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105 E Ridge Ln Suite #2, Somerset, KY 42501
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Selling Agent Questionnaire
Property Address
Subdivision
Lot No(s)
County
Deed Book/Page
Type of closing
Cash
Lender
Name of Lender
Selling Agent
Office
Office Address
Agent Lic. No
Broker Lic. No
Cell No
Office No
Email
Sales Price ($)
Commission
Listing %
Based On ($)
Selling %
Total %
Admin Fee ($)
Broker Commission
If you reference this as something other than Admin Fee, what do you call it?
Earnest Money Deposit ($)
Held By
Buyer #1 - Name
Last 4 of SSN
Buyer #2 - Name
Last 4 of SSN
Current Address
Tax Mailing Address
Marital Status
Spouse at closing?
Yes
No (Please provide a copy of recorded POA)
Buyers attending closing in person?
Yes
No
Will the documents be sent overnight or via email?
Overnight
Email
Email
Phone Number
If buyer is an LLC/Corp, who will sign?
(Please provide a copy of corporate resolution)
Title
Home Info
Is the Termite Inspection to be POC or paid at closing?
POC
Paid at closing
Are there damage/repair costs?
Yes
No
Are funds to be held in escrow?
Yes
No
How much? ($)
Is home warranty/inspection to be POC or paid at closing?
POC
Paid at closing
Homeowner's Association?
Yes
No
Does the buyer wish to purchase the owner's title insurance?
Yes
No
(For cash closings, it is FSLT policy that the Buyers must purchase Owner’s Title Insurance)
Please provide a copy of the following documents:
Copy of the purchase/sale contract
Max. file size: 100 MB.
Copy of the source deed
Max. file size: 100 MB.
Copy of POA (if applicable)
Max. file size: 100 MB.
Copy of resolution (if applicable)
Max. file size: 100 MB.
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