Release Of Buyer Request Form - Great Pacific Escrow Page 2
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2INSTRUCTIONS FOR COMPLETING THE DE 2220R RELEASE OF BUYER REQUEST FORM
PURPOSE: To provide information required to process a Certificate of Release of Buyer request,
pursuant to Sections 1731 and 1732 of the CUIC.
BUYER INFORMATION:
Indicate if the buyer currently has or previously had an EDD account number
NAME: Enter buyer(s) name (MANDATORY)
DBA: Current business name of buyer (if applicable)
ADDRESS: Current business address of buyer (if applicable)
PHONE # AND FAX #: Number(s) to contact buyer for additional information
SELLER INFORMATION:
Indicate if seller currently has or previously had an EDD account number
NAME: Enter seller(s) name (MANDATORY)
DBA: Enter business name being sold
ADDRESS: Address of business location being sold (MANDATORY)
Indicate if seller(s) has more than one location. If so, please list locations, other than the
location being sold, under Special Instructions.
PHONE # AND FAX #: Number(s) to contact seller(s) for additional information
FEIN: Enter Federal Employer Identification Number (if known)
LIQUOR LICENSE NUMBER: (if known)
FORWARDING ADDRESS: (if known)
ESCROW COMPANY/AGENT:
ESCROW NUMBER:(if applicable)
NAME: Name of Escrow Company or Agent
ESCROW OFFICER/AGENT: Name of escrow officer or agent representative
ADDRESS: Address of escrow company or agent
PHONE # AND FAX #: Number to contact escrow officer/agent for additional information
OTHER REQUIRED INFORMATION:
PURCHASE PRICE: The amount paid for the business by the buyer (and/or liabilities assumed)
(MANDATORY)
ESTIMATED CLOSING/ACQUISITION DATE: The date the buyer will take over the assets from the
seller (MANDATORY)
SPECIAL INSTRUCTIONS: Any other pertinent information not provided above, i.e., other business
locations not being sold, additional owner or business names, etc.
SIGNATURE/TITLE/DATE SIGNED: Signature and title of preparer with date signed
DE 2220R Rev. 1 (6-00) (INTERNET)
Page 2 of 2
CU
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