Buyer Information Form Step 1 of 6 16% Email(Required) Property Address?(Required) If this is your first time working with The Humphries Law Firm, please provide your agent license number: Agent Contact Information (Phone Number and Email)(Required) If you are using a Transaction Coordinator for this closing please provide their name and email. Agent Commission & Mailing Address for Commission Check *(Required) Buyer #1 - Full Legal Name(Required) Buyer #1 Martial Status(Required) Single Married Separated Divorced Widowed Buyer #1 Contact Information ( Phone Number & Email)(Required) Buyer Mailing Address Preferred to be Listed on the Deed (where future property tax bills will be mailed) Buyer #2 - Full Legal Name Relationship to Buyer #1 Buyer #2 Martial Status Single Married Separated Divorced Widowed Buyer #2 Current Mailing Address Buyer #2 Contact Information ( Phone Number & Email) Buyer #2 Mailing Address Preferred to be Listed on the Deed? To be Primary Residence?(Required) Yes No Is this Purchase a Second Home? Yes No Power of Attorney Closing? Yes No Lender Name Lender Contact Information (Phone Number and Email) HOI/ Flood Insurance Yes No Others Please provide details.(Required) HOA Company Yes No Others Please provide details.(Required) Survey Yes No Others Please provide details.(Required) Home Inspection Yes No Others Please provide details.(Required) Home Warranty Yes No Others Please provide details.(Required) Pest Inspection Yes No Others Please provide details.(Required) Termite Bond Yes No Others Please provide details.(Required) Additional Information/Invoices. Please list any bills to be paid by the Buyer and send to closings@humphriesfirm.law upon receipt. Δ