New Open Escrow Agent Submission Form
Agent's Name
*
Agent's Email
*
Contract Acceptance Date
*
-
Month
-
Day
Year
COE
*
-
Month
-
Day
Year
Purchase Price
*
Property Address
*
Street Address
Street Address Line 2
City
Postal / Zip Code
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Buyer's Name
*
First Name
Last Name
Secondary Buyer's Name
First Name
Last Name
Source
*
SOI
Agent Referral
Past Client
Referral - Past Buyer
Referral - Past Seller
Sign Call
Zillow.com
Trulia.com
Realtor.com
Renter
YouTube
Open House
Boldlead
Other - Enter details in notes below
Source Notes
Buyer's Email
*
Buyer's Phone
*
Financing
*
Cash
Conventional
VA
FHA
Loan Pre-Approval / POF
Transaction Type
*
Bank Owned
Short Sale
New Home
Traditional Equity
MLS #
*
Listing Agent
*
Listing Agent Email
*
Mortgage Company
*
Loan Officer
*
First Name
Last Name
Loan Officer Email Address
*
Loan Officer Phone Number
*
-
Area Code
Phone Number
EMD
*
Buyer will Wire
EMD Check in Safe
Escrow To Be Opened By?
*
I already have opened
Transaction Coordinator - Please open for me
Title Company
*
Escrow Officer
*
First Name
Last Name
Escrow Officer Email Address
Escrow Officer Phone Number
-
Area Code
Phone Number
Has Client been given Vendor list
*
Yes
No - Pls email to client
Home Inspection
*
Please send client options and then order
I already scheduled
Commission % Amount: Buyer Side
*
Referral Fee to be paid out?
*
yes
no
Referral Fee: Amount
Referral Fee: Brokerage Name
Referral Fee: Agent Name
Referral Fee: Agent Email
BBA?
*
yes
no
Upload BBA
Transaction Fee Amount?
*
If you are charging a fee you MUST upload BBA
Home Warranty
*
Yes - Please email client copy of options
No - Waived
Notes to TC
Full Package
*
Upload a File
Cancel
of
Duties Owed
MUST submit signed Duties Owed with RPA
Supplemental List of Licensees to Duties Owed
MUST submit signed Supplemental List with RPA
RPA - Residential Purchase Agreement
RDG - Residential Disclosure Guide Receipt
MUST submit SIGNATURE PAGE ONLY with RPA
Was Property Built Prior To 1978?
Yes
No
Is Property a Short Sale?
Yes
No
KW Buyer Disclosure Stmt (AGENT MUST SIGN)
Before You Purchase CIC...Did You Know?
Counter Offer, if needed
Counter 2, if needed
For Your Protection
Earnest Money Receipt Form and Copy of Check (only applicable if Client hands you a check)
Lead Based Paint Disclosure
If Built Prior To 1978, Buyer MUST sign LBP Disclosure
Lead Based Paint Pamphlet
If built prior to 1978, Buyer MUST sign front page of LBP pamphlet
Short Sale Addendum
If a Short Sale, Buyer MUST sign Short Sale Addendum
Estimated Costs Sheet
Submit
Should be Empty: