SELLER INFORMATION REQUEST FORM
SELLER(S) NAME FIRST, MIDDLE, LAST:
SELLER’S MARITAL STATUS:
(If married, name of spouse: )
*IMPORTANT: If married, both spouses will need to sign closing documents (even if only one of you has a title interest in the property being transferred.)
SELLER’S PHONE NUMBERS:
EMAIL ADDRESS:
SELLER SOCIAL SECURITY NUMBER or EIN: His: Her: EIN:
COMMISSIONS: Buyer Agent % Seller Agent % ● Flat Fee $ Paid By:
ADDRESS OF PROPERTY BEING SOLD:
SELLER FORWARDING ADDRESS:
*****WILL SELLER BE ATTENDING CLOSING *****
MORTGAGE/DEED OF TRUST INFORMATION: PLEASE COMPLETE OR WRITE N/A FOR NO MORTAGE OR EQUITY LINE
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Lender Name
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Loan Number
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Phone Number
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Equity Line (yes or no)
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(1)
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(2)
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(3)
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DOES SELLER WANT GOINS LAW TO PREPARE SELLER DOCS FOR A FEE OF $250?
IS THIS A MANUFACTURED/MOBILE?
If yes, please provide VIN
HOMEOWNER’S ASSOCIATION INFORMATION: PLEASE COMPLETE OR WRITE N/A FOR NO HOA
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Amount Per Month
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Amount Owing
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Management Company
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Telephone Number
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SELLER PROCEEDS AFTER CLOSING:
*Seller proceeds and realtor commission checks will be available after we have funding authorization from the lender (if applicable) AND we have recorded closing documents with the Register of Deeds. If you plan to pick up your check, it will be available at 2212 Eastchester Dr. 2nd floor, High Point, NC 27265, unless other arrangements have been made.
**IMPORTANT: Please send all invoices you want to be paid at closing (i.e. building inspectors, etc.) as soon as you receive them.
DISCOUNTED PREMIUM SERVICES
Would you like this service:
September 23, 2026
(Seller Name)
RE: Your Sale of Real Estate Located at (the “Property”)
Our office has been engaged by the buyer to represent them in their purchase of your property referenced above (the “Property”). To facilitate closing, we would be happy to prepare the seller documents, consisting of a deed, limited power of attorney, 1099, tax proration agreement and all necessary lien waivers (the “Documents”). My fee for the preparation of these documents is $250 and will be reflected on the settlement statement and collected at closing. If, however, you wish to have your own attorney prepare seller documents for you, we will, of course, have to review the accuracy of those documents, please have these sent to our office prior to closing.
While I will do my very best to make this as smooth a process as I can for you and the buyer, please understand that I only represent the buyer. This means that I will not be able to give you legal advice about the terms of the Documents that I will be preparing.
If these terms are agreeable to you, please indicate your approval by signing below and returning this signed letter to my office. I look forward to meeting you in person and closing this deal for you.
Very truly yours,
Jason M. Goins
