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New Transaction Intake Form
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Intake Form
Agent's First Name:
*
Agent's Last name:
*
Your Role in Transaction:
*
Choose one
Co-Op Agent Name:
*
Co-Op Phone Number:
Co-Op Email:
*
Property Address
*
Multi-line address
Country/Region
*
Address
*
City
*
Zip / Postal code
*
Contract Price:
*
Earnest Money:
*
Effective/Ratification Date:
*
Month
Day
Year
Closing Date:
*
Month
Day
Year
Effective/Ratification Date:
*
Possession Date
*
At closing
Other
Client 1 First Name:
*
Client 1 Last Name:
*
Client 1 Email:
*
Client 2 First Name:
*
Client 2 Last Name:
*
Client 2 Email:
Marital Status:
*
Married
Single
Title Company/Closing Attorney:
*
Escrow Officer Name:
*
Title Company/Closing Attorney:
*
Lender Name and Company:
*
Lender Email:
*
Home Inspector Name (if known):
Comission Percentage/Flat Fee:
If yes, to whom and what %?
Is there a referral fee?
*
Yes
No
Home Warranty?:
*
Yes
No
If yes, provider:
Termite/Moisture Inspection Needed?:
*
Yes
No
Are there any special addendums or contingencies we should track? (e.g., Short sale, rent-back, repair cap)
Upload Fully Executed Contract & Addendums
Upload File
Upload Lead-Based Paint Disclosure (if applicable)
Upload File
Submit
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