrow Holder shall have no liability or

responsibility after properly initiating the outgoing wire transfer.

The undersigned acknowledge that the Proceeds/Funds Disbursement Instructions are

complete and accurate.

___________________________________________________________________

Print Name(s): _________________________________________________

_____________________________

Date:

Address:

______________________________________________

Home Phone:

______________________________________________

Cell Phone:

______________________________________________

Business Phone:

______________________________________________

Proceeds/funds Disbursement Form - First American Title

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