Borrower or Seller Info

    Name *

    Address:

    City/State/Zip:

    Home Phone:

    Cell Phone:

    Email*

    Realtor Information

    Realtor Name:

    Buyer's Agent:

    Buyer's Name:

    Phone:

    Email:

    Seller's Agent:

    Realtor Name:

    Phone:

    Email:

    Lender/Originator Information

    Company Name:

    Contact:

    Email:

    Company Address:

    Phone:

    Loan Information:
    FHAVAUSDAReverseConventional, conforming (Fannie Mae/Freddie Mac)Conventional, non-conforming

    Home Info

    Home Type:
    ManufacturedSite Built HomeModular Home

    Manufactured Home Size:
    Single WideDouble WideTriple Wide

    Property Address to be inspected:

    Is the home... VacantOccupied

    **Tie down installation available -- call for pricing.
    Payment

    Manufactured Home Fee Options (choose one):
    $425 - Certification paid at inspection$450 - Certification lender guaranteed billed to escrow$495 - Certification not guaranteed & billed to escrow

    Site Built/Modular Home Fee Options (choose one);
    $475.00 - Certification paid at inspection$495.00 - Certification lender guaranteed billed to escrow$550.00 Certification not guaranteed & billed to escrow

    Will the invoice be paid out of escrow?
    YesNo
    **If yes, lender guarantees payment. Please complete escrow information. Payment will be secured with credit card:

    Escrow Information

    Escrow Company:

    Escrow Contact:

    Escrow Co. Phone:

    Escrow Co. Email:

    Escrow #:

    Estimated Close Date:

    MISC. INFORMATION/SPECIAL INSTRUCTIONS:

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