Offer Request

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Offer Request Form

Agent First name*

Agent Last name*

Agent Email Address*

Agent Phone*

Date Offer Request Needed*

Do you already have Buyer Agency?*

Yes

No

If you do not have Buyer Agency, how long is the term? Or is it property specific?

Buyer #1 Full Legal Name*

Buyer #1 Email*

Buyer 1 Phone Number*

Buyer #2 Full Legal Name

Buyer #2 Email

Buyer 2 Phone Number

Property Address or MLS #*

The property will or will not include a manufactured home....*

Will Include

Will Not Include

The Property will or will not include an off-site and/or separate septic lot, boat slip, garage, parking space, or storage unit.*

Will Include

Will Not Include

Purchase Price*

Due Diligence Amount

Due Diligence Date

Or days after ratified contract

Are you doing EM or AEM*

EM

AEM

Neither

EM or AEM Amount

Date of AEM (if applicable)

How will funds be delivered?*

Cash

Personal Check

Official Bank Check

Wire Transfer

Electric Transfer

Settlement Date*

Or days after ratified contract

Escrow Agent*

Personal Property to convey (blank = none)

Do you have a Prequal Letter or Proof of Funds?

Yes

No

If yes, please email to KellyC@homecontractsconcierge.com

Loan Type*

Cash

Conventional

V/A

FHA

USDA

Other

Down Payment or Principle Amount of Loan

Additional Loan Information

Does the buyer(s) have to sell a property to buy?*

Yes

No

If yes, what is the property address?

Is the property currently under contract?

Yes

No

If no,

is listed with and actively marketed by a licensed real estate broker.

will be listed with and actively marketed by a licensed real estate broker.

Buyer is attempting to sell/lease the Buyer's Property without the assistance of a licensed real estate broker.

Is there a fuel tank located on the property?*

Yes

No

If yes, is it currently in use?

Yes

No

Single choice

Owned

Leased

If yes, is it owned or leased?

Yes

No

If leased, what is the name of the company it is leased from?

Is it above ground or below ground?

Above Ground

Below Ground

Type of fuel?

Oil

Propane

Gasoline and/or Diesel

Other

Is this property leased?*

Yes

No

How will name(s) appear on the Deed?*

Closing Costs (blank = none)

Home Warranty?*

Yes

No

Any other addenda to be included?

Appraisal Addendum, Additional Provisions, etc.

Any additional Information

When offer has been signed, would you like us to send it to the Listing Agent or do you want to send it yourself?*

Please send on my behalf

I will send

Undecided

All information is deemed private and confidential. Please inquire about our Non-Compete and Confidentiality Agreements

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