Seller Closing Information

Property Address:*

Street Address Address Line 2 City State ZIP Code

Your Forwarding Address

Street Address Address Line 2 City State ZIP Code

Seller 1 Information

Name

First Last

Social Security

Mobile

Work

Email

Seller 2 Information

Name

First Last

Social Security #

Mobile

Work

Email

Realtor Information

Listing Agent Name

First Last

Listing Agent Phone

Listing Agent Email

Buyer Agent Name

First Last

Buyer Agent Phone

Buyer Agent Email

Homestead Information

Marital Status

Married
Unmarried

Name of Spouse

First Last

Principal Residence Certification

Principal Residence Last 2 of 5 Years?*

I owned and used the residence as my principal residence for periods aggregating 2 years or more during the 5-year period ending on the date of the sale or exchange of the residence.

True
False

Have Not Sold Other Principal Residence*

I have not sold or exchanged another principal residence during the 2-year period ending on the date of the sale or exchange of the residence.

True
False

At least one of the following three statements applies:

The sale or exchange is of the entire residence for $250,000 or less
I am married, the sale or exchange is of the entire residence for $500,000 or less, and the gain on the sale or exchange of the entire residence is $250,000 or less.
I am married, the sale or exchange is of the entire residence for $500,000 or less, and (a) I intend to file a joint return for the year of the sale or exchange, (b) my spouse also used the residence as his or her principal residence for periods aggregating 2 years or more during the 5-year period ending on the date of the sale or exchange of the residence, and (c) my spouse also has not sold or exchanged another principal residence during the 2-year period ending on the date of the sale or exchange of the residence.

Not Acquired Through Tax Exchange*

During the 5-year period ending on the date of the sale or exchange of the residence, I did not acquire the residence in and exchange to which section 1031 of the Internal Revenue Code applied.

True
False

Exchange Occurred 5 Years Prior*

If my basis in the residence is determined by reference to the basis in the hands of a person who acquired the residence in an exchange to which section 1031 of the Internal Revenue Code applied, the exchange to which section 1031 applied occurred more than 5 years prior to the date I sold or exchanged the residence.

True
False
Not Applicable

Nonqualified Residence Period*

There has not been a period of nonqualified use of the residence during the period I owned the property (not including any period prior to January 1, 2009)

True
False

Gain Excludable?*

The full amount of the gain on the sale or exchange of the residence is excludable from gross income for federal income tax purposes under section 121 of the Internal Revenue Code.

True
False

Attorney Information

If you are represented by an attorney other than an attorney from our firm, please complete the information below.

Name

First Last

Phone

Fax

Email

Current Mortgage Information

1st Mortgage Company

1st Mortgage Phone

1st Mortgage Account#

2nd Mortgage

2nd Mortgage Phone

2nd Mortgage Account#

Equity Lines or Other Mortgages/Liens

Recent Mortgage Statements

Drop files here or

Condo Information (If Applicable)

Name of Condo Association

Management Company

Phone

Fax

Email

Additional Information

Authorization

By checking this box I authorize the Law Offices of Peter. T. DaMore, Jr. to request payoff figures and insurance binders relative to this transaction. I specifically authorize the Law Offices of Peter T. DaMore, Jr. to sign my name to payoff and binder requests, if necessary.

Payoff & Other Paperwork

Please upload payoff statements, payoff authorizations and/or any other information that you may have.

Drop files here or

Additional Info./Comments

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Email

This field is for validation purposes and should be left unchanged.

Seller 1 Information

Seller 2 Information

Realtor Information

Homestead Information

Principal Residence Certification

Attorney Information

Current Mortgage Information

Condo Information (If Applicable)

Additional Information

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