Long & Foster Settlement Services, LLC

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Please provide AS MUCH information as possible to expedite order.
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Contact Information

Your Name:

Company Name:

Phone:

Fax:

E-mail

Address:

Transaction Type:

Purchase

Property Use:

If other please specify

Property Type:

If other please specify

Occupied By:

Property Address:

City:

State:

Zip:

County:

Tax Parcel #:

Settlement Date:

Sale Price:

Deposit Amount:

Seller Credits:

Seller Info.

Name:

Social Security #:

Day Phone:

Home Phone:

Address:

City, State, Zip:

Name:

Social Security #:

Day Phone:

Seller’s Additional Contacts or Representatives

Real Estate Agent

Will the Seller’s Agent be doing conveyancing? Yes No

Name:

Company Name:

Phone:

Fax:

Seller’s Attorney

Name:

Company Name:

Phone:

Fax:

Buyer/Borrower Info.

Name:

Social Security #:

Day Phone:

Home Phone:

Address:

City, State, Zip:

Name:

Social Security #:

Day Phone:

Lender Info.

Contact Name:

Company Name:

Phone:

Fax:

Address for CPL:

City, State, Zip

Loan Amount:

Buyer’s Additional Contacts or Representatives

Real Estate Agent

Name:

Company Name:

Phone:

Fax:

Buyer’s Attorney

Name:

Company Name:

Phone:

Fax:

Mortgage Broker

Name:

Company Name:

Phone:

Fax:

Other Information

Please fax a copy of the fully signed Agreement of Sale
to 610-225-2418.

Thank you for your business. Please call 610-225-6050
if you have any questions.

DO NOT PRESS SUBMIT UNTIL YOU HAVE CHECKED YOUR ORDER FOR ACCURACY! Thank you.

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