Call 541-504-0799
“Experience & Education for your protection”
Name * [text* your-name]
Address: [text Address]
City/State/Zip: [text City-State-Zip]
Home Phone: [tel HomePhone]
Cell Phone: [tel CellPhone]
Email* [email* your-email]
Realtor Name:
[text realtor]
Buyer’s Agent:
Buyer’s Name:
[text buyername]
Phone:
[tel realtor-phone]
Email:
[email realtor-email]
Seller’s Agent:
[text realtor2]
[tel realtor-phone2]
[email realtor-email2]
Company Name: [text companyname]
Contact: [text companycontact]
Email:[email lender-email]
Company Address: [text companyaddress]
Phone: [tel companyPhone]
Loan Information: [checkbox loan-information “FHA” “VA” “USDA” “Reverse” “Conventional, conforming (Fannie Mae/Freddie Mac)” “Conventional, non-conforming”]
Home Type: [radio hometype “Manufactured” “Site Built Home” “Modular Home”]
Manufactured Home Size: [radio mfrHomeSize “Single Wide” “Double Wide” “Triple Wide”]
Property Address to be inspected: [text propaddress]
Manufactured Home Fee Options (choose one): [radio HomeFee “$425 – Certification paid at inspection | 425.00” “$450 – Certification lender guaranteed billed to escrow | 450.00” “$495 – Certification not guaranteed & billed to escrow | 495.00”]
Site Built/Modular Home Fee Options (choose one); [radio HomeFee “$475.00 – Certification paid at inspection | 475.00″ ” $495.00 – Certification lender guaranteed billed to escrow | 495.00″ ” $550.00 Certification not guaranteed & billed to escrow | 550.00″]
Will the invoice be paid out of escrow? [radio paidEscrow “Yes” “No”] **If yes, lender guarantees payment. Please complete escrow information. Payment will be secured with credit card:
Escrow Company: [text escrowCompany]
Escrow Contact: [text EscrowContact]
Escrow Co. Phone: [tel EscrowCo.Phone:]
Escrow Co. Email: [email escrowemail]
Escrow #: [text EscrowNo]
Estimated Close Date: [text EstimatedCloseDate]
MISC. INFORMATION/SPECIAL INSTRUCTIONS: [textarea miscInstructions]
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[submit “Submit”]
