Sale Retainer

Add seller

Property Address

Street Address

City/Town

State

Zip Code

Mailing Address

Street Address

City/Town

State

Zip Code

Phone

Work

Cell

Email address

Your address AFTER the sale

Name of Buyer's Attorney (if known)

Your Real Estate Agent (if any)

Phone

Are there any mortgages or home equity loans secured by the property?

Yes No

Add another lender

Date of original purchase

Anticipated closing date of sale

What attorney represented you at the time of purchase?

Is the property currently your primary residence?

Yes No

Has the property been your primary residence for 2 of the last 5 years?

Yes No

Have you been married (or civil union) or divorced since purchasing the property?

Yes No

Please provide your spouse's name if since married or a copy of the divorce order if since divorced.

Divorce Order (if necessary)

Add file

Please upload a file

Have you conveyed the property to your trust, limited liability company or other entity?

Yes No

Name of entity

Has anyone been added or removed from ownership of the property since you purchased?

Yes No

Name

Has any co-owner died since purchasing the property?

Yes No

Name

Have you rented this property or used it for commercial purposes?

Yes No

Has any portion of the property been conveyed since you purchased? Examples include a subdivision, boundary line adjustment, new easement, new right-of-way, etc.

Yes No

Please explain

Have you made any improvements or changes to the property?

Yes No

Did you obtain permits from the town/city for those improvements?

Yes No

Will all sellers of the property be residents of Vermont on the day of closing?

Yes No

Is any seller of the property a foreign person (non-resident alien or foreign entity)?

Yes No

Whom?

Is your property a condominium or part of a planned community that collects homeowner's dues? If yes, please order and provide us with a re-sale certificate from your property manager or association.

Yes No

Is your property a condominium or "public building" which shares a common roof or wall? If yes, please order and provide us with a copy of a current fire safety inspection.

Yes No

Does your property have a well as its water supply? If yes, please contact our office for information to be provided to the buyer(s) regarding water supplies.

Yes No

Are there any items (fuel oil, propane, wood, etc.) that should be prorated or the buyer will owe you for at closing?

Yes No

Please provide

Is your property within 250 feet of the shoreline on a Vermont lake or pond?

Yes No

Have you done any clearing or construction of impervious surfaces since 7/1/14?

Yes No

What have you done? Did you obtain a Shoreland Permit?

Please add any attachments you may want to provide.

Add file

Please upload a file

By completion of this form you acknowledge our representation of you in your sale.

Who referred you to us?

Payoff Authorization

Borrower Name

Social Security No.

Co-Borrower Name

Social Security No.

Account Number

The undersigned hereby authorizes Gale & McAllister PLLC to obtain information on the above referenced loan for the purpose of obtaining a mortgage payoff statement, including but not limited to escrow information. If you have any questions regarding the request for a payoff statement, please contact Gale & McAllister PLLC at 802.876.7478

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